Reducing Waterborne Diseases in 131 Kenyan Schools

Objectives

• End-Year Program Assessment: Evaluate the achievements and challenges faced in the 2025 WASH Program in 10 partner schools.
• Stakeholder Engagement: Gather direct feedback from head teachers and teacher health champions on the program’s impact and areas of improvement.
• 2026 Planning Preparation: Review and initiate planning for the 2026 WASH Program.

Activity Summary

1.1) Conduct End Year Impact Evaluation Workshop for Head Teachers (October 13th)

Day One-Head Teacher Training

The primary objective of the October 2025 End Year Workshop was to assess the impact of the WASH intervention in primary schools across Mumias East Sub-County. This workshop provided an opportunity to measure progress against the baseline data from January 2025, focusing on reductions in student illness, improvements in menstrual hygiene, and overall health benefits resulting from enhanced WASH facilities.

1.2) Conduct End Year Impact Evaluation Workshop for Teacher Health Champions (October 14th) Day Two- Teacher Health Champions Training

 The objective of the second-day training was to engage teacher health champions who are essential to implementing and sustaining the WASH program in their respective schools. This session aimed to support these champions with practical tools, address program challenges, and create a forum for exchanging ideas to strengthen hygiene practices and health awareness among students.

  Activities/Proceedings

13^th October 2025 - Head Teachers’ and BoM End-Year Training

• WE REACH held a Head Teachers’ WASH Review Workshop bringing together school heads and BOM Representatives from all 10 partner schools to reflect on the year’s implementation progress.
• The session began with a recap of the WE REACH WASH Strategy, highlighting achievements made in 2025, followed by a presentation of End Year survey data comparing baseline and current outcomes.
• Findings showed major improvements, including a 70.3% reduction in water-related illnesses, 33.4% decrease in menstrual hygiene challenges, and 67.7% reduction in skin and oral infections among learners.
• After the data presentation, participants engaged in group discussions to provide feedback and reflections on the program’s impact.
• Head teachers shared success stories such as increased school attendance, improved hygiene practices, and greater learner engagement in health clubs.
• One head teacher remarked, “Our learners no longer miss class due to waterborne diseases, it’s a real transformation.”
• The session concluded with recommendations on improving infrastructure maintenance, community sensitization, and enhancing school-level ownership for sustainability.
• The Teacher Health Champions Workshop brought together teacher champions from partner schools to assess behavior change and learning outcomes achieved through the WASH program.
• The workshop began with a recap of the WE REACH WASH Strategy and a presentation of End Year survey data, highlighting progress made since baseline and how it reflects in daily school routines.
• Teachers then provided feedback and practical insights on classroom integration of WASH messages, student health clubs, and menstrual hygiene management.
• They shared creative approaches such as drama, songs, and peer learning sessions that have sustained hygiene behaviour among pupils.
• One teacher noted, “Our pupils have become WASH ambassadors, they remind each other to wash hands and keep their environment clean.”
• The workshop ended with a joint action plan to strengthen coordination between teachers, head teachers, and Public Health Officers (PHO’s) for sustained impact.

14^th October 2025 - Teacher Health Champions’ End-Year Training 15^th October 2025 – Field Visits to Tranche 7 Schools and Shelton Trust Project Assessment:

WE REACH had pre-identified eligible schools based on need, availability of space for installation, and commitment to maintaining the infrastructure.

During the visit, the team assessed each school’s suitability, existing WASH infrastructure, and potential for sustainability after installation.

Mr. Steve engaged with head teachers, and school management to understand the context and readiness for the intervention.

One head teacher expressed, “This project will save our girls from walking long distances to fetch water, we are ready to maintain it once installed.”

The findings from the visit confirmed that two of the three proposed schools met the eligibility criteria, paving the way for implementation of the project.  

16^th October 2025 – 2025 Review and 2026 Planning

Internal review meeting with Steve and the WE REACH WASH team.

Analyzed feedback from head teachers and teacher champions workshops.

Conducted year-end review of program achievements and challenges.

Planned the 2026 WASH strategy and school engagement schedule.

Training Overview-Head Teachers and Board of Management Representatives

Workshop Summary:

The two evaluation workshops brought together Head Teachers, Teacher Health Champions, and Board of Management representatives from the ten partner primary schools. The sessions provided a platform for participants to share progress, lessons, and challenges experienced during 2025 implementation.

