THE NATIONAL GUIDELINES FOR WATER, SANITATION AND HYGIENE IN HEALTH CARE FACILITIES THE UNITED REPUBLIC OF TANZANIA MINISTRY OF HEALTH, COMMUNITY DEVELOPMENT, GENDER, ELDERLY AND CHILDREN THE NATIONAL GUIDELINES FOR WATER, SANITATION AND HYGIENE IN HEALTH CARE FACILITIES OCTOBER, 2017 MINISTRY OF HEALTH, COMMUNITY DEVELOPMENT, GENDER, ELDERLY AND CHILDREN TABLE OF CONTENTS TABLE OF CONTENTS ..........................................................................................................................I LIST OF TABLES ..................................................................................................................................VI LIST OF FIGURES ............................................................................................................................VIII FOREWORD ........................................................................................................................................IX ACKNOWLEDGEMENTS ................................................................................................................... X ABBREVIATIONS AND ACRONYMS ..............................................................................................XI GLOSSARY ...................................................................................................................................... XV CHAPTER ONE ...................................................................................................................................... 1 1.0 INTRODUCTION......................................................................................................................... 1 1.1 BACKGROUND .................................................................................................................................... 1 1.2 SCOPE OF THE GUIDELINES .................................................................................................................. 2 1.3 USERS OF THE GUIDELINES .................................................................................................................. 2 1.4 RATIONALE FOR DEVELOPING THE GUIDELINES ....................................................................................... 2 1.5 OBJECTIVES OF THE GUIDELINES........................................................................................................... 2 1.6 ORGANIZATION OF THE DOCUMENT ....................................................................................................... 3 CHAPTER TWO ..................................................................................................................................... 4 2.0 OVERVIEW OF WASH IN HEALTH CARE FACILITIES .................................................... 4 2.1 WASH IN HEALTH CARE FACILITIES: A GLOBAL PERSPECTIVE ................................................................... 4 2.2 GLOBAL INITIATIVES FOR IMPROVED WASH IN HEALTH CARE FACILITIES ................................................... 4 2.3 WHO MINIMUM WASH STANDARDS IN HEALTH CARE FACILITIES ................................................................ 5 2.4 OVERVIEW OF WASH IN HEALTH CARE FACILITIES IN TANZANIA ................................................................ 5 2.5 STRATEGIES FOR IMPROVING WASH IN HEALTH CARE FACILITIES IN TANZANIA ............................................ 7 CHAPTER THREE ................................................................................................................................. 8 3.0 LEGAL AND INSTITUTIONAL FRAMEWORK FOR WASH IN HEALTH CARE FACILITIES IN TANZANIA .......................................................................................... 8 3.1 OVERVIEW ......................................................................................................................................... 8 3.2 RELATED SECTORAL NATIONAL POLICIES ............................................................................................. 8 3.2.1 National Health Policy 2007 ................................................................................................... 8 3.2.2 National Water Policy 2002 ..................................................................................................... 9 3.2.3 National Environmental Policy 1997 ...................................................................................... 9 3.2.4 Community Development Policy 1996 .................................................................................... 9 3.3 RELATED NATIONAL LEGISLATIONS ...................................................................................................... 9 3.3.1 Environmental Management Act, 2004 ................................................................................... 9 3.3.2 The Tanzania Occupational Health and Safety Act, 2003 ....................................................... 9 3.3.3 Public Health Act, 2009 ........................................................................................................... 9 3.3.4 The Local Government (District and Urban Authorities) Act, 1982 as amended on 30 June, 2000 .................................................................................................................... 10 3.3.5 Energy and Water Utilities Regulatory Authority (EWURA) Act, 2001 ................................ 10 3.3.6 Water Supply and Sanitation Act No. 12 (2009) .................................................................... 10 3.3.7 Water Resources Management Act, 2009 .............................................................................. 10 ii THE NATIONAL GUIDELINES FOR WATER, SANITATION AND HYGIENE IN HEALTH CARE FACILITIES 3.4 RELATED NATIONAL STRATEGIES ....................................................................................................... 10 3.4.1 The National Water Sector Development Strategy 2006-2015 .............................................. 10 3.4.2 The National Environmental Health, Hygiene and Sanitation Strategy (NEHHSAS 2008-2017) ......................................................................................................... 10 3.5 INSTITUTIONAL FRAMEWORK .............................................................................................................. 10 3.5.1 National level ......................................................................................................................... 10 3.6 REGIONAL AND COUNCIL LEVELS HEALTH MANAGEMENT TEAMS ........................................................ 10 3.7 COUNCIL HEALTH SERVICE BOARDS AND HEALTH CARE FACILITY GOVERNING COMMITTEES ................ 10 3.8 HEALTH FACILITY MANAGEMENT TEAMS ........................................................................................... 12 CHAPTER FOUR .................................................................................................................................. 13 4.0 PLANNING AND BUDGETING FOR WASH IN HEALTH CARE FACILITIES ............. 13 4.1 INTRODUCTION ................................................................................................................................. 13 4.2 PLANNING FOR WASH ACTIVITIES IN HEALTH CARE FACILITIES ................................................................ 13 4.2.1 Planning Process ................................................................................................................... 13 4.3 FUNDS ALLOCATION CRITERIA ............................................................................................................ 13 4.4 MAJOR CONSIDERATIONS IN PLANNING AND DESIGNING OF WASH INTERVENTIONS ................................. 14 4.4.1 WASH plans as integral part of CCHP .................................................................................. 14 4.4.2 Involvement of community/users ........................................................................................... 15 4.4.3 Strategic partnership with other stakeholders ....................................................................... 15 4.4.4 Choice of low-cost and quality WASH facilities .................................................................... 15 4.4.5 WASH facilities for people with special needs ...................................................................... 15 4.4.6 Needs for women, girls and children ..................................................................................... 15 4.4.7 Environmental safeguards ..................................................................................................... 16 4.4.8 Sustainability plans................................................................................................................ 16 CHAPTER FIVE ................................................................................................................................... 18 5.0 WATER SUPPLY IN HEALTH CARE FACILITIES ............................................................. 17 5.1 WATER NEEDS IN HEALTH CARE FACILITIES .......................................................................................... 17 5.2 WATER SOURCES .............................................................................................................................. 17 5.2.1 Types of water sources ........................................................................................................... 17 5.2.2 Basic considerations in selecting appropriate water sources for HCFs ............................... 17 5.2.3 Selection of available and feasible options of water sources ...............................................