AN INTRODUCTION TO SANITATION HYGIENE AND EDUCATION

The presentation is intended to assist students acquire knowledge and skills in providing education in sanitation and hygiene to the community members.

1. SANITATION AND HYGIENE
EDUCATION
SHE212
By
Mr.J.M’soni
PGD.M & E | BSc EH | MSc.PH* | MBA.PM* | M.Eng. San*

2. |INTRODUCTION
•Thecourseisintendedtoassiststudentsacquireknowledgeandskills
inprovidingeducationinsanitationandhygienetothecommunity
members.
•Thecoursewillalsohighlightthetechniquesofmanaginghygiene
educationprogrammesatcommunitylevelincludingtheenforcement
oflawsrelatedtosanitation.

3. | COURSE AIM
•Toequipstudentswiththeknowledgeandskillsinsanitationand
hygieneeducationapproaches.

4. | COURSE COMPETENCIES
•Applyconceptsofsanitationduringprogrammeimplementation
•Identifyappropriatepreventivemeasuresagainstfaecal-oraldiseases
•StatelegalandinstitutionalframeworkforsanitationinZambia
•Identifylawsrelatedtosanitation
•Enforcelawsrelatedtosanitation
•Analysevarioussanitationtechnologies
•Illustratefaecal–oralrouteoftransmission

5. | COURSE COMPETENCIES
•Recommendappropriatesanitationtechnologiestohouseholds
•Adviseappropriatesanitationoptionsduringanemergency
•Demonstratetheconstructionofsanitationtechnologies
•Recommendappropriatemethodsoffaecalsludgemanagement
•Conducthygieneeducationatcommunitylevel
•Managehygieneeducationprogrammes
•Analysevarioushygieneeducationmethodsyoucanrecommendat
communitylevel

6. UNIT 1: INTRODUCTION TO
SANITATION
By
Mr.J.M’soni
Eden University

7. | Definition of key concepts in sanitation
•Amongtheimportantconceptsyouwilllearninthiscourseareexcreta,
blackwater,greywater,brownwater,andsanitation.
a)Sanitation:Publichealthissuespertainingtocleandrinkingwater,
sewagetreatment,andhumanexcretadisposal
b)Blackwater:themixtureofurine,faecesandflush-wateralongwith
analcleansingmaterials.Blackwatercontainsthepathogensof
faecesandthenutrientsofurinethataredilutedintheflushwater.
c)Brownwater:isthemixtureoffaecesandflushwater,anddoesnot
containurine.Itisgeneratedbyurine-divertingflushtoilets.
d)Greywater:isthetotalvolumeofwastewatergeneratedfrom
washingfood,clothesanddishware,aswellasfrombathing,butnot
fromtoilets.

8. | Reasons for managing excreta
appropriately
•Improvingsanitationisproventohaveabigpositiveinfluenceon
humanhealthbothinhouseholdsandthroughoutcommunities.
Inadequatesanitationisaprimarysourceoffaecal-oralillnesses
worldwide.
•Humanexcrementthatisdisposedofcarelesslycanpollutewater
suppliesandcauseanumberofillnesses.
•Alloftheexcrementthatisuphilliscarriedintostreamsandriversby
runoffwaterduringtherainyseason,pollutingthem.
•Itispossibleforseepagefromimproperlyplacedlatrinesto
contaminategroundwater.

9. | Reasons for managing excreta
appropriately
•Whenhumanwasteisimproperlydisposedof,domesticanimalsmay
consumeitandthenbecomeinfectedbyconsumingthefleshofsick
animals,suchasworminfestations.
•Tapewormsmaybecarriedbycattleiftheygrazeonpollutedgrassand
ground.
•Flyreproductionisenhancedwhenexcrementisdisposedof
carelessly.Animportantfactorinthemechanicalspreadoffaecal-oral
illnessesisflies.
•Excretathatisimproperlydisposedofmightdeteriorateintougly
situationsthatcanirritatetheeyeandsmellfoul.