Overall, the year recorded remarkable improvements in school health indicators and WASH behavior change among learners. The End-Year Survey reported:

70.3% reduction in water-related illnesses

33.4% reduction in menstrual hygiene management (MHM) issues

67.7% reduction in skin and oral infections

These findings reflected the effectiveness of early implementation, improved monitoring, and strengthened collaboration between WE REACH, the Ministry of Education (MoE), and the Ministry of Health (MoH).

In attendance was Mr. Steve Ashton, a key advisor to WE REACH’s WASH initiatives, who used this opportunity to gain firsthand insights into the experiences of schools. Listening directly to the headteachers’ accounts allowed Mr. Ashton to better understand the progress and ongoing needs, reinforcing the importance of sustained support for these interventions.

Key Workshop Proceedings and School Highlights:Eshikufu Primary School

• Renovated a cemented water tank through support from Friends of Timothy (NGO).
• Successfully conducted fundraising to acquire additional tanks.
• Reported wear and tear on gutters and stock-outs of sanitary pads.
• ECDE classes still face challenges with floor conditions causing jigger infestations.
• “We’ve made progress with water access, but our younger learners still suffer from preventable conditions like jiggers. We must prioritize infrastructure.” Head Teacher, Eshikufu Primary. “Thanks to WE REACH our students are are healthier, happier and more aware of hygiene practices” Teacher champion Eshikufu”
• Borehole available but WASH points are inadequate.
• Tap breakages remain a concern, often caused by playful ECDE pupils.
• After WE REACH trained Young Peer Promoters (YPPs) on soap making, the initiative became popular, children were “too excited” and even stole soap due to its nice scent.
• Makini Group supported the school with reusable pads after WE REACH trained head teachers on resource mobilization.
• Floors were repaired to address jigger infestations, and Public Health Officers (PHO’s) supported jigger prevention through routine school visits.
• A BoM member who is a nurse sensitized students during School Health Parades.
• Concern raised: some parents take sanitary pads issued to girls and use them at home.
• “The training on resource mobilization truly worked, we got partners to support us. Now we just need to protect what we have built.” Head Teacher, Eluche Primary. “The program has made a tangible difference in behaviour and health outcomes” Teacher Champion Eluche Primary.
• Credited the WE REACH WASH Program for significant behavioral change and improved health among learners.
• Reported a clear reduction in water-related illnesses and increased hygiene awareness across the school.
• “The WASH program has changed how our learners think about hygiene.” Head Teacher, Ebwaliro Primary. Seeing fewer sick children every month shows this program works” BoM Representative Ebwaliro.
• Established a sick bay used by girls as a private changing room during menstruation.
• Health clubs meet weekly and use drama and peer education to promote hygiene practices.
• Maintains a ‘sick leave-out’ tracking system and uses hospital reports to update student health records.
• Health clubs organize weekly cleaning sessions, with rewards for the cleanest classes — resulting in fewer skin/oral infections.
• Students expressed low preference for rewashable pads.
• “Our health club has become a voice for good hygiene. Learners are proud to lead by example.” Teacher Champion, Shitoto Primary. “The students are learning not just about hygiene but responsibility. WE REACH made it practical and fun” Head Teacher Shitoto Primary.

Eluche Primary SchoolEbwaliro Primary SchoolShitoto Primary SchoolAdditional Requests and Suggestions:

Schools requested WE REACH-branded T-shirts and stickers to strengthen program identity.

Requested WE REACH to liaise with Friends of Timothy for possible lunch program support and enhanced service delivery.

Joint WE REACH–Steve Ashton Reflection Meeting (16th October 2025)

After the workshops, the WE REACH WASH team met with Mr. Ashton to review insights gathered. Key lessons and observations included:

LESSONS LEARNT:

