2. Some schools have limited access to
water.
Students must walk to a local water
source during the school day or bring
water with them from home to
contribute to school water.

3. Water access at schools makes a difference for providing water for
handwashing.
One SWASH+ study showed a 66% reduction in diarrheal prevalence and a
similar reduction in days of illness among pupils in “water scarce” schools
(schools with no improved water source within two kilometers) that
received a water supply, hygiene promotion, water treatment and
sanitation intervention, compared to pupils in water scarce control schools
(Freeman, 2012).

4. Another barrier for proper
handwashing is lack of
supplies such as water
containers and soap. Tonde
primary school, which did
not participate in the
SWASH+ program,
demonstrates the challenges
that many schools face in
providing sufficient water
storage containers and
access to soap.

5. A sustainability assessment of the
SWASH+ project revealed that only 2% of
the pilot schools provided soap for
handwashing on the day of the assessment
(Saboori et al., 2010). The two main
barriers to soap provision were insufficient
school funds and soap theft.
If soap is not supplied at schools, students
will not be able to practice proper
handwashing. Studies show that
handwashing with soap can reduce the risk
of diarrheal disease by more than 42%
(Curtis and Cairncross, 2003).

6. In an effort to improve the availability of soap in
schools, SWASH+ piloted an innovative soapy
water (literally, soap dissolved in water for hand
washing) project in 11 schools in Nyando,
Rachuonyo and Suba districts in Western Kenya.
A majority of school interviewees found powdered
soap cheaper and easier to use; soap theft was
also reduced. Additionally, 10 of the 11 schools
reported repurchasing powdered soap over bar or
liquid soap during the 2009 school year. The higher
rate of repurchase and preference for soapy water
suggests that it may be a more sustainable method
of handwashing than the current alternatives.

7. During 2008 and 2009 SWASH+ staff made regular
unannounced monitoring visits and measured positive
handwashing behavior (using soapy water). However,
after an entire year with no visits, there was a 60%
decrease in the presence of soapy water bottles and a
20% decrease in children using soapy water.
Potential reasons for this decrease could be a lack of
funds and lack of monitoring. Monitoring school WASH is
particularly important for sustaining positive handwashing
behavior. Monitoring visits may help motivate schools to
continue supplying soapy water in schools. Insufficient
funds for soap provision was cited as another reason for
the decrease in soapy water at schools.

8. Improved access to water and
handwashing supplies can be
achieved through additional
funding allocated specifically to
school WASH for both
infrastructure investments like
handwashing containers and
consumables like soap.

9. References
Freeman, MC., Clasen, T., Dreibelbis, R., Saboori, S., Greene, L., & Rheingans, R. (2012).‘The impact of
a school-based water supply and treatment, hygiene, and sanitation program on pupil diarrhea:
A cluster-randomized trial’
Saboori, S., Mwaki, A., and Rheingans, R. (2010). ‘Is Soapy Water a Viable Solution for Hand Washing
in Schools?’ Waterlines 29:4.
Curtis, V. and Cairncross, S. (2003). ‘Effect of washing hands with soap on diarrhoea risk in the
community: a systematic review’ Lancet Infectious Diseases 3: 275–81.
Photography by CARE/Brendan Bannon. Photo essay by Julie Straw; edited by Malaika Cheney-Coker.
SWASH+ is a five-year applied research project to identify, develop, and test innovative approaches
to school-based water, sanitation and hygiene in Nyanza Province, Kenya. The partners that
form the SWASH+ consortium are CARE, Emory University, the Great Lakes University of Kisumu,
the government of Kenya, and the former Kenya Water for Health Organisation (KWAHO), and
Water.org. SWASH+ is funded by the Bill & Melinda Gates Foundation and the Global Water
Challenge. For more information, visit www.swashplus.org.