Water, Sanitation and Hygiene in Primary Schools 2013 by Plan International

Water, Sanitation and Hygiene in

Primary Schools in South-East Asian Countries Realities, needs and recommendations t General education trends t WASH facilities status/ inventory t Enablin factors t Challenges, opportunities, best practices

Desk Review

Cross Country Comparative Assessment of wash

Implementation gaps

Sustainable solutions

Validation of desk review findings and actual implementation experiences: t National level t Sub-national level t School level, is time permits

Country Studies

In-depth assessment of wash in Cambodia, Indonesia, Laos & Phils

900

834

800 700 600 500

492

437

514

500

401

435

400

385

351

300 200

278

216

sia

odi

one

Lao

Ind

sia

lay

anm

gap

ilip

ore

Viet Nam

Les

or-

t Na

Vie

Tim

12%

Timor-Leste

53%

Lao PDR

24%

Cambodia

78%

WASH in schools

ilan

Tha

Sin

20%

ENABLING SERVICES

40%

60%

DEVELOPING SERVICES

80%

SUSTAINING SERVICES

Behavioural change

sal

rus

nei

Bru

SERVICE DELIVERY PATHWAY

Policy frameworks

Provision of hardware (construction, maintenance and sustainability of WASH facilities in schools)

Planning t Management and coordinating mechanisms t Partnerships

Monitoring Evaluation Mechanism to support maintenance of WASH facilities and programmes

Provision of software (human resources, knowledge and capacity of decision-makers and implementers)

Financial mechanisms Socio-cultural norms related to water and sanitation

Pre-primary (one year)

Complementary WASH programmes

Primary (six years)

Secondary (four to five years)

Pre-primary (two years)

Tertiary (two to four years)

Common curriculum (two years) General secondary education

Applied secondary education

Private 40%

Specialized education

Specialized education needs

Pre-university level

Vocational or technical education

Public (MOE) 59%

Public (MORA) 1%

150 Private 36%

131

100

MOE 62%

122 81

MORA 2%

‘00

‘10 Public

Female 48%

Private

Male 52%

32773 30842

MOE

25519

MORA

MORA 24093

814

932

Y 2000

Y 2005

Y 2010

Basic education

Pre-school (three years)

Primary (six years)

Technical / vocational (one to three years)

Lower secondary (three years)

Higher / tertiary education (at least two years)

Upper secondary (three years)

Urban 15%

Urban 10% Rural 85%

Rural 90%

14%

Number

Percent

12%

Female 48%

250,000

200,000

150,000

100,000

50,000

2005/06 2005/06 2005/06 2005/06 2005/06 2005/06 Academic Yr

81%

80%

40%

Water sour 67%

61%

60%

Sanitation facilities

56%

29%

20%

South East Asia averager Total Urban 82.30% 89.5% 70.1% 84.4%

18%

Water Sanitation

0% Total

Urban

Rural

Rural 76.3% 58.2%

Basic education Pre-school (pendidikan anakusia dini)

Primary school (sekolah dasar) (six years)

Junior high school (sekolah menengah pertama) (three years)

Senior high school (sekolah menengah atas)

University

Senior high school (sekolah menengah kejuruan)

Vocational training

Urban 13%

Private 9%

Rural 87%

Public 91%

100%

89%

Water sour

80%

80% 60%

Sanitation facilities

71%

67% 52%

40%

35%

South East Asia averager Total Urban 82.3% 89.5% 70.1% 84.4%

20%

Water Sanitation

0% Total

Urban

Rural

Rural 76.3% 58.2%

Basic education

Pre-school (three years)

Primary (five years)

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%

General upper secondary (three years)

Lower secondary (four years)

Higher / tertiary education (at least three years)

Secondary vocational (three years)

Water sour

86%

Sanitation facilities

72% 57%

53%

51% 38%

Total

South East Asia averager Total Urban 82.3% 89.5% 70.1% 84.4%

Water Sanitation

Urban

Rural

Primary years 1–6 (6+ to 11+ years)

Lower secondary form 1–3 (12+ to 14+ years)

Upper secondary form 4–5 (15+ to 16+ years)

Post-secondary

National school

Academic

Technical vocational

Matriculation

National Chinese school

Academic/ religious

Remove class

National Tamil school

University/ college/ employment

Form 6 College/ polytechnic

Sports/arts

Private 3% Public 97%

Rural 48%

Urban 52%

Urban 29%

Female 49%

100%

100% 96%

95%

Water sour

99% 96%

Total

Urban

Pre-primary

Pre-primary (five years)

Rural 71%

Male 51%

Sanitation facilities

95%

South East Asia averager Total Urban 82.3% 89.5% 70.1% 84.4%

90%

Water Sanitation

Rural

Rural 76.3% 58.2%

Basic education

Secondary (six years)

Tertiary/higher education (at least three years)

Lower primary (three years)

Lower or middle school (four years)

Upper primary (two years)

100% 80%

71%

Upper or high school (two years)

Water sour

86%

81%

75%

69%

79%

Sanitation facilities

60% 40% South East Asia averager Total Urban 82.3% 89.5% 70.1% 84.4%

20%

Water Sanitation

0% Total

Urban

Rural

Rural 76.3% 58.2%

Basic education

Primary (six years)

Kindergarten

Secondary (six years)

Tertiary/higher education (at least one year) Junior high school (four years) Senior high school (two years)

Private 8%

Private 17%

Public 92%

100%

Public 83%

93%

91%

80%

Water sour

87%

80%

75%

Sanitation facilities

69%

60% 40% South East Asia averager Total Urban 82.3% 89.5% 70.1% 84.4%

20%

Water Sanitation

0% Total

Urban

Rural

100%

Rural 76.3% 58.2%

Water sources(2006)

80%

Water sources(2008)

60%

Sanitation facilities (2006)

40%

Sanitation facilities (2006)

20% 0% Total

Urban

Rural

Foundation stage (four years) Pre-school (three years)

Primary (six years)

Arts institutions

Special/ express course

Secondary (four to five years)

Normal (academic) course

Orientation stage (two years)

Normal (technical) course

Institute of technical

Postsecondary/ tertiary

education

University/ higher education

Polytechnics Junior college/ centralized Institute

Private (Gov’taided)24% Female 48%

Male 52%

Public 76%

General or academic track Pre-school (one to three years)

Primary (six years)

Lower secondary (three years)

Bachelor’s degree (at least four years)

Upper secondary (three years)

Post-secondary/ higher education (at least two years)

Associate degree / vocational/technical (two years)

Vocational track

100%

100% 89%

99%

92%

Water sour 82%

80%

Sanitation facilities

60% 40% South East Asia averager Total Urban 82.3% 89.5% 70.1% 84.4%

20%

Water Sanitation

0% Total

Pre-school

100%

Urban

Primary (six years)

Rural

Lower secondary (three years)

Senior secondary (three years)

Water sour

86%

80%

76%

69%

60%

Sanitation facilities 63%

50%

40%

20%

Total

South East Asia averager Total Urban 82.3% 89.5% 70.1% 84.4%

Water Sanitation

0% Urban

Rural

Upper secondary (three years)

Pre-school

80%

99% 94%

94%

Professional vocational (three to four years) Tertiary/higher education (at least three years)

Male 54%

Water sour

92%

75% 67%

60%

Rural 76.3% 58.2%

Lower secondary (four years)

Secondary (seven years) Vocational (one to three years)

Primary (five years)

Female 46%

100%

Rural 76.3% 58.2%

Tertiary

Sanitation facilities

40% 20%

Total

Urban

South East Asia averager Total Urban 82.3% 89.5% 70.1% 84.4%

Water Sanitation

0% Rural

Rural 76.3% 58.2%

Higher education college & university

Private 4% Public 96%

350,000 300,000

10%

Male 52%

The designations employed and the presentation of material throughout this publication do not imply the expression of any opinion whatsoever on the part of UNICEF concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The presentation of data and information as contained in this book, and the opinions expressed therein, do not necessarily reflect the position of UNICEF. UNICEF are committed to widely disseminating information and to this end welcomes enquiries for reprints, adaptations, republishing or translating this or other publications.

Water, Sanitation and Hygiene in Primary Schools in South-East Asian Countries Realities, needs and recommendations © UNICEF, East Asia and Pacific Regional Office, 2013 Any part of this publication may be freely reproduced with the appropriate acknowledgement. Printed in Thailand Cover photos: Front (from top to bottom): 1. © UNICEF/MGLA2007-00194/Jim Holmes, Mongolia, 2007, 2. © UNICEF/NYHQ2009-1892/Josh Estey, Indonesia, 2009, 3. © UNICEF/IDSA2010-01773/Josh Estey, Indonesia, 2007, 4. © UNICEF/NYHQ2008-1275/Josh Estey, Indonesia, 2008 Inside photos: © SEAMEO Innotech, 2012 ISBN: 978-974-680-365-6 Design and Layout by Inís Communication, www.iniscommunication.com

Water, Sanitation and Hygiene in

Primary Schools in South-East Asian Countries Realities, needs and recommendations

III

Acknowledgement The “Water, Sanitation and Hygiene in Primary Schools in South-East Asian Countries: Realities, Needs and Recommendations” is released as a joint attempt by Education and Young Child Survival and Development units of UNICEF EAPRO. Over the past three years, UNICEF has developed and supported the use of WASH in School monitoring tools which also involved collaboration with SEAMEO INNOTECH and global experts. In 2012, SEAMEO INNOTECH assessed the current status of water and sanitation facilities in primary schools in the SEAMEO member countries and identified the critical areas for improvement by their experts on the functionality of WASH facilities in schools, including the impact of school construction support by major donors with respect to WASH facilities, and, to the extent possible, an analysis of related school performance outcomes such as attendance, repetition and drop-out. The onerous task of summarizing and weaving all country findings was admirably accomplished by SEAMEO INNOTECH through its Project Management Office, headed by Dr. Ramon C. Bacani – Center Director, Philip J. Purnell – Manager, Educational Research and Innovation Office, and Yolanda CastilloDe Las Alas – Senior Specialist, Solutions Evaluation and Adaptation Unit, and the principal author of this report: Lauren Nerisse Samac-Bautista – Senior Associate and, with guidance and comments during the preparation of this paper provided by Clifford Meyers – Regional Adviser Education and Chander Badloe – Regional Adviser on WASH. The views expressed in this paper represent those of the authors and not necessarily those of the UNICEF. Gratitude also goes out to all Ministries of Education and UNICEF country offices in the 11 SEAMEO member countries for their support during the research phase. Likewise, we sincerely thank all those who have been part of the research study – NGOs, INGOs, development agencies, government agencies, school heads and teachers, and students, especially in Cambodia, Indonesia, Lao PDR, and the Philippines for imparting their time to accommodate the research team. Our appreciation also goes out to Annemarieke Mooijman, WASH Specialist for her initial comments on the draft report, Tanaporn Perapate for her support in the review and lay-out of this document, and to Karen Emmons for the final editing of this report.

ACKNOWLEDGEMENT

Foreword There is clear evidence that poor water and sanitation conditions in schools have a significant impact on children’s well-being, health, and educational performance. Lack of access to adequate drinking water, hygienic sanitation facilities and hygiene education significantly increase the risk of diarrhea, worm infestation and other water-borne diseases among children: health problems that cause additional damage by reducing school attendance and educational performance. The impact of poor sanitation on girls’ education, particularly as they approach puberty, is even higher, because girls’ school attendance and enrolment levels often fall considerably when schools are not able to provide adequate hygiene facilities. In the South-East Asia region, access to safe water, appropriate toilets, and hand-washing facilities in schools remains a challenge on several levels. A review of the literature on the subject reveals that quality hygiene education programs are not common in any South-East Asia countries. Many Ministries of Education do not have reliable data on the status of water and sanitation facilities in their schools, so the scope of the problem is difficult to gauge. Where monitoring has taken place, it has revealed substantial problems about the functioning of water and sanitation facilities even in schools where they exist. The global 2011 WASH in Schools Monitoring Guidelines provided Education, Management Information System (EMIS) and survey instruments to collect school data on water and toilets and how well they were functioning. Using these Guidelines, a number of countries including Lao PDR, Cambodia, Myanmar and Timor-Leste have integrated stronger WASH indicators in their EMIS, and on-going data collection and analysis is being used to strengthen WASH in schools. This new publication examines a number of country situations and provides lessons learned, recommendations and examples of good practice, all based on the 2011 WASH in Schools Guidelines. UNICEF supports governments in their efforts to improve WASH in schools in a number of ways, from provision of child-friendly sanitation and safe drinking water facilities to promotion of hand washing practices and policy advocacy and standard setting and modelling, and through monitoring and research practices. This new publication – “Water, Sanitation and Hygiene in Primary Schools in South-East Asian Countries: Realities, Needs and Recommendations” – aims to provide a better understanding of opportunities to successfully implement WASH in Schools programs (planning, operations, management, and policy formulation). We hope it will encourage the routine collection and use of more reliable data to strengthen country and regional level planning for WASH in schools, and will serve to guide policy-makers on steps necessary to ensure that water and sanitation issues are not an obstacle to a quality education for all the children of our region.

FOREWORD

CONTENT

CONTENT Acknowledgement . . . . . . . . . . . . . . . . . . . . . . . . . . . . IV Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . V ABBREVIATIONS AND ACRONYMS . . . . . . . . . . . . . . . . . . . . VIII PART I: REGIONAL ASSESSMENT . . . . . . . . . . . . . . . . . . . . . . 1 I. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 A. Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 B. Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2 C. Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2 D. Structure of the report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 II. General trends in education in 11 South-East Asian countries . . . . . . . . . . . . . . . . . . . . . .5 III. WASH in schools in 11 South-East Asian countries . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 A. National policy frameworks and other enabling environment factors . . . . . . . . . . . . . . . 10 B. Status of WASH facilities in schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 C. Challenges in member countries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 IV. Issues and challenges: Findings from the four country studies . . . . . . . . . . . . . . . . . . . . 19 A. Enabling services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 B. Developing services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 C. Sustaining services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 V. Innovations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 A. Model and paradigm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 B. Multi-sector partnerships . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 C. Government leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 D. Developing WASH champions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 VI. Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 A. Support to policy development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 B. Collaborative approach to WASH in schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 C. Appropriate and responsive infrastructure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 D. Enhanced data and monitoring systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 E. Translating awareness into action and sustained behavioural change . . . . . . . . . . . . . . . 28 F. Evidence-based WASH initiatives in schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 G. Inclusive WASH initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 H. Dynamic role of UNICEF Country Offices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

PART II: COUNTRY PROFILES . . . . . . . . . . . . . . . . . . . . . . . . 30 Country profile: Brunei Darussalam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Country profile: Kingdom of Cambodia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Country profile: Republic of Indonesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Country profile: Lao People’s Democratic Republic . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 Country profile: Malaysia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Country profile: Myanmar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Country profile: Republic of the Philippines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Country profile: Republic of Singapore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 Country profile: Kingdom of Thailand . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 Country profile: Democratic Republic of Timor-Leste . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Country profile: Socialist Republic of Viet Nam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76

ANNEXES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 Annex 1: Definition of improved and unimproved sanitation facilities, based on Millennium Development Goal 7 targets . . . . . . . . . . . . . . . . . . . . . . . 81 Annex 2: WASH conditions in schools in the South-East Asian countries . . . . . . . . . . . . . . . . 81 Annex 3: Issues and challenges in the South-East Asian countries . . . . . . . . . . . . . . . . . . . . 84

REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91

LIST OF CHARTS Chart 1: Annual incidence rate of diarrhoeal disease in South-East Asia, 2004 . . . . . . . . . . . . . . 8 Chart 2: Proportion of public primary schools with adequate sanitation facilities in selected South-East Asia countries . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Chart 3: Primary schools in Brunei Darussalam, 2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Chart 4: Primary school enrolment in Brunei Darussalam, 2010 . . . . . . . . . . . . . . . . . . . . . 32 Chart 5: Increase in number of primary schools* in Brunei Darussalam, 2000–2010 . . . . . . . . . . 32 Chart 6: Enrolment in Brunei Darussalam, by sex, 2010 . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Chart 7: Primary school enrolment trends* in Brunei Darussalam, 2000–2010 . . . . . . . . . . . . . 33 Chart 8: Primary school enrolment in Cambodia, by location, 2010 . . . . . . . . . . . . . . . . . . . . 36 Chart 9: Primary schools in Cambodia, by location, 2010 . . . . . . . . . . . . . . . . . . . . . . . . . 36 Chart 10: Repeaters as a percentage of total primary school enrolment in Cambodia . . . . . . . . . 36 Chart 11: Enrolment in Cambodia, by sex, 2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Chart 12: Proportion of the population with access to a safe/improved water source and adequate/improved sanitation facilities in Cambodia, 2008 . . . . . . . . 37 Chart 13: Primary schools in Indonesia, by location, 2011 . . . . . . . . . . . . . . . . . . . . . . . . . 44 Chart 14: Primary schools in Indonesia, 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Chart 15: Proportion of population with access to a safe/improved water source and adequate/improved sanitation facilities in Indonesia, 2008 . . . . . . . . . . . . 44 Chart 16: Proportion of the population with access to a safe/improved water source and adequate/improved sanitation facilities in Lao PDR, 2008 . . . . . . . . . 49 Chart 17: Primary school enrolment in Malaysia, 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 Chart 18: Primary schools in Malaysia, 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 Chart 19: Primary school enrolment in Malaysia, by location, 2011 . . . . . . . . . . . . . . . . . . . . 54 Chart 20: Primary schools in Malaysia, by location, 2011 . . . . . . . . . . . . . . . . . . . . . . . . . 54 Chart 21: Enrolment in Malaysia, by sex, 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Chart 22: Proportion of the population with access to a safe/improved water source and adequate/improved sanitation facilities in Malaysia, 2008 . . . . . . . . . 55 Chart 23: Proportion of the population with access to a safe/improved water source and adequate/improved sanitation facilities in Myanmar, 2008 . . . . . . . . . 58 Chart 24: Primary school enrolment in the Philippines, 2010 . . . . . . . . . . . . . . . . . . . . . . . 60 Chart 25: Primary schools in the Philippines, 2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Chart 26: Proportion of the population with access to a safe/improved water source and adequate/improved sanitation facilities in the Philippines, 2008 . . . . . . 61 Chart 27: Proportion of the population with access to a safe/improved water source and adequate/improved sanitation facilities in the Philippines, . . . . . . . . . 61 Chart 28: Enrolment in Singapore, by sex, 2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 Chart 29: Primary schools in Singapore, 2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 Chart 30: Proportion of the population with access to a safe/improved water source and adequate/improved sanitation facilities in Thailand,2008 . . . . . . . . . . 72 Chart 31: Proportion of the population with access to a safe/improved water source and adequate/improved sanitation facilities in Timor-Leste, 2008 . . . . . . . . 74 Chart 32: Enrolment in Viet Nam, by sex, 2009 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Chart 33: Proportion of the population with access to a safe/improved water source and adequate/improved sanitation facilities in Viet Nam, 2008 . . . . . . . . . 78

LIST OF FIGURES Figure 1: Methodology framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Figure 2: Modified service delivery assessment framework . . . . . . . . . . . . . . . . . . . . . . . .20 Figure 3: Brunei Darussalam’s education structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Figure 4: Primary schools in Brunei Darussalam, by location, 2010 . . . . . . . . . . . . . . . . . . . . 32 Figure 5: Cambodia’s education structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Figure 6: Service delivery assessment highlights for Cambodia . . . . . . . . . . . . . . . . . . . . . 42 Figure 7: Indonesia’s education structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Figure 8: Service delivery assessment highlights from Indonesia . . . . . . . . . . . . . . . . . . . . 47 Figure 9: Lao PDR’s education structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 Figure 10: Service delivery assessment highlights from Lao PDR . . . . . . . . . . . . . . . . . . . . 52 Figure 11: Malaysia’s education structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Figure 12: Myanmar’s education structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Figure 13: Philippines’ education structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Figure 14: Service delivery assessment highlights from the Philippines . . . . . . . . . . . . . . . . . 67 Figure 15: Singapore’s education structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 Figure 16: Thailand’s education structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 Figure 17: Timor-Leste’s education structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Figure 18: Viet Nam’s education structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76

LIST OF TABLES Table 1: Number of primary schools and student enrolment in South-East Asia . . . . . . . . . . . . .6 Table 2: Proportion of the population with access to a safe or improved water source and adequate or improved sanitation facilities in South-East Asia, 2008 . . . . . 6 Table 3: Proportion of the population using improved and unimproved sanitation facilities in South-East Asia, 2008 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Table 4: Enrolment in South-East Asia, by sex, various years . . . . . . . . . . . . . . . . . . . . . . . .9 Table 5: Gross enrolment ratios and survival rates in South-East Asia, 2005–2009 . . . . . . . . . . . 10 Table 6: Primary schools and student enrolment, by location, 2010 . . . . . . . . . . . . . . . . . . . 36 Table 7: Number of repeaters in primary school in Cambodia, 2005–2010 academic years . . . . . . . 37 Table 8: Primary schools and student enrolment in Malaysia, by location, 2011 . . . . . . . . . . . . . 54 Table 9: Primary school enrolment in Thailand, by jurisdiction, 2007 . . . . . . . . . . . . . . . . . . . 72 Table 10: Repeaters in Timor-Leste, 2008–2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74

ABBREVIATIONS AND ACRONYMS

CONTENT

ADB

Asian Development Bank

AusAID

Australian Agency for International Development

BDA

Border Development Association

BEFF

Basic Educational Facilities Fund

BEIS

Basic Education Information System

BOS

School Operational Assistance Fund

CBTS

community-based total sanitation

CFS

child-friendly schools

CLTS

community-led total sanitation

DANIDA

Danish International Development Agency

DECS

Department of Education, Culture and Sports

DOH

Department of Health

eBEIS

Enhanced Basic Education Information System

EFA

Education for All

EFA-FTI

Education for All-Fast Track Initiative

EHCP

Essential Health Care Programme

EMIS

education management information system

FIT

Fit for School

GCE

General Certificate of Education

GDPM

General Department of Preventive Medicine

GER

gross enrolment ratio

GIZ

Deutsche Gesellschaftfür Internationale Zusammenarbeit (GIZ) GmbH

INNOTECH

Regional Centre for Educational Innovation and Technology

KOICA

Korea International Cooperation Agency

JICA

Japan International Cooperation Agency

LOO

Let’s Observe Ourselves

MDG

Millennium Development Goal

MECYS

Ministry of Education, Culture, Youth and Sports

MOE

Ministry of Education

MOES

Ministry of Education and Sports

MOEYS

Ministry of Education, Youth and Sport

MOH

Ministry of Health

MOET

Ministry of Education and Training

MRA

Ministry of Religious Affairs

MRD

Ministry of Rural Development

NGO

non-government organization

SCWASH

School Community Water, Sanitation and Hygiene Programme

SDA

service delivery assessment

SEAMEO

Southeast Asian Ministers of Education Organization

UIS

UNESCO Institute of Statistics

UKS

Usaha Kesehatan Sekolah (School Health Programme)

UNESCO

United Nations Educational, Scientific and Cultural Organization

UNESCO-IBE

United Nations Educational, Scientific and Cultural Organization-International Bureau of Education

UNDP

United Nations Development Programme

UN-HABITAT

United Nations Human Settlements Programme

UNICEF

United Nations Children’s Fund

USAID

United States Agency for International Development

VEDC

Village Education Development Committee

WASH

water, sanitation and hygiene

WHO

World Health Organization

WISE

Water, Sanitation and Hygiene in Support of School Empowerment

9MP

Ninth Malaysia Plan

PART I REGIONAL ASSESSMENT

I. Introduction

A. Background When schools provide students with clean water, adequate sanitation and handwashing facilities and hygiene education, children’s health – now and as they grow through adulthood – as well as their education outcomes significantly benefit.1 Adequate facilities entail an improved (safe) water source, such as piped water, boreholes or protected dug well; separate toilets for boys and girls; handwashing facilities near the toilets; and the safe disposal of wastewater and other wastes. Such critical access helps reduce children’s risks to diarrhoea, worm infestation and other water-borne diseases. The impact on girls is particularly notable because they more likely will attend school during their menstrual period. According to the World Health Organization (WHO), approximately 194 million school days would be gained annually if the Millennium Development Goal for sanitation was achieved.2 Improved hygiene education and school environments also have generated positive impact beyond schools, with children acting as agents for change in their homes and communities and changing their hygienic behaviour for the rest of their lives. In 2009, the WHO set international standards for water, sanitation and handwashing facilities and hygiene education (WASH) in schools in a ‘guideline’ publication entitled, Water, Sanitation and Hygiene Standards for Schools in Low-Cost Settings. Although some countries have set their own national standards, other countries have taken steps to update their standards in accordance with those WHO guidelines. In South-East Asia, access to safe water, appropriate toilets and handwashing facilities in schools remains a challenge. Quality hygiene education programmes are not common in any of the member countries of the South-East Asian Ministers of Education Organization (SEAMEO).3 Many education ministries do not have reliable data on the status of water and sanitation facilities in their schools, so the scope of the problem and its potential impact is difficult to gauge. Yet, governments that monitor the status of school water and sanitation facilities reveal huge differences in comparison with those that don’t in terms of the availability and functionality of the facilities. UNICEF supports education ministries in their efforts to improve WASH conditions in schools through the provision of child-friendly sanitation and safe drinking water facilities, the promotion of handwashing practices and facilities, policy advocacy, setting and modelling standards, monitoring and documenting the good practices. In 2010 UNICEF developed (and continues to support the use of) the WASH in Schools Monitoring Package, which provides education management information system (EMIS) instruments that can be used to collect school data on facilities and their level of functionality. Concerned by the limited attention on WASH in schools, including the relative low levels of coverage, coupled with the significance of the impact on learning and girls’ attendance or completion, UNICEF in October 2011 commissioned the SEAMEO Regional Centre for Educational Innovation and Technology (INNOTECH) to produce a regional study that would help strengthen the body of school-related WASH information in member countries. This report reflects the findings of that regional study.

See Jasper, Le and Bartram, 2012.

Hutton and Haller, 2004.

This situation was discussed during the Consultative Workshop on Values-Based Water Education that SEAMEO and UN-HABITAT convened, in cooperation with the Asian Development Bank, in Manila, Philippines in December 2003.

PART1: REGIONAL ASSESSMENT

B. Objectives The study assessed the current status of WASH facilities and programmes (such as the availability and functionality of facilities; scope and effectiveness of programmes; and to the extent possible, trend analysis of school performance indicators, such as attendance, ‘pushed-out’4 and completion rates) in primary schools. The researchers also singled out critical areas for improvement and possible solutions to strengthen the WASH conditions in schools. Specifically, the study aimed to: a. gather and review existing data and other information on the coverage and functionality of WASH facilities in schools, including toilets, handwashing facilities and water supply systems;5 b. assess the status of WASH in schools in terms of coverage, functionality, use, health and hygiene practices, including issues and challenges in implementing WASH programmes or projects in schools; c.

identify the facilitating factors and/or good practices that contribute to sustainable sanitation in schools;

d. to the extent possible, determine the impact of WASH facilities on school performance indicators, such as attendance, repetition, pushed-out and completion rates; and e. provide reasons for governments, development partners, schools and communities to improve the status and monitoring of the WASH conditions in schools. There remains a dearth of reliable data on the status of water and sanitation facilities in schools, which makes it difficult to understand the scale of the WASH problem in South-East Asia. This study’s findings should add clarity on and appreciation of the national policy frameworks, challenges and opportunities related to WASH in schools. The findings also can inform the future development of policies and practices in the broader effort of strengthening the quality of education, with a particular focus on poor and disadvantaged areas.

C. Methodology The study was conducted in two phases: i) desk review and ii) in-depth country study. The desk review generated a profile of WASH in schools in the 11 South-East Asian countries. Through the desk review, the researchers looked to determine: a. the proportion of primary schools, both in urban and rural areas, that have access to WASH facilities; b. the nature and type of WASH facilities available in schools; c.

the proportion of school children who benefit from the WASH facilities; and

d. the factors affecting each policy environment and strategies on water and sanitation. Using the review of data gathered from secondary sources (reports, articles, and websites), the study then moved into the in-depth visit phase, targeting four sample countries: Cambodia, Indonesia, Lao Peoples’ Democratic Republic and the Philippines.The in-depth country studies included one-on-one key informant interviews and small focus group discussions to address the information gaps that surfaced through the desk review and to provide more qualitative data to better understand the quantitative data gathered from the secondary sources. Supporting documents were also requested from the key informants and donor partners to complement the information collected through the interviews. Each country study aimed to understand more deeply the actual issues and opportunities related to implementing WASH programmes in schools, including planning, operations and management as well as policy formulation:

The term ‘pushed out’ is used to denote students in poor school environments who need to leave school because of reasons beyond their control, such as not having WASH facilities (as opposed to ‘dropping out’, which may imply students who choose to leave school without regard as to why).

The 11 South-East Asian countries are Brunei Darussalam, Cambodia, Lao PDR, Indonesia, Malaysia, Myanmar, Philippines, Singapore, Thailand, Timor-Leste and Viet Nam.

PART1: REGIONAL ASSESSMENT

a. National policy frameworks. This involved assessment of the relevance and effectiveness of the national policy framework or the presence of any such framework. b. WASH in schools status. This covered the validation of data, including the operational definition of ‘functional’ and ‘damaged’ facilities, standards in operating and managing facilities, the extent or scope of hygiene education in the curriculum, the availability of capacity building for teachers and other WASH-related activities for children in schools. c.

Challenges, lessons, opportunities and good practices. This included the validation of identified implementing issues and challenges and responses or actions taken and/or being done to address them at the national and subnational levels as well as new opportunities, good practices and lessons learned.

The interviews and focus group discussions with key informants were guided by six primary questions that covered those three areas: 1.

How responsive are the existing national policies and implementing frameworks, strategies and plans in supporting water, sanitation and hygiene improvements in the country?

