Gender, WASH and education case study: Enhancing girls’ participation in schools in Pakistan 1 Introduction In 2010, Pakistan was ranked 125 out of 169 countries in the United Nations (UN) Human Development Index, and falls under the category of ‘medium’ human development.1 It has a population of 176 million, around 48 per cent of whom are women. It is estimated that half of the population is illiterate, including two out of three women. Poverty is widespread, with one in four people living below the poverty line, unable to meet their basic needs. Half of them live in the Punjab, Pakistan’s most populous province. It is estimated that 6.8 million children are out of school – the second largest out-of-school population in the world after Nigeria according to Global Monitoring Report 2010 – accounting for 7 per cent of global absentees.2 In recent years, the country’s literacy rate has improved at a moderate pace. According to data from the 2007–08 Pakistan Social and Living Standards Measurement (PSLM) Survey, the overall literacy rate (those aged ten years old and above) was 56 per cent, and rose by 1 per cent to 57 per cent in 2008-2009. Figure 1: Literacy rates in Pakistan between 2006 and 20093 Literacy Rate 10 Years & Above 20062007200807 08 09 67 69 69 42 44 45 55 56 57 45 49 48 72 71 74 Gross Enrolment Rate (GER) Primary (age 5-9) 20062007200807 08 09 99 97 99 81 83 83 91 91 91 84 83 85 106 106 106 Net Enrolment Rate (NER) Primary (age 5-9) 20062007200807 08 09 60 59 61 51 52 54 56 55 57 52 51 53 66 66 68 Pakistan Male Female Both Rural Urban Gender Parity Index (GPI) 0.63 0.64 0.65 0.82 0.86 0.83 0.85 0.88 0.87 Source: Economic Survey of Pakistan 2009-2010 According to the latest PSLM Survey for 2008–2009, the overall literacy rate is 57 per cent (69 per cent for male and 45 per cent for female) compared to 56 per cent (69 per cent for male and 44 per cent for female) for the period 2007–08. The data shows that levels of literacy remain higher in urban areas (74 per cent) than in rural areas (48 per cent), and are more prevalent for men (69 per cent) compared to women (45 per cent). However, it is evident from the data that overall female literacy is increasing over time, but progress is uneven across the provinces. There are also significant differences in literacy rates and gross enrolment rates within provinces. In the Punjab, for instance, southern districts have much lower literacy rates than northern districts. These districts are very remote and underprivileged and prone to natural disasters such as floods. These areas not only have lower literacy rates, but the incidence of violence against women is also very high. Compared with other South Asian countries, Pakistan has the lowest public expenditure on education as a percentage of gross domestic product (GDP).4 Education spending amounted to 2.5 per cent of GDP in 2006–07 and 2.47 per cent in 2007–08, and is estimated at 2.1 per cent for 2008–09 and 2.05 for year 2009-2010.5 Pakistan spends even less public money on education than Bangladesh and Nepal. 2 Figure 2: Public Expenditure (as %) of GDP Source: Ministry of Education Apart from poor access there is also a serious problem with the quality of education imparted to students not only with respect to curricula, but also regarding the quality of teaching. Other issues, such as teacher absenteeism, cultural and social barriers (that prevent girls from getting an education), dysfunctional school management committees, lack of proper infrastructure and the gap between communities, schools and local government educational departments for active participation of all stakeholders, have all further exacerbated the situation in the education sector. Gender and education The adult literacy rate for women (44 per cent) in Pakistan is among the lowest in the world, and lags far behind that for men (69 per cent). Girls’ educational attainment is also far below that of boys.6 It is unfortunate that the education of women is not considered as a vehicle for social change, or a process by which they can be empowered to question and become agents of change.7 There is also a gender gap in overall school attendance, at 46 per cent for girls and 71 per cent for boys (2007–08). Enrolment in primary education is another area marked by wide gender disparity. In 2007–08, the gross enrolment rate for primary children (aged five to nine) was 97 per cent for boys and 83 per cent for girls. Net enrolment rates for the same age group were 59 per cent for boys and 52 per cent for girls.8 Literacy rates, particularly for girls, are a critical indicator of social and economic development. Studies have shown that there is a clear link between lack of economic opportunities and illiteracy, poverty and violence against women. The Millennium Development Goals (MDGs) The MDGs, agreed by world leaders at the UN General Assembly in 2000, set out eight targets to reduce poverty and tackle the biggest social development problems around the world by 2015.9 The second MDG goal is to ‘ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling’. Pakistan made a commitment to eliminating gender disparity within education at primary and secondary levels by 2015. Although some small improvements have been made, much more needs to be done to bring about gender parity at every tier of the country’s education system. A slight improvement in the gender parity index (GPI)10 was witnessed during 2007– 08, rising from 0.63 in 2006–07 to 0.64. The GPI for middle (secondary) schools during 2007–08 remained at 0.77, whereas it was 0.75 for secondary education during the same period.11 Figure 3 highlights the prevailing gender disparity at various levels of education between 2000 and 2008. 