Malawi Country Programme Annual Report 2018/19 Improving WASH in Healthcare Centres Malawi Annual Report 2018/19 WaterAid/Dennis Lupenga WaterAid/Dennis Malawi Annual Report 2018/19 Table of Contents Welcome to WaterAid ...................... 1 Trachoma Elimination ................... 10 About WaterAid ................................ 3 Case Study: Magamba................... 11 Our programmes ............................. 7 Our work in small towns ............... 13 Sustainable Programme Case Study: Chayamba .................. 15 Delivery ......................................... 4 Wash & Nutition ............................. 17 Sanitation and Hygiene Case Study: Ntondoko ................... 19 Advancement & Prioritization .... 4 Citizen empowerment .................. 21 Sector Engagement and Sector strengthening..................... 23 Influencing ................................... 4 Programme Finances .................... 27 2017/2018 Highlights ....................... 5 Sanitation and Hygiene Wash in Health Care Facilities ........ 7 prioritization ................................... 24 Abbreviations and Acronyms ART: Anti-Retroviral Therapy MOH: Ministry of Health CAI: Citizens Action Initiative NGO: Non-Governmental CCIM: Community Case Organization Integrated Management NICE: National Initiative for CICOD: Circle for Integrated Civic Education Community Development NTDs: Neglected Tropical CF: Citizen Forum Diseases CHWs: Community Health Workers ODF: Open Defecation Free CLTS: Community Led Total PMTCT: Prevention of Mother to Support Child Transmission CMT: Community Midwife SEI: Sector Engagement and Technician Influencing CRWB: Central Region Water SHAP: Sanitation and Hygiene Board Advancement and DC: District Commissioner Prioritization DCA: District Citizens’ Assembly SRHP: Sexual and Reproductive DCSA: Disease Control Health Policy Surveillance Assistants SLTS: School Led Total Sanitation DFID: Department for SMC: School Management International Committee Development SPD: Sustainable Programme DHO: District Health Office Delivery ELDS: Evangelical Lutheran SSDI: Support for Service Development Services Delivery Integration HCF: Health Care Facilities T/A: Traditional Authority HSA: Health Surveillance TSP: Training Support For Assistant Partners IPC: Infection Prevention and WA: WaterAid Control WASH: Water, Sanitation and LWB: Lilongwe Water Board Hygiene LIA: Low Income Area WAG: Women Action Groups MDGs: Millennium Development WESNET: Water and Environmental Goals Sanitation Network MNH: Maternal and Newborn Health Layout & Design: ElyMedia Malawi Annual Report 2018/19 i Foreword It is with great pleasure that we share with you this 2018/2019 Annual Report which summarizes the progress we have made in implementing various interventions, the exciting stories from the people we have served on the changes they have experienced with safe water, improved sanitation and good hygiene as well as the lessons we have learnt in the implementation processes. Over the year, we have not only seen ourselves scaling sanitation and hygiene as public health issues. We up our work in WASH and Health, but have embarked have seen inclusion of sanitation and hygiene in the on our WASH and Nutrition integration work in Early strategic documents such as the ODF strategy, School Childhood Development and primary school feeding Health and Nutrition Strategy. We have proactively programme as one way of contributing towards engaged with the review processes of Health Sector curbing malnutrition in Malawi. Strategic Plan and Sexual Reproductive Health and School Health and Nutrition Strategies where we have Through our work on WASH in Health Care Facilities advocated for inclusion of sanitation and hygiene in (HCFs), we have reached 19 Health Centres, in these documents. Kasungu, Nkhotakota, Machinga and Ntchisi districts, serving a catchment population of 490,496 people, We have seen our ABCDE hygiene approach being where we have registered incredibly life-changing included in the National Sanitation and Hygiene stories, especially for our women, girls and children. Strategy as a recommended approach for achieving Our engagement with the Nation Publication Limited hygiene behaviour change. The approach uses visual Mother’s Fun Run campaign has seen us making a long cues and less text, for a quick uptake of information term commitment to support improvement of WASH in for high illiterate population. This has been a huge health care facilities in Ntchisi District, beginning with shift from the business as usual processes in hygiene an initial support of MK40m to 3 HCFs. promotion. A total of 14,763 people in communities and schools As we look forward to 2019/20 with so much optimism, in Nkhotakota, Kasungu and Machinga