2. How are WASH interventions monitored and outcomes and/or impact evaluated? How are the monitoring and evaluation findings being used? 3. How relevant are the existing standards in meeting the health and hygiene needs of primary school children? 4. What have been the innovations and good practices of WASH implementation in schools? 5. What are the major challenges related to implementation of WASH interventions, and how are the challenges being addressed? How are existing and new opportunities being used or optimized? 6. What major lessons and insights can be drawn from WASH implementation in public primary schools? These overarching questions were complemented by follow-up questions to probe more deeply into each area. The SEAMEO INNOTECH researchers created a list of guiding questions, based on the UNICEF WASH in Schools Monitoring Package. WASH in schools encompasses more than the education sector. Related issues cut across many sectors, including health, finance, public works and rural development, at both the national and subnational levels. International development partners and local non-government organizations are likewise engaged. Given this, the targeted key informants represented a multi-sector mix of actors who are directly and currently involved in and committed to promoting effective management (planning or policy formulation, coordination, implementation, maintenance, monitoring and evaluation). The key informants were limited to those working at the national, provincial and district levels. They were selected through the literature review and recommendations from the UNICEF Country Offices, education ministry officers and other institutional partners. The key informants included the following: • national coordinators of water and sanitation programmes or strategies, technical working groups or committees and representatives from government agencies who are most knowledgeable or have a substantial role in planning and policy formulation related to the water and sanitation sector at the national level; • national officials who are involved not only in planning and policy formulation but also coordination and implementation of the water and sanitation policies directly related to schools; • EMIS officers who are most knowledgeable in monitoring WASH indicators in schools; • provincial or subnational officials and selected school district supervisors who have hands-on experience in implementing WASH projects in schools; • representatives of selected international donor and development partners, local non-government and community organizations engaged in WASH interventions in schools. Given the limited resources, the SEAMEO INNOTECH researchers selected one sample province in each of the four countries for interviewing key informants (such as officers in a provincial or district education office). The four provinces were selected through the recommendations from the education ministries and the UNICEF Country Offices and based on the following conditions:

PART1: REGIONAL ASSESSMENT

• WASH in schools is effectively practised and/or supported (by national and subnational government, international donor and development partners, local NGOs, school management or community organizations); and • WASH in schools implementation remains a challenge (due to geographic location, ethnicity, peace and security, conditions of infrastructure, etc.). The provinces visited needed to be easily accessible, in consideration of the study’s budget. Additionally, the four in-country studies covered selected schools in each sampled province to observe and document (photograph) the conditions of WASH facilities and to meet with school officials, members of parent– teacher–village associations and school children.

Figure 1: Methodology framework • General education trends • WASH facilities status/ inventory • Enabling factors • Challenges, opportunities, good practices

Desk Review

Cross Country Comparative Assessment of WASH

Implementation gaps

Sustainable solutions

Validation of desk review findings and actual implementation experiences: • National level • Sub-national level • School level, if time permits

Country Studies

In-depth assessment of wash in Cambodia, Indonesia, Lao PDR and Philippines

SEAMEO INNOTECH was invited to present the overview and initial findings of the study at the Third East Asia Sanitation Conference (EASAN) in Bali, Indonesia in September 2012. During that conference, the service delivery assessment framework used by the World Bank’s Water and Sanitation Programme was discussed and subsequently integrated into the INNOTECH study analysis (see the illustrative highlights at the end of each profile for the four countries assessed in greater detail). 834

900

The draft report was presented at the SEAMEO High Officials Meeting in Bangkok, Thailand in November 800 2012 to share the content and seek further inputs. Additionally, SEAMEO INNOTECH engaged an independent 700 consultant to review the report.

600 500

500

492

437

401

D. Structure of the report 400

514 435

385 351

Average (440)

or -L

Tim

Da r

• education structure and trends in primary school education

ilip

ay sia

M al

PD R

sia

La o

m bo

278 The report is 300 divided into two parts, with annexes: To give a more regional perspective, the first part 216 summarizes the 200highlights of the literature review for all 11 countries and the interviews and discussions in the four countries selected for more in-depth analysis. The second part provides an overview of each country in terms of six themes:

• rationale for WASH activities in schools • enabling environment • WASH in schools • main challenges • partners.

PART1: REGIONAL ASSESSMENT

Viet Nam

12%

II. General trends in education in 11 South-East Asian countries The inclusion of data on the education structures and trends in primary school education in each country profile provides a basic understanding of the education system in the 11 South-East Asian countries. Generally, primary school in South-East Asia spans six years and is part of compulsory education. Lao PDR, Myanmar and Viet Nam are the only countries in which primary school encompasses five years. The number of years children spend in primary school (which is not always the same as the number of grades they complete due either to the duplication of grades or their dropping out) provides an indicative representation of children’s opportunity to access water and sanitation facilities in schools. The availability of WASH facilities is significant, especially in countries in which the proportion of population having access to safe water sources and adequate sanitation facilities remains small. Lao PDR is one of the countries that still have a low level of improved water and sanitation coverage, especially in the rural areas. It is also quite likely that some households do not have such facilities but their children use them at school. In all 11 countries, primary education is compulsory. It is a basic task of all governments to provide appropriate conditions, including a safe and healthy environment, that lead to achieving universal primary education (according to the MDG targets). As table 1 indicates, more than 80 per cent of primary schools6 in the region are operated and/or supportedby the government (public schools). It is important to make note of the proportion of public schools and the multitude of children enrolled in them, considering these schools are dependent on government funds and financial mechanisms as opposed to private schools (schools not dependent on government), which can independently raise funds to provide for all the needs of the children enrolled, including proper water and sanitation systems. The provision of water and sanitation facilities in public schools tends to receive low priority in government budgets. As shown in table 1, Brunei Darussalam, Malaysia and Singapore present a different case because their public schools are all provided with WASH facilities. Brunei Darussalam’s public primary schools account for 60 per cent of the total number of primary schools, while in Malaysia, 97 per cent of primary schools are public. In the case of Singapore, where education is primarily provided by the State, 76 per cent of primary schools are fully government supported. The remaining 24 per cent, although considered as private schools because they have their own fundraising facility, are still partially supported by the Government.

Average of countries where disaggregated data are available.

PART1: REGIONAL ASSESSMENT

Table 1: Number of primary schools and student enrolment in South-East Asia 7 Public (government dependent) Country

# of schools

% of total

Student enrolment

% of total

Brunei Darussalam

122

60%

28 116

64%

Cambodia

Indonesia Lao PDR Malaysia Myanmar Philippines Singapore Thailand Timor-Leste

130 563 NA 7 753 NA 38 351 132 NA NA

Viet Nam

91% 97% 83% 76%

Private (non-government dependent) # of % of Student % of schools total enrolment total 81

40%

NA NA 3 018 601 NA 13 019 145 NA NA NA

12 689 NA 223 NA 7 613 41 NA NA

96% 92%

16 099

3% 17% 24%

NA NA 122 017 NA 1 146 921 NA NA NA NA

# of schools

Student enrolment

203

44 215

6 767

2 191 192

36%

NA 9%

Total

4% 8%

143 252 29 498 266 8 968 920 000 7 976 3 140 618 36 205 5 185 138 45 964 14 166 066 173 256 801 5 910 489 1 012 214 660 15 783

7 020 000

Note: NA = Information not available.

Table 2: Proportion of the population with access to a safe or improved water source and adequate or improved sanitation facilities in South-East Asia, 2008 8 Water Sources

Sanitation Facilities

2008 (%)

Country Brunei Darussalam Cambodia Indonesia Lao PDR Malaysia Myanmar Philippines Singapore Thailand Timor-Leste Vietnam AVERAGE

Total

Urban

Rural

Total

Urban

Rural

NA 61 80 57 100 71 91 100 100 69 94 82.3%

NA 81 89 72 100 75 93 100 100 86 99 89.5%

NA 56 71 51 99 69 87

NA 29 52 53 96 81 76 100 89 50 75 70.1%

NA 67 67 86 96 86 80 100 92 76 94 84.4%

NA 18 36 38 95 79 69

99 63 92 76.3%

82 40 67 58.2%

Note: NA = Information not available. Source: UNICEF, State of the World’s Children, 2011. 7

See the following sources of data and other notes for each country: • Brunei Darussalam – The data for public schools include all primary schools (as well as enrolment) under the Ministry of Education and three schools under the Ministry of Religious Affairs. All figures are based on 2010 data. Source: Department of Planning, Development and Research, Ministry of Education, Education statistics, 2010. • Cambodia – All figures are based on 2010/2011 academic year data. Source: MOEYS, Education Statistics Indicators, 2005–2010. • Indonesia – The figures for number of schools are based on 2010 data; total number of student enrolment is based on 2006/2007 academic year data. Sources: Ministry of Education and Culture (number of schools); UNESCO-IBE, World Data on Education, 2011 (for student enrolment). • Lao PDR – All figures are based on 2009/2010 data. Source: UNESCO-IBE, World Data on Education, 2011. • Malaysia – The number of primary schools include religious schools under the state government, which accounts for 38 primary schools, for a total of 11,764 schools. Source: Ministry of Education. • Myanmar – The number of schools include 34,178 MOE schools, 853 schools under the Border Area Development Association and 1,174 monastic schools under the Ministry of Religious Affairs. Source: UNESCO-IBE, World Data on Education, 2011. • Philippines – All figures are based on 2010/2011 academic year data. Source: Department of Education, Basic Education Statistics 2011. • Singapore – Schools categorized as private are actually government-aided schools. All figures are based on 2010 data. Source: Ministry of Education, Education Statistics Digest, 2011. • Thailand – The figure is based on 2007 data. Source: UNESCO-IBE, World Data on Education, 2011. • Timor-Leste – Source: UNICEF Timor-Leste, Education management information system data, 2011. • Viet Nam – The number of schools include 15,172 primary schools and 611 combined primary and secondary schools. All figures are based on 2009/2010 data. Source: UNESCO-IBE, World Data on Education, 2011.

Although most of the population of Brunei can access a piped-water system, 2 per cent of the rural population relies on the slow-sand filtation propopak system. River catchment covers around three quarters of the country’s land area, and it is this surface water that feeds the public water supply. Around 86 per cent of the country’s sewage is treated before disposal, and 44 per cent of the population is served by the public sewerage system (Department for Water Services, Brunei Darussalam).

PART1: REGIONAL ASSESSMENT

In terms of geographic location, statistics on the proportion of the population in urban and rural areas having access to safe sources of water and adequate sanitation describe, to some extent, children’s access to such facilities in schools (table 2). In general and based on 2008 data, a wide gap between the urban and rural areas exists in terms of access to a safe or improved safe water source. This is largely apparent in Cambodia, Lao PDR and Timor-Leste, where disparity is marked by more than 20 percentage points. There is also a wide disparity between the proportions of population in urban (89 per cent) and rural (71 per cent) areas that have access to a safe or improved water source in Indonesia (table 2). The gap between urban and rural areas is much wider in terms of access to adequate or improved sanitation facilities.9 The same countries (Cambodia, Indonesia, Lao PDR, Timor-Leste) registered the widest disparity, at more than 30 percentage points. In Viet Nam, the gap is also wide, with 94 per cent of the urban population and only 67 per cent of the rural population having access to adequate or improved sanitation facilities (table 2). In Cambodia, where the urban–rural gap is widest for both water and sanitation (25 percentage points and 49 percentage points, respectively), only 56 per cent of the rural population has access to a safe or improved water source, while only 18 per cent has adequate sanitation facilities. Cambodia’s improved sanitation coverage is the lowest in the region (table 2). Yet, around 90 per cent of the primary schools in Cambodia are located in rural areas, accounting for 85 per cent of the total primary school enrolment.10 Similarly in Indonesia, 87 per cent of the primary schools are in rural areas, where sanitation facilities are in scant supply.11 This data suggests that many children in the region’s rural areas are vulnerable to health risks. In Lao PDR, where safe water coverage is the lowest in the region, only 57 per cent of schools offer full primary education (grades 1–5), while the rest, mostly located in rural and remote areas, offer only a few years of primary schooling.12 In Malaysia, there is a seemingly imbalanced distribution of student enrolment in terms of geographic location, with about half of the total school enrolment accommodated in only about a quarter of the total number of primary schools. Even though 71 per cent of primary schools are located in rural areas, student enrolment is split somewhat equally between rural (48 per cent) and urban (52 per cent) areas (table 8 in the country profile). Nonetheless, the data is inconclusive regarding the quality of the learning environment in schools located in urban areas. The enrolment data may give an impression of crowded urban schools, but school size and availability and functionality of facilities could make an important difference. Considering the low safe water and sanitation coverage in Cambodia, Indonesia, Lao PDR and TimorLeste, it is alarming to see the considerable proportion of populations in these countries that still practise open defecation13 (table 3). Cambodia has the smallest proportion of population using an improved sanitation facility and has the largest incidence of open defecation practice. In addition to the unavailability of adequate facilities, another factor that could be sustaining the practice of open defecation is ineffective hygiene education. Although hygiene classes are available in these four countries, the extent and efficacy of such classes may not be sufficient to raise the awareness of children on the importance of proper sanitation and hygiene practices and values. For instance, in Cambodia, according to the informants, good hygiene behaviour is not extensively taught through the school curricula.14

See Annex 1 for a definition of improved and unimproved sanitation facilities.

10 MOEYS (Cambodia), Education Statistics Indicators 2005–2010. 11 Ministry of Education and Culture (Indonesia), 2011 data. 12 Figure based on 2006–2007 data sources from UNESCO-IBE, World Data on Education, 2011. 13 Refers to the absence of sanitation facilities. 14 WHO, 2010.

PART1: REGIONAL ASSESSMENT

Table 3: Proportion of the population using improved and unimproved sanitation facilities in South-East Asia, 2008 Unimproved Country

Improved

Brunei Darussalam Cambodia Indonesia Lao PDR Malaysia Myanmar Philippines Desk Singapore Review Thailand Timor-Leste Viet Nam

Sharing

Unimproved

Open defecation

NA 2 12 6

NA 64 26 38

1 8

4 15

43 6

NA NA 29 5 52 10 53 3 96 4 81 11 • General education trends 76 15 • WASH facilities status/ inventory 100 • Enabling factors 96 4 • Challenges, opportunities, good practices 50 3 75 4

Cross Country 1 Comparative Assessment of WASH

Note: NA = Information not available.

Implementation Source: WHO, Sanitation and Hygiene in East Asia, 2010. gaps

Sustainable solutions

Although all primary schools in Brunei Darussalam are equipped with WASH facilities, a 2010 study revealed that only 41 per cent of school children washed their hands after using the toilet,15 reflecting that amid the adequate facilities there is still a need for a complementing hygiene awareness programme.

Validation of desk review findings and In-depth assessment implementation experiences: These conditions all actual contribute to WASH-related illness, such as diarrhoeal diseases (cholera, Country of wash in Cambodia, • National level health risks, such as H1N1, bird flu and hand, foot and mouth amoebiasis, typhoid) and other related Studies Indonesia, Sub-national disease. According to a• WHO report,16level diarrhoeal diseases remain the second-biggest cause of children’s Lao PDR and Philippines • School level, ifAmong time permits death in most East Asian countries. South-East Asian countries, Timor-Leste has the highest annual incidence rate of diarrhoeal disease, with 834 cases for every 1,000 people. It is almost twice as much as the region’s average incidence rate (chart 1).

Chart 1: Annual incidence rate of diarrhoeal disease in South-East Asia, 2004 834

900 800 700 600

500

492

437

500

401

514 435

385 351

400

Average (440)

278

300

te es

Tim

or -L

e Th

ilip

ay sia

M al

PD R

sia

La o

a di

m bo

Da r

200

216

Source: WHO, Sanitation and Hygiene in East Asia, 2010.

15 Brunei Times, 2010. 16 WHO, 2010.

Viet Nam 8

Timor-Leste

12% 53%

PART1: REGIONAL ASSESSMENT

For countries with sex-disaggregated school enrolment data available, actual enrolment data show that male enrolment is generally greater than female enrolment across the region (table 4). For countries where data were not available, the sex-disaggregated gross enrolment ratio (GER)17 for primary school was considered. Looking at the GER, the same generalization can be made – male enrolment is generally greater than female enrolment. This is especially true in Lao PDR, where girls lagged behind by 11 percentage points, the highest sex-based disparity in the region (table 5).

Table 4: Enrolment in South-East Asia, by sex, various years18 Country

Male

% of total

Female

% of total

Brunei Darussalam

22 860

52%

213 55

48%

Cambodia

1 147 810

52%

1 043 382

48%

Indonesia

Total 44 215 2 191 192 29 498 266

Lao PDR

Malaysia

1 614 801

Myanmar

5 185 138

Philippines

14 166 066

Singapore

133 023

Thailand

Timor-Leste

Viet Nam

3 790 000

NA 51%

52%

1 525 817

123 778

920 000 49%

48%

NA 3 230 000

256 801 5 910 489

NA 54%

3 140 618

214 660 46%

7 020 000

Note: NA = Information not available.

Based on the review of existing literature, the sex disparity in enrolment may be attributed to the following gender-based factors: i) traditional culture in which females are meant to stay at home to help the mother do household chores, hence sending females to school is not a priority; and ii) females, especially during the age when they start to menstruate, tend to not go to school when water and sanitation facilities are not available or not adequate because it is very inconvenient for them.19 It is also possible that male students are larger in number due to more male children in the population. Nevertheless, for hygiene consideration, schools should have separate toilets for boys and girls. The WHO and UNICEF recommend having one toilet for every 25 female students and one toilet and a urinal for every 50 male students.20 The availability of adequate water sources and sanitation facilities in schools also affects the proportion of children entering the first grade of primary school who reach the last primary grade (survival rate). Children who are vulnerable to health risks and poor health tend to drop out of school. Research cited21 in the reviewed literature also pointed out that children, especially girls of menstrual age, are not comfortable attending school when water and sanitation facilities are inadequate. Such conditions can largely affect contact time and quality of learning during the foundation years of basic education. In South-East Asia, children in Cambodia and Lao PDR have the lowest survival rate to the last primary grade, with 54 per cent and 67 per cent, respectively (table 5). This low survival rate may be attributed to poor hygiene facilities and practices and unsafe water. As shown in table 2, Lao PDR has the lowest access to safe water sources and Cambodia has the lowest access to adequate sanitation facilities.

17 Gross enrolment ratio (GER) for primary school refers to the number of children enrolled in primary school, regardless of age, expressed as a percentage of the total number of children of official primary school age. The desk review considered the GER instead of the net enrolment ratio (NER), which is the number of children enrolled in primary school who are of official primary school age, expressed as a percentage of the total number of children of official primary school age, to determine a more absolute figure for children, regardless of age, who need access to WASH facilities in school. 18 See table 1 for the same sources of data. 19 See Abraham et al., 2012; Nahar et al., 2006; Assaad et al., 2010; UNESCO, 2006. 20 WHO, 2009. 21 See Abraham et al., 2012; Nahar et al., 2006; Assaad et al., 2010; UNESCO, 2006.

PART1: REGIONAL ASSESSMENT

Table 5: Gross enrolment ratios and survival rates in South-East Asia, 2005–2009 Primary school gross enrolment ratio Country

(2005–2009)

Survival rate to last primary grade (%)* (2005–2009)

Brunei Darussalam

Male 107

Female 107

Cambodia

120

112

Indonesia

121

118

Lao PDR

117

106

67 92

Malaysia

Myanmar

117

Philippines

111

109

Singapore

Thailand

99**

Timor-Leste

110

103

Viet Nam

107

101

AVERAGE

109.9

105.9

78.8%

Notes: NA = Information not available. * = Based on UIS administrative data unless otherwise specified. ** = Thailand based on Demographic and Health Survey and the Multiple Indicator Cluster Survey Source: UNICEF, State of the World’s Children, 2011.

III. WASH in schools in 11 South-East AsiaN countries A. National policy frameworks and other enabling environment factors National policy frameworks At the national level, most South-East Asian countries have strategies on the provision and/or improvement of water and sanitation coverage. The strategies involve various policies, such as those concerning environmental, water and sanitation management plans and building codes as well as awareness campaigns. The national policies guide the education ministries and other government agencies in their efforts to achieve education targets. The environmental, water and sanitation management plans and policies generally focus on the provision and sustainability of water sources and sanitation facilities. For instance, Cambodia’s National Policy on Water Supply and Sanitation, developed by the Ministry of Rural Development and the Ministry of Industry, Mines and Energy in 2003, intends for every person in rural areas to have sustained access to safe water and sanitation services by 2025. The Rural Water Supply and Sanitation Investment Plan for 2005–2015 illustrates the overall sector financing requirements and expected levels of coverage in the country. The National Policy on Urban Sanitation (2003) and the National Strategy on Rural Water Supply, Sanitation and Hygiene for 2010–2015 both involve demand-based approaches to development, investment, roles and responsibilities of national and subnational agencies related to sanitation services and the participation of the private sector. Other related policies in the country are the National Drinking Water Quality Standards, which was approved in 2004, the National Water Resources Policy and the Law on Water Resources Management, which was approved in 2007.

PART1: REGIONAL ASSESSMENT

Myanmar’s Environmental Health Programme under its National Health Plan supports the development and/or monitoring of community water supply, sanitation and pollution conditions. The Philippines relies on its Sustainable Sanitation Roadmap. Other sanitation policies and plans include: • Clean Water Act of 2004, which provides for comprehensive water-quality management • Administrative Order on Sustainable Sanitation as a National Policy and National Priority Programme of the Department of Health • National Environmental Health Action Plan • National Sewerage and Septage Management Plan. In Singapore, the Government focuses on sustaining its water sources (water from catchment areas and imported from Malaysia) and continuously developing new sources (reclaimed water known as NEWater and desalinated water). The Government, through the Public Utilities Board, also engages communities in taking ownership of the management of the country’s water resources. The governments of Cambodia, Indonesia and Timor-Leste adopted the community-based total sanitation (CBTS) model as part of their respective national strategies. Standards in constructing WASH facilities in schools are also embodied in national building codes. In Malaysia, the Guidelines and Rules of Building Plan (2008) indicates that primary and secondary schools should have a ratio of one toilet for every 20 students, the gross area of each toilet should be 3.5–4.5 m2 per unit, and the design of the facility must comply with the approved design by the Department of Works.22 The Philippine Department of Education adheres to sections 902–904 of the National Building Code in terms of water and wastewater disposal systems. In Viet Nam, the Ministry of Health issued Decision No. 08/2005/QDBYT, which is the guide for adhering to national standards for latrine construction, operation and maintenance. Governments have taken steps to raise people’s awareness on the importance of safe water and proper hygiene. Cambodia adopted the Hygiene and Sanitation Transformation policy to promote hygienic practices in rural areas. The Cambodia WASH Initiative, started in 2008 through the Department of Rural Health Care in the Ministry of Rural Development, is developing a body of knowledge based on the experiences of partners’ programmes and projects. A manual for household latrine selection was developed and distributed to government agencies, NGOs and the private sector to help raise awareness and demand for improved latrines. Singapore is keen on reaching all citizens with information on the importance of clean water and good sanitation practices. The Health Promotion Board emphasizes public awareness on the importance of handwashing, with such education materials as posters, guides and articles easily accessible through its website. In Timor-Leste, behavioural change communication and the demonstration of good hygiene behaviours are undertaken through the Ministry of Health’s Integrated Community Health Service. Local governments in Viet Nam take responsibility for promoting and implementing adequate sanitation practices. Capacity building and information dissemination campaigns are provided by the national Government to support the local governments.

WASH in schools programmes and initiatives Programmes and initiatives that directly contribute to WASH improvements in schools are evident across the region, both at the national (government-instituted) and school (school- or student-led) levels. This includes collaboration among education ministries, other government agencies with some relationship to water and rural development, international development organizations and the private sector.

22 As reported by the Ministry of Education (Malaysia).

PART1: REGIONAL ASSESSMENT

The Strategic Plan 2007–2011 of Brunei Darussalam’s Ministry of Education focused on improving its responsiveness to the individual needs of students and help make the school environment and culture more conducive to learning. All public primary schools in the country are now equipped with WASH facilities,23 and the Ministry concentrates on raising awareness among children on good practices. The Ministry launched the Cleanliness, Comfort and Safety Awareness Award through the Health Promotion Unit of the Department of Schools to promote good sanitation habits. The Ministry also developed Guidelines on School Toilet Usage, containing such information as maintaining school toilet cleanliness and proper toilet etiquette (washing hands and flushing) and practices (reciting the doa, or Muslim prayer, after using the toilet). A total of 5,000 pamphlets were distributed in January 2012 to all primary, secondary and higher education institutions and religious schools across the country. In the past, a capacity-building workshop for teachers in Brunei Darussalam was offered to assist them in developing values-based lesson plans. In 2007, for instance, the National Echo Training of Teachers on Human Values-Based Water, Sanitation and Hygiene Education – Integrated Lessons was offered as an offshoot of the Human Values in Water, Sanitation and Hygiene Education Programme that was introduced to education ministries in 2003 by SEAMEO, the United Nations Human Settlements Programme (UN-HABITAT) and the Asian Development Bank (ADB). The four-day workshop aimed at teaching students the sustainable use of water and promoting proper sanitation and good hygiene. The teachers were to observe the students’ attitudes towards water use ethics and sanitation practices. Preand post-tests were administered to distinguish the impact of the new lessons plans. Brunei Darussalam’s Estate Management and Maintenance Department (within the Ministry of Education) introduced a contract system to facilitate the maintenance of school toilets. The Ministry also engages the entire school community in keeping toilets clean. In addition to the school cleaners’ tasks, school heads are held responsible for maintaining good hygiene and clean toilets within the school. In Cambodia, the Ministry of Education, Youth and Sports (MOEYS) concentrates on developing childfriendly schools (CFS), based on the model pioneered by UNICEF. The CFS approach includes investing in water and sanitation facilities as a means to promote school safety and healthy behaviour among children. As of the 2010/2011 academic year, nearly 67 per cent of all primary schools were characterized as child-friendly.24 Complementing the child-friendly schools initiative is the Ministry’s Policy on School Health, which outlines several strategies and approaches to promoting school health activities. The policy manual provides guidelines on integrating hygiene and sanitation messages into various communication formats (textbooks and information materials, such as billboards, posters and newsletters); improving the learning environment by including facilities for good hygiene and sanitation practices; and enhancing the involvement of government ministries and institutions, development partners, the private sector and civil society in improving hygiene and sanitation practices and facilities in schools. The Ministry initiated opportunities for building up capacity on operations and maintenance among school directors and teachers. Guided by the CBTS model, schools in Cambodia have implemented a School-Led Total Sanitation Programme. And the Government added two hours of health education per week into the primary school curriculum. In Indonesia, students help stimulate good hygiene practices. The Jum’at Bersih, or Clean Friday, is a student-led project that promotes proper handwashing during the weekly Islamic holy day. The project Dokter Kecil, or Little Doctors, promotes good hygiene through community theatres in which children in grades 4–6 perform plays on the importance of proper handwashing. The Lao Ministry of Education and Ministry of Health forged a partnership to implement the School Health Programme, as guided by the National School Health Policy. With the general objective of improving and promoting the physical, emotional and mental health of children, the policy covers the strengthening of personal hygiene, life skills and the physical school environment, among other factors. 23 As reported by the Health Promotion Unit, Department of Schools, Ministry of Education (Brunei Darussalam). 24 Data provided by the Ministry of Rural Development (Cambodia).

PART1: REGIONAL ASSESSMENT

The policy manual specifies the provision of safe water, clean and separate latrines for boys and girls and sufficient convenient places for handwashing. Lao schools also have adopted the Blue Box concept. The Blue Box is a participatory learning approach in the classroom in which children learn the value of handwashing, personal hygiene, proper sanitation and safe water through games and stories. In the Philippines, the institutionalizing of universal kindergarten education provides an avenue to encourage proper sanitation habits among children as young as 5 years old. This includes construction of sanitation facilities in kindergarten buildings that are appropriate for 5-year-olds.25 The Philippine Department of Education issued guidelines on the use of the Basic Educational Facilities Fund that cover the construction and/or rehabilitation of water and sanitation facilities in schools. Of the 11.3 billion pesos (approximately US$262 million) available for 2011, around 2.45 billion pesos (approximately US$57 million) was allotted to the construction and/or rehabilitation of classrooms, including the water and sanitation facilities.26 Policies on WASH facilities in Philippine schools are subject to two policies: • DECS Order No. 60, 1994, which states that sanitation facilities must be one of the cleanest areas in schools and that school heads have responsibility for ensuring that old toilets are renovated or new ones installed and for providing water and handwashing facilities. • Department of Education Orders No. 56 and No. 66, 2009, which pertain to the construction of handwashing facilities in all schools. Complementing these policies, the Education Facilities Manual27 was produced to enforce the standards for the construction of WASH facilities in schools. Collaboration among the Government, the private sector, civil society organizations and foundations led to a Schools Water and Electrical Facilities Assessment Project to assess the water facilities in schools, locate schools with poor or without water and sanitation facilities and good hygiene practices and then to provide necessary interventions. In 2009, the Department of Education issued a policy on the Implementation of the Essential Health Care Programme (EHCP) for School Children.28 In partnership with international development agencies, local government units and the business sector, the programme works to reduce the incidence of diseases associated with poor hygiene and sanitation. The EHCP provides safe drinking water access, toilets and handwashing facilities in schools, combined with campaigns on the need for good hygiene and deworming treatment for children. As of April 2011, a total of 8,708 schools, accounting for more than 2 million children, had benefited.29 In addition, the Department of Education in August 2011 issued a policy directive30 on the use of a monitoring tool for EHCP, which included collecting data on sanitary requirements, such as water supply, toilet facilities, handwashing facilities, drinking fountains and waste disposal system as well as data on the integration of health education into the curriculum and in school activities. Also in terms of monitoring, the Philippine Basic Education Information System gathers data on water and toilet facilities.31 Thailand’s school-based approach to avian influenza prevention and pandemic influenza preparedness resulted in the development of manuals on these diseases and diarrhoea.