3 Figure 3: Reasons for boys and girls dropping out of primary school Reasons for dropping out of primary school Parents did not allow Too expensive Too far Had to help parents with work Had to help with domestic chores Child not willing to attend Boys Urban (%) 3 33 0 8 3 41 Rural (%) 3 18 1 8 5 45 Total 3 23 1 1 8 44 Girls Urban (%) 20 34 3 3 1 21 Rural (%) 19 17 6 6 2 27 Total 19 22 5 5 1 25 Source: Pakistan Integrated Household Survey (PIHS) 1998/99 In most cases, poverty is the main reason why families do not send their children to school – they simply cannot afford to. Figure 3 shows some of the reasons why children (boys and girls in both rural and urban areas) do not attend or drop out of schools. It is interesting to note that for boys in rural and urban areas, only 3 per cent cited their parents not allowing them to attend school, whereas for girls, this figure was 20 and 19 per cent respectively in urban and rural areas. It is clear that traditional attitudes about gender and girls’ education prevail in both rural and urban areas. The learning environment is a big contributing factor in motivating or de-motivating children to attend school. Another key reason – ‘the child is not willing to attend’ – is associated with corporal punishment in schools, the lack of adequate facilities and absenteeism of teachers. However, the data presented here is ten years old, and there is no recent data available. Figure 4: Government targets for provision of WASH facilities In 2009, Pakistan’s Ministry of Education introduced the following standards for water and sanitation facilities in schools: Drinking water Water supply systems should be provided in each school to ensure sufficient availability of improved drinking water all year round, with a tamper-free storage tank where water supply is intermittent or likely to be disrupted. The storage capacity must be five litres per child per day. Sanitation and hygiene There should be at least one latrine for every 50 children. This standard can be revised and reviewed where school enrolment is under 100. There should be separate sanitation facilities for girls and boys. A hand washing facility should be provided near the latrines. There should be at least one tap for hand washing for every 50 children. Soap containers should be fixed at a suitable point on or near the hand washing facility. Latrines must be located 30 metres away and downhill from a ground water source/facility to reduce the chances of contamination, with proper arrangements for drainage water. A container must be provided for solid waste management. The Ministry of Education has also highlighted some key factors that should be considered in order to make the facilities more accessible to children, as follows: Strength needed to use the pump or to open taps or open the door (weight of door); Access to facilities must be open and clear, while ensuring enough privacy (particularly for girls) so that children feel comfortable when using the toilets or water points; 4 Height of door knobs/locks should be appropriate for users. Access to water, sanitation and hygiene (WASH) facilities Almost 50 million, of Pakistan’s 176 million people, lack access to clean drinking water (2008).12 Only 42 per cent of people have access to sanitation facilities (latrines) – 65 per cent in urban areas and 30 per cent in rural areas.13 Around 30 per cent of people in urban areas live in katchi abadis (squatter settlements) and slums, with totally inadequate sanitation and sewage disposal facilities. Many people live near open sewers or drains, causing serious public health problems. From 2000 to 2003, diarrhoeal diseases accounted for 14 per cent of all deaths in children under five.14 Every day, 670,000 children miss school due to illness.15 One in three schools has no safe drinking water, and half of all schools lack proper sanitation facilities.16 In addition, many people do not have a clear understanding of the link between poor hygiene and the spread of disease. Overall, water, sanitation and hygiene-related illnesses are estimated to cost Pakistan’s economy around Rs112bn per year.17 The National Sanitation Policy of Pakistan aims to ensure ‘an open defecation-free environment; the safe disposal of liquid and solid waste; and the promotion of health and hygiene practices’.18 The National Drinking Water policy was drafted to give everyone the right to safe drinking water (see Figure 4 for policy on provision of services in schools). The seventh MDG aims to halve the proportion of people without sustainable access to safe drinking water and basic sanitation by 2015. In Pakistan, government spending on water and sanitation is very low, at 0.09 per cent and 0.10 per cent of GDP in 2003–04 and 2004–05 respectively. The need to invest in water, sanitation and hygiene services, particularly in and around schools, is reflected in several other international agreements and instruments, including the Dakar Framework of Action, Education for All (2000), and Vision 21 (2000). The 2002 World Summit on