Threats for school children: Infection risks, lack of privacy and hygiene
Researchers and practitioners alike agree that safe water and sanitation in schools leads to better health for school children. This, in turn, increases school attendance and can enhance the ability to learn.

In Tanzania, MKUKUTA, the 2005 National Strategy for Growth and Reduction of Poverty, set two main goals for school sanitation: firstly, sanitation facilities for all schools by 2010, and secondly, a ratio of 20 girls and 25 boys per latrine. Reality looks different, however, with an average of 60 students per latrine being observed. This ratio has not improved over three years. In Zambia, only one third of the primary schools have permanent toilets and only 9% of the schools provide an adequate number of toilets for girls. The National Rural Water Supply and Sanitation Programme aims that by 2015, 80% of rural schools in Zambia have the number of adequate and functioning toilets stipulated by the Public Health Regulations of Zambia, was well as sufficient, adequate hand washing facilities.

Today, many school sanitation facilities in the South African Development Community (SADC) region are insufficient. This is demonstrated by the lack of water for hand washing, the lack of facility maintenance and the lack of hygiene education programs. Current facilities do not adequately address the privacy and security needs of school children. Girls are particularly disadvantaged by a lack of clean and safe private sanitation facilities. This often prevents them from attending school during menstruation. Good school sanitation and health education not only contributes to reducing the drop-out rate among girls but also increases the chances of their future children surviving.

Improving hygiene and health in schools in the SADC-region
During the process of DEWATS School Based Sanitation (SBS) implementation in schools, BORDA and its SADC partners work with local partners to reconcile the interests of all stakeholders in order to construct sanitation facilities which meet the needs of children and young adults. Various technical options are available and can be adapted to local demand. Education, evaluation and training programs assure correct handling and reliable maintenance, and contribute to the sustainability of the whole SBS project.

Design of School Based Sanitation projects
Each school sanitation project starts with the establishment of a school sanitation committee, which can be formed from an existing school committee.  Once its members have been identified, the general project cycle is explained to the committee and specific responsibilities are assigned. One such important responsibility is mobilizing local resources within the community.

Secondly, a water and sanitation survey is conducted to identify the location and distribution of resources (transect walk) and to assess local water and sanitation needs.  The subsequent design of sanitation options takes into account factors such as the availability of water, construction costs, cultural sanitation behavior, availability of construction material and the handling of operation and maintenance.

Possible sanitation options are then introduced and explained to the school sanitation committee through the informed choice approach.  Benefits and disadvantages are explained to stakeholders (e.g. through illustrated posters) before the selection of a preferred technical option is completed. This approach ensures the support of all stakeholders for the project and, consequently, sustainable operation and maintenance of the facilities.

Once this has been done, a project management and implementation plan can be drawn up which covers aspects such as the management of funds and human resources and the involvement and responsibilities of the stakeholders. Tangible steps in the implementation process are then identified. Data for a health impact assessment baseline study is also collected, which provides for effective assessment after project implementation. 

The establishment of school sanitation clubs is another important part of the process. These clubs exist to educate children about hygiene and health as well as to ensure the sustainable operation and maintenance of the facilities.  Selection criteria for club members, as well as their rights and responsibilities, are defined.  Furthermore, the financing of sanitation competitions is determined, which will serve as incentives for appropriate sanitation behavior and good maintenance of the facilities.  Finally, construction takes place, followed by thorough caretaker training covering issues such as toilet cleaning, maintenance of the treatment plant and the use of biogas for cooking. 

After commissioning, the facilities are handed over to their users and to the community.  As a final measure, performance monitoring and a health impact assessment study is undertaken.