• Safety of Girls: Collecting water from distant springs remains unsafe; alternative safe water sources or fencing around tanks should be prioritized.
• Community Engagement: Families, especially those where children live with grandparents, need greater awareness of WASH practices to reinforce behavior at home.
• Early Implementation: Starting program activities in January led to more consistent outcomes throughout the year.
• Collaboration: Continuous coordination with MoE, MoH, and PHOs strengthened program credibility and follow-up.
• Smart Farming: Schools can utilize small garden spaces to generate income and sustain hygiene supplies (soap, sanitary towels).
• Specific Reporting: Schools should document causes and symptoms of absenteeism to improve health data accuracy and interventions.
• Behavioral Change Beyond School: Sharing WASH success stories with parents helps extend hygiene practices into homes.
• Persistent wear and tear of infrastructure (gutters, taps).
• Limited MHM supplies and occasional misuse of sanitary pads.
• High dependence on government capitation, affecting sustainability of WASH maintenance.
• Ignorance and poverty at household level, limiting reinforcement of hygiene practices at home.
• Strengthen MHM Support: Secure sustainable partnerships for menstrual hygiene products and continuous sensitization for both learners and parents.
• Enhance Water Safety: Fence and secure water points to ensure safety and prevent contamination.
• Community Sensitization: Integrate parents and local leaders in WASH awareness campaigns to sustain change.
• Resource Mobilization: Encourage schools to pursue creative resource generation, including small-scale income projects.
• Monitoring and Evaluation: Expand M&E tools to capture data on absenteeism causes, symptoms, and health outcomes.
• Brand Visibility: Provide WASH-branded materials (T-shirts, stickers) to strengthen school ownership and visibility of the program.

CHALLENGES:RECOMMENDATIONS: CONCLUSION:

The 2025 End-Year Evaluation and Strategic Planning sessions marked yet another milestone in WE REACH’s mission to strengthen school health systems in Kakamega County. The workshops showcased how far the program has come from to holistic health promotion and behavioral change.

With strengthened partnerships, improved data use, and greater community engagement, WE REACH is poised to make the 2026 WASH Program even more impactful and sustainable for the schools and communities it serves.

1.0 ACTIVITY PROCEEDINGSDuring the month of July 2025, the WE REACH WASH team undertook a second round of Monitoring, Assessment and Support (MAS) visits to our 10 partner schools in Mumias East Sub County, following the June school visits. These visits aimed to track the progress of the School Health Clubs (SHCs), provide on-the-ground mentorship to Teacher Health Champions, and support schools in strengthening sustainable WASH interventions.The July visits came at a time when the momentum around hygiene, sanitation, and menstrual health had visibly picked up within the schools, with Group 7 School Health Clubs playing a central role in driving the change.Strengthening Peer-Led Health EducationAll 10 schools now have fully functional School Health Clubs, whose membership has grown steadily, each club recording an increase of 2–3 new members since the last visit. The clubs are now highly active, holding weekly or biweekly sessions that use songs, drama, parades, and skits to pass on messages about hygiene, menstruation, sanitation, and disease prevention. These interactive tools have improved understanding and participation, especially among boys, helping to break menstrual taboos and create supportive environments for girls.Class Health Champions: A student in every classroom, have been instrumental in keeping WASH conversations alive. They continue to offer a safe space for students (especially girls) to raise concerns or ask questions, which are then escalated to the Teacher Health Champions for action. This structure has improved the flow of information and made it easier to respond to student needs promptly. Teacher Health Champions: A Backbone of SupportOur Teacher Health Champions, who were trained earlier in March 2025, have been at the forefront of mentoring student leaders and implementing School Health Club work plans. During the visits, they reported consistent peer-learning activities, cleanliness campaigns, and active parent involvement. They also participated in a government-organized training on deworming, held in July for all health teachers in Mumias East Sub County. The Teacher Champions who attended this training shared their insights with the rest of the club members and school staff, and are now actively preparing their schools for the upcoming county-wide deworming campaign, ensuring that children are not only aware but ready to benefit from it.Engaging the School CommunityBeyond the clubs, several schools are integrating WASH practices into the broader school culture. Kitchen gardens are flourishing, with vegetables being sold to fund soap-making projects, thus promoting both handwashing and school-based income generation. In four schools, Eshikufu, Eluche, Mungabira, and Shitoto Annual General Meetings (AGMs) were held where Teacher Health Champions sensitized parents on WASH practices. As a result, more parents are now encouraging children to wear shoes, practice home-based hygiene, and support club-led school cleanliness campaigns leading to a visible reduction in jigger infestations and improvement in student presentation.Local health dispensaries also played a role by conducting community sensitizations and supporting the typhoid vaccination campaign, which saw over 5,000 learners vaccinated in July 2025. This collaborative effort complements school-based hygiene education and disease prevention, especially as schools continue teaching about water treatment methods like boiling and LifeStraw use.Outcomes and Next StepsImproved Health Literacy: Students can now confidently discuss issues around menstruation, hygiene, and sanitation.Disease Reduction: Typhoid, waterborne illnesses, and parasitic infections have reduced due to combined efforts of the Health Clubs and government health interventions.Parental Engagement: Parents are more engaged and contributing to school and home hygiene. Sustainability Models: Kitchen gardens and soap-making projects are helping schools sustain WASH supplies.Remaining Gaps:Despite the gains, a few challenges persist:Poor toilet infrastructure in some schoolsLimited access to clean waterShortage of sanitary padsInconsistent access to soap in lower-income schoolsThese will be addressed in subsequent support visits, with plans to work more closely with school management committees and local government departments. 1.       Eluche Comprehensive School