Sustainable Development called for action to improve sanitation in public institutions, especially schools, to promote safe hygiene practices among all children as agents of behavioural change in their families and wider communities.19 Oxfam GB’s20 integrated education programme in Pakistan Oxfam has been working in Pakistan since 1973 and is striving to address the key issues described above through different projects and programmes. It is currently implementing a specific programme on education, which aims to improve the Government policy environment, budget allocations and expenditure at national, provincial and district levels on education to ensure greater access and better quality of education for girls in Pakistan. The programme is made up of a number of projects which address the issues of poor educational attainment – especially amongst girls – high pupil-teacher ratios, lack of appropriate facilities and other basic amenities, quality education both in terms of curricula and teaching, strengthening governance and accountability systems in education, and mobilising wider civil society organisations to demand accessible and quality education for girls in four provinces of Pakistan. Along with donors and implementing partners, Oxfam is taking an integrated approach to programming to tackle the range of issues that contribute to low literacy rates and low attendance and retention of girls in education. Some of the activities being implemented include empowering communities to actively participate in supporting the improvement of health and hygiene in schools, and encouraging more girls to enrol and stay on in school. This work includes providing safe drinking water, separate sanitation facilities for girls and boys, promoting key messages about good hygiene habits, as well as enabling children to be agents of transformational change in their families and in their wider communities. At the same time, Oxfam is striving to empower civil society groups to raise their voices and demand greater resources for education budgets at national level, along with effective and rationalised utilisation of allocated budgets. The programme has five projected outcomes: 1. Enabling Policies and adequate expenditure on education services to ensure that girls in four provinces of Pakistan access high quality education in a risk-free environment. 2. Strengthened Governance and Accountability systems for educational institutions in X districts of four provinces of Pakistan. 3. Strengthened capacities and networks of civil society groups to demand for removal of supply and demand side barriers to girls' education at national and provincial level in Pakistan. 4. Enhanced availability and quality of education services especially for poor girls and boys in X provinces of Pakistan. 5. Community attitudes towards girls' education changes in favour of increased enrolment and retention of girl students in X districts of four provinces of Pakistan. 5 Oxfam’s commitment to Gender and WASH Although promoting access to water, sanitation and hygiene (WASH) was not explicitly identified as a key area of Oxfam’s work in the country it was clearly recognised that these are essential services that help poor people to move out of poverty. In addition, WASHrelated activities have historically been a central component of Oxfam’s humanitarian response in Pakistan. The integration of WASH activities into broader development programmes is therefore a natural progression. Within its education programme, Oxfam has been implementing a number of projects specifically relating to WASH in education. WASH in schools Schools can play a very important role in helping to shape children’s futures and through the provision of quality education, ‘When the girls are younger we can help to break the cycle of poverty. In love to send them to school, but for Pakistan many schools do not have basic us it is very difficult to send girls to infrastructure, with inadequate or no latrines school if they are in the age of or other sanitation related facilities. These puberty. It is a matter of respect result in high dropout and low enrolment and dignity for us.’ Yasmeen, rates, particularly for girls, especially when they reach puberty – also considered a sign Village Peer, Mashaikh District that they are ready for marriage. In rural areas many boys and girls travel long distances to attend school, many returning home to use toilets due to inadequate or no facilities in school. Girls face further challenges during menstruation when they have to remain absent from school for up to a week or more every month. These absences affect children’s learning achievements. Objectives of implementing WASH into education programming The main objectives of implementing WASH activities into the Pakistan education programme are to tackle high dropout rates and absenteeism among girls and boys, to help children to become agents of transformative change and to protect children particularly from harm. 1. Tackling high dropout rates and absenteeism Girls often drop out of school when there are no suitable toilets, especially when they reach adolescence and have menstrual hygiene needs. Schools can play an important role in keeping children healthy and protecting them from risks. Providing WASH facilities such as toilets, hand washing stations and drinking water points improves the learning environment