25 Department of Education Order No. 91: Kindergarten School Building Project (November 2011). 26 WASH in Schools Technical Working Group (Philippines), WASH in Schools Country Profile, November 2011. 27 See the manual’s Annex 9 on standards for WASH-related facilities in schools in the Philippines. 28 Department of Education Order No. 65, 2009. 29 ECHP performance report as of 18 April 2011 (Department of Education). 30 Department of Education Order No. 61: Use of the Monitoring Tool for the Essential Health Care Programme (August 2011). 31 WASH in Schools Technical Working Group (Philippines), WASH in Schools Country Profile, November 2011.

PART1: REGIONAL ASSESSMENT

In Viet Nam, the National Target Programme for Rural Water Supply and Sanitation, under the Ministry of Agriculture and Rural Development, stipulates that all primary schools, kindergartens and nurseries in rural areas were to provide access to safe water and hygienic latrines by 2010.

Partnerships Many international development agencies are active in strengthening the WASH conditions in schools throughout South-East Asia. Regionally, a memorandum of agreement on Human Values-Based Water Sanitation and Hygiene Education in South-East Asia, or Project SEAWAVE, was signed in 2003 by SEAMEO member countries, in partnership with the ADB, UN-HABITAT and the SEAMEO Secretariat. The project aimed to promote a better quality of life in the region and to support the achievement of the MDG targets associated with access to adequate water and sanitation facilities primarily through: i) an assessment protocol on water and sanitation facilities in schools; and ii) capacity building on the integration of values-based water sanitation and hygiene education in academic curricula and other school activities. International development agencies along with local NGOs provide vital support, especially in terms of financial resources. The private sector has been encouraged to participate in national strategies on improving water and sanitation coverage by building facilities and marketing products for daily hygiene practices (soap, toothpaste, toothbrush, deworming tablets, etc.). Additionally, communities across the region are asked to take responsibility in raising awareness on safe water and sanitation practices. The UNICEF contribution to the region has been significantly evident in the construction of WASH facilities, awareness campaigns, technical assistance and capacity-building programmes. Other international development partners, international NGOs and the private sector also have provided support to improving the WASH conditions in schools. In 2011, Dubai Cares, UNICEF, CARE International and Save the Children partnered to support the Water, Sanitation and Hygiene in Support of School Empowerment (WISE) programme in Indonesia. The programme enables the construction of sanitation, handwashing and water facilities, including capacity building for teachers and community representatives on the effective delivery of hygiene education. In Lao PDR, international development agencies have been supportive of the Government’s efforts to achieve its goals under the Education for All or Learning for All (EFA/LFA) by funding the construction of water and sanitation facilities in schools. An example is the Japan Committee for UNICEF and the AEON Corporation of Japan, which funded the construction of improved water, sanitation and hygiene facilities in the provinces of Savannakhet, Luang Prabang and Xiengkhouang. AusAID and the World Bank also have extended funding to assist Lao PDR under the EFA-Fast Track Initiative. Part of the programme’s long-term goal is to provide children with a safe, protective and healthy learning environment, including access to safe water and adequate sanitation. Specifically, a subcomponent of the programme targets the construction and/or rehabilitation of sanitation facilities and the water source in schools. In Myanmar, the Ministry of Health, the Ministry of Education and UNICEF collaborate to continuously promote good sanitation practices among school children through such activities as the ‘4 Cleans’ campaign (clean food, clean water, clean toilet, clean hands) and participation in the UNICEF Global Handwashing Day. Another example is the Lion Corporation’s drive towards sanitation improvement and promotion of good sanitation practices. In 2010, the soap company pledged to donate a portion of its income for a three-year period to UNICEF WASH projects in schools. Sixteen primary schools were selected to receive assistance for the construction of improved water sources and upgraded toilets and handwashing

PART1: REGIONAL ASSESSMENT

facilities. Water filters, soap and garbage bins were provided. Complementing these facilities were capacity building programmes for the teaching staff, together with instructional materials for class use.32 Public–private partnerships and civil society organizations also have high levels of participation in sanitation improvement initiatives, particularly in the Philippines. Water concessionaires partner with national and local government units to improve access to water sources and wastewater management. Local business people also contribute, helping to improve sanitation facilities, while civil society organizations are active in raising public awareness on the importance of good hygiene and safe water. One example of effective public–private partnership is the Fit for School (FIT) programme, which is spearheaded by the international development agency GIZ. The programme is implemented in collaboration with the Department of Education, the Department of Health, other international development agencies (the Danish International Development Agency (DANIDA), UNICEF and AusAID), the private sector (GlaxoSmithKline, Lamoiyan Corporation, Procter & Gamble and Unilever), NGOs (Fit for School, Inc., GMA Kapuso Foundation) and the Philippine Dental Association and the World Dental Federation. Inwent33 also has been part of the programme. The United States Agency for International Development (USAID) recently expressed interest to expand the programme. The FIT programme, awarded by the World Bank, the United Nations Development Programme and the WHO on Innovation in Global Health in 2009, provides an inexpensive framework for school health through realistic templates for implementing activities and advocates for a supportive policy environment. It promotes cleanliness and the prevention of WASH-related diseases by providing school health interventions (see the model highlighted as innovative in chapter v).34 Capacity building is also provided to strengthen the skills of teacher-facilitators in implementing and monitoring the programme. The FIT programme extends technical assistance through training and research to facilitate the successful and sustainable implementation of the Essential Health Care Programme for School Children through the Department of Education. The FIT programme is implemented in 27 provinces and cities across the Philippines, with 415 school districts receiving training sessions on managing the school-based handwashing, tooth-brushing and deworming programmes, including an introduction to a web-based monitoring tool in 2010. With the success of the FIT programme in the Philippines, GIZ planned to establish a regional school health programme, based on the Fit for School concept. In partnership with the SEAMEO Secretariat and SEAMEO INNOTECH, GIZ conducted a situation analysis in 2011 to assess the context of school health in Cambodia, Indonesia and Lao PDR. The analysis clearly indicated the feasibility and appropriateness of focusing on school health in those countries. The six-year regional programme stretches from October 2011 until 2016, in partnership with SEAMEO INNOTECH.35 In Timor-Leste, UNICEF has partnered since 2003 with the Ministry of Education, the Ministry of Health and the Ministry of Infrastructure in its WASH in schools programmes. The cooperation has led to the provision of WASH facilities and hygiene promotion using the child-to-child approach. UNICEF also helps the Ministry of Education improve its EMIS data collection. Cooperation programmes with international development agencies, such as UNICEF, Plan International, World Vision, DANIDA, AusAID and the Netherlands Directorate-General of Development Cooperation, have operated in Viet Nam since the 1980s.

32 Lion Corporation, ‘Lion Announces the Implementation of ‘Circle of Beauty Surrounding Asia’ Activities, a Partnership between Kirei Kirei and UNICEF’ 2010. See: www.lion.co.jp/en/press/html/2010012f.htm 33 Inwent, or Capacity Building International, is a German NGO that is now part of GIZ. 34 See the Fit for School website at: www.fitforschool.ph 35 Fit For School, Inc., 2010.

PART1: REGIONAL ASSESSMENT

Desk Review

• WASH facilities status/ inventory • Enabling factors • Challenges, opportunities, good practices

Comparative Assessment of WASH

B. Status of WASH facilities in schools

Implementation Sustainable It can gaps be expected that all primary schools in the high-income economies of solutions Brunei Darussalam and Singapore have adequate water and sanitation facilities. As noted previously, both countries are much more focused on the proper maintenance of the facilities and raising awareness on the importance of good hygiene and appropriate behaviour of children as well as increasing the awareness on the Validation of desk review findings and importance of supervising and monitoring WASH facilities. In-depth assessment

actual implementation experiences: Country of wash in Cambodia, • National level Nonetheless, about US$70,000 of the annual budget for education in Brunei Darussalam Studies Indonesia,was allocated • Sub-national level for capital expenditures to support WASH projects in schools. From 2006 Lao untilPDR 2011, a total of 90 school and Philippines • School level, if time permits 36 construction projects (improved water sources and toilets) were facilitated.

In Malaysia, although all primary schools have WASH facilities, the Ministry of Education focuses on reducing the urban–rural differences in basic infrastructure, including water, sanitation and hygiene facilities. From 2003 to 2006, 627 rainwater-collection facilities were constructed in rural areas; 189 tubewells or boreholes were constructed in rural areas from 2008 to 2009.37 834 900 however, the proportion of public primary schools that have adequate sanitation facilities Across the region, (particularly in800 some low- and lower-middle-income economies) remain significantly small (chart 2).

700

or -L

ilip

ay al

sia

bo m

Only 12 per cent of public primary schools in Viet Nam, for example, have adequate sanitation facilities 600 514 (chart 2). A survey conducted492 by the General Medicine in 2007 revealed that 500 Department of Preventive 437 435 80 per cent had latrines. Not all were 500schools canvassed 401 385 considered of the primary in 20 provinces, Average (440) 351 sanitary, according to the sanitation standards on construction, operation and maintenance. Only 7.7 400 278 per cent of the 300schools met all three standards. Nearly 63 per cent of the schools had sanitary-type 216 latrines, such as a septic tank, pour-flush latrine, double-pit latrine, ventilated pit latrine or a biogas tank 200 that does not necessarily conform to standards. Nearly 46 per cent of the schools had septic tanks, while nearly 20 per cent did not have latrines at all.38

Tim

In terms of water sources, nearly 84 per cent of primary schools had access to safe water, with 66 per cent having a water source on the premises while the rest took their water from other sources (from home or from a nearby source). The most common source of water in schools was running water (piped water), at 33 per cent, followed by dug wells, at 25 per cent, while 16 per cent of the primary schools in the survey did not have a water source. About 35 per cent of the schools had a handwashing area, but only 27 per cent had adequate clean water for handwashing.39

Chart 2: Proportion of public primary schools with adequate sanitation facilities in selected South-East Asian countries 12%

Viet Nam

53%

Timor-Leste Lao PDR

24%

Cambodia

78%

20%

40%

60%

80%

Source: WHO, Sanitation and Hygiene in East Asia, 2010.

36 As reported by the Health Promotion Unit, Department of Schools, Ministry of Education (Brunei Darussalam). 37 As reported by the Ministry of Education (Malaysia). 38 General Department of Preventive Medicine and UNICEF, 2007. 39 Ibid.

ENABLING SERVICES

DEVELOPING SERVICES

SUSTAINING SERVICES

PART1: REGIONAL ASSESSMENT

SERVICE DELIVERY PATHWAY Policy frame-

Management and

Partner-

Financial mecha-

Social norms

Hardware

Software

WASH pro-

Monitor- Evaluation

Mainte-

ural change

in schools

In Timor-Leste, only about half (53 per cent) of the public primary schools had adequate sanitation facilities as of 2010 (chart 2). From 2009 until 2011, UNICEF provided 30 improved water sources, 33 toilets, 5 latrines and 27 handwashing stands to schools located in rural areas.40 Only about a quarter (24 per cent) of the public primary schools in Lao PDR had adequate sanitation facilities as of 2010 (chart 2). The Japan Committee for UNICEF and the AEON Corporation of Japan have partnered to provide funds for the construction of improved water, sanitation and hygiene facilities in four provinces. From 2006 until 2011, 148 rural schools were given toilets and handwashing facilities. In 2008, 47 per cent of schools with the full primary cycle were provided with clean water and latrines.41 In Cambodia, only 78 per cent of public primary schools had adequate sanitation facilities as of 2010 (chart 2). From 2006 until 2010, UNICEF provided tubewells (30), protected dug wells (394), rainwater tanks (174), ceramic water filters (3,890), toilets (455) and handwashing stands (759) to child-friendly schools.42 Indonesia’s WISE programme43 facilitated the construction of sanitation, handwashing and safe water facilities in 450 schools, benefitting 90,000 children.44 In Myanmar as noted previously, 16 primary schools were selected to receive assistance from the Lion Corporation for the construction of a water source and the upgrading of their toilets and handwashing facilities (with water filters, soap and garbage bins also provided).45 The natural disasters brought about by the 2004 Indian Ocean tsunami and the 2011 flooding in Thailand resulted in the disruption of the country’s water and sanitation systems. Household sanitation systems did not operate under the floodwater, and trash and sewage piled up after the floodwater subsided. More than 1,000 schools were affected and forced to end the term early.46 In general, the most common sources of water in schools in the region are hand pumps and wells, while the flush toilet is the most common form of sanitation facility. Hygiene behaviour is tackled in social science classes, health hygiene classes and life skills classes. (See Annex 2 for a summary of the available WASH facilities and complementary measures in the 11 South-East Asian countries.)

C. Challenges in member countries As highlighted in the reviewed literature, problems, issues and concerns related to improving sanitation facilities in the region revolve around the lack of sufficient funds and financial mechanisms to support the construction, operation and maintenance of facilities; weak human capacity to operate, maintain and monitor facilities as well as supplies; the need to increase awareness among students as well as other stakeholders on the importance of improved sanitation; and inconsistencies in policy frameworks or guidelines, or lack thereof, to implement strategies. The lack of harmonized policy frameworks tops the list of constraints in Cambodia, Philippines and Timor-Leste. Despite the numerous policies and strategies issued by the Government of Cambodia, for instance, coordination among the national agencies to implement a sanitation strategy seems to be lacking. The absence of a procurement committee at the subnational level to manage tendering and monitoring slows down work that needs to be done at the school level because decision-making is handled centrally. There is also poor compliance and weak understanding and enforcement of national strategies, policies and approaches to support WASH activities in schools.

40 UNICEF Timor-Leste, through a survey questionnaire distributed by SEAMEO INNOTECH to UNICEF Country Offices during the early stages of the study. 41 National School Health Policy Manual, May 2010. 42 UNICEF Cambodia, through a survey questionnaire distributed by SEAMEO INNOTECH to UNICEF Country Offices during the early stages of the study. 43 WISE = Water, Sanitation and Hygiene in Support of School Empowerment programme. 44 Dubai Cares, 2011. 45 Lion Corporation, 2010. 46 ETNA, 2011.

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The WHO reports that in the Philippines, sanitation is not considered a priority.47 Weak sector planning and management is due to poorly resourced institutions, insufficient data and surveillance systems, weak coordination and institutional uncertainty and variability in leadership, at both the national and local levels.48 Regulatory standards vary. Due to the many construction standards (the Code on Sanitation of the Philippines, the Philippine National Standards for Drinking Water 2007, the Water Code of the Philippines, the Revised National Plumbing Code of the Philippines, the Ecological Solid Waste Management Act), it may seem that some school standards do not follow the national codes. For instance, the Department of Education’s Education Facilities Manual indicates the following ratios: • one toilet for every 100 male students • one toilet for every 50 female students • one drinking facility for every 75 students Whereas, the Code on Sanitation of the Philippines indicates: • two toilets for 50–100 male students • one toilet for fewer than 30 female students • two toilets for 30–100 female students • one drinking facility for every 100 students. And the National Building Code of the Philippines recommends one toilet for every 100 students. Similarly, sanitation is not perceived as a government priority concern in Timor-Leste.49 The operation and maintenance of WASH facilities in schools is not a priority. Prior to 2011, the Ministry of Education did not have a department that covered WASH in schools. Also, and probably resulting from the lack of a comprehensive policy or guidelines, the Ministry of Education’s initial proposed standard design for school sanitation facilities was expensive. The poor road infrastructure across the country contributes to the challenges; poor road conditions made it difficult for organizations or agencies to reach some schools to provide interventions, especially in the rainy season. In all other countries (where data was available), the need for policy frameworks was highlighted as a contributing factor to the issues and challenges. Particularly at the local government level, little importance is given to the sanitation conditions. This may be due to not understanding the reasons for having adequate facilities, hence the low prioritization. There is also lack of good guidelines to implement strategies, including lack of a standard design for WASH facilities in schools. Policies on budget allocation in some countries for WASH facilities in schools are also inadequate, if not totally lacking. Adequate funds are not allocated to ensure the construction, operation and maintenance of WASH facilities in schools. Viet Nam considers the lack of sufficient funds as its major constraint, although all other countries (where data was available) recognize it as part of their obstacles also. Additionally, some funds for constructing such facilities may be available, but no funds are particularly allocated to maintain and/or renovate the facilities. Inadequate human capacity to operate, maintain and monitor WASH conditions was cited as the top constraint in Brunei Darussalam and Lao PDR. In some countries, facilities as well as supplies (such as soap) are poorly operated and maintained, especially at the provincial and district levels. Weak capacity in terms of implementing and coordinating WASH programmes, optimizing opportunities and/ or resources and carrying out good hygiene education is also evident in the region.

47 WHO, 2010. 48 These challenges are cited in the Manila Declaration on the Advancement of Sustainable Sanitation and Wastewater Management in the Philippines, signed at the Philippine Sanitation Summit on 5 July 2006. 49 WHO, 2010.

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In Indonesia, the lack of community awareness and education on hygiene and sanitation behaviour tops its list of reported constraints. There is difficulty in promoting and supporting community participation, especially in the rural areas. Generally, there is a need to increase the level of commitment to implement plans and the sense of ownership of WASH facilities among students, parents, teachers and community leaders in the region. An instance that highlights this need is the case of the EHCP implementation in the Autonomous Region of Muslim Mindanao in southern Philippines, where the presence of donor partners led to a false perception among some public officials that they could expect payments and other benefits in return for their cooperation. That perception placed the donor partnership at risk as well as the sustainability of the programme.50 In Brunei Darussalam, there is a need to increase the awareness of operators and managers in terms of supervising and monitoring facilities. Awareness on good hygiene among students is also rather low. In Viet Nam, children are not taught the proper use of facilities and are not aware of their roles in terms of WASH operation and maintenance, except cleaning the toilets as a form of punishment. In Lao PDR, there is difficulty in promoting sanitation programmes, especially in the remote areas. Monitoring is also a big hurdle in all countries (where data was available). Monitoring is not well coordinated, which often results in conflicting information. Monitoring systems, such as the education management information system, may gather such WASH data as the number of facilities but a more specific and detailed inventory also should be available. Data in terms of the adequacy and functionality of facilities were rather scarce, if not totally lacking. For some countries, the availability of facilities in terms of sheer number was accessible. Nonetheless, the absolute number of facilities in schools is not a satisfactory indicator of accessibility of such facilities. For instance, toilets may be available in some schools but are under such dire conditions that they are unusable (no flush, no water). It is also possible that some schools have the facilities but the number of functioning facilities is not enough to accommodate all students (such as having one toilet for every 100 students or no separate toilets for boys and girls). In Indonesia, for example, some facilities were categorized as ‘slightly damaged’ and ‘heavily damaged’, although there were no criteria to define the parameters of such damage.

IV. Issues and challenges: Findings from the four country studies This chapter provides a more detailed analysis of the issues and challenges in the region, with a focus on the four sample countries (Cambodia, Indonesia, Lao PDR and the Philippines). It points out bottlenecks affecting the delivery of adequate and sustainable WASH conditions in schools, at least those that emerged through the use of the service delivery assessment (SDA) framework of the World Bank’s Water and Sanitation Programme. The SDA framework is used in more than 40 countries in Latin America, sub-Saharan Africa, South Asia and East Asia and the Pacific to locate bottlenecks and improve performance in the water and sanitation sector. The assessment involves generating a scorecard through a country-led process, assessing needs, estimating needed resources and building a consensus around what to prioritize. Use of the SDA framework contributes to improving sector planning, monitoring and evaluation. It also provides opportunity for sector reform through the joint use by a government and development partners, and, more importantly, it highlights the needs to be addressed.51 50 GIZ, 2011. 51 Smets, 2012.

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Figure 2: Modified service delivery assessment framework DEVELOPING SERVICES

SUSTAINING SERVICES

SERVICE DELIVERY PATHWAY Policy frameworks

Management and coordination

Partnerships

Financial mechanisms

Social norms

Policy frameworks

Hardware

WASH programmes

Software

Provision of hardware (construction, maintenance and sustainability of WASH facilities in schools)

Planning • Management and Coordination mechanisms • Partnerships Socio-cultural norms related to water and sanitation

Maintenance

Monitoring Evaluation Mechanism to support maintenance of WASH facilities and programmes

Provision of software (human resources, knowledge and capacity of decision-makers and implementers)

Financial mechanisms

Monitor- Evaluation ing

Behavioural change

WASH in schools

ENABLING SERVICES

Complementary WASH programmes

The SDA framework helped flesh out the issues and challenges along the WASH service delivery pathway for schools in the four sample countries. The analysis here, however, does not involve a numerical scorecard but instead focuses on a qualitative analysis of the issues. As mentioned previously, developing a numerical scorecard entails a country-led process, which none of the countries had done at the time of the study, particularly for WASH conditions in schools. For this study’s analysis, a colourcoded scheme illustrates the level of availability of indicators (enabling factors) along the service delivery pathway: green for sufficient and working enabling factors; yellow for work being done but not fully Pre-primary sufficient; and red forPrimary areas in which moreSecondary work needs to be done. This illustrative useTertiary of the SDA Post-secondary (one year) (six years) (four to five years) (two to fourinyears) framework was carried out only for Cambodia, Indonesia, Lao PDR and(two the years) Philippines (included each of the four country profiles in Part II). Common curriculum The following three sections highlight the conclusions (two years) of the service delivery assessment in the four sample countries. General secondary education

Applied secondary education

A. Enabling services

Specialized education

Specialized education needs

Pre-university level

Vocational or technical education

1. Policy frameworks There is an abundance of national policy frameworks but limited application. The region has a 120 primary schools profusion of national policy frameworks on the provision and/or improvement of water and sanitation coverage, such as those concerning environmental, water and sanitation management plans or policies, building campaigns. Nonetheless, the enabling policies largely remain at the Privatecodes 40% and awareness Public (MOE) 59% national level. Translating them into action remains a challenge due to inadequate appreciation for local implementation. In some cases, there is little knowledge of these policies at the local level. In some places, varying standards emanate from different government agencies, which leads to conflicting project implementation (such as in the construction of facilities). Public (MORA) 1% 37 primary schools

National standards exist, but largely are not followed. For example, there are national standards on the ratio of sanitation facilities to the number of pupils; and yet, many primary schools still do not meet the 14 primary schools 32 primary schools minimum ratio due to insufficient funds.

2. Planning a. Management and coordination mechanisms There is a lack of coordination from the national, provincial and district levels down to the school level. The critical role of a school principal as coordinator and 150decision-maker is oftentimes not Private 36%

MOE 62%

100 50

131

122

PART1: REGIONAL ASSESSMENT81 68

supported to achieve a seamless functioning coordination mechanism. The planning process is typically not sufficiently managed within schools; for example, monitoring reports are not used for needs assessments, planning, target setting or even evaluations. b. Partnerships The division of roles and responsibilities is unclear and thus inhibits progress in multi-sector partnerships. Although multi-sector partnerships related to WASH in schools (such as technical working groups and task force committees) are evident in the region, there appears to be unclear definitions of the roles and responsibilities in some areas. For instance, which sphere has overall responsibility for WASH in schools? Is the overall responsibility under the education ministry, with possible support from other ministries, such as the health ministry? Which agency or service provider is in charge of ensuring that schools have a safe water supply and adequate sanitation facilities, especially in remote rural and upland communities? Is this the responsibility of the public works ministry, the water ministry or the rural development ministry? Unconsolidated WASH initiatives contribute to inefficient implementing processes. Amid the number of existing multi-stakeholder technical working groups, the consolidation of the various efforts by many actors (such as international and local NGOs and the private sector) seems to be weak or lacking, resulting in a duplication of tasks. For instance, beneficiary schools and/or government departments have to prepare numerous reports to comply with donor requirements, which sometimes leads to weak appreciation of the process. Opportunities for integrating WASH initiatives into donor projects are not maximized. In some school construction projects, adequate water and sanitation components are not included.

3. Financial mechanism

A rain catchment facility in a school – water is only available during the rainy season

The limited available funds for school infrastructure are hardly used to improve and/or maintain WASH facilities. National and local governments have budget allocations for general school building and maintenance. Funds, however, are oftentimes not specifically allocated for the WASH facilities, especially for operation and maintenance (such as for soap and utility bills for water and electricity for a water pump). When construction funds are not sufficient to complete a school building, toilets are often the first to be removed. In some cases, teachers take the initiative of buying WASH-related consumable items, such as soap, with their own money.

There is inadequate investment in long-term water sources near school premises. In some areas, WASH facilities are not fully functional because there is no sustainable source of water in the school. Due to insufficient funds for infrastructure, governments cannot cope with the demand for water supply and sewerage systems.

4. Values and socio-cultural norms related to WASH The gap between inputs and the values and the socio-cultural or environmental contexts does little to encourage pride of ownership. Inputs are sometimes designed without full appreciation of the local context; hence, WASH intervention programmes do not adequately generate community or parent

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involvement and a sense of ownership among them. In many cases, WASH services are not fully responsive to the needs of girls, especially during their menstrual period, or are not resilient to climate change and/or responsive to disaster-prone school communities. There is lack of appreciation for WASH as an integral part of education. Public works (such as the construction of toilets, a water system and a sewerage system in schools) are not regarded as interventions that improve the quality of education but are seen as peripheral infrastructure projects.

B. Developing services 1. Provision of hardware (WASH facilities, water supply and sewerage systems) Many schools still do not meet the minimum student–toilet ratio. There is lack of access to appropriate, well-designed and sustainable facilities. In some schools, facilities built by donors are not maintained due to the expensive maintenance costs. In some cases, facilities are not used because it entails high maintenance cost. Some facilities are also kept locked because nobody wants to clean them or the teachers want their own toilets. Some schools do not have WASH facilities at all. Some WASH facilities do not fully cater to the needs of children. In many cases, the WASH services are not fully responsive to the needs of girls, especially during their menstrual period (no privacy available), and are not resilient in areas with a high risk of natural disaster.

2. Provision of software (human resources, knowledge and capacity of decision-makers and implementers) Human resources and capacity are not adequate to maintain WASH facilities in schools. Capacitybuilding programmes for school directors and teachers on general school-based management, curriculum development, operation and maintenance are available, but not specifically on schoolbased health management (monitoring and evaluation of WASH facilities, planning, operation and maintenance of WASH facilities). In most cases, the community is in charge of maintaining (repairing) the facilities. However, without the necessary skills, the community cannot properly repair facilities when needed, hence broken facilities are abandoned. In many schools, teachers and children are tasked to clean the toilets due to the school’s insufficient budget to hire additional staff to keep the toilets clean. The importance of WASH issues is not yet fully valued, especially at the local level. The inadequate level of awareness, understanding and commitment to the importance of WASH conditions generates little or weak support from local governments towards effectively implementing national policies and/ or programmes related to WASH in schools.

3. Complementary WASH programmes Advocacy for WASH as an integral part of education is not adequate for it to become a legitimate education concern. WASH awareness campaigns and activities are generally evident in the region, but the advocacy for WASH as an integral part of education is not prevalent or strong enough for it to become a standard component; its impact on access to quality education and holistic child development is not sufficiently emphasized. WASH activities are taught through a theoretical approach without adequate complementary practical activities. In many areas, the daily practice of WASH activities (handwashing, brushing teeth) is not fully integrated into the academic curriculum.

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C. Sustaining services 1. Monitoring WASH indicators presented in the education management information system are weak and data elements are underused. In the four countries, the WASH monitoring and evaluation mechanisms are not fully operational. Data on WASH in schools are often times not systematically collected or analysed. In schools in which facilities are monitored, the functionality of those facilities is sometimes difficult to assess due to the lack of EMIS indicators. Despite all the interventions, a bigger and more comprehensive picture of the WASH status in schools is still lacking due to the huge data gaps. There is also a lack of adequate data consolidation and a sharing mechanism that would allow a more comprehensive (global, regional, national, provincial) look at the status of WASH in schools. Based on the available data, many schools in the four countries appear to be still wanting of adequate water and sanitation facilities. Monitoring reports are not used as completely as they could be, such as for planning, evaluation and target setting within schools. Given the weak quality of the EMIS data, quantitative analysis of the correlation between the availability of WASH facilities and school performance indicators, such as the rates for attendance, repetition, pushed-outs and completion, was difficult. Monitoring of WASH conditions in schools is not conducted on a regular basis. In most cases, data, if any, are old, inaccurate or incomplete. Monitoring is usually for compliance purposes only and not as an input to the day-to-day planning activities. Data are not consolidated and analysed for use in any annual or regular reporting. What WASH data analysis that does take place, and sometimes even data collection, is most likely for programmatic purposes – the data is collected or analysed only upon request (such as by a donor).

2. Evaluation There is no mechanism or a weak one for consolidating and analysing all data gathered from numerous indicators included in the monitoring tools. School administrators typically lack the capacity and technology to function as monitoring and evaluation managers. The consolidation and analysis of data require a particular knowledge and/or technology (skills of a statistician, computer software) to generate relevant reports. There are no or not enough evaluation reports and/or tools to determine the impact of WASH facilities on learning to support the planning process.

3. Mechanisms to support the maintenance of WASH facilities and programmes There is no sustainable financing model to support the operation and maintenance of WASH facilities and practices in schools. WASH issues are not fully integrated into the school or district improvement plans, and thus there are no provisions for overseeing and maintaining facilities and programmes. (See Annex 3 for a summary of WASH-related concerns in the four sample countries as well as the other South-East Asian countries.)

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V. Innovations A. Model and paradigm The Fit for School approach In partnership with local and international NGOs, the private sector and communities, the FIT approach is being implemented through the Essential Health Care Programme of the Philippine Department of Education. The model, developed by the local NGO Fit for School Inc. (which is supported by GIZ), encourages the role of the education ministry (or its equivalent) and the practice of school-based management as facilitators of change. It provides a framework for strengthening health-related activities in schools by developing realistic templates for implementing activities and advocates for a supportive policy environment. It integrates daily practices in school to institutionalize behavioural change that promotes cleanliness and prevents WASH-related diseases in schools: i) daily handwashing with soap, ii) tooth brushing with fluoride toothpaste and ii) biannual deworming. The entire package amounts to less than a dollar per child for one school year.

