Sanitation remains one of the Sustainable Development Goals, with slow progress. Tanzania has been implementing the National Sanitation Campaign through a Community-Led Total Sanitation (CLTS) approach since 2012. Njombe District Council (DC) has been identified to be among the best performing councils in the implementation of the sanitation campaign. A qualitative study was conducted to document how the CLTS was carried out in Njombe DC, assess progress on CLTS implementation and define the success factors for CLTS implementation. Findings show that CLTS intervention has resulted in increased coverage of improved latrines at a household level from 7.5% before the intervention in 2011 to 99.8% in September 2018. In addition, households with functional hand washing facilities have increased from 5.1% before the intervention to 94% in September 2018. Involvement of political leaders and government officials from the council level to the lowest governmental unit offered important support for CLTS implementation. The best mix of sanitation education, regulation and enforcement was instrumental in raising community awareness, changing collective behavior, making people comply with the village sanitation laws, and the overall success in the sanitation campaign.

This study assesses the intermediate outcomes of the Tanzania National Sanitation Campaign (NSC) for schools. A cross-sectional study was designed as part of a process evaluation of the NSC in Tanzania on 70 primary schools and 54 regional and district education officers. Data was collected between August and December 2014 using questionaires, key informant interviews, and desk studies. The results showed that only 50% of schools met the Tanzania guideline of 50 boys per drop hole, while 43% met the guideline of 40 girls per drop hole. In addition, 53% of schools had a reliable water supply, 43% had some functional handwashing stations, but only 29% and 19% had water and soap available at the stations, respectively. Overall, the implementation of the NSC in schools was found to be effective, though poor planning and coordination, inadequate funding, and low technical capacity were identified as barriers to achieve the intended objectives. The study recommends stronger and coordinated stakeholder partnerships with clearly defined roles including cost sharing.Government and other stakeholders should also consider the impact of increasing funding for both software and hardware components to improve the enabling environment, and to develop a standardised monitoring mechanism for sustainable school water, sanitation and hygiene.

Access to improved sanitation facilities has been a challenge, especially in developing countries. In 2012, Tanzania launched a rural-based National Sanitation Campaign to address the challenge of low coverage of improved sanitation and hygiene at household and school levels using a combination of approaches including Community-Led Total Sanitation (CLTS) and behavior change communication. In June 2016, a study that involved interviews with heads of households, complemented by observations of sanitation and hygiene facilities in 2,875 households from 289 villages, was carried out in campaign and non-campaign villages. Overall, 94.7% of the households had a basic toilet; whereas 7.0% of the households from non-campaign villages against 3.5% from the campaign villages had no toilet. Moreover, overall coverage of improved sanitation was found to be 52.6% and varied between campaign (62%) and non-campaign (43%) villages. Hand washing points were hardly observed in both campaign and non-campaign villages, although they differed significantly between the two areas: 42.7 vs. 26.7% for campaign and non-campaign villages, respectively. Factors associated with households' access to improved latrines include economic status of the household, education level of the head of household and geographical location of the household. Further studies are needed before drawing clear-cut conclusions about the impact of the campaign.

BackgroundHealth risks associated with poor sanitation behaviours continue to be reported mostly from low-income countries (LICs). Reports show that various factors limit many people from accessing and using improved latrines, forcing some to opt for sharing latrines with neighbours, others practicing open defecation. Meanwhile, debate prevails on whether shared latrines should be categorised as unimproved according to WHO/UNICEF-JMP criteria. We contribute to this debate based on results from a study undertaken in three regions, Tanzania.Materials and methodsData were collected through observations in 1,751 households with latrines, coupled with collection of opinions from heads of such households regarding the latrine-sharing practices. Bivariate and multivariate logistic regression analyses were performed to assess associations between the outcome and possible predictor variables.ResultsOf all 1,751 latrines, 14.6% were shared. Among the shared latrines, 74.2% were found being generally clean as compared to 69.2% of the non-shared ones. Comparing the shared and non-shared latrines, the non-shared latrines were significantly less likely to be found with floors built with permanent materials (OR = 0.73, 95% CI: 0.55, 0.98); washable floors (OR = 0.69; 95% CI: 0.51, 0.93); and lockable doors (OR = 0.73; 95% CI: 0.56, 0.95). Shared latrines were less likely to have floors with faecal matter, functional handwashing facilities (HWFs), HWFs with running water, and roofs; albeit the differences in all these scenarios were not statistically significant. Respondents expressed desire for improved latrines, but also did not find it wrong to share latrines if cleanliness was maintained.ConclusionHaving an ‘improved’ latrine remains important as JMP recommends, but based on our study findings, we argue that possessing a non-shared latrine neither guarantees safety to its users nor its categorisation as ‘improved’. Instead, the state of the latrine, the construction technology used and the behaviours of the users may be more important.