and makes schools more accessible to children. Children also have a right to these basic services. As noted above, many schools in Pakistan either have no latrines or latrines that do not work properly, causing many girls to stay away from school each month during menstruation. This regular absence often leads to them dropping out of school altogether. Furthermore, the absence of gender-specific latrines discourages many girls from remaining in school. Studies have shown that 11 per cent more girls who have reached puberty attend school where latrines are available.21 2. Helping children to be agents of transformational change Every day, 4,000 children die from diseases caused by unsafe water and sanitation, mainly from diarrhoeal diseases like cholera and dysentery. Yet all are easily prevented through water, sanitation and hygiene projects. The simple act of washing hands with soap and water can reduce diarrhoeal diseases by over 40 per cent. It is widely acknowledged that children can be agents of change in their families and communities. Schools partly determine children's health and well-being by providing a healthy or unhealthy environment. Water and sanitation facilities in schools are a basic right of all children for well-being. A 6 school has the potential to play a vital role in developing healthy habits among children. Children are enthusiastic to learn new skills and ideas and promote these ideas in their communities. Teachers can play a key role in promoting good hygiene practices among children in the school environment. Education can also play a hugely important role in shaping the lives of girls in terms of helping them to develop life skills on health and hygiene – knowledge they can use to improve the lives of their own families and children. Engaging children and enabling them to participate fully in learning about good hygiene is a very costeffective intervention as it promotes healthier practices among their families and wider community and is more likely to bring about changes that are sustainable in the longer term. 3. Protecting children If a school has no latrine, children have to go to nearby fields when they want to go to the toilet. This increases children’s, especially girls’, vulnerability and leaves them open to violence and harm, such as sexual harassment, assault, rape, kidnapping and/or other dangers. Many parents are not keen on sending their girls to school for this reason. If a school has improved and adequate facilities, children (especially girls) benefit and teachers are more likely to want to work there. WASH activities in Oxfam’s education programme The following WASH activities are an integral component of our programme to improve girls’ access to education: Building water and sanitation infrastructure in schools, including hygiene promotion in school activities; Forming mothers’ groups and/or girls’ youth clubs (for out-of-school girls) to promote literacy and improved hygiene practices; Advocating with the Ministry of Education and strengthening its capacity to develop strategies to improve water and sanitation infrastructure in schools and to provide good public hygiene education; Research/data collection to measure changes in girls’ school attendance as a result of community-level intervention, for example mothers’ literacy group, improvements in water supply or installing latrines. WASH activities have been carried out in 208 schools in six districts of the Punjab (Chiniot, Multan, Muzaffargarh, Rahim Yaar Khan (RYK), Jhang and Rajanpur). Providing safe drinking water and improving sanitation facilities Oxfam and its partners have installed or repaired toilets and handwashing facilities in 64 schools. A total of 31 new toilets blocks were constructed and 74 were rehabilitated, along with the installation of 29 water pumps and 29 hand pumps. In many schools, toilets were not being used because of the unavailability of water, so water and sinks were provided near the toilet blocks to enable children to use the facilities properly. ‘Now we like our school more than anything because it has new toilets, new rooms and we have also a wash basin and soap to wash our hands.’ Noor Sania, third grade student, Government Girls Primary School, Multan Rehabilitation consists of restoring the structure and facilities to their original/working condition as well as providing new items such as soap dishes, towel rails and showers. Larger septic tanks have been provided so that the waste can decompose completely before exiting the tank. Larger tanks ensure less pollution to the surroundings because they get filled less quickly and chances of leakages are reduced. The drains are properly covered and located at a reasonable distance from the toilet blocks, further minimising the risk of contamination and pollution. 