A qualitative assessment of disability friendly water and sanitation facilities in primary schools, Rumphi, Malawi

Figures & data

Figure 1. Water and sanitation facilities in primary schools, Rumphi, Malawi: (a) Afridev hand-pump with uneven pathway and platform, (b) raised seat over the pit latrine squat hole made from local bricks, and (c) municipal piped water tap.

Table 1. Results of accessible water, sanitation and hygiene facilities in study schools.

Indicator	Public school % (n = 7)	Private school % (n = 3)
Sufficient toilets – one per 25 girls and one for female staff; one toilet plus one urinal (or 50 cm of urinal wall) per 50 boys, and one for male staff	14 (1)	0 (0)
Toilets are easily accessible to all, including staff and children with disabilities – no more than 30 m from all users, with male and female toilets separated	14 (1)	0 (0)
Toilets provide privacy and security – presence of walls and doors (not necessarily locking)	43 (3)	33 (1)
Toilets are appropriate to local cultural and social conditions, age and gender appropriate and accessible for children with disabilities or suffering from chronic diseases (i.e. toilets are child-friendly) – indication that toilets are able to be accessed by children with disabilities at the time of the site visit	29 (2)	0 (0)
Toilets are hygienic to use and easy to clean – no presence of flies, faeces, urine or wet floors	0 (0)	0 (0)
Toilets have convenient handwashing facilities close by – presence of water (not necessarily soap)	14 (1)	0 (0)
A cleaning and maintenance routine is in operation, ensuring that clean and functioning toilets are available at all times	100 (7)	100 (3)
Reliable water source at the school – indication of water available at the time of the site visit	71 (5)	100 (3)

Note: Checklist adapted from World Health Organization (2009).

Table 2. Suggestions to promote accessible water, sanitation and hygiene facilities in schools.

Suggestions from local government (n = 2)	Suggestions from teachers (n = 11)	Suggestions from children with disabilities (n = 23)
Construct facilities on the initiative of community members Use school sanitation clubs to assist with daily care of facilities Encourage learning visits to other schools Use the district water office for technical support Train special education teachers in each school	Increase number of buckets with taps near or in classrooms Increase number of water sources Provide ramps Raise awareness of accessible pit latrine designs Provide a resource centre for children with disabilities inclusive of WASH and other topics Provide wheelchairs or gloves and glasses for children with disabilities Place water sources closer to classrooms Build new urinals Improve paths to pit latrines and water sources Train general teachers on accessible WASH facilities Ask the child’s parents what to do	Place hand-pump handle at a reachable height Place a cup for drinking at the water source Provide shade at water sources and sanitation facilities Use piped water rather than a hand-pump Clean sanitation facilities daily Ensure presence of doors at each sanitation facility Reduce step height at the facility entrance Place kneepads and hand walkers at the pit latrines for children with leg and arm impairments Build more pit latrines in relation to school population

Table 3. Estimated cost to adapt existing sanitation facilities.

	Public school A	Public school B	Public school C	Public school D	Public school E	Public school F	Public school G	Private school A	Private school B	Private School C
Infrastructure	Cost in MK
Path marker	8821	1500	2500	2536	2981	6767	11375	717	2609	400
Ramp	4000	5000	0	7000	4000	3500	4000	0	5000	4000
Steps	5000	3000	0	0	3500	0	7000	3500	2500	6000
Entrance	2000	2000	5000	4500	12000	5000	10000	5000	4000	2500
Presence of a door	200	0	0	100	400	200	100	100	100	150
Door handles	1000	1000	4000	4000	4000	4000	4000	1000	4000	4000
Internal space	10 000	50 000	40 000	30 000	0	20 000	0	9000	35 000	40 000
Raised seat	1500	2000	2000	1500	1500	1500	1500	2000	1500	1500
Handrails for support	3000	3000	3000	3000	3000	3000	3000	3000	3000	3000
Handwashing station	3000	3000	3000	3000	3000	3000	3000	3000	3000	3000
Clear paths	4000	0	4000	3000	2000	0	4000	0	0	9000
Drop-hole cover	1000	1000	1000	1000	1000	2000	1000	1000	1000	1000
Total	43 521	71 500	64 500	59 636	37 381	48 767	48 975	28 317	61 709	74 550

WHO, 2009. Water, sanitation and hygiene standards for schools in low-cost settings. Edited by Adams, J, Bartram, J, Chartier, Y & Sims, J. World Health Organization, Geneva, Switzerland. http://www.who.int/water_sanitation_health/publications/wash_standards_school.pdf Accessed 18 August 2017.

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