3S Enabling Principles:

Simple

Packaged & Focussed Evidence-based Cost-effective

Scalable

Uniform Modular Using Existing Structures

Sustainable

Community Involvement Government Funded Enabling Policy Framework

M&E / Research

3S-The Fit For School Action Framework

The model also provides the opportunity to improve school infrastructure and access to safe water and adequate sanitation conditions. It has developed a facility prototype for group handwashing and tooth-brushing activities that is low cost (less than US$40), durable and can accommodate up to 20 children at a time.52

Capacity building is provided to strengthen the skills of teachers in implementing and monitoring the programme. The model Source: Benzian et al., 2012. includes a simple monitoring and evaluation tool that serves as the data collection system and as a venue for promoting participatory roles of school officials, parents and community. Clear Vision & Values Supporting Multi-level Advocacy Formalised Intersectoral Collaboration Contributing to Broad Development Agenda

The FIT approach, which was initially piloted in 16 provinces in the Philippines in 2003 before it expanded to 24 provinces and three cities, is now being piloted in Cambodia, Indonesia and Lao PDR.

BLING SERVICES

DEVELOPING SERVICES

SUSTAINING SERVICES

Management and coordination

Behavioural change

SERVICE DELIVERY PATHWAY B. Multi-sector partnerships

Financial WASH Multi-sector technical working groups Software are apparent in theMonitoring region, particularly in Indonesia, Lao PDR Social norms Hardware Evaluation Maintenance mechanisms programmes and the Philippines. By involving different actors, such as from the government, development partners and NGOs along with school officials, parents, school children and community leaders in the planning and implementing of WASH programmes, the working groups have created opportunity to strengthen meworks Provision of hardware Monitoring coordination and to develop among communities. he numerous national • Monitoring system is not well Current status: a deeper sense of ownership Partnerships

on water and sanitation, there sanitation sector strategy

• 5,279 schools with latrines (MOEYS, EMIS 2011) • 1,488 (22%) schools without latrine (MOEYS, EMIS 2011)

ent and coordination 52 See the Fit for School website at: www.fitforschool.ph ation among national agencies National standards: t fully harmonized • Two latrines per 100 students ng procurement committee at • Three urinals per 100 male students 24 ational level to undertake • Three toilets per 100 female students g and monitoring of work in Provision of software

integrated into the review and planning processes

Evaluation No report Mechanism to support maintenance of WASH facilities and programmes REGIONAL ASSESSMENT • No ﬁnancial mechanismPART1: to support the operation and maintenance of WASH interventions in schools

In Indonesia, the National Development Planning Agency, or BAPPENAS, took the lead to establish the Water and Sanitation Network, which involves government line agencies, academic partners, corporate partners, donor agencies and development partners as well as representatives from the media. In Lao PDR, five international development partners established the Lao PDR WASH Technical Working Group in 2007, with the Ministry of Health and the National Center for Environmental Health and Water Supply as members. It is now expanding its membership to include other partners working on WASH, with the goal of integrating all WASH efforts in the country. International development partners also participate in the ongoing revision of the Blue Box (learning material on WASH used in schools) that the Ministry of Education and Sports spearheads. The WASH Technical Working Group in the Philippines was established in 2011 as an advisory group to the Department of Education. It is composed of ten organizations (development partners) and various units from the Department of Education. The formation of the working group led to the Department’s recognition of problems related to WASH and its openness to solutions. The Department of Education has since embraced the initiative and chaired the working group, which has resulted in the highlighting of WASH-related issues in its activities. One recent example is the National Schools Maintenance Week (Brigada Eskwela), during which school officials, parents, community leaders, NGO staff and corporate partners come together to help refurbish schools before classes start at the beginning of a new academic year. The 2012 Brigada Eskwela campaign focused for the first time on improving WASH facilities and promoting hygiene in schools.

C. Government leadership Government agencies are becoming more engaged and are stepping up to take the lead in addressing WASH-related concerns in schools. In Cambodia, the Ministry of Rural Development and the Ministry of Education, Youth and Sport have become increasingly active in WASH activities, such as implementing the Fit for School programme. As noted, the BAPPENAS of Indonesia has taken the lead role in coordinating a multi-sector task force on WASH in schools. In Lao PDR, the Ministry of Education and Sports and the Ministry of Health work hand in hand to implement WASH programmes in schools. In the Philippines, the Department of Education has not only taken an active role but has developed a deeper sense of ownership and commitment to WASH-related programmes. The ability of a government to assume a leadership role and, more importantly, provide inputs and perspectives to development plans ensures that WASH programmes provided by development partners are in line with the overall goals of that government. It also helps ensure that all government investments for WASH are aligned.

D. Developing WASH champions WASH champions, particularly in Cambodia, Indonesia, Lao PDR and the Philippines, who are committed to finding solutions to WASH-related problems not only advance the drive for healthier conditions but also serve as focal persons who create access to the right channels and appropriate authorities. The WASH champions represent not only different sectors (government, business, NGOs and development partners) but the different layers of government agencies (high-ranking ministers and cabinet secretaries and/or undersecretaries, directors and staff) and communities (provincial, district, village). They also help enhance coordination with other line agencies and strengthen cooperation among the many actors.

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VI. Recommendations The main recommendations focus on: i) support to policy development, ii) a collaborative approach to WASH in schools, iii) appropriate and responsive infrastructure, iv) an enhanced data and monitoring system, v) translating awareness into action and sustained behavioural change, vi) evidence-based WASH initiatives, vii) inclusive WASH initiatives and viii) the dynamic role of UNICEF Country Offices.

A. Support to policy development Build up the capacity of local governments to enhance their readiness to implement national WASH policies. Additional capacity building for local leaders is necessary to provide them with an adequate understanding and appreciation of the importance of WASH issues. Although political will at all levels is imperative, the buy-in of local governments is crucial when implementing school interventions. The combination of local ownership of WASH concerns with institutional capacity to act on them at the community level will help usher in responsive, contextualized and sustainable WASH programmes in schools. Develop policies and guidelines to expand budget allocations for WASH activities in schools. There is a need to strengthen policies on national and local budgets allocated for WASH conditions in schools, particularly for the construction, operation and maintenance of water and sanitation facilities. Alternative and sustainable sources of funds for consumables (utility bills, soap) and repair or maintenance of facilities should be established. Special provision on water and electricity rates for school communities may also be helpful. If financing does not come from government resources, other sources have to be developed to pay for the consumables. Sustainable sources of funds for consumables, such as soap, should be developed

Call for stronger advocacy and support for long-term and low-cost sustainable water and sanitation infrastructure in schools. Governments, donor organizations and development partners should be encouraged to prioritize investments in the supply of safe water and low-cost, sustainable sanitation systems in schools. Investments in appropriate and sustainable facilities (waterless or water-saving toilets, for example) as well as other infrastructure (such as roads as a contributory factor) should be encouraged. Donors and development partners should also ensure that WASH initiatives are embedded in their education projects, particularly in school construction projects. Stimulate a more active role of the education ministry. Encourage the education ministry (or its equivalent) in each government to support the improvement and sustainability of WASH programmes and services in schools by making it a strategic goal, particularly in terms of facilitating the collection of data and in recommending guidelines, standards and policies relating to the provision of appropriate water and sanitation facilities.

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B. Collaborative approach to WASH in schools Coordinate among all actors to ensure the efficient delivery of services. As evidenced by existing multi-sector partnerships on WASH activities in schools, the collaborative approach has proven to be effective in addressing WASH-related issues. Clear division of roles and responsibilities, including recognition of who should take the lead, however, is necessary to facilitate coordination among all actors to ensure the sound and timely delivery of services. The education sector has the potent responsibility in coordinating and synchronizing all WASH initiatives in schools to ensure their sustainability and scalability.

The Usaha Kesehatan Sekolah, or School Health Programme, has a dedicated room in schools in Indonesia

There is a need to revive and/or strengthen existing coordinating mechanisms (as in the case of the Usaha Kesehatan Sekolah (UKS), or School Health Programme, in Indonesia) to enable the education ministry (or its equivalent) to assume its crucial role on the delivery, coordination and sustainability of WASH facilities in schools. Encourage the participation of school leaders in promoting WASH programmes. There is a need to highlight the role of school administrators as WASH ‘champions’ or ‘health managers’. Adequate capacity building on school-based health management, which covers planning, monitoring, evaluating and target setting related to WASH, should be provided to school leaders.

School children are tasked to clean toilets at schools in the Philippines

Adopt a child-friendly approach to cleaning WASH facilities. The role of children in maintaining WASH facilities in schools should be revisited. Although it is good to teach children their responsibilities in keeping their environment clean, a child-friendly approach to cleaning toilets should be practised. Cleaning should not be introduced as a form of penalty but as a responsibility. Nonetheless, it would be better to have a hired cleaning source if schools can afford it.

Encourage more private sector partnerships that support sustainability rather than one-time doleout contributions. Corporate social responsibility programmes within the private sector should be aligned with national government strategies and must be anchored on sustainability so as not to create dependency on donors. The impact and sustainability of private initiatives deserves further research.

C. Appropriate and responsive infrastructure Ensure that WASH initiatives in schools are responsive to the local situation. WASH infrastructure needs to be appropriate for any school context (including in areas prone to natural disasters) and to be anchored on usability and sustainability to generate a greater sense of ownership within the school community. Strengthen the mechanism for exchanging information within a country and across communities, between countries and regions.

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D. Enhanced data and monitoring systems Build up the WASH monitoring and evaluation systems. The need for better capacity in managing WASH monitoring and evaluation systems should be addressed. The timeliness, completeness, accuracy of data (including a clear definition and indicators of the ‘functionality’ of WASH facilities and sexdisaggregated data) is important to conduct needs assessment, monitor progress and use evidence for planning and decision-making. Data collection should be cost and time efficient – too many indicators may be futile because they complicate the analysis of the data. Disaggregate the national data (which is important for macro-level planning) to see the actual disparities. Data should be used not only at the national level but most especially within schools for assessing needs, planning and setting targets. Review and simplify the monitoring tools to facilitate more efficient data collection. The UNICEF WASH in Schools Monitoring Package is a good starting point as a monitoring and evaluation toolkit that could help consolidate data across WASH initiatives from donors, government agencies and development partners. For each programme, however, the toolkit needs to be reviewed and simplified to avoid unnecessary questions and to make it more concise and easier for users to understand the indicators and questions. Reach agreement among actors involved in WASH service delivery on the tools and indicators to be used to make data collection, consolidation and analysis more efficient. Development partners should have a consensus on the use of a single monitoring tool. For instance, a large World Bank education project on construction of school buildings could use the UNICEF WASH in Schools Monitoring Package to reduce the burden of collecting and consolidating data at both the national and subnational levels. Conduct an outcome study of the indicators that measure what influences behaviour change. Evaluation reports are practical for supporting any planning process. An evidence-based outcome study that focuses on indicators that measure the effects of WASH activities in influencing behaviour change (attitudes, values, perceptions, knowledge on healthy hygiene habits) among students, families and communities may be relevant to define the impact of adequate WASH facilities in schools. It remains an area that needs further research and development; the Raven’s Test, however, is an example of a cognitive study that could be used.

E. Translating awareness into action and sustained behavioural change Shift the paradigm of WASH as an infrastructure project to WASH as a (learner-centred) behavioural change programme. WASH infrastructure is necessary because it is an enabler; but the end goal is to change WASH practices to improve the hygiene habits of children. WASH needs to be recognized as an education intervention that improves the quality of children’s learning and access to it. Institutionalize the daily practice of WASH activities (handwashing, brushing teeth) in addition to theoretical lessons. Better appreciation and daily practice of WASH activities allows students to transcend simple awareness or knowledge of WASH and fundamentally change their behaviour. Strengthen the convergence of education and health initiatives within donor programmes. There needs to be cross-sector integration between various educational and health initiatives of the government, donors and development partners. WASH should be seen as an integral component affecting access to quality education. It needs to be integrated not only into the academic curriculum but also into other health initiatives, such as deworming and nutrition programmes, to allow WASH habits to become part of all children’s development process (social, psychological and physical development).

PART1: REGIONAL ASSESSMENT

F. Evidence-based WASH initiatives Support and scale up evidence-based WASH initiatives in schools. Promote good practices, innovations or breakthroughs (such as the low-cost Fit for School approach, which uses simple, scalable and sustainable hygiene practices) and evidenced-based programmes and services for the continuous improvement and institutionalizing of WASH facilities and activities in schools. Support global and national initiatives on WASH through networking and knowledge management (such as the celebration of the Global Handwashing Day) and through the coordination with existing national WASH coalitions (such as in Cambodia and Myanmar). Develop advocacy communication strategies for scaling up good practices. Assess how various good practices can match the institutional frameworks and structures within the water and sanitation sector.

G. Inclusive WASH initiatives Expand WASH in schools to include other emerging issues, such as education in disaster-affected communities. Elevate the significance of WASH in emergencies in education planning and financing to strengthen a school’s agility, readiness and capacity to build climate-resilient infrastructure and to function as an evacuation centre in times of emergency. Schools that promote a healthy learning environment for pupils ensure their access to safe water and sanitation facilities and the teachers actively engage them in group handwashing as a daily routine to develop good hygiene habits. Thus, sustained capacity-building efforts and resources must be invested to transform schools into ‘healthpromoting and climate/disaster-resilient schools’. Inclusive WASH initiatives should include: the non-school or non-formal education sector that caters to out-of-school youth and adult learners; people with a disability and special needs; indigenous people who may have different cultural values than a majority population; WASH in waterless or water-scarce communities; WASH in early childhood care and development and secondary education; and menstrual hygiene facilities.

H. Dynamic role of UNICEF Country Offices Leverage the UNICEF ability to serve as a clearinghouse for various WASH innovations in schools. As part of the international community, UNICEF Country Offices are in a position to take up the role of a clearinghouse or a catalyst for WASH innovations from other countries and to share ideas and good practices. The Country Offices are in a position to help the education ministry (or its equivalent) and national partners to contextualize and/or translate resources (such as the monitoring toolkit) that have been developed in other countries. The regular updating and translating of tools should be a function built into Country Office mechanisms.

PART1: REGIONAL ASSESSMENT

PART II COUNTRY PROFILES

Policy frameworks

Provision of hardware (construction, maintenance and sustainability of WASH facilities in schools)

Planning • Management and Coordination mechanisms • Partnerships

Monitoring Evaluation Mechanism to support maintenance of WASH facilities and programmes

Provision of software (human resources, knowledge and capacity of decision-makers and implementers)

Country profile: Brunei Darussalam Financial mechanisms Socio-cultural norms related to water and sanitation

Complementary WASH programmes

Education structure and trends in primary school Figure 3: Brunei Darussalam’s education structure Pre-primary (one year)

Primary (six years)

Secondary (four to five years)

Post-secondary (two years)

Tertiary (two to four years)

Common curriculum (two years)

General secondary education

Applied secondary education

Specialized education

Specialized education needs

Pre-university level

Vocational or technical education

The education system in Brunei Darussalam spans 15–18 years, beginning from pre-school and moving through six years at the primary level and up to the tertiary level. The secondary level can be completed in four to five years, depending on the track that a student opts take.schools The first two years offer the 120 to primary common curriculum to all secondary students, followed by two to three years of a specialized track on general secondary education, applied secondary education, specialized education or specialized Private 40% education needs. Public (MOE) 59% The post-secondary level offers two options that can be completed in two years: i) pre-university that leads to further tertiary education or ii) vocational and technical education in which students acquire technical skills that can be readily applied in the work environment or used as a preparation for further Public (MORA) 1% technical studies. In the tertiary level, students have the option to pursue two-year or four-year diploma 37 primary schools programmes. 14 primary schools

32 primary schools

Brunei Darussalam has a total of 203 primary schools dispersed among its four districts (Brunei Muara, Tutong, Belait and Temburong). Of them, 60 per cent are public schools under the Ministry of Education (MOE), including three Arabic schools under the Ministry of Religious Affairs (MORA); the rest are private schools (table 1 and chart 3). A large concentration, about 60 per cent, of the primary schools is located in Brunei Muara, the smallest but most populous district in the country (figure 4).53

150 Private 36%

100

MOE 62%

50 0 MORA 2%

131

122 81

‘00

‘10 Public

Private

53 Map taken from www.worldatlas.com. Figures are from the Department of Planning, Development and Research of the Ministry of Education, 2010.

PART2: COUNTRY PROFILES

31 Female 48%

Male 52%

(two years)

General secondary education Pre-primary Pre-primary (one year) (one year)

Applied secondary education PrimaryPrimary (six years) (six years)

Specialized Specialized Pre-university Vocational or education Secondary education needs Post-secondary level technical education Secondary Post-secondary TertiaryTertiary five years) (two years) (two to(two four years) (four to(four five to years) (two years) four to years)

Chart 3: Primary schools in Brunei Darussalam, 2010

Figure 4: Primary schools in Brunei Darussalam, by location, 2010

Common curriculum Common curriculum (two years) (two years)

120 primary schools

secondary secondarySpecialized Specialized Specialized Specialized Pre-university Pre-university Vocational Vocational or GeneralGeneral secondary AppliedApplied secondary or education education education education education needs level technical technical education education education education needs level education Private 40% Public (MOE) 59%

Public (MORA) 1%

PrivatePrivate 40% 40%

120 primary schools 120 primary schools 37 primary schools

Public Public (MOE) (MOE) 59% 59%

14 primary schools

32 primary schools

Note: MOE = Ministry of Education; MORA = Ministry of Religious Affairs. Sources: MOE, 2010.

(MORA) Public Public (MORA) 1% 1%

37 primary 37 primary schoolsschools

There has been a minimal increase in the total number of primary schools in the past decade, from 199 14 primary schools schools in 2000 to 203 in 2010. Although, the proportion of government schools14under the MOE and primary schools 150 32 primary schools 32 primary schools MORA slightly declined (7 per cent) in that same time period, the number of private schools increased 131 122 by almost 20 per cent (chart 4). 100 Private 36% MOE 62% 81 68 Chart 4: Primary school enrolment in Chart 5:50Increase in number of primary

Brunei Darussalam, 2010 MORA 2%

schools*0in Brunei Darussalam, ‘10 2000–2010 ‘00 150 150

PrivatePrivate 36% 36%

MOE 62% MOE 62%

Public

131 100 100

131

50 68

MORA MORA 2% 2%

‘00

‘00 PublicPublic

Female 48%

Private 122

122

‘10 ‘10 Private Private

Male 52%

Note: *Includes both pre-primary and primary schools; MOE = Ministry of Education; MORA = Ministry of Religious Affairs. Source: Education Statistics, Brunei Darussalam, Department of Planning Development and Research, Ministry of Education, MOE, 2010.

A total of 44,215 primary school students were enrolled in 2010. Of them, 64 per cent were enrolled in government schools while the rest were in private schools (table 1 and chart 5). There was not much disparity between the numbers of male and female students (chart 6). Male 52% FemaleFemale 48% 48% Male 52% A very small portion, less than 1 per cent, of the total students enrolled in 2010 were repeaters. Of the 181 repeaters, 77 per cent attended private school.54 32 773

30 842

MOE MORA

25 519

MORA

24 093at the pre-primary level. Figures are from the 2010 education statistics, Department of Planning, Development and Research in the MOE. 54 This includes repeaters

32 773 32 773 814

PART2: COUNTRY PROFILES MOE MOE

30 842 30 842 932

Private 36%

Public

MOE 62%

0 MORA 2%

‘00

Chart 6: Enrolment in Brunei Darussalam, by sex, 2010

Female 48%

Male 52%

Female 48%

Male 52%

Private

‘10 Public

Private

Source: Education Statistics, Brunei Darussalam, Department of Planning Development and Research, Ministry of Education, MOE, 2010.

Along with a decline in the number of government primary schools was a slight decline in total enrolment in government schools from 2000 to 2010, at 6.9 per cent in public school and 5.9 per cent in private school. On the other hand, despite the 20 per cent increase in the number of private primary 32 773 MOE 30 8427). schools, enrolment increased by only 6 per cent during the same period (chart

MORA

Chart 7: Primary school enrolment trends* in Brunei Darussalam, 2000–2010 24 093 32 773

25 519

MORA

30 842

MOE MORA

814 24 093

25932 519

Y 2000

Y 2005

814

MORA

Y 2010 932

Basic education

Y 2005 Y 2010 Technical / vocational (one to three years) Higher / tertiary education Pre-school Primary Lower secondary Note: *years) = Includes both Religious (atofleast twoAffairs. years) (three (sixpre-primary years) and primary (threeenrolment; years) MOE = Ministry of Education; MORA = Ministry Upper secondary Source: Education Statistics, Brunei Darussalam, Department of Planning Development and Research, Ministry of Education, MOE, 2010. Basic education (three years) Y 2000

Technical / vocational

RationalePrimary for WASH activities(oneintoschools three years) Pre-school Lower secondary

Higher / tertiary education 55 years) (three years) (six years) (three (at leastper two1,000 years) According to the 2010 WHO report, the country has 437 cases of diarrhoeal disease people Upper secondary every year. According to a study jointly conducted by the Department of Schools in the Ministry of (three years) 56 Education and the Ministry of Health in November 2010:

• There were recent outbreaks of diarrhoea and infectious diseases, such as H1N1, bird flu and hand, foot and mouth disease. • Only 41 per cent of schoolchildren washed their hands after using the toilet; many forget to wash their hands, thus health education needs to be reinforced in school.

55 WHO, 2010. 56 Brunei Times, 2010.

PART2: COUNTRY PROFILES

Enabling environment Enabling factors in the country include: • The Government embraces the national hygiene and sanitation strategy; one example of such support is the free connection to existing sewerage system offered to households using on-site septic tanks. • Through its Strategic Plan 2007–2011, the MOE committed to improving its responsiveness to the individual needs of students as part of its strategic objectives to enhance the learning environment and culture. The Health Promotion Unit under the MOE reported that all primary schools in the country are equipped with WASH facilities. About US$70,000 of the annual national budget for education was allocated for capital expenditures to support WASH projects in schools. From 2006 until 2011, a total of 90 school construction projects (such as improved water sources and toilets) were facilitated.

WASH in schools National school water and sanitation coverage

All primary schools in the country are equipped with WASH facilities

Water source common to schools

Sanitation facilities common to schools

Hygiene education and water values

• Water-use ethics and sanitation to be included in lesson plans56 • Hygiene behaviour is effectively included in curricula • Capacity-building programme for teachers on developing valuesbased lesson plans57

Initiatives to support WASH activities in schools

• As a result of the capacity-building programme, teachers were required to prepare an assessment report, based on their observations of students’ attitudes towards the use of water58 • Term contract system for maintenance of school toilets59 • Cleanliness, Comfort and Safety Awareness Award • Guidelines on School Toilet Usage

Note: NA = Information not available.

Main challenges The main challenge in Brunei Darussalam is the lack of sufficiently skilled and experienced human resources. Within the institutional framework, little importance is given to sanitation by the local government, and thus facilities are poorly operated and maintained.61 More specifically, the study conducted by the Ministry of Education and the Ministry of Health revealed that government primary schools face the following challenges:62 • poor maintenance of hygiene facilities and supplies (soap dispensers were kept empty, paper towels for hand drying were not provided and hand dryers were out of order); • lack of handwashing facilities, such as wash basins and hand dryers; • poorly located wash basins for students to wash their hands before and after meals; 57 Brunei Times, 2007. 58 Ibid. 59 Ibid. 60 Brunei Times, 2007. 61 WHO, 2010. 62 Brunei Times, 2007.

PART2: COUNTRY PROFILES

Female 48%

Male 52%

• high cost of soap; • lack of awareness on proper hygiene among students. Insufficient awareness in terms of supervising and monitoring was cited by the Health Promotion Unit of the MOE as its main impediment.

Partners Brunei Darussalam’s WASH partners encompass: 32 773 • Health Promotion Unit, Department of Schools, Ministry of Education 30 842 • Ministry of Health

MOE MORA

25 519

24 093

MORA

Country profile: Kingdom of Cambodia 814

932

Y 2005 Y 2010 Y 2000 Education structure and trends in primary school

Figure 5: Cambodia’s education structure Basic education

Pre-school (three years)

Primary (six years)

Lower secondary (three years)

Technical / vocational (one to three years) Upper secondary (three years)

Higher / tertiary education (at least two years)

Although not obligatory, children in Cambodia may begin school at age 3 within the pre-school system, which lasts three years. Compulsory or basic education begins at age 6 and spans nine years of primary and lower secondary school. As in most countries in South-East Asia, primary education lasts six years and is the first stage of basic education. The secondary education is split into two levels: lower and upper secondary. The lower secondary, spanning three years, forms the second stage of basic education. The basic education diploma is awarded to students who pass the national examination administered upon completion of lower secondary education. After completion of lower secondary school, students may opt to pursue upper secondary school, which leads to the baccalaureate or high school diploma, or enrol in technical and vocational programmes. Students who complete three years of technical and vocational programmes are also awarded a certificate equivalent to the baccalaureate. Higher or tertiary education consists of at least two years (associate degree) and may last up to eight years (bachelor’s degree), depending on the programme. Cambodia has a total of 6,767 primary schools. Of them, 90 per cent are located in rural areas (table 6 and chart 8). Close to 67 per cent of the primary schools are considered child-friendly schools.63

63 Data provided by the Ministry of Rural Development.

PART2: COUNTRY PROFILES

Table 6: Primary schools and student enrolment, by location, 2010 Urban

Rural

Total

# of schools

Student enrolment

# of schools

Student enrolment

# of schools

Student enrolment

652

334 772

6 115

1 856 420

6 767

2 191 192

Cambodia

Source: MOEYS, Education Statistics Indicators 2010–2011.

Chart 8: Primary school enrolment in Cambodia, by location, 2010

Chart 9: Primary schools in Cambodia, by location, 2010

Urban 15%

Urban 10% Rural 85%

Rural 90%

Sources: Cambodia MOEYS, Education Statistics Indicators 2010–2011

Urban 10%

Urban 15%

Given that a huge proportion of the primary schools are located in rural areas, student enrolment is likewise greater in this area, at 85 per cent of the total enrolment in primary schools (chart 9).

85%

Rural 90%

Percent Rural 85%350,000

Number

14%

12% 300,000 In terms of sex, male student enrolment remains higher than females, although there is not much 10% 250,000 disparity between the two (chart 10).

Female 48%

Male 52%

6% Chart 10: Repeaters as a percentage of total primary school enrolment in Cambodia 4% 2%

200,000 150,000 Chart 11: Enrolment in Cambodia, 100,000 by sex, 2010 50,000

12%

0% 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 350,000 Academic Yr 300,000

10%

250,000

200,000

Number

14%

6% 4% 2% 0%

90% 80% 70%

Percent

Female 48%

0 14% 12% 10%

Male 52%

8% 6%

150,000

81%

100,000

67% 61%

56% 2005/06 60% 2006/07 2007/08 2008/09 2009/10 2010/11 Academic Yr

50,000 0

Water source

4% 2%

Sanitation facilities

2005/06 2006/

50%

40% MOEYS, Education statistics Indicators 2005–2010. Sources: Cambodia 29%

% 67%

rban

56%

30% South-East Asia averages 18% academic From the20% 2005/2006 academic year to the 2010/2011 year, an average of 10 per cent of the Total Urban Rural total primary school enrolment per year repeated. The proportion of student repeaters has trended 90% 81% Water 82.30% 89.5% 76.3% 10% Water source downward, from 13 per cent in the 2005/2006 academic year to just 7 per in the 2010/2011 academic 80%cent Sanitation 70.1% 84.4% 58.2% 0% year (chart 11 and table 7). 67% Sanitation facilities 70% Total Urban Rural 60%

61%

Sa 56%

50% 40% South-East Asia averages Basic education 18% Total Urban Rural Water 82.30% 89.5% 76.3% SanitationPrimary school 70.1% 84.4% Junior58.2% high school 36 Pre-school (sekolah menengah (sekolah dasar) Rural (pendidikan anak usia dini)

(six years)

pertama) (three years)

29%

30% 20%

18%

Senior 10% high school (sekolah menengah atas) 0%

University

Senior high school

Vocational

PART2: COUNTRY PROFILES Total Urban

South-Ea

Water Sanitatio Rural

Table 7: Number of repeaters in primary school in Cambodia, 2005–2010 academic years 2006/07 Academic Year

2007/08 Academic Year

2008/09 Urban 10% Academic Year

2009/10 Academic Year

2010/11 Academic Year

326 255 Rural 85%287 882

262 191

232 463

200 985

158 287

2 311 107

2 262 833

2 240 651

2 191 192

Urban 15% 2005/06

Academic Year

Repeaters

2 558 467

Total enrolment

2461135

Rural 90%

Source: Cambodia MOEYS, Education statistics indicators 2005–2010.

Rationale for WASH activities in schools The following points provide the rationale for WASH activities in schools: • Only 56 per cent of the population in rural of the primary schools are Number Percent 14% areas, where 90 per cent 350,000 located, has access to a safe/improved water source (table 2 and chart 12). 12%

300,000

150,000

100,000

50,000

• Cambodia has the lowest adequate sanitation coverage among the South-East Asian countries, 10% 250,000 Female 48%only 29 per cent with its total population, 67 per cent of its urban population and 18 per cent of Maleof52% 8% 200,000 its rural population having access to adequate/improved sanitation facilities (table 2 and chart 12). • A large proportion of the population, 64 per cent, still defecates in the open (table 3).

• The annual incidence rate of diarrhoeal disease in the country is 492 per 1,000 people (chart 1).

• The proportion of children entering the first 0%grade who eventually reach the last grade in primary 0 2005/06 2006/07 2007/08 2008/09 (table 2009/10 5). 2010/11 school is at 54 per cent, the lowest among the South-East Asian countries Academic Yr

Chart 12: Proportion of the population with access to a safe/improved water source and adequate/improved sanitation facilities in Cambodia, 2008 90% 80% 70% 60%

Water source

81% 67% 61%

Sanitation facilities 56%

50% 40% 30% 20%

29% 18%

10% 0% Total

Urban

South-East Asia averages Total Urban Water 82.30% 89.5% Sanitation 70.1% 84.4%

Rural 76.3% 58.2%

Rural

Source: UNICEF, State of the World’s Children, 2011.

