CRIS WASH-WaterAid Project District Lodhran

CRIS-WASH PROJECT

1. Project: Climate Resilient Inclusive & Sustainable Water, Sanitation and Hygiene (CRIS-WASH) Safe Healthcare Facility Project Presenter Name: M Asif Malik Presentation Date: 19-06-2023

2. Project Basic Information Project Duration (10 Months) May 15, 2023 – March 31, 2024 Estimated cost of Project PKR 30,860,200   Area 02-03 Healthcare facilities of Tehsil Lodhran / Karoor Paka (Area will be finalized with the consultation of Health department and other relevant department) Funded by WaterAid Implemented by Doaba Foundation

3. District Lodhran Map

4. Project Overview Project Title: Climate Resilient Inclusive & Sustainable Water, Sanitation and Hygiene (CRIS-WASH) Safe Healthcare Facility Project Impact of the Project: The overall impact of the project is to reduce disease burden in one of the most poor and marginalized districts ( Lodhran ) of Punjab Province. Local communities of the selected healthcare facility and its surrounding community and healthcare facilities’ staff will be the primary beneficiaries, whereas through influencing for replication and scalability, the entire province’s population may benefit. Women and girls, persons with disabilities will be specifically targeted in the project

5. Outcomes

6. Project Outputs

7. The project envisages to embark upon the following lines Hospital Waste Management (segregation and disposal of hospital waste, incineration, and capacity development of HCF staff, implementation of standardized IPC protocols, and staff capacity building in IPC to manage waste ). Staff and Community Hygiene Behaviour Change for an all-inclusive sustainability (demand creation) of the project gains . WASH inclusion in HCFs on international standards and taking innovative approaches for post intervention.

8. Project Approach & Key Features Development of infrastructure and capacity building of HCF staff on safe disposal of solid and liquid waste including medical waste (hazardous waste) management in a proper manner to eliminate/minimize the impact on the environment. To cope with energy crises as well to minimize carbon emission, medical waste incinerators will be operated through solar power instead of conventional energy, also the chimney of incinerator will be specially designed to trap maximum carbon in the smoke. Red, Green, Yellow waste bins will be installed in facility and staff will be trained on segregation of different types of medical waste. Sewerage system for the target facility/s will be rehabilitated/upgraded along with development of small scale custom designed Sewage Treatment Plant (STP) for the HCF.

9. Project Approach & Key Features Roof rainwater harvesting storage and ground water recharge will be developed in the vicinity of the facility. Water source in the facility will be checked for water quality and if required customized solar powered water filtration/purification system will be installed to provide safe drinking water to the users. Gender inclusiveness will be integrated through infrastructure features for increased access such as inclusive Women Friendly Toilets, provision of ramps and other requirement for ease in access to aged people and Persons with Disabilities. To neutralize the corban footprint of the hard installation in the facility in the proposed project, tree plantation will be done in the target facilities, in upcoming monsoon season, which is suitable for tree plantation.

10. Project Target Group Healthcare Facility Staff: This group has been selected because they are directly involved in WASH practices and medical waste management within the healthcare facilities. Their training and capacity building is essential to ensure the safe and sustainable management of medical waste and improvement of WASH facilities. Patients: Patients are key beneficiaries of the project, as they are the main users of the healthcare facility. The project aims to improve the WASH facilities for the patients, which will provide them with a safer and more comfortable environment during their stay at the healthcare facility. Community Members: The project also aims to benefit the community members living in the surrounding areas of the healthcare facility. The improved medical waste management and WASH practices will reduce the risks of infectious diseases and environmental pollution (carbon trapped incinerator), leading to a healthier community. Policy Makers: The project aims to influence policymakers by providing evidence and good practices in HCF service delivery. Policymakers will be able to use the project's outcomes and best practices to develop policies and regulations for sustainable medical waste management and WASH practices in healthcare facilities.