10. | Transmission of faecal-oral diseases (F-
diagram)
•Poorhygienepractices,lackofadequatesanitationandunsafeor
limitedwatersuppliescancontributetothespreadofpreventable
diseasessuchascholeraortyphoid.
•Understandinghowpathogens(organismsthatcausedisease)are
transmittedallowsengineersandpublichealthworkerstointervenein
appropriatewaystobreakthetransmissioncycle,savinglivesand
reducingunnecessarysuffering.

11. | Transmission of faecal-oral diseases (F-
diagram)
•Themovementofpathogensfromthefaecesofasickpersontowherethey
areingestedbysomebodyelsecantakemanypathways,somedirectand
someindirect.
•ThisF-diagramillustratesthemainpathways:Theyareeasilymemorizedas
theyallbeginwiththeletter‘f’:
i.Fluids(drinkingwater)
ii.Food,
iii.Flies,
iv.Fields(cropsandsoil),floors,
v.Fingersand
vi.Floods(andsurfacewatergenerally).

12. | Transmission of faecal-oral diseases (F-
diagram)
•Infectiousfaecal-oraldiseasesarespreadwhenasusceptibleperson
(orinsomecases,ananimal)ingestsapathogenthatgivesthemthe
disease.
•Thepathogenmultipliesinsidethemandissubsequentlyfoundintheir
faeces.
•Excreta-relatedwater-bornediseasescanbetransmittedbyanyroute
whichallowsfaecalmattertoenterthemouth;thefaecal-oralroute.
•In1958,WagnerandLanoixidentifiedthemajormeansoftransmission
andproducedwhatisnowknownasthe‘f’diagram’.

13. | F-diagram

14. | Types of faecal-oral disease
•Thediseasesspreadbyfaecal-oralroutescanbecategorizedas:•
Water-bornediseases,wherepathogensareingestedviacontaminated
drinkingwaterorfood.
•Thisisaddressedbyimprovingwaterquality.
•Water-washedorwater-scarcediseases,wherethediseaseisspread
duetopoorhygienepractices,suchasalackofhandwashingafter
defecationandbeforepreparingandeatingfood.
•Thisisaddressedbyimprovingwaterquantity
•Excreta-relateddiseases,wherepoorsanitationcontributestoits
spread.

15. | Preventive measures against faecal-oral
diseases
•Poorhygienepractices,lackofadequatesanitationandunsafeor
limitedwatersuppliescancontributetothespreadofpreventable
diseasessuchascholeraortyphoid.
•Understandinghowpathogens(organismsthatcausedisease)are
transmittedallowsengineersandpublichealthworkerstointervenein
appropriatewaystobreakthetransmissioncycle,savinglivesand
reducingunnecessarysuffering.
•Thespreadofthediseasecanbehaltedbycuringeverybodycarrying
thedisease,soitisnolongerintheirfaeces,butthisleavesthem
vulnerabletonewsourcesofinfection.

16. | Preventive measures against faecal-oral
diseases
•Vaccinationhasbeenverysuccessfulinreducingthespreadofpolioby
reducingthenumberofsusceptiblepeopleinthepopulation.
•Onceabout80%ofthepopulationareimmune,thecycleoftransmissionis
effectivelybroken,butvaccinesarenotavailableforeveryfaecal-oral
disease.
•Generallyamoresustainablesolutionistobreakthetransmissionroutes.
Thiscanbecarriedoutatseveralstages,takingamultiplebarrierapproach.
So,ifonebarrierdoesnotstopthetransmission,anothermay.
•Safewater,adequateexcretadisposalorhandwashingmayeachonly
reducethediseasebyabout30%.
•Together,theimpactismuchhigher,butwiderenvironmentalsanitation
measuresandimprovedgeneralhealth(nutrition,forexample)also
contributetothereductionofdisease.