districts, and we remain greatly indebted to our donors and Mponela and Kasungu towns have accessed safe water, implementing partners, the Malawi government, the 39,360 people reached with hygiene behavior change communities we work with and all supporters, for their messages and 5,012 have accessed basic and improved unfaltering support in sharing our vision of ensuring sanitation services. that everyone, everywhere, has access to potable water, decent sanitation and good hygiene by the year We are also proud to have contributed towards 2030. Trachoma elimination in Malawi, and that we have managed to rehabilitate on-site sewer systems for Chayamba Secondary School and Kasungu Mercy Masoo District Hospital that were dysfunctional for a long time causing health risks to students and patients, respectively. We have made great strides in raising the profile and building consensus among stakeholders around COUNTRY DIRECTOR 1 Malawi Annual Report 2018/19 WaterAid/Dennis Lupenga WaterAid/Dennis WE ARE WaterAid Is a world where everyone, Our everywhere has safe water, Vision sanitation and hygiene Is to transform the lives of the poorest and most marginalized people by Our improving access to safe Mission water, sanitation and hygiene Define our culture and unite us across the many countries Our in which we work. They are Values at the very heart of WaterAid RESPECT COLLABORATION We treat everyone with We work with others dignity and respect and to maximize our impact, champion the rights respecting diversity and contribution of all and difference in the to achieve a fairer pursuit of common world goals COURAGE ACCOUNTABILITY We are bold and We are accountable to aspiring in our those whose lives we hope actions and words, and to see transformed, to uncompromising in those we work with and our determination to those we support to pursue our mission INNOVATION INTEGRITY We are creative and We act with honesty agile, always learning and conviction and our and prepared to take actions are consistent risks to accelerate with openness, change equality and human rights Malawi Annual Report 2018/19 It is our understanding that this can only Since 1999 be achieved when citizens are empowered WaterAid Malawi and take responsibility and actively engage has been working in the realisation of their rights to WASH; towards ensuring About when sustainable, equitable and inclusive that there is an WASH services are delivered at scale; increased focus on when sanitation and hygiene is recognised water, sanitation and prioritised across sectors as a public and hygiene at all WaterAid health concern and when the sector is levels and across well coordinated, responsive, accountable all sectors. and creates an enabling environment for integrated delivery of equitable and Malawi sustainable WASH services. Since 1999 WaterAid has been working in Malawi to ensure that there is an increased focus on water, sanitation and hygiene at all levels and across all sectors. Working in partnership and collaboration with numerous stakeholders, WaterAid has made significant strides towards improving access to safe water, sanitation WaterAid is an international non- and hygiene through a variety of projects governmental organisation dedicated implemented in the districts of Nkhotakota, to helping the poorest and most Mzimba, Machinga, Karonga, Rumphi, marginalised communities escape from Balaka, Dedza, Ntcheu, Chikwawa, Zomba, suffering caused by lack of safe water, Ntchisi, Kasungu, Lilongwe City, Kasungu improved sanitation and hygiene. Municipality and Mponela town. WaterAid believes that universal access WaterAid has modelled provision of WASH to safe water, improved sanitation and in schools, health centres, towns and good hygiene will have a lasting impact communities through the construction and in contributing towards eradication of rehabilitation of boreholes, water kiosks, extreme poverty among the poorest and rehabilitation and expansion of gravity fed marginalised groups and communities. systems and construction of sanitation WaterAid/Dennis Lupenga WaterAid/Dennis 3 Malawi Annual Report 2018/19 infrastructure in schools, urban markets facilitates the development and adoption of and health centres. innovative technologies and strategies that supports effective delivery of sustainable, WaterAid has worked with other sector equitable and inclusive WASH services. players on policy and advocacy initiatives, focusing on enhancing sector coordination, It also champions citizen empowerment integrated planning, resourcing and initiatives so that people understand their implementation at both national WASH rights and responsibilities and and decentralized levels, and sector are able to claim their entitlements and performance monitoring and accountability