7 ‘Our school was very dirty. There were broken rooms and no latrines. But now we have latrines and also a sink where we can wash our hands. Before, I don’t like to come in school, but now it gives me pleasure to be in school. It feels more like a home.’ th Samina, 5 grade student, Government Girls Primary School, Aliwala Promoting good health and hygiene Rehabilitating facilities alone is not sufficient to bring about changes in people’s hygiene habits; educating people about good hygiene is one of the most effective ways of reducing the spread of illnesses such as diarrhoea.22 The project teams designed innovative and fun ways to get across key messages about good hygiene practices. So far, more than 10,000 girls and 450 teachers in more than 200 schools have been trained using a range of participatory methods. Advocacy and lobbying work While it is vital to provide basic services in schools to increase children’s (and particularly girls’) enrolment, it is also important that teachers, parents, communities and civil society organisations get involved in advocacy and lobbying work to demand better access to water and sanitation, and to ensure sustainability. Many schools have been involved in the annual Global Hand Washing Day (21 October), creating drawings, posters, plays, poems or short plays about the importance of hygiene and hand washing; older children gave demonstrations to younger children about how to wash their hands properly. This was just one event in a much wider international campaign to draw decision-makers’ attention to the importance of water, sanitation and hygiene promotion for children in school, especially girls. Although the government of Pakistan has approved national policies for the provision of water and sanitation, there are no specific chapters covering drinking water and better sanitation practices in schools. There is also limited technical capacity within government. These are important areas for community-based advocacy work, which the education programme is working on as part of its broader advocacy strategy. Tools used to implement WASH strategies The project team used different tools to engage children, teachers, parents and other members of the community to ensure their active participation and ownership of the processes. These include the health checklist, a Snakes and Ladders board game, other information, education and communication (IEC) materials, and theatre for development. Health checklist The health checklist is a motivational tool that has resulted in tremendous improvements in children’s personal care on a daily basis in school. Children receive green stars from their teacher if they arrive clean and tidy, or black and red stars for untidiness. This has also created healthy competition between children to keep them clean and get more stars. ‘The health checklist has solved many of our problems regarding neatness and cleanliness of children. We have been striving since many years to tell children to come in school with clean uniform, but they were hardly bothered. But since we have started to mark the stars, children have improved themselves remarkably.’ Ms Rehana, Teacher, Government Girls Elementary School, Chak Number 193 P IEC materials The project teams promoted key messages about why it is important to wash your hands before eating food and after going to the toilet through IEC materials such as posters and leaflets, produced in the local language. In each district, Oxfam works with the Ministry of Education to replicate our work in other schools. The materials are put up in schools to reinforce the messages given to children in awareness raising sessions. 8 Snakes and Ladders game This popular children’s board game has been adapted as a fun way to get key messages across to children about why they should change their hygiene habits. It helps them to really remember the messages about good hygiene practices. The snakes represent all healthrelated negative behaviours such as not taking a bath, not cleaning their teeth with a toothbrush, and not washing their hands after going to the toilet. Ladders represent healthy behaviours such as brushing their teeth regularly, washing their hands after going to the toilet and before handling food, etc. When the snake bites (when the child’s counter lands on the snake’s head, after rolling the dice), the player has to come down from a higher number to a lower number. The game is a fun, visual way of showing that negative behaviour (in this case, poor hygiene practices) will always set you back, but if you adopt positive behaviour (good hygiene practices) you will do well and could win the game. ‘We enjoy a lot while playing with snakes and ladders. It has given us knowledge and we know that snakes bite us when we don’t wash our hands after defecation.’ rd Shanzay, 3 grade, Government Girls Primary School, Chak Number 184 RYK Theatre for development Theatre for development is a very innovative and interactive approach to working with children in schools to promote changes in behaviour. Usually, the performances are based on themes around the benefits of education and what happens if you do not take your studies seriously. For instance, in the ‘Education Fairy’ (Ilum Pari) and ‘Ignorance Giant’ (Inparh Dieo) plays, the lead performers talk about good and bad habits. Theatre for development has also been used to raise Girls watching theatre (above) issues around violence against women. Life skills story book Under the project, a life skills book was developed to address different topics which can help girls to face the challenges of life. A health and hygiene related story was also the part of it which was supplemented interactive exercise to help children to understand the difference between unhealthy and healthy behaviours. A girl reading the life skills story book (above) Impact of integrating WASH activities into education programming Monitoring and evaluation Monitoring the impact of WASH activities