Enabling environment Basic education The Ministry of Education, Youth and Sports (MOEYS) is engaged in developing child-friendly schools, Senior high school based on the UNICEF model. The approach includes investing in water and sanitationUniversity facilities as a (sekolah menengah atas) Junior high school Primary school Pre-school means to promote school safety and healthy behaviour among children. As of the 2010/2011 academic (sekolah menengah (sekolah dasar) (pendidikan year, slightly 66 per centpertama) of primary child-friendly.64 (threeschools years) were considered (six years) anak usia dini) more than Vocational Senior high school training (sekolah menengah kejuruan)

64 Ministry of Rural Development, referencing the EMIS 2010–2011.

Urban 13% PART2: COUNTRY PROFILES

Private 9%

Complementing the child-friendly school initiative is the Policy on School Health65 that outlines strategies and approaches to promoting good health in school.The policy manual provides guidelines on integrating hygiene and sanitation lessons or messaging in different communication formats (textbooks and information materials, such as billboards, posters and newsletters); improving the learning environment by including facilities for hygiene and sanitation practices of students; and expanding the involvement of government ministries and institutions, development partners, the private sector and civil society in improving hygiene and sanitation practices and facilities in schools. At the national level, the Cambodia Millennium Development Goals specifically target commitment to providing access to safe drinking water and improved sanitation under Goal 7: Ensure environmental sustainability: • Overall target 14: Halve by 2015 the proportion of people without sustainable access to safe drinking water –– Target 7.10: Increase the proportion of the rural population with access to a safe water source, from 24 per cent in 1998 to 50 per cent by 2015 –– Target 7.11: Increase the proportion of the urban population with access to a safe water source, from 60 per cent in 1998 to 80 per cent in 2015. • Overall target 15: Halve by 2015 the proportion of people without sustainable access to improved sanitation –– Target 7.12: Increase the proportion of the rural population with access to improved sanitation, from 8.6 per cent in 1996 to 30 per cent in 2015 –– Target 7.13: Increase the proportion of the urban population with access to improved sanitation, from 49 per cent in 1998 to 74 per cent in 2015. In line with the Cambodian MDGs, the Rural Water Supply and Sanitation Investment Plan for 2005–2015 and the National Strategy on Rural Water Supply, Sanitation and Hygiene for 2010–2015 were developed to guide the financing requirements and expected levels of coverage. The following additional policies, strategic plans and initiatives were instituted to help achieve the Government’s goals: • National Policy on Water Supply and Sanitation • National Drinking Water Quality Standards • National Water Resources Policy • Law on Water Resources Management • National Policy on Urban Sanitation (2003) • Establishment of Child-Friendly Schools • Establishment of the Cambodia WASH Initiative • Sub-Degree No. 25 ANK, which indicates school hygiene as the responsibility of the MOEYS (1992) • Joint Prakas No. 0396/09, which establishes the School and Community Water, Sanitation and Hygiene Committee (2009) • Sub-Degree No. 21 ANKPK and Prakas No. 482 OYKPK, which clarify the role of the Department of School Health (1998). The national policies provide the ‘backbone’ to support the MOEY efforts in promoting good health in schools, particularly in terms of investing in adequate water sources and sanitation facilities, especially in the rural areas. International development agencies (see the list in the section on partners) support Cambodia’s WASH programmes.

65 See Annex 4 for details on Cambodia’s Policy on School Health.

PART2: COUNTRY PROFILES

WASH in schools National school water and sanitation coverage

• 78% of public primary schools have latrines

Water source common to schools

• Well/pump, pond, river/lake, taps

• About half of the total number of primary schools do not have handwashing facilities • Safe water for more than 41,000 school children provided through wells constructed in 131 schools in 200665

Sanitation facilities common to schools

• Flush toilets • Latrine blocks were constructed in 137 primary schools and 304 community pre-schools in 200666 • Primary schools without access to latrines are mostly school annexes

Hygiene education and water values

• Social science classes • Two-hour physical and health education per week (2006) and two-hour life skills education programme per week • Hygiene behaviour is not carried out effectively in school curricula67

Initiatives to support WASH activities in schools

• Capacity building on operations and maintenance for school directors and teachers • School-Led Total Sanitation Programme (2007, based on the CLTS model) • Focusing Resources on Effective School Health (FRESH) • Bright Smile, Bright Future (with the private sector) • School and Community Water, Sanitation and Hygiene Committee, 2009 • Child-friendly schools

Main challenges666768 Despite the numerous government policies and initiatives, the following constraints were cited in the 2010 WHO report:69 • The lack of sound sanitation sector strategy and coordination among national agencies tops the country’s challenges. • There is a lack of sufficient funding and financial mechanisms to support the construction, operation and maintenance of infrastructure. • Cambodia’s monitoring system is not well integrated into the review and planning processes. • There is a lack of human capacity to plan, coordinate and implement WASH interventions in schools as well as in communities, even at the provincial and district levels. • The lack of operation and maintenance of water sources that were built on school premises has also cut off school access to a clean water supply. The country study validates the issues and concerns cited in the 2010 WHO report. The coordinating mechanism for national agencies as well as within the MOEYS, particularly in terms of monitoring, is quite fragmented. For instance, the Ministry of Rural Development (MRD) conducts the Knowledge, Attitude and Practice (KAP) Survey as a monitoring and evaluation tool. The survey, however, is not coordinated with other ministries, and the results are generally used by the MRD only. Additionally, the monitoring system within the MOEYS is not fully coordinated among its departments; the data collected by the District Training and Monitoring Team, for example, is used by the Department of Primary Education but not by the School Health Department, which conducts its own evaluations on selected schools. 66 ‘The WASH in Schools Situation across the East Asia Pacific Region: A Preliminary Look’, at: www.scribd.com/doc/26863880/The-WASH-in-SchoolsSituation-Across-the-EAP-Region-a-Preliminary-Look 67 Ibid. 68 WHO, 2010. 69 Ibid.

PART2: COUNTRY PROFILES

There is no budget specifically allocated for WASH programmes in schools. The Government allocates US$2 per student every year for all school expenses. Of this budget, US$0.40 is allotted for overall maintenance costs. Given this, schools cannot follow the prescribed standards due to the budgetary constraints.

An improvised handwashing facility in a school in Cambodia – the students wash their hands with soap in the basin and use the same water for rinsing

The standards prescribe having three toilets per 100 female students and three urinals per 100 male students in each school. All schools must have a water source and handwashing facilities. Not all rural schools have WASH facilities because some areas do not have a water source. In some rural schools, toilets were installed but they are not useable because there is no water. Some schools have handwashing facilities but do not follow the standards and appropriate practice – students wash their hands in a basin and use the same water for rinsing.

When school buildings are built through donor funds, standards are not necessarily followed. The donors can design and create any kind of facility. It is not monitored by the MOEYS because there is no regulation covering WASH in schools. The School and Community Water, Sanitation and Hygiene Committee guidelines only refers to working together, coordination and roles and responsibilities but does not include specifications on construction and materials. Donor support also mostly comes in the form of scholarships and/or school building A handwashing facility in a school in Cambodia – the design (height) construction. In the case of construction, it requires students to squat or bend down to wash their hands was difficult to determine what amount has been directed towards WASH facilities because the funds are generally provided for the whole school building. Also, donor support only covers the construction of facilities and excludes the maintenance of them, which should be undertaken by the Government, the school or the community. Schools that do not have a good relationship with the community tend to not receive much donor support. That relationship is an important factor in determining the support from community officials. Given the meagre salaries of community officials, there is not enough incentive for them to be motivated and committed to participate in WASH programmes or projects;70 the village chief receives the equivalent of US$10 per month while the commune chief receives the equivalent of US$20 per month in salary – hardly commensurate to the amount of work they perform. Staffing concerns also slow down the MOEYS in performing monitoring activities. The small number of EMIS staff within the MOEYS (a total of 15 at the national level, including administrative staff and two to three statisticians) cannot cope with the demands of the monitoring tasks. Capacity building, particularly on monitoring and evaluation, is needed to improve the knowledge and skills of the staff. School directors also need to improve their finesse with generating resources.

70 Community officials are stakeholders in the school community WASH programmes and projects, particularly with the construction and maintenance of water sources and toilets. For instance, when a school water source or toilet is damaged, the repair often is done by community officials.

PART2: COUNTRY PROFILES

There have been particular problems on data related to the child-friendly schools. The collected data are not reliable because some schools do not even know what is a child-friendly school or some schools claiming to be child friendly were not complying with the standards when visited for monitoring purposes. UNICEF has determined other issues as well: • There is no existing procurement committee at subnational level to undertake tendering and monitoring of works. This slows down the work that needs to be done in schools because decision-making is done centrally. • The budget to support schools in the renovation of WASH facilities is insufficient. Only 3 per cent of the Government’s programme budget goes to WASH interventions. • The Provincial Department of Rural Development and the Provincial Office of Education have a number of capacity and institutional weaknesses, including a poor compliance, understanding and enforcement of the national strategies, policies and approaches to supporting school WASH activities. • There is weak capacity and poor commitment at all levels to plan, coordinate and implement WASH interventions in schools and communities. • Engagement of local governance (commune councils) on school WASH issues is inadequate. This is seen as a responsibility of schools and directors and not the community or local government. • Opportunities to better coordinate with NGOs and other development partners at the provincial level are not optimized. In provinces where annual operational plans have been done for SCWASH, it is noted that significant resources are being invested by NGOs and other partners in a non-coordinated fashion. Given the above-mentioned issues and challenges, the following suggestions were offered by the key informants during the country study: • There is a need to revisit the guidelines on school health programmes and hygiene promotion, which was instituted in 1992. The review should be a collaboration among the MOEYS, the Ministry of Rural Development and the Ministry of Health. • The community should be engaged in improving the monitoring of WASH conditions in schools. • The MOEYS should conduct benchmarking of model schools found in other countries, and the MOEYS should also develop one model school in each district using the Fit for School concept. • Financial support from the Government and donor partners should be made available to ensure the availability of hygiene materials as well as good-hygiene promoting materials.

Partners Cambodia’s WASH partners encompass: • Department of Rural Health Care within the Ministry of Rural Development • Ministry of Education, Youth and Sport • International development agencies, such as UNICEF, World Vision Cambodia, Borda Cambodia, the World Bank, the United Kingdom Department for International Development (DFID), the International Development Enterprises, Lien AID, the Swedish International Development Cooperation Agency (SIDA), Save the Children Norway and the Kampuchean Action for Primary Education • Other government departments concerned with youth, education and rural development

PART2: COUNTRY PROFILES

Supporting Multi-level Advocacy Formalised Intersectoral Collaboration Contributing to Broad Development Agenda

Figure 6: Service delivery assessment highlights for Cambodia Cambodia

DEVELOPING SERVICES

SUSTAINING SERVICES

SERVICE DELIVERY PATHWAY Policy frameworks

Management and coordination

Partnerships

Financial mechanisms

Policy frameworks • Despite the numerous national policies on water and sanitation, there is still no sanitation sector strategy Planning Management and coordination • Coordination among national agencies is not yet fully harmonized • No existing procurement committee at the subnational level to undertake tendering and monitoring of work in progress • Capacity and institutional weaknesses, such as poor compliance, understanding and enforcement of national strategies, policies and approaches to support WASH activities in schools Partnerships • Opportunities to better coordinate with NGOs and other development partners at the provincial level are not optimized Financial mechanisms • Lack of sufficient funding and financial mechanisms to support the construction, operation and maintenance of infrastructure • Insufﬁcient budget to support schools in the renovation of WASH facilities

Social norms

Hardware

Software

Provision of hardware Current status: • 5,279 schools with latrines (MOEYS, EMIS 2011) • 1,488 (22%) schools without latrine (MOEYS, EMIS 2011) National standards: • Two latrines per 100 students • Three urinals per 100 male students • Three toilets per 100 female students Provision of software • Lack of human capacity, especially at the provincial and district levels • Inadequate skills on the operation and maintenance of water sources

WASH programmes

Monitoring

Evaluation

Maintenance

Behavioural change

WASH in schools

ENABLING SERVICES

Monitoring • Monitoring system is not well integrated into the review and planning processes Evaluation No report Mechanism to support maintenance of WASH facilities and programmes • No ﬁnancial mechanism to support the operation and maintenance of WASH interventions in schools

Complementary WASH programmes • Focusing Resources on Effective School Health (FRESH) • Bright Smile, Bright Future (with the private sector) • School and Community Water, Sanitation and Hygiene (since 2009) • School-Led Total Sanitation Programme (since 2007)

Values and socio-cultural norms related to water and sanitation • Weak capacity and poor commitment at all levels to plan, coordinate and implement WASH interventions in schools and communities (district and school levels) • Engagement of local governance (commune councils) on school WASH issues is inadequate

Sufficient and working enabling factor Some work already being done but not fully sufficient More work needs to be done

Indonesia

DEVELOPING SERVICES SERVICE DELIVERY PATHWAY

SUSTAINING SERVICES PART2: COUNTRY PROFILES nge

ols

42 ENABLING SERVICES

80% 70% 60%

67% 61%

Sanitation facilities 56% Number

14%

50%

Country profile: Republic of Indonesia 40%

12%

29%

Female30% 48%

10%

Male 52%

20%

Percent

South-East Asia averages Total Urban Water 82.30% 89.5% Sanitation 70.1% 84.4%

18% 8% 6%

10% 0%

Total

Urban

300,000 250,000 200,000

Rural 76.3% 150,000 58.2% 100,000

2% Rural

50,000

Education structure and trends in primary school 0%

Figure 7: Indonesia’s education structure

350,000

2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 Academic Yr

Basic education

90%

Pre-school 80% (pendidikan anak usia dini) 70%

60%

81%

Primary school (sekolah dasar) (six years)

61%

Junior high school (sekolah menengah 67% pertama) (three years) 56%

Senior high school Watermenengah source atas) (sekolah

University

Sanitation facilities Senior high school (sekolah menengah kejuruan)

Vocational training

50% Pendidikan anak usia dinior (pre-school) is not compulsory in Indonesia. Compulsory education in the 40% 29% dasar (primary school) and sekolah menengah pertama (junior high school). country consists of sekolah 30% South-East Asiaschool averages Upon completion of junior high school, students may senior high through either sekolah 18% pursue 20% Total Urban Rural menenga atas (SMA) or sekolah menengah kejuruan (SMK). The SMA functions as a preparatory Water 82.30% 89.5% 76.3% 10% ground for students who want to continue their education through a university or college, while the 70.1%Private 84.4% 58.2% 13% education to studentsSanitation 9% after 0% vocationalUrban SMK provides or technical who want to work immediately senior Total Urban Rural high school.

Rural 87%

Public 91%

While most primary schools are under the Ministry of Education and Culture (MOEC), 13 per cent are Madrasah Ibtidaiyah under the Ministry of Religious Affairs,71 in which the curricula focus on Arabic and Islam studies. Basic education In 2011, there were 143,252 primary schools in the country under the MOEC.72 Of them, only 9 per cent school were private schools, and only 13 per cent were located in urban Senior areas high (table 1 and charts 13 and 14). University (sekolah menengah atas) Junior high school Primary school Pre-school (sekolah menengah (sekolah dasar) (pendidikan The sex-disaggregated gross enrolment ratio for 2005–2009 indicated that males outnumbered females pertama) (three years) (six years) anak usia dini) Vocational Senior high school by three percentage points – 121 per cent boys and 118 per cent menengah girls (table 5). Additionally, female training (sekolah kejuruan) Water source 100% 89% students were more likely to drop out of school than male students. In primary school, six of ten students 80% girls.73 who dropped out were Sanitation facilities

80%

67%

71%

Chart 13: schools in Indonesia, 60% Primary 52% by location, 2011 40%

Chart 14: Primary schools in Indonesia, 2011

36%

Urban 13%

20% Rural 87% 0% Urban

Total

Sources: MOEC, 2011.

Private 9% South-East Asia averages Total Urban Rural Water 82.3% 89.5% 76.3% Public 91% Sanitation 70.1% 84.4% 58.2%

Rural

Basic education

100% 89% 71 Figure based on 2006/2007 data sourced from UNESCO-IBE, 2011.

Primary Lower secondary Pre-school (five years) (four years) (three years) 80% 73 UNICEF, ‘Fact 80%Sheet: Girls’ Education in Indonesia’, undated. 71% 67%

General upper secondary Water source (three years)

Higher / tertiary education Sanitation facilities (at least three years) Secondary vocational (three years)

72 As reported by the National Office of Education Research and Development, MOEC.

60% 52% PART2: COUNTRY PROFILES 40%

43 36%

Basic education Senior high school (sekolah menengah atas)

University

Senior high school Rationale for WASH activities in schools (sekolah menengah kejuruan)

Vocational training

Pre-school (pendidikan anak usia dini)

Junior high school (sekolah menengah pertama) (three years)

Primary school (sekolah dasar) (six years)

The following points outline the rationale for WASH activities in schools in Indonesia: • Although Indonesia has a large proportion of population with access to a safe/improved water source, both in urban and rural areas, only a little more than half (52 per cent) of the total population has access to adequate/improved sanitation facilities (table 2 and chart 15). • Access to adequate/improved sanitation facilities in the rural areas remains significantly minimal (chart 15). Urban 13% Private 9% • Only 67 per cent of the urban population has access to adequate/improved sanitation facilities (chart Rural15). 87%This represents the smallest proportion in the region, tied with Cambodia (table 2).

Public 91%

• The proportion of the total population that continues to defecate in the open remains at 26 per cent (table 3). • About 400 of every 1,000 people suffer from diarrhoeal disease each year (chart 1).

Chart 15: Proportion of population with access to a safe/improved water source and adequate/improved sanitation facilities in Indonesia, 2008 100% 80% 60%

Water source

89% 80% 67%

Sanitation facilities

71%

52%

40%

36%

South-East Asia averages Total Urban Water 82.3% 89.5% Sanitation 70.1% 84.4%

20% 0% Total

Urban

Rural 76.3% 58.2%

Rural

Source: UNICEF, State of the World’s Children, 2011.

Basic education

Enabling environment

General upper secondary

The government budget for education, amounting to 20 per centyears) of the total national budget, allows the (three Higher / tertiary Primary Pre-school opportunity to provide adequate Lower water secondary and sanitation facilities to all schools. In addition, schools can education (five years) (four years) (three years) (at least three years) Secondary vocational tap the BOS (School Operational Assistance) Fund to finance their WASH needs. The BOS Fund, which (three years) amounts to approximately US$60 (580,000 rupiahs) per student for each year, is available for nonpersonnel school operational expenditures. The MOEC Regulation No. 57/2004 also provides Grants for Healthy School. The MOEC Healthy School Environment programme stipulates standards for clean water and sanitation.

Water source

100%

The National Mid-Term Plan 2010–2014 86% underscores the government’s efforts to promote open 90% defecation-free society and the practice of 3Rs (reduce, reuse, recycle) to lessen incidence of flooding. Sanitation facilities 80% 72% This is also in line with the national strategy for community-based total sanitation (CBTS) developed 70% by the Ministry of Health. The Government supports the advocacy and capacity building on sanitation 57% 60% improvement in schools53% through the SANIMAS-BES 51% programme.

50% 40% 30% 20% 10% 0%

38%

South-East Asia averages Total Urban Water 82.3% 89.5% Sanitation 70.1% 84.4% Total

Urban

Rural

Rural 76.3% 58.2%

PART2: COUNTRY PROFILES

The Ministry of Education and Culture (formerly the Ministry of National Education), the Ministry of Health, the Ministry of Home Affairs and the Ministry of Religious Affairs jointly established the Usaha Kesehatan Sekolah (UKS), or School Health Programme, in 1984. International development organizations and foundations are quite active in WASH programmes in Indonesia: • Dubai Cares, UNICEF, CARE International and Save the Children collaborate to support the Water, Sanitation and Hygiene in Support of School Empowerment (WISE) programme in the country. Under the programme, sanitation, handwashing and water facilities were constructed in 450 schools, benefitting 90,000 children. Capacity-building programmes were offered for teachers and community representatives on the delivery of hygiene education. • Since the disasters caused by the tsunami in 2004 and earthquake in 2005, UNICEF has supported WASH projects in schools, such as school hygiene promotion and education, construction of sanitation and handwashing facilities and teacher/facilitator training.

WASH in schools National school water and sanitation coverage

Water source common to schools

Sanitation facilities common to schools

Hygiene education and water values

Life skills

Initiatives to support WASH activities in schools

• Establishment of the Usaha Kesehatan Sekolah (UKS), or School Health Programme (1984) • WISE programme • Project Dokter Kecil, or Little Doctors, promotes good hygiene through community theatres; children in grades 4–6 stage plays about the importance of proper handwashing • Jum’at Bersih, or Clean Friday, is another student-led project that promotes proper handwashing during the weekly Islamic holy day • SANIMAS-BES programme, which addresses sanitation facilities and related capacity building for schools

Note: NA = Information not available.

Main challenges The 2010 WHO report74 cited the following constraints in Indonesia: • The national monitoring system is not well coordinated, thus enabling conflicting streams of information. Hygiene education is not well managed. • There is difficulty in promoting and supporting community participation, especially in rural areas. • Although there is a national strategy for CBTS, a good guideline for sanitation improvement is lacking. Local government units also show little interest in improving sanitation facilities. • Funding and financial mechanisms are not sufficient enough to support the construction and proper operation and maintenance of water and sanitation facilities. • Lack of community awareness and education on healthy hygiene and sanitation behaviour tops the country’s challenges related to sanitation improvement.

74 WHO, 2010.

PART2: COUNTRY PROFILES

The country study indicates that weak coordination among government line agencies posts the biggest challenge in implementing WASH interventions in schools. WASH efforts exist in a fragmented and disharmonized manner. As part of the UKS, for instance, the Ministry of Health implements sanitation programmes in both communities and schools, while the Ministry of Home Affairs asks local governments to allocate funds for the education and health sectors but does not directly implement WASH programmes in schools. The Ministry of Religious Affairs has responsibility for the madrasahs (Muslim educational institutions) only. There is no common school health plan among the four partner ministries. None of the agencies appears to be taking the lead to coordinate WASH efforts. The absence of guidelines on the roles and responsibilities of participating agencies results in a lack of cooperation and hinders the efficient implementation of WASH interventions in schools. The MOEC should take the lead in school health programmes, including WASH. The MOEC has the financial resources to take on this role but it needs to strengthen its personnel capacity (skills and know-how related to WASH) to do so. Nonetheless, the National Development Planning Agency, or BAPPENAS, is taking the lead in designing a school sanitation road map in cooperation with other line agencies, including donors and development partners. The road map consists of programmes to strengthen advocacy, waste management and facility construction. Guidelines for sanitation improvement are also lacking. There are no formal guidelines (such as a Ministry Decree) for WASH in schools. There is a need to highlight good health and proper sanitation practices within the basic education curriculum. Teaching sanitation is a good investment for school children. It is especially beneficial in addressing the lack of community awareness and education on proper hygiene and sanitation practice. In some areas, however, it has been difficult to promote and encourage community participation due to cultural beliefs. For instance, some communities believe that is not good to defecate in just one place because the collected waste is a potential source of disease – but they believe it is best to spread the waste so that diseases will not converge in the one area. Some people think that it is better to drink water straight from the river because water that has touched a metal surface is not good for health. Because sanitation is not part of the health education curriculum, hygiene education is not carried out well. If students are educated on the importance of proper hygiene and sanitation, they can function as change agents in their family and community. There is also a need to strengthen the skills of district education officials in managing school health-related programmes. The difficulty in monitoring is another concern that may have been brought about by the weak coordination among national agencies. As noted, the monitoring system thus generates conflicting information. The fiscal decentralization in 2001 also contributed to challenges in data collection; there is no consolidated data on WASH conditions in schools at the district, provincial and national levels. Monitoring data derives from several partner organizations working on WASH. Even though there was a proposal to have the district Office of Education collect data from schools, WASH data is not yet collected because it is not regarded as a priority in the same vein as classrooms, chairs, books and other learning materials. According to UNICEF data, primary schools in Indonesia have more than 250,000 toilets. Of them, only 58 per cent are in good condition, 19 per cent are slightly damaged and 21 per cent are heavily damaged. And 2 per cent of them is not part of school property.

Partners Indonesia’s WASH partners encompass: • Ministry of Education and Culture • Ministry of Health • Ministry of Resettlement and Regional Infrastructure (especially after the tsunami and earthquake in 2004 and 2005) • International development agencies and foundations, such as UNICEF, United Nations Environment Programme, the World Food Programme, CARE International, Save the Children and Dubai Cares • Communities

PART2: COUNTRY PROFILES

More work needs to be done

Figure 8: Service delivery assessment highlights from Indonesia Indonesia

DEVELOPING SERVICES

SUSTAINING SERVICES

SERVICE DELIVERY PATHWAY Policy frameworks

Management and coordination

Partnerships

Financial mechanisms

Social norms

Hardware

Software

Policy frameworks • A good guideline for sanitation improvement is lacking • There are no formal guidelines for implementing WASH activities in schools (such as a Ministerial Decree)

Provision of hardware Current status: No information

Planning Management and coordination • Until recently, no agency took the lead to coordinate WASH efforts in schools; in 2012, the National Development Planning Agency began addressing WASH issues in schools

Provision of software • Insufficient capacity at the district level to manage health-related programmes in schools

Partnerships • Approach to the issue is in a fragmented or sporadic manner Financial mechanisms • Funds and financial mechanisms are not adequate to support the construction of facilities in schools, although the Government allocates 20% of its national budget for the education sector

National Standards: No information

Complementary WASH programmes • Water, Sanitation and Hygiene in Support of School Empowerment (WISE) • Project Dokter Kecil, or Little Doctors, is promoting good hygiene through community theatre • Jum’at Bersih, or Clean Friday, is a student-led project that promotes proper handwashing during weekly Islamic holy day • Health and sanitation are not integrated into the basic education curriculum

WASH programmes

Monitoring

Evaluation

Maintenance

Behavioural change

WASH in schools

ENABLING SERVICES

Monitoring • Monitoring system is not well coordinated, thus resulting in conflicting information; the fiscal decentralization in 2001 contributed to the difficulty in data collection • No data on WASH conditions in schools at district, provincial and national levels Evaluation No report Mechanism to support maintenance of WASH facilities and programmes • Funds and financial mechanisms are not adequate to support the proper operation and maintenance of facilities in schools

Values and socio-cultural norms related to water and sanitation • Local government units show little importance to sanitation • Lack of community awareness and education on hygiene and sanitation behaviour • Changing the hygiene habits of the urban and rural communities remains challenging (open defecation is still widely accepted, for instance)

Sufficient and working enabling factor Some work already being done but not fully sufficient More work needs to be done

Lao PDR

DEVELOPING SERVICES

SUSTAINING SERVICES

47 ge

PART2: COUNTRY PROFILES ENABLING SERVICES

100% 80%

Water source

89% 80%

60%

67%

Sanitation facilities

71%

Country profile: Lao People’s Democratic Republic 52%

40%

36%

South-East Asia averages Total Urban Water 82.3% 89.5% Sanitation 70.1% 84.4%

20%

Total Urban Rural in primary school Education structure and trends

Rural 76.3% 58.2%

Figure 9: Lao PDR’s education structure Basic education

Pre-school (three years)

Primary (five years)

Lower secondary (four years)

General upper secondary (three years)

Higher / tertiary education (at least three years)

Secondary vocational (three years)

Similar to other countries in the region, pre-school education in Lao PDR is not compulsory. Early childhood education is offered in crèches (for 3-month-olds to 3-year-olds) and kindergarten classes (3Water source to 5-year-olds). 100% 86%

90%

Sanitation facilities Unlike in 80% most other countries in72% the region where primary school lasts six years, however, primary school in 70% Lao PDR spans only five years (grades 1–5); and lower secondary lasts four years (grades 6–9) – a year than53% in other countries in the region. Prior to the 2009/2010 academic year, lower 60% longer57% 51% secondary50% only covered three years (now it is four years). Primary school and lower secondary comprise 38% basic education 40% in the country. 30%

South-East Asia averages

Upper secondary schooling, both the general and vocational tracks, lasts three years; combined, lower Total Urban Rural 20% and upper secondary school lasts seven years, which is a year longer than the82.3% usual six years coverage Water 89.5% 76.3% 10% of secondary schools in other countries. Sanitation 70.1% 84.4% 58.2%

Total

Urban

Rural

Tertiary education can be completed in three to seven years, depending on the programme. There were 8,968 primary schools in the country in 2009–2010, with about 920,000 children enrolled. Of them, 57 per cent offered full primary education (grades 1–5), while the rest, mostly located in rural and remote areas, offered what they could.75 The gross enrolment ratio for 2005–2009 showed that females lagged behind by more than 10 percentage points – at 106 per cent for females and 117 per cent for males (table 5). Upper secondary Higher Primary Lower secondary

years 1–6 (6+ to 11+ years)

form 1–3 (12+ to 14+ years)

form 4–5 (15+ to 16+ years)

Post-secondary

National

Academic

Technical

Matriculation

education college & university

Rationale for WASH activities in schools The following activities in schools in Lao PDR: school points outline the rationale for WASH vocational

• The proportion of children reaching the last primary grade in the country is at 67University/ per cent, the Academic/ Form 6 college/ religious second smallest in theRemove region (table 5). employment

National Chinese school

class • OnlyTamil about half of the total population has access to a safe/improved water source (57 per cent) National school College/ Sports/arts polytechnic and sanitation facilities (53 per cent) (table 2 and chart 16).

• Access to safe/improved water sources in the country is the lowest in the region, at 57 per cent (table 2).

