Water and Sanitation Status in the Kilifi DSS.

1. Water and Sanitation Status in the Kilifi DSS. B.K.Tsofa

2. The Kilifi DSS • Was set up by KEMRI-WTRP in 2000 to, • To establish a population framework for epidemiological studies of diseases of local importance • To measure mortality trends accurately over time (in the absence of accurate vital statistics) • To evaluate the impact of interventions of national public health importance • Comprises of 80% of the clients who utilize KDH for health services • Enumeration is done 3 times in a year

3. Introduction • A total of 247,624 residents from 15 locations in the Kilifi DSS were involved in the water sources and sanitation survey none in the DSS round 19 enumeration. • The question asked were; • What is the main source of water? • Do you(DSS resident) boil, treat, filter water before drinking? • What is the main type/mode of human waste disposal? • 2299 (0.9%), 3931(1.6%) and 3003(1.2%) answered “don't know” to the first, second and third question mentioned above respectively • Majority (82.62%) of DSS residents were resided in the rural areas

4. Water sources • Overall, 80 % of Kilifi DSS residents had access to piped water • 7.8 % of the residents used water from unprotected wells • Ponds, dam, rivers, harvested rain water, and water vendors accounted for about 1 % • Inter-location rates for piped water ranged between 44% in Junju location and 99 % in Sokoke location

5. Water sources by region in Kilifi DSS

7. Water Sources by location

8. Modes of Human Waste Disposal

9. Achievements-Triggered plus spill over

10. Kilifi district latrine coverage by Division

11. Modes of Human Waste Disposal • Approximately 49 % of the residents used covered pit latrines • 37 % go to the bush for defecation • 5.8 % used uncovered pit latrine • 0.4 % used other modes like bucket latrines, main sewer, and cess pool, etc

12. Cont... • Inter-location rates for pit latrine usage ranged between 15 % in Jaribuni location and 76.4 % in Ziani location • The use of bush for defecation ranged between 10.8 % in Ziani location and 80.2% in Jaribuni location • The coverage of VIP latrines ranged between 2.4 % in Roka location and 6.9 % in Ngerenya location

14. Pit latrine Coverage

15. ODF Prevalence

16. Water Treatment at Point of Use • 93.4 % of the residents in the DSS did not treat, boil or even filter the water before drinking • Only, about 6.6 % of all the residents reported to boil, treat or filter water before drinking • More residents (4.84 %) treated water before drinking than they boiled water before drinking 1.25 %

17. Cont... • Residents using water from improved water sources were 37 % less likely to disinfect drinking water compared to residents using water from unimproved water sources • Those residing in the peri-urban areas were 73 % more likely to disinfect drinking water than those residing in the rural areas

18. Planned work • Base line data for prevalence of water (fecal mater ) contamination • Continuous monitoring of water contamination levels with improved sanitation • Case –control studies for water-borne and water-washed diseases

19. Thoughts on CLTS in Kilifi • Piloted in Jaribuni village, in July 2007,as a collaborative effort between MoH ,Plan Kilifi and the community • DHMT, all PHOs & PHTs and some Plan Kilifi staff were trained on the CLTS concept in May 2008 • Lots of enthusiasms for scale up spearheaded by DHMT

20. Profiling Kilifi Sanitation • We have profiled Kilifi and hosted all sorts of visitors • Global media coverage; press media and internet network • Positioned Kilifi on the ‘Global sanitation map’ • Can we sustain this momentum and our position on the global sanitation map?

21. Challenges as per Sigomaba’s Presentation • Sustaining the momentum by the community after CLTS triggering, inadequate follow up of natural leaders and officers in triggered villages. • High water tables/collapsible soils/hard rocks requiring special latrine technology out of reach to the community. • Some CHWs and provincial administrators expected to be role models have not taken leading roles. • Termites infestation • Seasonality and its effect on community participation in CLTS e.g. prolonged drought and rains.

22. Opportunities • Inherent capacity after the training of 2008 • Dedicated and true partners, community members, community leaders, Plan Kilifi • Established network of community leadership; CHWs, Village elders

23. Thoughts in Moving forward • Lets empower the communities to take a lead role Who among us here went to trigger Ngamani. Village.??? Why are they ODF...??? • Let the community engineers exercise their skills