focuses on both qualitative and quantitative aspects. With the health checklist, for instance, the number of green, red and black stars used can be easily counted. The colour-code system also helps teachers to easily identify children who are consistently failing to take the messages about personal hygiene on board (those who mostly get red and black stars). They can then find other ways to help those children and provide motivation, encouragement and support. Qualitative data has been gathered through focus group discussions with children, parents, teachers and other members of the community to assess what progress is being made. Children’s personal 9 stories have also been collected, recounting how their habits have changed as a result of being at a school that is supported by the project. WASH project components are monitored on a daily, weekly and monthly basis against a series of indicators, including the availability of water, soap and functioning latrines, as well as girls’ attendance in school, health checklists and children’s knowledge about key health messages. In Whole School Improvement Programme (WISP)23schools, construction work for WASH facilities, teacher training, school councils and other skill components were implemented together. In cluster24 schools, there was no construction work, but the focus was on teacher training to support interactive teaching methods and schools councils. Some of the WASH project activities were scaled up after the mid-term evaluation of the three-year project in September 2009, specifically:    distribution of IEC material in cluster schools; health and hygiene sessions in cluster schools; provision of the health checklist in all schools. In addition, it was recommended that toilets be renovated or newly built where necessary during the next phase of the project. Increasing girls’ access to education and helping to reduce dropout rates and absenteeism The impact of providing safe drinking water and improving sanitation facilities in schools on girls’ access to education can be measured in many ways. But data gathered before the project was implemented (baseline) and in a longitudinal study (after 12 to 18 months) suggest an increase both in girls’ enrolment and in learning levels. Short assessment forms were developed to measure skills in understanding the basic concepts taught in different subjects. As Figure 5 shows, there was an average increase in children’s learning level from 37 per cent to 63 per cent. In addition to other contributing factors, it can also be suggested that because of the availability of latrines children were able to stay in school. Similarly, Figure 6 shows an average increase in girls’ enrolment rates by 8 per cent compared with the baseline: enrolment rates increased by 5 per cent in Chiniot district, 12 per cent in RYK and 17 per cent in Muzzafargarh. This data indicates that implementing WASH activities in schools strongly contributes to increasing rates of enrolment and helps to reduce dropout rates and levels of absenteeism. Figure 5: Children’s level of learning before and after project activities. Learning Level Assessm ent 80 70 60 50 67 62 54 69 63 %age 42 42 40 40 30 23 20 10 0 Chiniot Multan Muzzafargarh Districts & Avg Rahim Yaar Khan 37 Avg Baseline Assessment 2nd Assessment Source: Oxfam baseline study and monitoring data. Figure 6: Increases in enrolment rates in districts where Oxfam is working on WASH and education. Increase Enrolment in Districts 12000 10000 8000 Districts 6000 4000 2000 0 Chiniot Multan Muzzafargarh Rahim Yaar Khan # of Increase enrolled Girls Baseline Assessment 2nd Assessment 10 Source: Oxfam baseline study and monitoring data. Children in schools have also adopted healthy and hygienic behaviour and helped their siblings to adopt these habits. The rehabilitation of latrines and the provision of sanitation facilities have also contributed towards the work that has been done to increase parents’ confidence in sending their girls to school. Lessons learned Many lessons have been learned through the education programme and WASH activities: It is important to equip children with the skills and knowledge to change their behaviour as well as providing them with access to clean water and adequate sanitation facilities. Maintenance of facilities should be a regular feature of all WASH programmes. In Rajanpur district, for instance, because of the energy crisis and power shortages, manual hand pumps were installed but became dysfunctional after just four months, requiring expensive repairs. When new facilities are installed, school councils, children and the community should be given control over their management and trained in how to provide regular maintenance. Services that are demand driven, through the active engagement of civil society, are likely to be more sustainable and result-oriented, promoting accountability, responsibility and ownership. Therefore, there is a strong need to empower civil society – school councils, teachers, children and parents – to demand better sanitation facilities in their area. School councils need training to help them prioritise WASH improvements as part of their annual school development plans. Children are agents of change and can play a key role in bringing about changes in people’s behaviour at all levels, including the household. Innovative approaches like child-to-child (CTC) and school sanitation and hygiene education (SSHE) should be used to achieve wider impact in schools and communities. However, even though children may have access to a latrine at school, they may not have one at home. So WASH activities in schools should be supported at community level through Community Led Total Sanitation (CLTS) schemes. School Led Total Sanitation approaches can be used too. Listening to children is crucial at all stages of the project cycle, from planning to implementation and monitoring. Developing the capacity of government and other partners is vital. WASH activities may involve a range of departments, including education, finance and planning, and public health, at various levels (district, provincial and national). Coordination and sharing of activities between different stakeholders and line departments is not enough. Policies and strategies for development must be in place, and must be implemented through effective partnerships. More research needs to be done on the impact of WASH activities on girls’ education to produce robust data, and find out which interventions work best in different settings. Success should be tracked and documented throughout the duration of any project. Women and girls’ needs and priorities should be considered at all stages of the project cycle, particularly when designing interventions for the provision of water and sanitation facilities in schools and villages. 11 Facilities related to sanitation should be installed that worked best at local level. Because of an energy crisis it is not possible to ensure availability of water in schools all the time by installing water pumps. School sanitation and hygiene (SSHE) approaches can help to ensure the availability of water even when power remains off. Where possible local donkey pumps can be used which work even when power remains off as these are easy to operate without much effort and children can also operate them considering it as a fun. Provision of sanitation facilities and promotion of health and hygiene is not enough. Facilities for drinking water should also be provided. Children, school councils, teachers and communities must be aware that they can install local low cost NADI25 filters in schools and children, school councils and teachers can be trained to clean the water at local level with low cost. In rural areas of Sindh, many women and girls have shared their experiences which have highlighted unhealthy practices during menstruation due to a lack of knowledge about menstruation management; young girls also followed these existing practices. During a meeting, participants shared their experience after the severe flooding that affected their communities. Many NGOs/INGOs came and provided information on menstruation health management to avoid any genital and other health-related problems. Thus, information on menstruation hygiene should be part of WASH activities in schools. Teachers should be trained to help adolescent girls on menstruation management. Low cost alternative technologies can be introduced in WASH. Many good practices and approaches to work can be replicated by adapting them to fit into the local context. Water Aid has introduced some very good low cost technologies which can be replicated so that we do not reinvent the wheel. Plans for scaling up should be part of the process from the beginning of the initiative. Challenges The challenge ahead is how we can scale up WASH activities in schools in terms of quality of impact as well as quantity. The key to this is ensuring that WASH activities focus just as much on promoting good hygiene habits and changing people’s behaviour, in schools as well as at home, as on the construction and installation of pumps and latrines. Although efforts have been made to address menstruation hygiene, through WASH activities, it is difficult to address this issue taking into account cultural contexts and social barriers. Wash activities are often implemented on a short-term basis, which does not allow for measuring change and impact over a longer period of time. The importance of involving children and working with them as agents of change was repeatedly stated by different civil society organisations. NGOs need to see children as partners in this process, not just as beneficiaries. While coordination among all sectors involved is important, cooperation with children and young people is also critical to the success of WASH programmes in schools. There is a need to combine top-down and bottom-up approaches that can be translated into demand, and promote accountability among all concerned. This is an ongoing challenge, to mobilise all partners and create space and opportunities for development. 12 1 United Nations Development Programme (UNDP) Human Development Report (2010) ‘The Real Wealth of Nations: Pathways to Human Development’, http://hdr.undp.org/en/ (accessed 11 January 2010). 2 UNESCO (2009) ‘EFA (Education For All) Global Monitoring Report 2009 – Overcoming Inequality: Why Governance Matters’, Paris: UNESCO (United Nations Educational, Scientific and Cultural Organisation). 3 Gross Enrolment Rate (GER) is the number of children attending primary school (irrespective of age) divided by the number of children who ought to be attending. Net Enrolment Rate refers to the number of students aged 5‐9 years that are enrolled in a primary school, divided by the number of children in the age group for that level of education. http://www.finance.gov.pk/survey/chapter_10/10_Education.pdf (accessed 09 September 2011). 