75 Figure based on 2006/2007 data, as sourced from UNESCO-IBE, 2011.

Private 3%

Private 4% 48

PART2: COUNTRY PROFILES Public 96%

Public 97%

20%

Water Sanitation

0% Total

Urban

Total 82.3% 70.1%

Urban 89.5% 84.4%

Rural 76.3% 58.2%

Rural

• There is a large disparity between urban and rural areas, where many primary schools are located. Access to safe/improved water sources in urban areas is at 72 per cent while access in rural areas is at 51 per cent. An even larger disparity is apparent in terms of access to adequate/ improved sanitation Basic facilities, education at 86 per cent in urban areas and only 38 per cent in rural areas (table 2 and chart 16). • Only 24 per cent of public primary schools General have access adequate sanitation facilities (chart 2). uppertosecondary

(three years) • Around 38 per cent of theLower population still defecates in the open (table 3). Higher / tertiary Primary secondary Pre-school education (five years) years) disease in the country is 500 cases (three years) (atfor least three years) • The annual incidence rate of(four diarrhoeal every 1,000 people Secondary vocational (three years) (chart 1).

Chart 16: Proportion of the population with access to a safe/improved water source and adequate/improved sanitation facilities in Lao PDR, 2008 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%

Water source

86%

Sanitation facilities

72% 57%

53%

51% 38%

South-East Asia averages Total Urban Water 82.3% 89.5% Sanitation 70.1% 84.4% Total

Urban

Rural 76.3% 58.2%

Rural

Source: UNICEF, State of the World’s Children, 2011.

Enabling environment ThePrimary National State Lower Policysecondary on Safe Water Upper Supplysecondary and Drinking Water highlights the provision Higher of safe water for all Lao PDR citizens. The policy requires every ministry to develop its own programmes form 4–5 education college to years 1–6 Post-secondary form 1–3 (15+ to 16+ years) & university (6+ to 11+ years) (12+ to 14+ years) support the goals. One responding example is the Ministry of Public Works and Transports’ Urban Water Supply Policy (2002), which targets 80 per cent water coverage in urban areas by 2020. As of 2012, 62 perNational cent of that target had been achieved. Additionally, Strategy for Rural WASH (2011– Technical the National Academic Matriculation school vocational 2015) outlines the Ministry of Health’s programme related to the National State Policy on Safe Water Supply and Drinking Water. University/

Academic/ Form 6 college/ religious Remove employment The Ministry of Education class and Sports (MOES) and the Ministry of Health forged a partnership to National Tamil College/ implement theschool School Health Programme, which is guided by the National School Health Policy. With the Sports/arts polytechnic general objective of improving and promoting the physical, emotional and mental health of children, the National Chinese school

policy’s components consist of: i) personal hygiene and life skills, ii) the physical school environment, iii) the psychosocial school environment, iv) disease control and prevention, v) health care services, vi) nutrition promotion and vii) cooperation between schools and communities. The accompanying policy manual lays out the specifics for the provision of clean and safe water, clean and separate latrines for boys and girls and sufficient convenient places for handwashing.

Private 4%

Private 3%

The MOES developed standards on constructing water and sanitation facilities in schools (one toilet for every 50 students; minimum of two toilets/urinals for boys and two toilets for girls). The MOES enforces Public 97% Public 96% strict compliance with the standards. In cases in which the standards cannot be achieved, a dry latrine should at least be available in the school. The School Design and Construction Division of the MOES developed guidelines on the daily maintenance of school facilities, including WASH facilities.

PART2: COUNTRY PROFILES

Coordination among the national agencies and within the MOES has created a supportive environment for WASH activities in schools. Monitoring of those WASH interventions is jointly handled by the MOES (lead) and the Ministry of Health. As part of the Government’s decentralization efforts, a subcontract agreement between the Provincial Education and Sport Service and the Village Education Development Committees (VEDCs) was established to engage the support of the committees in managing school programmes, including school health issues. The District Education and Sports Bureau also provides guidance to the VEDCs. The local administration is empowered through the community-based construction/contracting training in which provincial, district and village officials receive tutoring on project management, procurement and even bank account management. Partnerships with international development agencies are flourishing. International development agencies have been supportive of the Lao Government’s efforts to achieve its goals under the Education for All-Fast Track Initiative (EFA-FTI) by providing financial resources for the construction of water and sanitation facilities in schools. Examples of such partnerships are: • An ADB-funded scholarship programme for 30 women on preparatory training on water supply engineering (as a precursor to pursuing a university degree). • Financial support from KOICA, JICA, the World Bank and UN-HABITAT to fund the construction of WASH facilities through the Urban Environmental Improvement Project with the ADB. • The MOES invited its development partners to participate in the revision of the hygiene curriculum and the Blue Box. The Blue Box is a participatory learning approach in the classroom in which children learn the values of handwashing, personal hygiene and safe sanitation and water use through games and stories. As of 2012, 4,000 of the almost 9,000 primary schools had been provided the Blue Box materials. During the revision, the developing partners could integrate their respective teaching aids into the Blue Box to ensure the effectiveness of the materials and avoid duplication.

The Blue Box containing picture stories and games

WASH in schools National school water and sanitation coverage

As of 2010, 3,467 (39%) of the 8,902 primary schools had improved water and sanitation facilities

Water source common to schools

Hand pump, tap water

Sanitation facilities common to schools

Flush toilets, urinals

Hygiene education and water values

Life skills, health and hygiene classes

Initiatives to support WASH activities in schools

• Blue Box • Community-based construction/contracting of toilets, water supply and other sanitation facilities in schools funded by development partners • Implementation of School of Quality framework, which includes a specific dimension on water, sanitation and hygiene

PART2: COUNTRY PROFILES

Main challenges The 2010 WHO report76 pointed out the country’s challenges related to WASH programmes: • The monitoring system is not well integrated into the review and planning processes. • There is limited support for the national strategy; for instance, there is no policy on subsidies for the sanitation sector. • There is difficulty in encouraging people to make or use sanitation improvements, especially in remote areas. • Although a national strategy was developed, there are no guidelines on how to implement it. • There are poor operation and maintenance of facilities. During the country study, informants reported that the sustained availability of financial resources remains a huge challenge. Funding is insufficient to support the construction, operation and maintenance of school facilities, particularly for the supply of clean water, in some areas. Given that Lao PDR’s natural supply of water is scarce, especially in the northern/upland parts of the country where underground water is unavailable, it will take considerable investment to create water sources. Although both the Ministry of Education and Sport and the Ministry of Health monitor the WASH conditions, the findings and data are not included in any annual published report. As a result, even if members of a school community know the importance of WASH, the emphasis on the matter seems low in terms of planning because the data are not used in reports. It is important to report WASH information to address the issues. In addition, the limited human resources capable of achieving all tasks related to the EFA-FTI goals, including meeting the demands for WASH improvements. More capacity-strengthening programmes are needed to improve management at the provincial and district levels, considering that the knowledge associated with construction (facilities) projects is still new to provincial, district and village officials.

Partners WASH partners include: • Ministry of Education and Sports • Ministry of Health • National Centre for Environmental Health and Water Supply (Nam Saat) • Village Education Development Committees • International development agencies that have supported or are supporting Lao PDR, including ADB, KOICA, JICA, UNICEF, Japan Committee for UNICEF, the World Bank, AEON, the Netherlands Development Organization, Plan International and AusAID

76 WHO, 2010.

PART2: COUNTRY PROFILES

More work needs to be done

Figure 10: Service delivery assessment highlights from Lao PDR Lao PDR

DEVELOPING SERVICES

SUSTAINING SERVICES

SERVICE DELIVERY PATHWAY Policy frameworks

Management and coordination

Partnerships

Financial mechanisms

Policy frameworks • Despite the number of national policy frameworks, limited support is given to the national strategy; for example, there is no policy on subsidies for the sanitation sector • Lack of systematic guidelines on how to implement the national strategy Planning Management and coordination • The District Education and Sports Bureau provides guidance to Village Education Development Committees (VEDCs) • Subcontract agreement between the Provincial Education and Sports Service and the VEDC as part of the decentralization effort of the Government Partnerships • Ministry of Education and Sport (MOES) invited donor organizations to participate in the revision of WASH teaching materials to harmonize the various efforts Financial mechanisms • Given the limited financial resources, the Government cannot fully respond to the great demand for water supply Values and socio-cultural norms related to water and sanitation Good practice • Community-based construction and empowerment of local administration, including training on procurement and bank account management

Social norms

Hardware

Software

Provision of hardware Current status: • Only 39% of primary schools have water and sanitation facilities (3,467 schools of 8,902 had a water source in 2010) • Main source of water is rainwater, but it is only abundant in the months of June and September National Standards: • One toilet per classroom • 1 toilet per 50 students

WASH programmes

Monitoring

Evaluation

Maintenance

Monitoring • Monitoring system is not well integrated into the review and planning processes Evaluation No report Mechanism to support maintenance of WASH facilities and programmes • Not enough funds for the operation and maintenance of the water supply

Provision of software • Lack of or poor skills on the operation and maintenance of facilities • Government staff numbers are inadequate to implement construction projects • Due to scarce human resources, it is very challenging to train village officials (such as the VEDC members) on the use of local materials and knowledge • The Government has improved its human resources support by hiring more engineers with assistance from such donors as World Bank and AusAID Complementary WASH programmes Good practice • Use of Blue Box materials • Under the leadership of the MOES, the MOES and the Ministry of Health jointly conduct monitoring and training on WASH programmes

Sufficient and working enabling factor Some work already being done but not fully sufficient More work needs to be done

The Philippines

ENABLING SERVICES

DEVELOPING SERVICES

PART2: COUNTRY PROFILES SUSTAINING SERVICES

Behavioural change

WASH in schools

ENABLING SERVICES

50% 40% 30% 20% 10% 0%

38%

South-East Asia averages Total Urban Water 82.3% 89.5% Sanitation 70.1% 84.4%

Rural 76.3% 58.2%

Country profile: Malaysia Total

Urban

Rural

Education structure and trends in primary school Figure 11: Malaysia’s education structure Primary years 1–6 (6+ to 11+ years)

Lower secondary form 1–3 (12+ to 14+ years)

Upper secondary form 4–5 (15+ to 16+ years)

Post-secondary

National school

Academic

Technical vocational

Matriculation

Academic/ religious

Form 6

Sports/arts

College/ polytechnic

National Chinese school

Remove class

National Tamil school

Higher education college & university

University/ college/ employment

Most children aged between 4 and 6 years begin their education at a pre-school, which both the Government and non-government agencies and the private sector operate throughout the country. They enter primary school at age 6 years.

Private 3%

Private 4%

Primary education comprises six years of compulsory education, years 1–6 (equivalent to grades 1–6). There are two types of primary schools – i) the national school with the Malay language of instruction 97% of instruction is Mandarin 96%Chinese and national Tamil schools in which thePublic and ii) thePublic national language and Tamil. For secondary education, the language of instruction is Malay. Lower secondary education consists of forms 1–3 (equivalent to grades 7–9). At the end of the third year of lower secondary education, students sit for the lower secondary school public examination and proceed to two years of upper secondary education, consisting of forms 4–5 (equivalent to grades 10–11). At the end of upper secondary school, students sit for the upper secondary school public examination. Not all students progress to secondary education. Post-secondary either a two-year form 6 programme or a matriculation programme, Rural 48% education follows Urban 52% Urban 29% Rural 71% which is considered a preparatory year for university entrance. Colleges and polytechnics offer diploma programmes and, upon completion, graduates from these institutions can proceed to university or the job market. As of 2011, a total of 7,976 public and private primary schools operated in the country.77 Of them, only 3 per cent were privately owned, with 4 per cent of the more than 3 million primary students enrolled during the same year (table 1 and charts 17 and 18).

Female 49%

Male 51%

77 The total number of primary schools includes religious schools under the state government, which accounts for 38 schools and 11,764 students. These are categorized as ‘public’ schools. Data from the Ministry of Education.

100%

96% PART2: COUNTRY PROFILES 95%

100%

Water source

99%

96%

95%

Sanitation facilities South-East Asia averages Total Urban

53 Rural

National National Chinese Chinese school school Primary Remove Lower Remove secondary years 1–6 class formclass 1–3 National National Tamil school school(12+ to 14+ years) (6+ to 11+ Tamil years) National

Academic school Chart 17: Primary school enrolment in Malaysia, 2011 National Chinese school

Remove class Private Private 4% 4% National Tamil school

Academic/ Academic/ religious Upperreligious secondary form 4–5 (15+Sports/arts to 16+ years) Sports/arts

Form Form 66

college/ college/ Higher employment employment education college & university

Post-secondary College/ College/ polytechnic polytechnic

Technical Chart 18:Matriculation Primary schools in vocational University/ Malaysia, 2011 Academic/ Form 6 college/ religious employment Private 3% 3% Private College/ Sports/arts polytechnic Public Public 97% 97%

Public Public 96% 96%

Private 3%

Private 4% Sources: MOE, Malaysia, 2011.

Public 97%

Public 96%

In terms of geographic location, there appears to be an imbalanced distribution of schools in terms of student enrolment. Although 71 per cent of the primary schools are located in the rural areas, student enrolment in terms of urban and rural location is split somewhat equally (table 8 and charts 19 and 20). Rural Rural 48% 48%

Urban Urban 52% 52%

Urban Urban 29% 29%

Chart 19: Primary school enrolment in Malaysia, by location, 2011

Rural 48%

Rural Rural 71% 71%

Chart 20: Primary schools in Malaysia, by location, 2011

Urban 52%

Urban 29%

Female Female 49% 49%

Rural 71%

Male Male 51% 51%

Sources: MOE, Malaysia, 2011.

Table 8: Primary schools and student enrolment in Malaysia, by location, 2011 Urban

100% 100%

Malaysia

Female 49%

# of schools 100% 100%

Student enrolment* 100% 100%

2 294

Source: MOE, Malaysia, 2011. 95% 95%

96% 96%

1 633 200 96% 96%

Rural

# of schools 99% 99% 5 682

95% 95%

90% 90%

100% 95%

Total Total

Urban Urban

Rural Rural

100%

99%

96%

Total Pre-primary Pre-primary

Urban Primary Primary (five (five years) years)

95%

Rural Secondary Secondary (six (six years) years)

Lower Lower primary primary (three (three years) years) Basic education

Pre-primary

Student # of enrolment* schools Water source source Water

Student enrolment*

1 507 418 7 976 Sanitation facilities facilities Sanitation

3 140 618

South-East Asia Asia averages averages South-East Total Urban Total Urban Water 82.3% 89.5% 89.5% Water 82.3% Sanitation 70.1% 84.4% 84.4% Sanitation 70.1%

Rural Rural 76.3% 76.3% 58.2% 58.2%

Water source

Basic Basic education education

90%

Total

Male 51%

Upper Upper primary primary (two (two years) years) Primary Secondary (five years) (six years)

Sanitation facilities South-East Asia averages Total Urban Water 82.3% 89.5% Sanitation 70.1% 84.4%

Rural 76.3% 58.2%

Tertiary/higher Tertiary/higher education education (at (atleast leastthree threeyears) years) Lower Lower or or middle middle school school (four (four years) years) Upper Upper or or high high school school (two (two years) years) Tertiary/higher education (at least three years) PART2: COUNTRY PROFILES

National Technical Academic Matriculation school vocational Rural 48% University/ Urban 52% Urban 29% Rural 71% Academic/ Form 6 college/ National Chinese school religious Remove employment class There is Tamil relative parity of participation between girls and boys, withCollege/ 49 per cent of children enrolled in National school Sports/arts primary school in 2011 female (chart 21). polytechnic

Chart 21: Enrolment in Malaysia, by sex, 2011

Private 4%

Female 49%

Private 3%

Male 51% Public 97%

Public 96%

Source: MOE, Malaysia, 2011.

Anecdotal accounts report that absenteeism is quite high and academic achievement is low among the indigenous children in primary schools of Sabah andWater Kelantan. The drop-out rates at the source 100% in the states 100% 99% 100%although minimal in percentages, in absolute numbers represents about 10,000 primary primary level, Sanitation facilities school children each year. 96% It is unclear why out’ before year 5 in 2004 and 2005; some 96% so many ‘dropped 95% 95% to a private school or moved to another state. may have shifted All of theAsia states that showed drop-outs South-East averages were states 6 enrolment was greater than year 1 enrolment five years earlier. These states Rural 48% in which year Total Urban Rural Urban 52% Urban 29% Rural 71% 78 have a net 90% in-migration of children during their primary school years. Water 82.3% 89.5% 76.3%

Total

Urban

Rural

Sanitation

70.1%

84.4%

58.2%

Rationale for WASH activities in schools The following points outline the rationale for WASH activities in schools in Malaysia: • Malaysia has universal coverage for improved water sources, and almost 100 per cent coverage Basic education for sanitation facilities, in both urban and rural areas (table 2). More than 70 per cent of primary schools in the country are located in a rural area (chart 19).

Female 49%

Male 51% high,Tertiary/higher Primary disease Secondary • The annual incidence rate of diarrhoeal remains at 435 caseseducation per 1,000 people (chart 1). Pre-primary (five years)

(six years)

(at least three years)

• Findings from a study conducted by SEAMEO and UN-HABITAT in 2005–2008 revealed that 37 per cent of the schools surveyed had no soap available for handwashing.79 Lower primary (three years)

Lower or middle school (four years)

Chart 22: Proportion of the population with access to a safe/improved water source and adequate/improved sanitation facilities Malaysia, 2008 Upper primary Upperin or high school (two years)

100% 95%

100%

100% 96%

Water source

99% 96%

Urban

Sanitation facilities

95%

90% Total

(two years)

Rural

South-East Asia averages Total Urban Water 82.3% 89.5% Sanitation 70.1% 84.4%

Rural 76.3% 58.2%

Source: UNICEF, State of the World’s Children, 2011.

Basic education

Pre-primary

Primary

Secondary

78 Malaysia Education for All Mid-Decade Assessment Report 2000–2007, (five years) (six September years) 2008.

Tertiary/higher education (at least three years)

79 This was discussed during the Consultative Workshop on Values-Based Water Education that was convened by SEAMEO and UN-HABITAT in cooperation with the ADB in Manila, Philippines in December 2003.

PART2: COUNTRY PROFILES

Lower primary (three years)

Lower or middle school (four years)

Upper primary (two years)

Upper or high school (two years)

Enabling environment Political commitment for education in Malaysia has been consistent and accompanied by resources required to fully achieve the goal of every child completing quality basic education by 2015. The Ninth Malaysia Plan (9MP) maintains the country’s commitment to continuously address socio-economic inequalities by ensuring that all citizens receive fair and equal educational opportunities regardless of geographical location, race, ability or ethnic background. The Education Development Master Plan (2006–2010) outlines the Ministry’s actions for realizing the goal of eliminating these imbalances by ensuring that no student drops out of the system due to poverty or geographical location. Education development spending under the 9MP continues to prioritize the building and upgrading of infrastructure in rural areas, especially in Sabah and Sarawak States. In 2007, the Ministry of Education provided basic infrastructure to schools that lacked 24-hour electricity and a clean water supply. The Government has a comprehensive set of education support measures, which include the supplementary food programme that provided breakfast for nearly 707,000 students and the school milk programme for nearly 570,000 students in 2006, a poor students’ trust fund and textbooks on loan.80 The MOE established a guideline for the construction of toilets in schools, both in the primary and secondary levels.The guideline specifies that each school should provide one toilet for every 20 students.

WASH in schools808182 National school water and sanitation coverage

All primary schools have WASH facilities81

Water source common to schools

Sources of drinking water: • local water utilities/piped water – 86% • bottled water – 14% • rainwater – 1% • well – 1%

Sanitation facilities common to schools

Types of toilets in place: • flush toilet – 97% • water-sealed latrine – 2% • pit latrine – 1%

Hygiene education and water values

Physical exercise and lessons on hygiene are included in the curricula

Initiatives to support WASH activities in schools

Guidelines and Rules of Building Plan (2008)

Partners Malaysia’s WASH partners encompass: • Ministry of Education • Ministry of Health • Ministry of Energy, Water and Communication

80 Malaysia Education for All Mid-Decade Assessment Report 2000-2007, September 2008. 81 Note that figures indicated are based on a survey conducted by SEAMEO and UN-HABITAT in 2005–2008, unless otherwise specified. Schools surveyed in Malaysia represented 91 secondary schools (including lower and upper secondary) and only 9 primary schools. 82 As reported by the Ministry of Education.

PART2: COUNTRY PROFILES

100% 95%

100%

100% 96%

Water source

99% 96%

95%

Sanitation facilities South-East Asia averages Total Urban Water 82.3% 89.5% Sanitation 70.1% 84.4%

Country profile: Myanmar 90%

Total

Urban

Rural

Rural 76.3% 58.2%

Education structure and trends in primary school Figure 12: Myanmar’s education structure Basic education

Pre-primary

Primary (five years)

Secondary (six years)

Tertiary/higher education (at least three years)

Lower primary (three years)

Lower or middle school (four years)

Upper primary (two years)

Upper or high school (two years)

Basic education in Myanmar consists of the primary and secondary levels. Primary school is further divided into two levels, the lower primary (grades 1–3) and upper primary (grades 4–5). Secondary education lasts six years, also split into two levels: the lower or middle school (grades 6–9) and upper or high school (grades 10–11). Technical and vocational programmes are available in some agricultural institutes, technical high schools and trade schools. Depending on the programme, tertiary and higher education can be completed in at least three years. In 2005–2007, a total of 36,205 schools offered primary education. Of them, 95 per cent were under the supervision of the Ministry of Education (MOE). The Ministry of Progress of Border Areas and National Races and Development, in cooperation with the MOE, established the Border Development Association (BDA) in 1996 to promote education, health, agriculture and government programmes in remote and border areas of the country. In 2005–2006, 853 primary schools operated under the supervision of the BDA. Monastic schools, under the Ministry of Religious Affairs (MRA), also supervise primary schools catering to children coming from poor families and children without primary caregivers. Primary schools under the MRA totalled 1,174 in the 2005/2006 academic year. During the 2005/2006 academic year, total enrolment in primary school was 5,185,138. Of them, nearly 5 million children were enrolled in schools under the MOE, with the remainder in the MRA and BDA schools.83

Rationale for WASH activities in schools The following points underline the rationale for WASH activities in schools in Myanmar: • The proportion of the population having access to a safe/improved water source remains below the average for the region – 71 per cent for the total population, 75 per cent in urban areas, 69 per cent in rural areas (table 2 and chart 23). • Although the statistics show that Myanmar’s adequate/improved sanitation coverage is higher than the regional average, particularly in the rural areas, some studies suggest that these may be overstated, considering the observations and comparisons with other countries that have similar health conditions.84

83 UNESCO-IBE, 2011. 84 ISF-UTS, 2011.

PART2: COUNTRY PROFILES

Chart 23: Proportion of the population with access to a safe/improved water source and adequate/improved sanitation facilities in Myanmar, 2008 100% 80%

71%

Water source

86%

81%

75%

69%

79%

Sanitation facilities

60% 40%

South-East Asia averages Total Urban Water 82.3% 89.5% Sanitation 70.1% 84.4%

20% 0% Urban

Total

Rural 76.3% 58.2%

Rural

Source: UNICEF, State of the World’s Children, 2011.

Enabling environment

Basic education

Collaboration between government units and international development agencies as well as with Primary Secondary Tertiary/higher education the private sectorKindergarten is apparent in the One(six example among the Ministry of (sixcountry. years) years) is the collaboration (at least one year) Health, the Ministry of Education and UNICEF to continuously promote sanitation values among school children through such activities as the ‘4 Cleans’ campaign (clean food, water, clean toilet, clean Juniorclean high school (four years) hands) and the Global Handwashing Day.85 Senior high school and promotion of Another example is the Lion Corporation’s drive towards sanitation improvement (two years) sanitation values. In 2010, the soap company pledged to donate a portion of its income for a three-year period to the UNICEF WASH in schools projects.

On the national level, the Environmental Health Programme under the National Health Plan supports the development and/or monitoring of community water supplies, sanitation facilities and pollution control.

Private 17%

Private 8%

WASH in schools

Public 83%

Public 92%

National school water and sanitation coverage

Water source common to schools

Hand pump, rainwater collection, open well, unprotected areas

Sanitation facilities common to schools

Flush toilets

Hygiene education and water values

Life skills, health, hygiene and science classes

Initiatives to support WASH activities in schools

4 Cleans campaign to promote proper handwashing, garbage disposal and toilet use

Note: NA = Information not available.

100%

80%

91%

75%

93% 80%

Water source

87% 69%

Sanitation facilities

60% 40% 85 Ibid.

South-East Asia averages Total Urban Water 82.3% 89.5% Sanitation 70.1% 84.4%

20% 0%

Total

Urban

Rural

Rural 76.3% 58.2%

PART2: COUNTRY PROFILES

Partners Myanmar’s WASH partners encompass: • Ministry of Education • Ministry of Health • Other government agencies concerned with water and sanitation, such as the Department of Development Affairs under the Ministry for Progress of Border Areas and the National Races and Development Affairs • International development agencies, such as (currently or previously) UNICEF, Save the Children, CARE, the Adventist Development Relief Agency, UNDP, United Nations High Commissioner for Refugees (UNHCR) and UN-HABITAT • The100% private sector, such as the Lion 86%Corporation

80%

71%

81%

75%

69%

79%

Water source

Sanitation facilities

60%

Country profile: Republic of the Philippines 40%

South-East Asia averages Total Urban Water 82.3% 89.5% Sanitation 70.1% 84.4%

20% 0%

Total

Urban

Rural 76.3% 58.2%

Rural

Education structure and trends in primary school Figure 13: Philippines’ education structure Basic education

Kindergarten

Primary (six years)

Secondary (six years)

Tertiary/higher education (at least one year) Junior high school (four years) Senior high school (two years)

As part of an ongoing revamp of the country’s education system (K–12 education reform), basic education consists of 12 years (six years of elementary or primary education, four years of junior high school and two years of senior high school) plus a year of kindergarten schooling. Tertiary and higher education offers a variety of programmes. Technical and vocational courses Private 17% can be Private 8% completed in one to three years. Associate degrees can be completed in two years while a bachelor’s degree requires at least four years. Post-graduate degrees are also available.

Public 83%

Public 92%

100%

91%

75% 80% PART2: COUNTRY PROFILES 60%

93% 80%

Water source

87% 69%

Sanitation facilities 59

Senior Seniorhigh highschool school (two (twoyears) years)

Chart 24: Primary school enrolment in the Philippines, 2010

Chart 25: Primary schools in the Philippines, 2010 Private Private 17% 17%

Private Private 8% 8% Public Public 83% 83%

Public Public 92% 92%

Sources: Department of Education, the Philippines, 2010.

In the 2010/2011 academic year, there were 45,964 primary schools, with more than 14 million students enrolled. More than 80 per cent were public schools, accounting for more than 90 per cent of the total Water Wateruniversities source source primary school those who were enrolled in state and colleges that 93% 93% 100% 100% enrolment, 91% 91% including 87% 87% offer primary education (table 1 and charts 80% 80%24 and 25). 75% 75%

80% 80%

Sanitation Sanitation facilities facilities

69% 69%

There is not much enrolment discrepancy between males and females, although male students slightly 60% outnumber60% the females, according to the gross enrolment ratio for 2005–2009, at 111:109) (table 5).

40% 40%

South-East South-East Asia Asia averages averages Total Total Urban Urban Rural Rural 82.3% 82.3% 89.5% 89.5% 76.3% 76.3% The following points underline the rationale for WASH activities in schools in the Philippines: Sanitation Sanitation 70.1% 70.1% 84.4% 84.4% 58.2% 58.2% 0% 0%

Rationale 20% 20% for WASH activities in schools Water Water

Total Total Urban Urban Rural Rural water source and sanitation facilities, both in • Although the population’s access to an improved urban and rural areas (table 2 and chart 26) is significantly higher than the regional average,86 the incidence of diarrhoeal disease remains high, at 514 cases for every 1,000 people (chart 1). • Despite the high improved water source and sanitation coverage, people living in slums and remote and coastal areas remain vulnerable. Wastewater is not necessarily properly treated before disposal, which could result in sanitation- and wastewater-related diseases.87

Water sources sources (2006) (2006) Water

100% 100%

• From 2006 to 2008, the country’s water and sanitation coverage slightly dropped (chart 27), which Water sources sources (2008) (2008) Water 80% 80% may be attributed to the increase in population. Nevertheless, a decrease in water and sanitation coverage impacts health in general, especially among children. Sanitation facilities facilities (2006) (2006) Sanitation

60% 60%

Sanitation facilities facilities (2006) (2006) Sanitation

40% 40% 20% 20% 0% 0% Total Total

Urban Urban

Foundation Foundation stage stage (four (four years) years) Pre-school Pre-school (three (threeyears) years)

Primary Primary (six (sixyears) years)

Secondary Secondary (four (fourto tofive fiveyears) years)

Rural Rural

Arts Arts institutions institutions

Special/ Special/ express express course course Normal Normal (academic) (academic) course course

PostPostsecondary/ secondary/ tertiary tertiary

Institute Instituteof of technical technical education education Polytechnics Polytechnics

University/ University/ higher higher education education

86 This is true except for the country’s sanitation coverage in the urban areas, where the Philippines is lagging behind by around 4 percentage points.

Normal Normal Summit on 5 July 2006. 87 According to the presentation materials during the Philippine Sanitation(technical) (technical) Orientation Orientation stage stage course course (two (two years) years)

Junior Juniorcollege/ college/ centralized centralized Institute Institute PART2: COUNTRY PROFILES

Public 83%

Private 8%

Public 92%

Private 17%

Public 83%

Public 92%

Chart 26: Proportion of the population with access to a safe/improved water source and adequate/improved sanitation facilities in the Philippines, 2008 100% 100%

40% 20% 0%

87%

80%

75%

80%

Sanitation facilities Water source

69%

93%

91%

Water source

87%

80%

75%

80% 60%

93%

91%

South-East Asia averages Total Urban Rural Water 82.3% 89.5% 76.3% South-East Asia Sanitation 70.1%averages 84.4% 58.2% Total Urban Rural Water 82.3% 89.5% 76.3% Sanitation 70.1% 84.4% 58.2%

60% 40% 20% Total

Sanitation facilities

69%

Urban

Rural

Source: UNICEF, State of the World’s Children, 2011.