Progress:

• Health Club Members: 23
• Increased WASH promotion through student-led activities (Health Clubs) and campaigns.
• Teacher Health Champions provided advanced training on WASH topics.
• Enhanced personal and environmental hygiene practices observed among students
• AGM parade sensitization led to an increase in the number of pupils wearing shoes, maintaining low jigger cases (one case).
• Implementation of a reusable pad program in progress to reduce waste and costs.

Challenges:

• Soap shortages persist, limiting handwashing implementation.
• Sanitary pad shortages cause 8 -10 girls to miss school monthly.

2.       Mabanga Primary School

Progress:

• Health Club Members: 20
• Conversion of an unused restroom into a fully operational MHM facility.
• Health club members involved in the cleanliness of the school environment.
• Collaboration with local NGOs for additional WASH resources and support.
• Frequent club meetings have reduced menstrual stigma, boosting girls’ confidence.
• Health Club members led water treatment sessions and Teacher Health Champions supervised vaccination of typhoid by the government which has reduced waterborne diseases in the school.
• Through establishing of kitchen gardens, the revenue collected is used to fund soap-making ingredients, improving handwashing from the pupils.

Challenges:

• Poor toilet conditions and lack of changing rooms hinder sanitation and MHM.
• Sanitary pad shortages continue, impacting girls’ attendance

3.       Khwikhondwe Primary School

Progress:

• Health Club Members: 17
• Revitalized the health club with new sessions for members.
• Awareness campaigns on safe drinking water practices extended to local communities.
• Regular maintenance checks on school WASH facilities to ensure functionality.
• Community sensitization by PHO’s and CHP’s increased shoe-wearing and general cleanliness increasing the pupil’s personal hygiene.
• Frequent club meetings educated students, reducing menstrual stigma and improving girls’ attendance.
• The government has vaccinated the children aged 3 to 14 years in schools and at home has led to the reduction of waterborne diseases.
• The area Member of parliament has established toilets for the school children improving the general condition of the school.

Challenges:

• Poorly maintained water tanks prevent consistent water access, forcing reliance on water from homes or collected rainwater.
• The absence of a school gate leads to theft of soap containers.
• Potholed classroom floors pose a challenge to jigger prevention, as they can harbor jigger eggs.
• No dedicated changing rooms, and pads are improperly disposed of in latrines.
•  Sanitary pad shortages since September 2024 contribute to high absenteeism among girls.

4.       Mungabira Comprehensive School

Mungabira Comprehensive School continues to strengthen its 20-member health club, which holds weekly sessions focused on cleanliness, sanitation, and water treatment, in line with earlier training. The school recently held its Annual General Meeting with a renewed emphasis on hygiene practices both at home and in school. Additionally, the headteacher remains committed to resource management by consistently providing tissue paper and supplying soap.

Progress:

• Health Club Members: 20
• Election of new health club leaders and class representatives.
• Conducted hygiene sensitization talks during weekly health parades.
• As a result of hygiene sensitization during the Annual General Meeting, the number of learners wearing shoes increased to 93%, contributing to the elimination of jigger cases. The emphasis on cleanliness has also led to noticeable improvements in personal hygiene and overall school sanitation.

Challenges:

• The leaking water tank remains unrepaired, limiting water access.
• No changing rooms or proper pad disposal facilities, affecting MHM.
• Sanitary pad shortages persist, with irregular government supplies.