4 UNESCO (2009) ‘EFA (Education For All) Global Monitoring Report 2009 – Overcoming Inequality: Why Governance Matters’, Paris: UNESCO. 5 Government of Pakistan, ‘Economic Survey of Pakistan 2009-10’. 6 Government of Pakistan, ‘Economic Survey of Pakistan 2008–09’. 7 S. Qureshi (2003) ‘Pakistan: Education and Gender Policy – Girl’s Education: A Lifeline to Development’, Center for Policy Studies, Budapest, http://www.policy.hu/qureshi/Respaper.pdf (accessed 21 January 2011). 8 Economic Survey of Pakistan 2008–09, pp.158–9. 9 The MDGs were agreed at the UN General Assembly in September 2000, http://www.un.org/millenniumgoals/ (accessed 11 January 2010). See also United Nations (2002) ‘Johannesburg Declaration on Sustainable Development’ and ‘Plan of Implementation of the World Summit on Sustainable Development’, http://www.un-documents.net/jburgpln.htm (accessed 21 January 2011). 10 The GPI measures progress towards gender parity in education participation and/or learning opportunities available for women in relation to those available to men. A GPI equal to 1 indicates parity between females and males. In general, a value less than 1 indicates disparity in favour of girls and a value greater than 1 indicates disparity in favour of boys. 11 Government of Pakistan, ‘Economic Survey of Pakistan 2008–09’. 12 ‘Clean drinking water’, DAWN.com editorial, 1 February 2010, http://news.dawn.com/wps/wcm/connect/dawn-content-library/dawn/news/pakistan/19-clean-drinkingwater-hh-04 (accessed 11 January 2010). 13 S.S. Nasir Khisro and M. Youna (Integrated Regional Support Programme), M. Ahmad, M. Nawaz Tahir, M. Afzal Khan, ‘Community Led Total Sanitation in Pakistan’, http://www.wateraid.org/documents/ch15_community_led_total_sanitation_in_pakistan.pdf (accessed 11 January 2010). 14 World Health Organization (2006) ‘Mortality Country Fact Sheet, Pakistan’, http://www.who.int/whosis/mort/profiles/mort_emro_pak_pakistan.pdf (accessed 11 January 2010). 15 Centers for Disease Control USA, Health Oriented Preventive Education (HOPE), Aga Khan University, Procter & Gamble (2002) ‘Karachi Soap Health Study’. 16 EMIS survey 2004–05 (Education Management Information System). 17 WASH news Asia & Pacific (2009) ‘Pakistan: National workshop on behavior change for water/sanitation’, http://washasia.wordpress.com/2009/07/31/pakistan-national-workshop-onbehavior-change-for-watersanitation/ (accessed 21 January 2011). 17 World Health Organization (WHO)/United Nations Children’s Fund (UNICEF) (2006) Joint Monitoring Programme (JMP) for Water Supply and Sanitation, http://www.wssinfo.org/ (accessed 21 January 2011). 18 Government of Pakistan, National Sanitation Policy, Revised Draft, 6 March 2006, http://www.asb.org.pk/sanitationpolicy.pdf (accessed 11 January 2010). 19 Summit on Sustainable Development, Johannesburg, South Africa, 26 August–4 September 2002. 20 Oxfam is an international confederation of 15 organisations of which Oxfam GB is one. The work in this paper is that of Oxfam GB which will be referred to as Oxfam hereafter. 21 ‘Water and Sanitation: The economic case for Global Action’ published by Tear Fund, p.3 http://www.sswm.info/sites/default/files/reference_attachments/TEARFUND%202008%20water%20an d%20sanitation.pdf (accessed 12 September 2011). 13 22 L. Fewtrell, R.B. Kaufmann, D. Kay, W. Enanoria, L. Haller, J.M. Colford (2005) ‘Water, sanitation and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis’. Lancet Infectious Diseases 5: 42–52. 23 WSIP stand for Whole School Improvement Programme and WSIP schools are those schools where infrastructure is also rehabilitated and teacher training is also given. 24 Cluster schools are located in the surroundings of nearby WSIP schools and in these schools no infrastructure is provided or rehabilitated but only teacher training has been carried out. 25 NADI filter is a self help biological sand filter. The approach to designing this filter was to look at water purification from a ‘no funds’ perspective in the hope that development would be started that could sustain itself without funding or external intervention. © Oxfam GB September 2011 This paper was written by Madiha Shafi. Oxfam GB acknowledges the assistance of Kathryn O’Neill, Hitomi Kuwabara, Carron Basu Ray, and Abigail Humphries Robertson in its production. The text may be used free of charge for the purposes of advocacy, campaigning, education, and research, provided that the source is acknowledged in full. The copyright holder requests that all such use be registered with them for impact assessment purposes. For copying in any other circumstances, or for re-use in other publications, or for translation or adaptation, permission must be secured and a fee may be charged. E-mail publish@oxfam.org.uk For further information on the issues raised in this paper please e-mail enquiries@oxfam.org.uk or go to www.oxfam.org.uk. The information in this publication is correct at the time of going to press. Published by Oxfam GB under ISBN 978-1-84814-956-4 in September 2011. Oxfam GB, Oxfam House, John Smith Drive, Cowley, Oxford, OX4 2JY, UK. Oxfam is a registered charity in England and Wales (no 202918) and Scotland (SC039042). Oxfam GB is a member of Oxfam International. 14