This case study describes the Siaya Health Education, Water and Sanitation Project (SHEWAS) which was implemented by the NGO CARE International in Siaya District in Kenya in 1990. It focuses on the use of PRA as a means of stimulating community participation in the identification and planning of water and sanitation micro- projects. The SHEWAS approach is outlined and some of the achievements and results, and lessons learned, are discussed.
Handwashing is a vital part of good sanitation and hygiene. When Community-Led Total Sanitation (CLTS) and its aim of ODF (open defecation free) communities are fully understood and put into practice it is clear that handwashing is implicit in the approach. Without addressing handwashing and other hygiene practices, communities can never become fully ODF since CLTS aims to cut all faecal-oral contamination routes. However, in practice, the degree to which handwashing is integrated into triggering and follow up, depends on the quality of facilitation. This guide, developed in Malawi, addresses the need for specific tools that help to incorporate handwashing into CLTS.