Total

Urban

Rural

Chart 27: Proportion of the population with access to a safe/improved water source and adequate/improved sanitation facilities in theWater Philippines, 2006-2008 sources (2006) 100% Water sources (2008)

80% 60% 40% 20% 0%

100%

Water sources (2006) Sanitation facilities (2006)

80%

Water sources (2008) Sanitation facilities (2006) Sanitation facilities (2006)

60%

Sanitation facilities (2006)

40% 20%

Total

Urban

Rural

0% Total

Urban

Rural

Source: UNICEF, State of the World’s Children, 2000–2011.

Foundation stage (four years)

Enabling environment

Special/ express course

Arts institutions Institute of Arts

Several government agencies have generated policies and plans relatedtechnical to water and sanitation: institutions Foundation stage

NormalSpecial/ PostUniversity/ education Pre-school Primary Secondary years) express (academic) secondary/ • Clean Water Act of(four 2004, which provides for comprehensive water quality management higher (three years) (six years) (four to five years) Institute of course course tertiary education • Administrative Order on Sustainable Sanitation as a National Policy and National Priority technical Polytechnics PostUniversity/ education Normal Normal Programme of the Department Pre-school Primary Secondary of Health (academic) secondary/ higher (technical) Orientation stage (three years) (six years) (four to five years) • Philippine Code on Sanitation (Presidential Decree No. tertiary 856, Chapter 6) Junior college/ education course course (two years) Polytechnics centralized • Ecological Solid Waste Management Act (Republic Normal Act 9003) Institute (technical) of Health, 2010) Orientation stagePlan (Department • National Sustainable Sanitation Junior college/ course (two years) centralized • National Environmental Health Action Plan Institute

• National Sewerage and Septage Management Plan (Department of Public Works and Highways).

Private (Gov’t aided) 24% Female 48%

Male 52%

PART2: COUNTRY PROFILES Female 48% Male 52%

Public 76% Public 76%

Private (Gov’t aided) 24% 61

The institutionalization of universal kindergarten education by the Department of Education provides an avenue to instil good sanitation-related practices among children as young as 5 years because the curriculum includes lessons on health habits. Likewise, the Department of Education requires construction of sanitation facilities appropriate for 5-year-olds in kindergarten buildings.88 The Department of Education also issued a guideline on the use of the Basic Educational Facilities Fund (BEFF), which extends to the construction and/or rehabilitation of water and sanitation facilities in schools. Specifically, the following Department of Education policies on sanitation facilities in schools have been issued: • DECS89 Order No. 60, 1994 – sanitation facilities must be one of the cleanest facilities in schools; school heads shall renovate old toilets or construct new ones and provide water and handwashing facilities • Department of Education Orders No. 56 and No. 66, 2009 – requiring the construction of handwashing facilities in all schools • Department of Education Order No. 62 – mandating the everyday practice of handwashing in schools • The Department of Education adopted sections 902–904 of the National Building Code regarding water and wastewater disposal systems • National Schools Maintenance Week (Brigada Eskwela) 2012, which focuses on water and sanitation. In accordance with those policies and plans, the Department Education institutionalized standards for the construction of WASH facilities in schools, embodied in the Education Facilities Manual.90 The Schools Water and Electrical Facilities Assessment Project was initiated by a collaboration of the Government, the private sector, civil society organizations and foundations to assess school water facilities and locate the schools with poor or without water and sanitation facilities and practices to provide necessary interventions. In 2009, the Department of Education issued a policy on the Implementation of the Essential Health Care Programme (EHCP) for School Children.91 In partnership with international development agencies, local government units and the private sector, the Department of Education sought to reduce the incidence of disease associated with poor hygiene and sanitation practices. The EHCP provides safe drinking water, toilets and handwashing facilities in schools, combined with campaigns for deworming and hygiene education. In terms of monitoring, the Enhanced Basic Education Information System (eBEIS) gathers data on water and toilet facilities along with other indicators.92 In addition to the eBEIS, the Department of Education issued a policy93 on the use of the monitoring tool for EHCP in 2011 (following the policy on the EHCP implementation). Included in the monitoring tool are data on sanitary requirements, such as water supply, toilet facilities, handwashing facilities, drinking fountains, waste disposal systems and the integration of health education in curricula and school activities.

88 Department of Education Order No. 91 (November 2011), Kindergarten School Building Project. 89 Department of Education, Culture and Sports (DECS) is the predecessor of the Department of Education. 90 See the manual’s Annex 6 on standards on WASH-related facilities in schools in the Philippines. 91 Department of Education Order No. 65 (2009). 92 WASH in Schools Technical Working Group (Philippines), WASH in Schools Country Profile, November 2011. 93 Department of Education Order No. 61: Use of the Monitoring Tool for the Essential Health Care Programme (August 2011).

PART2: COUNTRY PROFILES

Public–private partnerships and civil society organizations also have high levels of participation in the sanitation improvement efforts. Water concessionaires partner with national and local government units to improve access to water sources and wastewater management. Local business people contribute as well towards improving sanitation facilities, while civil society organizations are active in raising public awareness on the importance of good hygiene and safe water practices.

WASH in schools National school water and sanitation coverage

• For the 2011/2012 academic year, the average toilet to pupil ratio in public elementary schools was 1:28. • For the same year, there were 473,643 toilets (including individual urinals and urinal troughs) in 38,506 public primary schools and 86% of the public primary schools had access to a water source (local piped, well, rainwater and natural water)

Water source common to schools

As of the 2011/2012 academic year: • local piped – 33% • well – 25% • rainwater – 4% • natural water – 9% • combination – 8%

Sanitation facilities common to schools

Squat pot, pour flush, urinals

Hygiene education and water values

Hygiene behaviour is integrated into the curricula

Initiatives to support WASH activities in schools

• Kindergarten School Building Project requiring construction of sanitation facilities appropriate for 5-year-olds • Guideline on the use of the Basic Educational Facilities Fund (BEFF), which includes the construction and/or rehabilitation of water and sanitation facilities in schools • Education Facilities Manual, which guides construction of appropriate WASH facilities in schools • The Schools Water and Electrical Facilities Assessment Project assessed and identified schools with poor or without water and sanitation facilities to provide necessary interventions • ECHP, which aims to reduce the incidence of WASH-related disease by providing safe drinking water, toilets and handwashing facilities in schools

Main challenges The monitoring system is not well coordinated, resulting in conflicting information. Weak sector planning and management is evident due to poorly resourced institutions, insufficient data and surveillance systems, weak coordination and institutional uncertainty and variations in leadership, both in the national and local levels.94 The regulatory standards vary. Due to the many construction standards (Code on Sanitation of the Philippines, Philippine National Standards for Drinking Water 2007, Water Code of the Philippines, Revised National Plumbing Code of the Philippines, Ecological Solid Waste Management Act), it may seem that some of the school standards do not follow the national codes.

94 These challenges were highlighted in the Manila Declaration on the Advancement of Sustainable Sanitation and Wastewater Management in the Philippines, signed at the Philippine Sanitation Summit on 5 July 2006.

PART2: COUNTRY PROFILES

There is an inadequate level of human capacity to monitor, operate and maintain facilities at the provincial and district levels. There is also a need to increase awareness, coupled with a strong sense of ownership and commitment, on the importance of safe water and good hygiene practices among school children, parents, teachers and community leaders. In terms of financial resources, although some 20 per cent of the BEFF was allotted for the construction and/or rehabilitation of classrooms, including water and sanitation facilities, there was no specific guideline on the use of the fund specifically for water and sanitation facilities and supplies (such as soap). It also does not specify the amount of funds allotted for monitoring and maintenance of WASH facilities or for health education programmes or activities. Constraints in financial resources have curtailed WASH-related projects. There is no particular plan of action that comprehensively addresses WASH needs in schools. The Department of Education funds for WASH activities is inadequate to cover all schools, thus it prioritizes schools that are most in need (have no toilet or water supply).95 More importantly, improved sanitation is characterized as not a priority in the country.96 The following summarizes issues and challenges that were highlighted during the country study:

Policies, standards and guidelines

A non-functioning bathroom facility due to the unavailability of water

The country has a rich collection of well-crafted policies and strategic plans. The problem lies in the translating of them into, first, guidelines and then practice. In some cases, the implementing guidelines and plans remain at the national level and never reach the implementers. Some school heads are not updated on the latest information from the Department of Education. There is a need to develop an evidence-based approach to support the generation of guidelines.

A strong political will within the local government units is necessary to implement the national policies. The Government should encourage the local government units to adopt and follow through on the national policies. It may be difficult to harmonize the existing standards for the construction of facilities with the WHO/ UNICEF standards. Differences in topography and availability of local resources should be considered. The local context or situation should be carefully looked at before constructing facilities. For instance, in some schools, pour-flush toilets were built even if there was no water available, resulting in some toilets used as a stockroom or just locked shut. The water supply and sanitation issues must be responded to jointly, and yet the water supply needs typically attract the bigger chunk of the budget, with the sanitation needs left lagging. Meeting the prescribed student–toilet ratio may not be easy to achieve. The general sentiment among people interviewed for this study is that it is always better to have at least one functioning toilet in each school than have nothing at all and achieving the set standard can come later when sufficient resources are available. Setting standards is ideal, but it assumes that all actors (including children) understand the concept and that the resources are available.

95 WASH in Schools Technical Working Group (Philippines), November 2011. 96 WHO, 2010.

PART2: COUNTRY PROFILES

Human capacity The Department of Education is still challenged in terms of institutionalizing projects that it can sustain. In most cases, a national plan is developed for a particular project. When the project life ends, the Department does not integrate it into its ongoing activities. School superintendents lack planning capacity. Superintendents should be able to plan at least two years ahead so they are well informed of what the school and students will need. For instance, estimating the number of incoming grade 1 students for a particular academic year as early as two years ahead may prove beneficial to the school improvement plan.

Coordination mechanism WASH issues cut across government agencies, and several agencies have their own WASH programmes. There is no coordinated effort among the agencies to manage, operate and monitor the WASH concerns. These programmes must all converge at some point. It is also not clear who is in charge of WASH conditions in schools – is it the national agencies, the local government units, the communities or the schools?

Monitoring and evaluation The area of monitoring and evaluation remains a challenge for all agencies. There have been no useful reviews of water and sanitation projects because of the many monitoring and evaluation tools used by the different agencies (what has taken place has had minimal impact). Schools conduct their own monitoring of sanitation facilities for compliance purposes only. Subsequently, the monitoring results are not used for planning. There is little feedback from a district or division on how the data submitted by the principals are used. There is no separate report on WASH facilities; what is generated refers to learning facilities and materials (classrooms, chairs, textbooks). Local government units are required to report on household sanitation but not on WASH conditions in schools. Policy implementation by local governments is not monitored. There is inadequate feedback between the local government units and national agencies in terms of policy compliance.

Availability and use of funds Although the national education budget allocates funds for the annual repair of school facilities, there is no specific allocation for sanitation. If the budget is insufficient, toilets are the first to be removed from the plan. The school’s budget for maintenance and other operating expenses does not include any specification for water supply expenses and maintenance. Hence, when monthly fees are not paid, the school’s water supply is disconnected. WASH consumables, such as soap, are also not covered, according to the Commission on Audit rules. It is thus difficult to include such expenses in the school budget. There is a need for a policy that would institutionalize such expenses by requiring they be specified within the national budget.

PART2: COUNTRY PROFILES

Schools also have access to additional funds from the local government. The Local School Board (LSB) Fund is available from the real estate tax generated by the local government. Because small-income municipalities receive only a small amount of the LSB Fund, schools located within their jurisdiction do not receive enough funding to cover their WASH needs. The funds are usually used to pay for teacher aids allowances and to fund school sports competitions.

Partnership In some cases, the level of commitment and sense of ownership from communities as a partner in implementing WASH programmes is still low. Due to the weak sense of ownership as well as the low appreciation among children, facilities sometimes are defaced by children and/or other community members.

Other issues Some schools are located on disputed lands or in conflict areas and thus the improvement of their facilities is difficult. As well, schools are used as evacuation centres during emergencies – WASH facilities become dilapidated when schools are used as evacuation centres. Lastly, a viable sanitation system (including service providers for dislodging septic tanks and a method of waste disposal) remains a problem in the country. There are only two companies that have septage systems, both of which are private corporations. When a school’s septic tank is dislodged, proper disposal of the waste remains unclear.

Partners The Philippine WASH partners encompass: • Department of Education • Department of Health • Other government agencies, such as the Department of Environment and Natural Resources, the Department of Public Works and Highways and the Department of Social Work and Development • Local government units • International development agencies, such as (currently or formerly) GlaxoSmithKline, Lamoiyan Corporation, Procter & Gamble, Unilever, GIZ, DANIDA, UNICEF, AusAID, Inwent, Plan Philippines and USAID • NGOs, such as Fit for School, Inc. and GMA Kapuso Foundation • Philippine Dental Association and the World Dental Federation • SEAMEO INNOTECH

PART2: COUNTRY PROFILES

Figure 14: Service delivery assessment highlights from the Philippines The Philippines

DEVELOPING SERVICES

SUSTAINING SERVICES

SERVICE DELIVERY PATHWAY Policy frameworks

Management and coordination

Partnerships

Financial mechanisms

Policy frameworks • National standards are set but not met • Implementing guidelines are clear and available but not cascaded down to the ground level (weak at turning policies into actions) Planning Management and coordination • Department of Education’s priorities include WASH; targets are set (in terms of how to roll out the programme) • Department of Education’s centralized structure contributes to achieving clear roles and responsibilities among stakeholders; management and coordination emanate from top to bottom • Local government units (LGUs) have the power to implement policies, hence a supportive and active LGU leader/champion is the key to an effective WASH programme in schools Partnerships • The multi-sector WASH in Schools Technical Working Group (composed of international and local NGOs and headed by the Department of Education) is active in addressing WASH issues

Social norms

Hardware

Software

Provision of hardware Current status: • 79% of public primary schools have access to a water source (2010) • Water sources – local piped: 33%; well: 25%; rainwater: 4%; natural water: 9%; combination: 8% National standards: • Varying national standards Provision of software • Lack of human capacity to monitor, operate and maintain facilities, especially at the provincial and district levels • There is a need to strengthen the capacity of implementers (school heads), especially in terms of management Complementary WASH programmes • Essential Health Care Program (EHCP); from initial roll-out in 16 provinces in 2007, EHCP is now operational in 24 provinces and three cities (of 80 provinces) • Brigada Eskwela 2012, which integrates health and sanitation

WASH programmes

Monitoring

Evaluation

Maintenance

Monitoring • Improved monitoring indicators (based on the UNICEF WASH in Schools Monitoring Package) are integrated into the Basic Education Information System (BEIS, the equivalent of EMIS) but only the quantitative part and not the qualitative, such as access and functionality Evaluation No report Mechanism to support maintenance of WASH facilities and programmes • No sustainable ﬁnancial mechanism to support the operation and maintenance of WASH facilities • Utility bills (water and electricity) and maintenance costs are not included in the budget • WASH supplies (such as soap) are not part of the allowable items under the government audit system

Financial mechanisms • Financial constraints still exist, although the Department of Education allotted 100 million pesos for WASH in schools Values and socio-cultural norms related to water and sanitation • There is a need to increase awareness, coupled with a strong sense of ownership and commitment among stakeholders

Sufficient and working enabling factor Some work already being done but not fully sufficient More work needs to be done

PART2: COUNTRY PROFILES

Behavioural change

WASH in schools

ENABLING SERVICES

100%

Water sources (2006)

80%

Water sources (2008) Sanitation facilities (2006)

60%

Country profile: Republic of Singapore

Sanitation facilities (2006)

40% 20% 0%

Total

Urban

Rural

Education structure and trends in primary school Figure 15: Singapore’s education structure

Foundation stage (four years) Pre-school (three years)

Primary (six years)

Secondary (four to five years)

Orientation stage (two years)

Arts institutions

Special/ express course Normal (academic) course Normal (technical) course

Postsecondary/ tertiary

Institute of technical education Polytechnics

University/ higher education

Junior college/ centralized Institute

Singapore has achieved universal education at all levels. The Government is the main provider of primary, secondary and tertiary education. Pre-school education, however, is available only through the private sector (community foundations, religious bodies, social organizations and business organizations) and is not compulsory. Pre-school covers three years, consisting of nursery, kindergarten 1 and kindergarten 2.

Private (Gov’t aided) 24% Primary education lasts six years over two stages: foundation stage (primary 1–4) and orientation stage (primary 5–6). Secondary education offers three courses, each spanning four years: a special or express Female 48% to a General course that leads Certificate of Education (GCE) ‘O’ Level; a normal (academic) course Male 52% Public 76% leading to a GCE ‘N’ Level; and a normal (technical) course leading to a GCE ‘N’ Level. Students who have completed their primary education may choose one of those tracks for their secondary education. Some secondary schools offer an integrated programme that covers both secondary education and junior college. This is ideal for students who are certain about going to college and university for higher education. The integrated programme can be completed in five years. Upon completion of secondary education, students have the option to go to one of the post-secondary or tertiary schools: junior college or centralized institute for those intending to pursue university General orEducation offer applied Bachelor’s academics; polytechnics and the Institute of Technical tertiary degree education in academiccommunications, track least four years) and various fields, such as engineering, applied sciences, health(at sciences, business accounting, social sciences and media; or arts institution for those inclined towards the creative arts.

Post-secondary/ Pre-school Primary Lower secondary Upper secondary higher education (one to three In 2010, there were schools in theyears) country, of which 76 per cent were government schools (six years) (three (three years) years)173 primary (at least two years)

(chart 28).

Associate degree/

As mentioned, education in Singapore is primarily provided by the State; most schools are technical government Vocational vocational/ schools or those that are fully funded by the Government. significantly track Some schools, however, although (two years) funded by the Government, are also supported by private sources of revenue, such as fundraising activities. These schools are categorized as government-aided schools. For the purposes of this study, government-aided schools were categorized as private schools. During 2010, a total of 256,801 primary students were enrolled, 48 per cent of who were female (chart 100% 100% 29 and table 4). 99% Water source

100%

80% 68

60%

89%

92%

82%

Sanitation facilities PART2: COUNTRY PROFILES

course

(two years)

Chart 28: Enrolment in Singapore, by sex, 2010

Junior college/ centralized Institute

Chart 29: Primary schools in Singapore, 2010 Private (Gov’t aided) 24%

Female 48%

Male 52%

Public 76%

Sources: MOE, Singapore, 2010.

Enabling environment

General or

Bachelor’s degree

Although the country has achieved universal safe water and adequate sanitation coverage, the academic track (at least four years) Government is still keen on raising the awareness of people on water and sanitation values and providing a sustainable water supply (water from catchment areas, imported waterPost-secondary/ from Malaysia, reclaimed Pre-school Primary Lower secondary Upper secondary water known and desalinated water). The government, through theeducation Public Utilities Board, higher (oneas to NEWater three (six years) (three years) (three years) (at country’s least two years) also engages years) communities in taking ownership of the management of the water resources. Likewise, the Health Promotion Board is active in raising public awareness on the importance of Associate degree/ handwashing. Education materials, such as posters, guides and articles, are easily accessible through Vocational vocational/ technical the Health Promotion Board website. Some examples track of articles available online:

(two years)

• ‘Why are clean hands important for children’ at: www.hpb.gov.sg/infectiousdiseases/article.aspx?id=7054 • ‘Keep your hands clean’ at: www.hpb.gov.sg/infectiousdiseases/article.aspx?id=5652 • ‘Washy Washy Clean’ at: www.hpb.gov.sg/news/article.aspx?id=6068 100%

100%

9798 92% 100% in schools 89% WASH

99%

Water source 82%

Sanitation facilities

80% National school water/sanitation coverage

Universal safe water and adequate sanitation coverage

Water source common to schools

Sanitation facilities common to schools

40% Hygiene education/water values

Initiatives to support WASH activities in 20% schools

• STAR (Sustaining Toilets as Restrooms) Total Awards Urban Programme Rural for primary and secondary schools was established to Water 82.3% 89.5% 76.3% influence the school culture by encouraging students Sanitation 70.1% 84.4% 58.2% and teachers to maintain quality standards of restrooms. Rural Restrooms are judged on three focus areas: implementing education/awareness programmes for students; checking the standards of the restroom cleaners; and assessing the design of the restrooms.96

60%

0% Total

Pre-school

Urban

South-East Asia averages

• The LOO (Let’s Observe Ourselves) Campaign aims to encourage equal focus on the owners, operators, cleaners, contractors and users of restrooms. A LOO Award is given to organizations or individuals who have contributed to help the country achieve a world-class standard of restroom Junior secondary 97 Senior secondary cleanliness. Tertiary (three years) (three years)

Primary (six years)

• The Health Promotion Board has composed a handwashing jingle called ‘Washy Washy Clean’, which is used in preschools to teach children how to wash their hands properly. NA = Information not available. 97 Restroom Association of Singapore 98 Ibid.

100%

PART2: COUNTRY PROFILES 80% 69%

Water source

86%

Sanitation facilities

76% 63%

Foundation stage (four years) Pre-school (three years)

Primary (six years)

Partners

Normal (academic) course

Secondary (four to five years)

Singapore’s WASH partners encompass:

Orientation stage

(two years) • Ministry of Education

institutions

Special/ express course Postsecondary/ tertiary

Normal (technical) course

Institute of technical education

University/ higher education

Polytechnics Junior college/ centralized Institute

• Health Promotion Board • Public Utilities Board

• The private sector, including community and business organizations

Private (Gov’t aided) 24%

Country profile: Kingdom of Thailand Female 48%

Male 52%

Public 76%

Education structure and trends in primary school Figure 16: Thailand’s education structure General or academic track Pre-school (one to three years)

Primary (six years)

Lower secondary (three years)

Bachelor’s degree (at least four years)

Upper secondary (three years)

Post-secondary/ higher education (at least two years)

Associate degree/ vocational/ technical (two years)

Vocational track

Pre-school education in Thailand is not required and has been available through private schools. Beginning in 2009, however, the Government launched free pre-primary education in public schools within its 15-year free education policy. 100%

100%

99%

Water source

100% 92% of six years in the primary level (prathom 1–6) and three years Previously, basic education consisted 89% 82% in lower secondary (mattayom 1–3). Under the Basic Education Curriculum 2008, basic education was Sanitation facilities 80% expanded to include primary, lower secondary and upper secondary, although only the primary and lower secondary are part of the compulsory education. In the upper secondary level (mattayom 4–6), 60% students can choose between the general or academic track and the vocational track, each lasting three years. Post-secondary or tertiary can be completed in at least two years, depending on the programme. 40% South-East Asia averages Higher education in the country is categorized into two levels: one that leads to a bachelor’s degree, Total Urban Rural 20% which generally lasts four years but may be longer, depending on the programme; and one that leads Water 82.3% 89.5% 76.3% to an associate degree or a vocational/technical diploma, which is normally completed in two years. Sanitation

70.1%

84.4%

58.2%

Urbanwere enrolled Rural in primary schools (table 1).There is no available data In 2007, close toTotal 6 million children that separates public and private school enrolment. According to a UNESCO-International Bureau of Education report, 68 per cent were enrolled in schools under the jurisdiction of the Office of Basic Education Commission and 17 per cent under the Office of Private Education Commission. Both offices are under the Ministry of Education. Then 9 per cent were enrolled in schools supervised by other organizations (Department of Local Administration and the Bangkok Metropolitan Administration). And the remaining 6 per cent were part of the Government’s non-formal primary education or the out-ofschool programmes (table 9). Pre-school

Primary (six years)

Junior secondary (three years)

Senior secondary (three years)

Tertiary

PART2: COUNTRY PROFILES

Foundation stage (four years)

Arts institutions

Special/ express course

Institute of technical Table 9: Primary school enrolment inNormal Thailand,Postby jurisdiction, 2007 University/ education Pre-school Primary Secondary (academic) secondary/ higher (three years) (six years) (four to five years) 2007education course tertiary Polytechnics Formal primary 5 549 590 Normal (technical) Office of Basic EducationOrientation Commission stage 4 004 326 Junior college/ course (two years) Office of Private Education Commission 1 001 969 centralized Institute Department of Local Administration and the Bangkok Metropolitan Administration 543 295 Non-formal primary

360 899 5 910 489

TOTAL Source: UNESCO-IBE, 2011.

There is a relatively balanced enrolment in terms of the sexes, as evidenced by the gross enrolment ratio. From 2005 to 2009, the gross enrolment ratio for male students was 92 per cent, whilePrivate the female (Gov’t aided) 24% ratio was 90 per cent (table 5).

Female 48%

Male 52% Public 76% Rationale for WASH activities in schools Thailand has achieved universal coverage for safe/improved water sources. Access to adequate/ improved sanitation facilities, although generally high and well above the average for the region, has yet to cover 100 per cent of the population, especially in rural areas where only 82 per cent of the population has access to such facilities (table 2 and chart 30). According to the 2010 WHO study,99 4 per cent of the population reported access to improved sanitation facilities that were shared with other households100 (table 3).

General or

Bachelor’s degree

With the threats of the H1N1 (swine flu) virus and avian influenza in the country, schools academic track (at least four have years)become more active in instilling effective hygiene habits among children. Post-secondary/

Pre-school

Primary Lower secondary secondary There had not any water or sanitation programmeUpper in Thailand for more thaneducation ten years prior to the higher (one been to three (six years) (three years) (three years) years) tsunami disaster of 2004.101 Both that experience and the unprecedented flooding of (at least two2011 years)resulted in the disruption of the country’s water and sanitation systems. During the flood period, household sanitation Associate degree/ systems did not operate under the inundation. Trash and sewage piled up after the floodwater subsided. Vocational vocational/ technical 102 More than 1,000 schools were affected and forced to end their term early. The rehabilitation of WASH track (two years) facilities in schools is needed to help curb the spread of WASH-related health risks.

Chart 30: Proportion of the population with access to a safe/improved water source and adequate/improved sanitation facilities in Thailand,2008 100%

100%

100% 89%

92%

99%

Water source 82%

80%

Sanitation facilities

60% 40%

South-East Asia averages Total Urban Water 82.3% 89.5% Sanitation 70.1% 84.4%

20% 0% Total

Urban

Rural 76.3% 58.2%

Rural

Source: UNICEF, State of the World’s Children, 2011. 99 WHO, 2010. 100 Facilities that were shared with other households are considered unimproved, based on the MDG definition of improved sanitation. 101 “The WASH in Schools Situation across the East Asia Pacific Region: A preliminary look”. Available at: www.scribd.com/doc/26863880/The-WASH-inSchools-Situation-Across-the-EAP-Region-a-Preliminary-Look 102 ETNA, September 2011.

PART2: COUNTRY PROFILES Primary Pre-school

(six years)

Junior secondary (three years)

Senior secondary (three years)

Tertiary

WASH in schools National school water and sanitation coverage

General or NA academic track

Bachelor’s degree (at least four years)

Hand pump, rainwater collection, tap water

Water source common to schools

Sanitation facilities common to schools Squat pots, urinals Post-secondary/ Pre-school Primary Lower secondary Upper secondary Hygiene(one education and water values Health and physical education, which higherincludes educationstrengthening the to three (six years) (three years) (three years) years) (at least years) prevention and awareness of good health practices andtwo disease self-protection from various risk behaviours Policies and initiatives to support WASH activities in schools

Associate degree/ School-based approach to avian influenza prevention and pandemic Vocational vocational/ technical influenza preparedness project, which resulted in the development track (two years) of manuals related to these diseases, including diarrhoea

NA = Information not available.

Partners 100%

100%

Thailand’s 100% WASH partners encompass: 92% 89%

• Ministry of Education

80%

99%

Water source 82%

Sanitation facilities

• Ministry of Public Health

60% 40%

Country profile: Democratic Republic of Timor-Leste South-East Asia averages Total Urban Water 82.3% 89.5% Sanitation 70.1% 84.4%

20% 0%

Total

Urban

Rural 76.3% 58.2%

Rural

Education structure and trends in primary school Figure 17: Timor-Leste’s education structure

Pre-school

Primary (six years)

Junior secondary (three years)

Senior secondary (three years)

Tertiary

Similar to other countries in the region, pre-school education is not compulsory in Timor-Leste. Most of the pre-schools are operated by the private sector. Primary education lasts six years, while junior and senior secondary education each lasts three years. Water source 100%1,012 primary schools had a total enrolment of 214,660 In 2011, students. 86%

Sanitation facilities

76%

80% to the 69%gross enrolment ratio data for the primary school system, the actual number of According 63% students enrolled is larger than the number who are qualified (based on age), due to the repeating of a 60% 50% grade; additionally, male enrolment (110 per cent) was significantly higher than female enrolment (103 40% per cent) 40% from 2005 to 2009, by 7 percentage points (table 5). One attributing factor to the disparity South-East could be the larger proportion of male students who enrol in the Asia sameaverages grade as in the previous year Total Urban Rural (repeaters)(table 10). 20% Water Sanitation

0% Total

Urban

82.3% 70.1%

89.5% 84.4%

76.3% 58.2%

Rural

PART2: COUNTRY PROFILES

Associate degree/ vocational/ technical (two years)

Vocational track

Table 10: Repeaters in Timor-Leste, 2008–2010 Male (as % of total male enrolment) 100% 100% Female (as % of total female enrolment) 100% 92% 89%

99%

80%

2009

2010

14%

20%

19%

17%

15%

Water 12% source 82%

Source: World Bank Databank, 2010.