11. Intervention Logic Indicator Targets Means of Verification Assumptions Project impact: Outcome 1: Health Care Facilities are WASH friendly, Climate Resilient, Inclusive and Sustainable Evidence of two (2) CRIS WASH Safe HCFs 2 HCFs Project Completion reports, Project Monitoring Reports Political situation is stable Output 1.1. Evidence Generated to scope HCFs and catchment population's WASH related infrastructure and behaviour Formative Research Report 1 number Report Document Availability of accurate data of HCF Output 1.2: HCF infrastructure is CRIS WASH Compliant CRIS WASH compliant infrastructure developed 2 HCFs Assessment report, BoQ, Completion report Relevant Ministry is willing to allow infrastructure enhancement Timely approval Inflation rates and construction material costs remains stable Output 1.3: HCF Staff of respective HCF and selected district staff is trained and equipped to undertake safe CRIS WASH practices HCF staff trained and equipped 2 HCFs staff Training reports and attendance sheets Availability of staff for the trainings Outcome 2: Medical Waste Management Practices in Health Care Facilities are Improved and Environment-Compliant Evidence of of Safe MWM Models 2 HCFs Project Completion reports, Project Monitoring Reports Willingess of the relevant department Output 2.1: Evidence Generated to establish Waste Disposal and Hospital Solid Waste Management Mechanism Report Document 1 number Formative Research Report Availability of accurate data of HCF Output 2.2: climate friendly HWM Infrastructure Established HWM infrastructure developed 2 HCFs Assessment report, BoQ, Completion report Inflation rates and construction material costs remains stable Outcome 3: Wider Stakeholders influenced through evidence and knowledge management Evidence generated; wider stakeholders engaged Evidence generated; wider stakeholders engaged Policy Briefs, Completion Reports Willingness of stakeholders to participate Output 3.1: Policy makers are aware of HCF models with SAFE WASH and climate-safe waste management systems Relevant district level policy makers made aware District and Facility staff Policy Briefs, workshop reports, meeting minutes Willingness of policy makers to participate Output 3.2: Community are aware of CRIS WASH safe HCF models Relevant HCF catchment population made aware XX number of community members Community meetings minutes, monitoring reports Willingess of the community

12. Intervention Logic Indicator Targets Means of Verification Assumptions Project impact: Activity 1.1.1 Formative Research conducted to understand CRIS WASH situation of the selected HCFs in the district 1. Availability of data and information related to the selected HCFs in the district. 2. Willingness of the HCF staff to participate in the formative research. Activity 1.1.2 Dissemination of the formative research to the wider stakeholders Interest and engagement of wider stakeholders in the findings of the formative research Activity 1.2.1 Construction of improved, climate-resilient, inclusive WASH infrastructure in the target HCFs Material costs remain stable Activity 1.2.2 Training of the relevant HCF staff on the O&M of CRIS WASH infrastructure Willingness of the HCF staff to participate in the training program Activity 1.3.1 Development/adoption of training module on the findings of the formative research Relevance and accuracy of the findings of the formative research Activity 1.3.2 Training of the relevant staff on safe CRIS WASH behaviours and practices Willingness of the HCF staff to participate in the training program Activity 2.1.1: Conducted as a part of formative research   Activity 2.2.1: Assess, design and construct HWM climate friendly infrastructure in the selected HCF Material cost is stable Activity 2.2.2: Training of the relevant staff on safely managed clime friendly HWM O&M Willingness of the HCF staff to participate in the training program Activity 3.1.1: Conduct policy gap analysis and develop policy briefs Willingness of the policy makers to engage in the policy gap analysis. Activity 3.1.2: Sharing of the findings of policy gap analysis with stakeholders Interest and engagement of wider stakeholders in the findings of the policy gap analysis Activity 3.1.3: WASH monitoring indicators developed and submitted to Health Department for inclusion in DHIS Willingness of the Health Department to include the developed WASH monitoring indicators in DHIS Activity 3.1.4: CRIS WASH safe HCF Model showcased to wider stakeholders for replication Interest and engagement of wider stakeholders in the showcased CRIS WASH safe HCF model Activity 3.2.1: Inclusive BCC campaign is designed based on formative research findings Timely completion of the BCC material Activity 3.2.2: Roll out of BCC campaign at community level and especially targeting women and girls, persons with disabilities etc. Availability of effective channels in the community

13. WASH related Govt. of Pakistan Policies. National Sanitation Policy 2006, which primarily focuses on safe disposal of human excreta and the promotion of health hygiene in the country National Drinking Water Policy 2009, which states hygiene as one of the objectives emphasizing increase public awareness about water safety, safe hygiene practices and water conservation Pakistan Approach to Total Sanitation (PATS) was adopted (2010) as a key vehicle to surge the implementation of national sanitation and water policies National Water Policy 2018 underpins that the guidelines for water and sanitation should be sought from national drinking water and sanitation policies National Guidelines for Infection Prevention and Control (IPC), 2020 suggest interventions to reduce the burden of HCAIs Pakistan bio-safety rules 2005 standards. Healthcare waste includes infectious waste (15%–25% of total healthcare waste)

14. Appendix Budget Design documents Marketing plan Supplemental documents Contact information