17. | Legal and institutional framework for
sanitation in Zambia.
•Thissectionreviewsthepolicyandplanningframeworksforsanitation
inZambia.Inordertonarrowthescope,thissectionpresentsfindings
throughthelensoftheSDG6andWHOGuidelinesonSanitationand
Health.
i.ConstitutionofZambia
TheConstitutionofGRZestablishesthatlocalauthoritieshaveexclusive
functionsoverwaterandsanitationservices“limitedtopotablewater
supplysystemsanddomesticwaste-waterandsewagedisposal
systems,”(GRZ2016).

18. | Legal and institutional framework for
sanitation in Zambia.
ii.NationalWaterSupplyandSanitationActNo.28of1997
ThestatutedesignatedNWASCOasthesupervisorybodyresponsiblefor
regulatingsanitationandwaterdeliveryinZambia'surbanandruralareas.
TheactnotonlycreatesNWASCOandoutlinesitsduties,butitalsoallows
watersupplyandsanitationutilitiestobeestablishedasfor-profitbusinesses
underlocalgovernments.
Thisallowstheauthoritiestoofferwatersupplyandsanitationserviceswithin
theirrespectivejurisdictions.
Accordingtothestatute,serviceprovidersmustincludeshort-andlong-term
plansthatinclude"plansfortheprovisionofanefficient,affordableand
sustainablewatersupplyorsanitationservice"withtheirlicenseapplication.

19. | Legal and institutional framework for
sanitation in Zambia.
iii.LocalGovernmentActNo.2of2019
TheLocalGovernmentActNo.2of2019,whichwaspreviouslyknown
astheLocalGovernmentActCap281oftheZambianLaws,assignsthe
localauthoritiesthedutyofprovidingsanitation.
Thelegislationspecifiesthatthegovernmentmustgivelocalauthorities
particularfundingfromthenationaltreasurytocarryouttheirduties,and
itnameswatersupplyandsanitationastwoofthoseduties.

20. | Legal and institutional framework for
sanitation in Zambia.
iv.EnvironmentalManagementActNo.12of2011
Thefoundationforwastewaterregulationislargelyestablishedbythe
EnvironmentalManagementActNo.12of2011."Wastewaterorotherfluidof
domestic,agricultural,trade,orindustrialorigin,treatedoruntreated,and
discharged,directlyorindirectly,intotheaquaticenvironment"isthedefinition
ofeffluentsgivenbytheact.
Asperthelegislation,localauthoritiesarerequiredtomakesurethatwaste
effluentsaretreatedorchangedtoaccordancewithestablishedstandards
beforebeingdisposedofinafinalmanner.
Furthermore,thelegislationrenamedtheEnvironmentalCouncilthatwas
previouslyinplacetotheZambiaEnvironmentalManagementAgency(ZEMA).
ZEMAisnowinchargeofoverseeingwastewaterbyaccreditinginspectors
andimposingfinesfornoncompliancewithdefinedeffluentstandards.

21. | Legal and institutional framework for
sanitation in Zambia.
v.PublicHealthActCap295
SanitaryaccommodationsrequirementsareoutlinedinChapter295of
theLawsofZambia,whichcoverspublicplaces,includinghealth
institutions.Thelegislationalsoprohibitsnuisances,whichhelpsto
suppressandpreventillnesses.

22. Key Take-Aways
•Sanitation:Publichealthissuespertainingtocleandrinkingwater,sewage
treatment,andhumanexcretadisposal.
•SanitationisderivedfromaLatinword“sanitas”whichmeanshealth.
•Improvingsanitationisproventohaveabigpositiveinfluenceonhuman
healthbothinhouseholdsandthroughoutcommunities.
•Inadequatesanitationisaprimarysourceoffaecal-oralillnessesworldwide.
•Preventableillnesseslikecholeraandtyphoidcanspreadduetoinadequate
sanitation,unsafeorscarcewatersupplies,andpoorhygienehabits.
•Pathogenscantravelbyavarietyofdirectandindirectroutesfroman
infectedperson'sfaecestoaplacewheretheyareconsumedbyanother
person.
•TheF-diagramshowstheprimaryroutesandthisincludeFluids,Food,Flies,
Fields,floors,FingersandFloods.