2008

Sanitation facilities

60%

Rationale for WASH activities in schools 40%

South-East Asia averages The following points underline the rational for WASH activities in schools in Timor-Leste: Total

20%

Urban

Rural

• Access to a safe/improved water source and adequate/improved sanitation Water 82.3% facilities 89.5% remains 76.3% low. Only 69 per cent of the total population has access to a safe/improved water source, and only half Sanitation 70.1% 84.4% 58.2% 0% of the total population has access to adequate/improved sanitation facilities (table 2). Total Urban Rural • There is wide disparity between urban and rural areas in terms of access to safe water and adequate sanitation, with only 63 per cent and 40 per cent of the rural population having access to a safe/improved water source and adequate/improved sanitation facilities, respectively (table 2 and chart 31). • Around 43 per cent of the population still defecates in the open (table 3). • The annual incidence rate of diarrhoeal disease in the country is the highest in the region, with 834 cases per 1,000 of population (chart 1). 103 Primary Senior secondary • The 2010 WHO report pointedJunior out secondary that most schools do not have functional toilets and Pre-school Tertiary (six years) (three years) (three years) handwashing facilities. Only 53 per cent of public schools in the country have access to adequate sanitation facilities (chart 2).

Chart 31: Proportion of the population with access to a safe/improved water source and adequate/improved sanitation facilities in Timor-Leste, 2008 100% 80% 60%

Water source

86%

Sanitation facilities

76%

69%

63% 50% 40%

40%

South-East Asia averages Total Urban Water 82.3% 89.5% Sanitation 70.1% 84.4%

20% 0% Total

Urban

Rural 76.3% 58.2%

Rural

Source: UNICEF, State of the World’s Children, 2011.

Enabling environment Since 2003, UNICEF has partnered with the Ministry of Education, the Ministry of Health and the Ministry secondary Upperinclude secondary of Infrastructure in its WASH Lower programmes in schools, which the provision of facilities and (four years) (three years) promoting good hygiene practices through a child-to-child approach. UNICEF also assists the Ministry of Education to improve its EMIS data collection. Secondary (seven years)

Professional vocational (three to four years)

Vocational (one to three years)

Tertiary/higher education (at least three years)

Until 2011, the Ministry of Education Primarydid not have a department that covered WASH programmes in schools. Pre-school

103 WHO, 2010.

PART2: COUNTRY PROFILES

(five years)

The Ministry’s proposed standard design for school sanitation facilities initially was expensive; it was revised to include cost-effective design options for rural schools. The 2010 WHO report104 further noted that: • A partial national strategy on hygiene and sanitation exists. It is a starting point towards implementing a national strategy. • The Government, through the Ministry of Health’s Integrated Community Health Services, organized the national programme for hygiene promotion, with heavy emphasis on behavioural change communication and demonstrations of good hygiene behaviour. The Government also promotes the community-led total sanitation model. • The private sector is encouraged to help promote proper sanitation conditions by producing sanitation components. • Hygiene behaviour is reportedly well carried out in the school curricula. These government efforts provide a more conducive environment to integrate WASH programmes into schools.

WASH in schools105106 National school water and sanitation coverage

• UNICEF Country Office reported that of the 1,012 primary schools in the country, 440 schools have WASH facilities (43%): – 348 public schools – 92 private schools • Of the 440 schools with WASH facilities, 101 are located in urban areas and 339 are located in rural areas104 • The WHO reported in 2010 that 53% of public primary schools had adequate sanitation facilities105

Water source common to schools

Hand pump, tap water, unprotected sources

Sanitation facilities common to schools

Ventilated improved pit latrine, squat pot, flush toilets

Hygiene education and water values

Good hygiene behaviour is well promoted through the school curricula

Initiatives to support WASH activities in schools

UNICEF hygiene promotion, using a child-to-child approach

Main challenges The 2010 WHO report107 listed the following constraints in Timor-Leste: • Monitoring systems are not well coordinated, thus resulting in conflicting data. • Insufficient financial resources and mechanisms hinder the construction of infrastructure, operation and maintenance of sanitation facilities. • There is a lack of human capacity at the provincial and district levels. • The country’s top constraint related to sanitation improvement is the lack of a comprehensive policy and the currently weak implementation of what is in place; the Government does not perceive sanitation as a priority concern.

104 Ibid. 105 Schools located in ‘urban’ areas are in Dili or in district capitals, and schools in ‘rural’ areas are located outside the district capitals -- this definition was used in previous national surveys (UNICEF Timor-Leste). 106 WHO, 2010 107 Ibid.

PART2: COUNTRY PROFILES

Total

Urban

Rural

The UNICEF Country Office enumerated the following concerns: • Poor road infrastructure across the country makes access to some schools very difficult, especially in the rainy season. • The operation and maintenance of WASH facilities in schools is not a priority of the Government; Primary Junior secondary Senior secondary Pre-school Tertiary years) of funds (threeto years) (three years) there is no specific (six allocation maintain such facilities.

Partners WASH partners in Timor-Leste encompass: • Ministry of Education • Ministry of Health

Water source

100%

86% • Ministry of Infrastructure

• 80% UNICEF 69%

60%

Sanitation facilities

76% 63%

50% 40%

40%

Country profile: Socialist Republic of Viet Nam South-East Asia averages Total Urban Water 82.3% 89.5% Sanitation 70.1% 84.4%

20% 0%

Total

Urban

Rural 76.3% 58.2%

Rural

Education structure and trends in primary school Figure 18: Viet Nam’s education structure Lower secondary (four years)

Pre-school

Primary (five years)

Upper secondary (three years) Secondary (seven years)

Professional vocational (three to four years)

Vocational (one to three years)

Tertiary/higher education (at least three years)

Optional pre-school education in the country is available through crèches, kindergartens and ‘young sprout’ schools, offered by both the public and private sectors. Primary education consists of five years (grades 1–5). Upon completion of primary school, students may enrol in vocational training schools for one- to three-year programmes. Students may also pursue general secondary education, which is split into two levels: lower secondary, which lasts four years (grades 6–9), and upper secondary, which lasts three years (grades 10–12).

Female 46%

Male 54%

Students who complete secondary education may enrol in professional vocational schools for three to four-year programmes. Graduates of professional vocational programmes and of secondary education may pursue higher or tertiary education in junior colleges (leading to an associate degree) and universities (leading to a bachelor’s degree). In the 2009/2010 academic year, a total of 15,783 primary schools operated in the country, including 611 combined primary and secondary schools.108 More than 7 million students were enrolled, 46 per cent of who were female (table 4 and chart 32). 108 UNESCO-IBE, 2011.

94% 100% PART2: COUNTRY PROFILES

80%

75%

99% 94%

Water source

92% 67%

Sanitation facilities

100% 80%

Water source

86%

Sanitation facilities

76%

69%

Chart 32: Enrolment in Viet Nam,63%by sex, 2009 60% 50% 40%

40%

South-East Asia averages Male 54% Total Urban Water 82.3% 89.5% Sanitation 70.1% 84.4%

Female 46%

20% 0% Total

Urban

Rural 76.3% 58.2%

Rural

Source: UNESCO-IBE, 2011.

Rationale for WASH activities in schools A survey (2007) conducted by the General Department of Preventive Medicine (GDPM) in 966 schools (pre-school, primary and secondary and other public places in 20 provinces found: Lower schools) secondary Upper secondary

(four years) (three years) • Of the schools latrines, per cent had latrines that did not conform to sanitation Water source 94% 55 92% 94% that had99% 100% standards prescribed by the Ministry of Health’s Decision No. 08/2005/QBDYT.109 Slightly less than Secondary Professional vocational Sanitation facilities 75% 12 had latrines conforming to the sanitation standards. 80%per cent of schools (seven years) (three to four years) 67%

• Only 23 per cent of Primary schools in the northern mountainous regions, the central coast, central Pre-school (five years) 60% highlands and the Red River Delta had latrines that met the sanitation standard on construction; Vocational Tertiary/higher education only 14 per cent met the standards on operation and maintenance. (one to three years) (at least three years)

40%

South-East Asia only averages • Slightly less than 36 per cent of schools had handwashing areas; 29 per cent had sufficient Total Urban Rural 20% water and not quite 5 per cent had soap available for handwashing, resulting in a small percentage of Water 82.3% 89.5% 76.3% students who wash their hands with soap after using the toilet (nearly 12 per cent washed their hands 70.1% 84.4% 58.2% 0% soap after defecating, while less than 5 per centSanitation with washed their hands with soap after urinating). Total

Urban

Rural

• Some schools (21 per cent) had students who used a forest, garden, field, beach, stream or river’s edge as a defecating area. • Around 20 per cent of schools did not have a water source. Although the proportion of VietFemale Nam’s46% population having access to adequate/improved sanitation Male 54% facilities is larger than the average in the region, there is a huge disparity between the urban and rural areas, with 94 per cent and 67 per cent of its population, respectively, having access to improved sanitation facilities (table 2 and chart 33). It is somewhat alarming that only 12 per cent of public primary schools have access to adequate sanitation facilities (chart 2).

Chart 33: Proportion of the population with access to a safe/improved water source and adequate/improved sanitation facilities in Viet Nam, 2008 100% 80%

99% 94%

94% 75%

Water source

92% 67%

Sanitation facilities

60% 40%

South-East Asia averages Total Urban Water 82.3% 89.5% Sanitation 70.1% 84.4%

20% 0% Total

Urban

Rural 76.3% 58.2%

Rural

Source: UNICEF, State of the World’s Children, 2011. 109 For latrines to be considered sanitary or hygienic, Decision No. 08/2005/QDBYT stipulates that latrines should be one of the four types (double-vault composting latrines, ventilated pit latrines, pour-flush water-sealed latrines, septic tank latrines) and should follow standards on construction, operation and maintenance set out by the Ministry of Health.

PART2: COUNTRY PROFILES

Enabling environment The Government has national strategies and policies related to hygiene and sanitation that are widely applied: • The Ministry of Health issued Decision No. 08/2005/QDBYT, which serves as a guide to meeting the national standards for latrine construction, operation and maintenance. • The National Target Programme for Rural Water Supply and Sanitation Viet Nam, managed by the Ministry of Agriculture and Rural Development, which stipulated that all primary schools, kindergartens and nurseries in rural areas should have access to clean water and hygienic latrines by 2010. • Local governments are also enjoined to take responsibility in promoting and installing improved and safe sanitation conditions. The Government provides capacity building and information campaigns to support the local governments. Cooperation programmes with international development agencies (UNICEF, Plan International, World Vision, DANIDA, AusAID and the Netherlands Directorate-General of Development Cooperation) have been in operation since the 1980s. The private sector is encouraged to take part in latrine construction services.

WASH in schools National school water and sanitation coverage

• The Ministry of Education and Training reported that as of 2010: - 69.1% of primary schools had WASH facilities - 65.7% of kindergarten schools had WASH facilities • Results of the 2007 General Department of Preventive Medicine study showed that: - 80.1% of primary schools had latrines and 83.7% had access to water sources - 35.2% of primary schools had handwashing areas - 26.5% of primary schools had enough water in the handwashing areas

Water source common to schools

Results of the 2007 GDPM study showed that schools had the following water source: - running water – 32.6% - dug well – 24.8% - rainwater – 7.8% - water from river, lake or pond – 7.6% - upstream water – 5.4% - drilled well – 0.8%

Sanitation facilities common to schools

Results of the 2007 GDPM study showed that schools had the following sanitation facility: - septic tank – 45.9% - pour flush – 14.6% - double pit – 2%

Hygiene education and water values

Habits of physical exercise and good hygiene are included in the curricula

Policies and initiatives to support WASH activities in schools

The National Target Programme for Rural Water Supply and Sanitation Viet Nam stipulated that all primary schools, kindergartens and nurseries in rural areas should have access to clean water and hygienic latrines by 2010

PART2: COUNTRY PROFILES

Main challenges Viet Nam’s main challenges regarding sanitation improvements:110 • Monitoring systems are not well coordinated, resulting in conflicting information. • Despite the support provided by the national Government, local governments give little importance to sanitation improvements. • The country’s top constraint is the lack of financial resources and mechanisms to ensure the construction, operation and maintenance of facilities. The UNICEF Country Office additionally reported that: • There were no standard designs for WASH in schools until March 2008. Almost all schools that had WASH facilities did not have handwashing facilities and or had facilities that were not properly constructed. Facilities that were not re-built after standard designs were declared are either no longer usable or in very poor condition. • Construction costs of facilities following the standard design are high (US$15,000–$20,000). • Children are oftentimes not taught the proper use of facilities. They are often not aware of their roles in terms of WASH operation and maintenance, except for the cleaning of toilets as a form of punishment.

Partners Viet Nam’s WASH partners encompass: • Ministry of Education and Training • Ministry of Health • Ministry of Agriculture and Rural Development • International development agencies, such as UNICEF, Plan International and World Vision, DANIDA, AusAID and the Netherlands Directorate-General of Development Cooperation

110 WHO, 2010.

PART2: COUNTRY PROFILES

ANNEXES

Annex 1: Definition of improved and unimproved sanitation facilities, based on Millennium Development Goal 7 Improved

Unimproved

Flush or pour-flush to piped sewer system, septic tank, pit latrine

Shared improved sanitation facilities

Ventilated improved pit latrine (VIP)

Flush or pour-flush to elsewhere (street, yard, plot, open sewer, ditch, drainage)

Pit latrine with slab

Pit latrine without a slab or open pit

Composting toilet

Bucket latrine Hanging toilet or hanging latrine No facilities, only use of bush or field Open defecation

Annex 2: WASH conditions in schools in South-East Asian countries111 Country

Brunei Darussalam

Availability of WASH facilities in Complementary measures Operation and schools to support WASH in schools maintenance (hygiene education, capacity (proportion of of facilities development) schools with WASH Water Sanitation facilities) as of 2011 General water and sanitation coverage110

100% of primary schools are equipped with WASH facilities.

• Water-use ethics and sanitation are included in lesson plans.

Availability of WASH in schools baseline data (latest year available) NA

• Hygiene behaviour lessons are included in the curricula. • Capacity-building programme for teachers on developing valuesbased lesson plans.

Cambodia

5,279 (78%) of 6,767 primary schools have a latrine. 1,488 (22%) of 6,767 primary schools are without a latrine. About half of the total number of primary schools does not have handwashing facilities.

Part of overall school maintenance and other operating expenses.

2011 (Ministry • Two hours of physical and health of Education, Youth and education per week (2006) Sport) and two-hour local life skills education programme per week • Social science classes

• Capacity building on operations and maintenance for school directors and teachers • School-Led Total Sanitation Programme (2007, based on community-led total sanitation model) • FRESH (Focusing Resources on Effective School Health) • Bright Smile, Bright Future (with private/business sector) • School and Community Water, Sanitation and Hygiene, 2009 • Child-friendly schools.

111 Proportion of the population with access to a safe/improved water source and adequate/improved sanitation facilities (Source: UNICEF, State of the World’s Children, 2011)

ANNEXES

Country

Indonesia

Availability of WASH in schools baseline data (latest year available)

• Part of • Hygiene class No data on overall school • Establishment of Usaha WASH in maintenance schools at Kesehatan Sekolah (UKS), or and other School Health Programme (1984) the district, operating provincial and • WISE programme expenses national levels • Project Dokter Kecil, or Little • BOS (School Doctors, promotes good hygiene Operational through community theatre; Assistance) Fund provided children in grades 4–6 stage plays on the importance of for nonproper handwashing personnel school operational costs.

• Jum’at Bersih, or Clean Friday, is another student-led project that promotes proper handwashing during meetings on Islamic holy days • SANIMAS-BES, which refers to sanitation in schools and capacity building for schools.

Lao PDR

3,467 (39%) of Part of 8,902 primary overall school schools have water maintenance and sanitation and other facilities. operating expenses.

• Life skills, health and hygiene classes • Blue Box

2010 (Ministry of Education and Sport)

• Community-based construction/ contracting of latrine, water supply and other sanitation facilities in schools funded by development partners • Rainwater catchment construction in schools funded by development partner.

Malaysia

100

100% of primary schools have WASH facilities.

• Habits of physical exercise and hygiene are well included in the curricula.

Myanmar

• Life skills, health, hygiene and science classes

• 4 Cleans campaign to promote proper handwashing, garbage disposal and toilet use

ANNEXES

Country

Philippines

The average toiletto-pupil ratio in public elementary schools is 1:28. There are 473,643 toilets (including individual urinals and urinal troughs) in 38,506 public primary schools.

Part of overall school maintenance and other operating expenses

• Hygiene behaviour is well integrated into the curricula

Availability of WASH in schools baseline data (latest year available) 2012 (Department of Education)

86% of public primary schools have access to water sources. Singapore

100

100% of primary schools have WASH facilities.

• STAR (Sustaining Toilets as Restrooms) Awards Programme for primary and secondary schools

• LOO (Let’s Observe Ourselves) Campaign • Handwashing jingle called ‘Washy Washy Clean’ (Health Promotion Board). Thailand

100

• Health and physical education that include strengthening of health, capacity and disease prevention and self-protection from various risk behaviours

• School-based approach to avian influenza prevention and pandemic influenza preparedness. Timor-Leste

53% of public primary schools have sanitation facilities.

Hygiene promotion using the childto-child approach.

Viet Nam

69% of primary schools have WASH facilities.

Habits of physical exercise and hygiene.

2010 (Ministry of Education and Training)

Note: NA = Information not available.

ANNEXES

(Are they clear, effective and feasible? Are set standards being followed?)

Standards and guidelines

Cambodia

• Lack of sufficiently skilled and experienced human resources.

High cost of soap.

• Knowledge and skills in monitoring is still quite low.

• Schools that do not have a good relationship with the community tend to not attract much donor support. Schools supported by the community and donors have more toilets.

Community partnerships:

(Do partnerships work effectively to support progress? Are partners well-aware of WASH concerns? Are partners held accountable to contribute to national priorities? Does donor-supported school construction provide adequate WASH components?)

Partnerships with private sector, donors, community and development partners

• The engagement of local governance However: (commune councils) on school WASH • Provincial Department of Rural Development and issues is inadequate because these • Not all schools in rural areas have WASH Provincial Office of Education have a number of issues are seen as a responsibility facilities because some areas do not have capacity and institutional weaknesses, including of schools and directors and not the a water source. Some toilets are closed poor compliance, understanding and enforcement community or local government. because there is no water to use. of national strategies, policies and approaches to • Schools cannot follow support school WASH activities. • Some schools have handwashing facilities the prescribed ratio but do not follow the standards and due to the budgetary School leadership: appropriate practice. Students wash their Not all school heads are active and effective in hands in a basin and use the same water for constraints. sourcing additional financial support for the school. rinsing as well.

• 3 toilets per 100 female students. student/year for all expenses. Of this budget, US$0.40/ student/year is allotted for overall maintenance costs.

There is no budget • The small number of EMIS staff within the specifically allocated for Ministry of Education, Youth and Sport (MOEYS) WASH in schools. (15 at the national level, including administrative staff, only 2–3 staff assigned to statistics) cannot • The Government cope with the demands of the monitoring tasks. allocates US$2/

All schools should have toilets, water source and handwashing facility. Current standards prescribe:

• 3 urinals per 100 male students

Budget allocation: Human resources and capacity:

Little importance is given to sanitation by the local government.

Institutional capacity:

• Need to increase awareness of operators and managers in terms of supervising and monitoring.

• Facilities, including supplies, are poorly operated and maintained.

Human resources and capacity:

(including coordination mechanisms, management capacity, monitoring and evaluation)

Human and institutional capacities

Cost of consumables:

(Are governments investing enough? Are governments leveraging all available resources?)

Financial resources

Issues and challenges related to

Standards:

Brunei Construction standard: Darussalam Lack of hand-washing facilities, such as wash basins and hand dryers, and poorly located wash basins, which could have resulted from lack of construction standards.

Country

Annex 3: Issues and challenges in South-East Asian countries

Schools mostly use the lecture method in teaching hygiene.

Teaching methodology:

Schools supported by politicians tend to have adequate facilities.

Political influence:

Lack of awareness on good hygiene among students.

Awareness:

Others

ANNEXES

Country

Coordination:

(including coordination mechanisms, management capacity, monitoring and evaluation)

Human and institutional capacities

Extent of donor support:

Partnerships with private sector, donors, community and development partners

monitoring, they were found not complying with the CFS standards.

• There is no existing procurement committee at the subnational level to undertake tendering and monitoring of work, which tends to slow down the work that needs to be done in schools because decision-making is handled centrally.

• Standards are not followed when donors Given the extent of • Monitoring data collected by the District Training • Donor support only covers the build schools. They can design and create work at the village and and Monitoring Team is used by the Department construction of facilities. The any kind of facility. It is not monitored commune levels, the of Primary Education but not by the School Health Government or the school takes care of by the Ministry because there is no current salaries of a Department of the Ministry of Education, Youth maintaining the facilities. regulation on WASH in schools. village chief (US$10/ and Sport. • Donor support that goes directly into month)and a commune • The School Health Department conducts its own • The School and Community Water, the construction of WASH facilities chief (US$20/month) Sanitation and Hygiene regulation only evaluation study on selected schools only. could not be easily identified because refers to working together, coordination, do not provide enough • The Ministry of Rural Development (MRD) the support is generally given for the incentive for them roles and responsibilities but does not entire school construction. conducts the Knowledge, Attitude and Practice to be motivated and include guidelines on construction and committed to engage in (KAP) Survey as a monitoring and evaluation tool. • Donor support mostly comes in the use of materials. the school community’s However, the survey is not coordinated with other form of scholarships and/or school ministries and the survey results are generally building construction. Guidelines: WASH programmes or used by the MRD only. Data related to child-friendly schools (CFS) projects. • At the national and provincial levels, regular are not reliable because some schools do quarterly meetings are arranged with all civil not know what constitutes a child-friendly society and government actors. However, the school. Some schools indicated that they district and school levels need more coordination. are child friendly, but when visited for

Underpaid local officials:

(Are governments investing enough? Are governments leveraging all available resources?)

(Are they clear, effective and feasible? Are set standards being followed?)

Construction standards:

Financial resources

Standards and guidelines

Issues and challenges related to Others

ANNEXES

Indonesia

Country

Budget: Funding and financial mechanisms are not sufficient enough to support the construction and proper operation and maintenance of the facilities in schools.

Lack of good guidelines for sanitation improvement.

(Are governments investing enough? Are governments leveraging all available resources?)

(Are they clear, effective and feasible? Are set standards being followed?)

Guidelines:

Financial resources

Standards and guidelines

Local government units show little importance towards sanitation needs or conditions.

Institutional capacity:

The monitoring system is not well coordinated, thus resulting in conflicting information.

Monitoring:

Nobody is taking the lead to coordinate the WASH efforts in schools.

Coordination:

Hygiene education is not carried out effectively; sanitation is not part of the health education curriculum.

Human capacity:

(including coordination mechanisms, management capacity, monitoring and evaluation)

Human and institutional capacities

Issues and challenges related to

Lack of community awareness and education on hygiene and sanitation behaviour.

Community partnership:

Partnerships with private sector, donors, community and development partners

Others

ANNEXES

Myanmar

Funds are insufficient for the operation and maintenance of the water supply in some areas.

• There is no policy on subsidies for the sanitation sector.

Budget:

• Lack of good guidelines on how to implement the national strategy.

(Are governments investing enough? Are governments leveraging all available resources?)

(Are they clear, effective and feasible? Are set standards being followed?)

Guidelines:

Financial resources

Standards and guidelines

Malaysia

Lao PDR

Country

The monitoring system is not well integrated into the review and planning processes.

Monitoring

• Lack of management capacity to implement the construction (facilities) projects at the provincial and district levels.

• Poor operation and maintenance of facilities.

• With the country’s Education for All-Fast Track Initiative goals for 2010–2013, human resources are very limited and thus unable to achieve all the tasks, including meeting the demands for WASH.

Human resources and capacity:

(including coordination mechanisms, management capacity, monitoring and evaluation)

Human and institutional capacities

Issues and challenges related to

Partnerships with private sector, donors, community and development partners

There is still great demand for a water supply; given the country’s topography, water sources remain limited.

Geographic location:

Others

ANNEXES

Philippines

Country

(including coordination mechanisms, management capacity, monitoring and evaluation)

Human and institutional capacities

Partnership:

Partnerships with private sector, donors, community and development partners

• Given the differences in topography Local School Board • The Department of Education is still challenged • In some cases, the level of and available resources in each area, (LSB) Fund in terms of institutionalizing projects to sustain commitment and sense of ownership standards in constructing facilities cannot • Small-income them. In most cases, a national plan is developed from communities as a partner in be generalized. for a particular project. implementing WASH programmes is municipalities receive only a small portion of • The Schools Division Superintendents still lack the still low. • Given that the country has several the LSB Fund, hence different national standards on facilities capacity to manage planning processes. • Due to weak sense of ownership they do not receive construction, it is not easy to harmonize as well as little appreciation among enough funds to cover Coordination: the standards with WHO and UNICEF children, facilities are defaced by their WASH needs. • WASH issues cut across government agencies. standards. children and/or other community Funds are usually There is no coordinated effort among the agencies members. • Water supply and sanitation should come used to cover teacher to manage, operate and monitor WASH concerns. together. However, the water supply aids’ allowances and • Implementation guidelines and plans remain normally gets the bigger chunk of the sports competitions. at the national level and are not passed down budget while sanitation needs lag. • The fund includes to the implementers. Some school heads are Guidelines: allocation for not updated on the latest information from the There is a problem in translating national improvement of Department of Education. policies and frameworks into implementing the general school • It is not clear who is in charge of WASH in schools guidelines. facilities – not – is it the national agencies, the local government specifically for WASH units, the communities or the schools? needs.

Availability and use of funds: Human capacity:

(Are governments investing enough? Are governments leveraging all available resources?)

(Are they clear, effective and feasible? Are set standards being followed?)

Standard:

Financial resources

Standards and guidelines

Issues and challenges related to

Schools are used as evacuation centres during emergencies. WASH facilities get dilapidated when schools are used as evacuation centres.

Education in emergencies:

Some areas where schools are located are part of disputed lands or conflict areas, thus the improvement of facilities has become rather difficult.

Legal and security concerns:

Others

ANNEXES

Country

(Are governments investing enough? Are governments leveraging all available resources?)

(Are they clear, effective and feasible? Are set standards being followed?)

(including coordination mechanisms, management capacity, monitoring and evaluation)

Human and institutional capacities

allocation for annual • The area of monitoring and evaluation remains a regular repair of school challenge for all agencies. facilities, there is no Other institutional capacities: specific allocation for sanitation. If the budget is • LGUs are required to report on household insufficient, toilets are the sanitation but not on WASH in schools. first to be removed from • The lack of an effective sanitation mechanism the construction plan. remains a problem in the country. There are only • WASH consumables, two companies that have septage systems, and such as soap, are not both are private corporations. When a school’s allowed under the septic tank is dislodged, the proper disposal of Commission on Audit. waste remains unclear. Hence, it is difficult to include such expenses in the school budget.

• Policy implementation at the level of local governments is not monitored. There is no feedback mechanism between local government • Although the Government’s education units (LGUs) and national agencies in terms of policy compliance. budget has specific

General education budget

Expenses for the water sanitation facilities for compliance purposes only. supply and maintenance Monitoring results are not used for planning. There are not included in the is no feedback from the district/ division on how budget. When monthly the data submitted by principals are used. dues are not paid, the • There is no separate report on WASH facilities. school’s water supply Reports include learning facilities only gets disconnected. (classrooms, chairs).

Maintenance and other Monitoring and evaluation: operating expenses • Schools conduct their own monitoring of

Financial resources

Standards and guidelines

Issues and challenges related to

Partnerships with private sector, donors, community and development partners

Others

ANNEXES

Budget:

The Ministry of Education initially proposed • Insufficient financial a standard design for school sanitation resources and facilities that was expensive. mechanisms hinder the construction Guidelines: of infrastructure, Sanitation is not perceived as a priority operation and concern in the country, which may have maintenance of resulted from lack of a comprehensive sanitation facilities. policy and weak implementation. • No specific allocation of funds to maintain WASH facilities.

Timor-Leste Standards:

Thailand

(Are governments investing enough? Are governments leveraging all available resources?)

(Are they clear, effective and feasible? Are set standards being followed?)

Financial resources

Standards and guidelines

Singapore

Country

Monitoring systems are not well coordinated, thus resulting in conflicting data.

Monitoring:

• The operation and maintenance of WASH facilities in schools is not a priority of the Government.

• Prior to 2011, the Ministry of Education did not have a department that covered a WASH programme in schools.

• There is a lack of human capacity at the provincial and district levels.

Human capacity:

(including coordination mechanisms, management capacity, monitoring and evaluation)

Human and institutional capacities

Issues and challenges related to

Partnerships with private sector, donors, community and development partners

Poor road infrastructure across the country makes access to some schools very difficult, especially in the rainy season.

Infrastructures:

Others

ANNEXES

There were no standard designs for WASH Lack of financial in schools until March 2008. resources and mechanisms to ensure the construction, operation and maintenance of facilities.

Budget:

(Are governments investing enough? Are governments leveraging all available resources?)

(Are they clear, effective and feasible? Are set standards being followed?)

Construction standard:

Financial resources

Standards and guidelines

Note: NA = Information not available.

Viet Nam

Country

Local governments give little importance to sanitation.

Institutional capacity:

Monitoring systems are not well coordinated, resulting in conflicting information.

Monitoring:

• Children are not aware of their roles in terms of WASH operations and maintenance, except cleaning the toilets as a form of punishment.

• Children are not taught the proper use of facilities.

• Prior to 2006, schools were not actively involved in designing and implementing WASH programmes, as well as in operation and maintenance of facilities.

Human capacity:

(including coordination mechanisms, management capacity, monitoring and evaluation)

Human and institutional capacities

Issues and challenges related to

Partnerships with private sector, donors, community and development partners

Others

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REFERENCES

UNICEF East Asia and Pacific Regional Office (EAPRO) 19 Phra Atit Road Chanasongkram, Phra Nakorn Bangkok 10200, Thailand E-mail: eapro@unicef.org Website: www.unicef.org/eapro Tel: +662-356-9499 Fax: +662-280-3563