5.       Eshikufu Comprehensive School

Progress:

• Health Club Members: 22
• Continued focus on menstrual health and hygiene, with new educational materials developed.
• Health club sessions held for boys and girls to understand and support menstrual health.
• The Annual General Meeting (AGM) emphasized personal cleanliness and boiling drinking water, leading improved hygiene, and no jigger cases.
• Water-related diseases have reduced, supported by the government’s typhoid vaccination for children aged 3 to 14 years.
• Student-led soap-making, funded by kitchen garden revenue, ensured a steady handwashing soap supply.
• Health Club members relayed menstrual concerns to teachers, improving MHM support.

Challenges:

• No water tank; reliance on a community spring persists.
• Sanitary pad shortages continue, with girls missing 2–3 days of school monthly.
• Lack of changing rooms hinders MHM.

6.       Shitoto Primary School

Progress:

• Health Club Members: 30
• Increased participation in school health parades with demonstrations on soap making.
• Organization of a community clean-up day involving students and parents.
• Establishment of a health monitoring committee to ensure sustainable hygiene practices.
• New handwashing stations increased hygiene compliance to 85%.
• Frequent club meetings reduced menstrual stigma, boosting girls’ confidence.
• Health Club and Teacher-led water treatment and TCV vaccination reduced waterborne diseases, including typhoid.

Challenges:

• Poor toilet conditions and irregular pad supplies affect sanitation and MHM.
• No dedicated changing rooms, limiting menstrual hygiene practices.

7.       Bumwende Primary School

Progress:

• Health Club Members: 27
• Successful implementation of the vegetable garden project, generating funds for WASH initiatives.
• Proposal writing is ongoing whereby the Head Teacher and the Teacher Health Champion are targeting the area MP for funds to build abolition block or the school.
• Engagement of older students as WASH ambassadors to mentor younger pupils.
• AGM sensitization led to 95% shoe-wearing, reducing jigger cases to one.
• Frequent Health Club meetings reduced menstrual stigma, improving attendance.

Challenges:

• Inadequate washing points and poor toilet conditions persist.
• Lack of proper pad disposal facilities affects MHM.
• Water access remains limited due to insufficient infrastructure.

8.       Rise and Shine Special School

Progress:

• Health Club Members: 20
• Re-established health club activities with new leadership.
• WE REACH team provided training for the new teacher health champion.
• Child-led WASH structures implemented effectively to address ongoing issues.
• Daily adapted hygiene sessions reduced menstrual stigma, with the girls reporting confidence attending school during periods.
• The health teachers led water treatment (using LifeStraw filters tailored for accessibility) and TCV vaccination eliminated waterborne diseases.

Challenges:

• Limited caregiver support for maintaining disability-friendly hygiene facilities increases staff workload.
• Poor toilet conditions, lacking accessible features (e.g., ramps, wider doors), hinder sanitation for students with mobility challenges.

9.       Mutono Primary School

Progress:

• Health Club Members: 20
• Enhanced drama activities to convey WASH messages, including performances for local community events.
• Development of a WASH newsletter distributed to parents during Parent Teacher Association (PTA) meeting
• Installation of new hand washing stations through donations by the Ministry of Health in collaboration with other NGO’s
• Through regular health club meetings, more children are now coming to school with shoes regardless of type leading to increased shoe-wearing which reduces jigger infections.

Challenges:

• Poor toilet conditions and lack of changing rooms hinder sanitation and MHM.
• Sanitary pad shortages persist, with irregular supplies.

10.   Ebwaliro Comprehensive School

Progress:

• Health Club Members: 18
• Expansion of the health club with additional members.
• Introduction of a peer-mentoring program to sustain hand washing and latrine hygiene practices.
• Collaboration with local health workers PHO’s and CHPs for monthly hygiene workshops.
• Soap-making workshop, funded by kitchen garden revenue, ensured two months’ soap supply.
• Frequent club meetings reduced menstrual stigma, improving attendance.

Challenges:

• Poor toilet conditions and lack of pad disposal facilities persist.
• No dedicated handwashing stations, limiting hygiene training.

Sanitary pad shortages remain a concern

2.0:  LESSONS LEARNT:

• Sensitization in Eshikufu, Eluche, Mungabira, and Shitoto significantly improved hygiene and shoe-wearing.
• Club meetings normalized menstruation, with tailored sessions at Rise and Shine achieving higher impact.
• Teacher-led treatment and TCV vaccination reduced typhoid and other diseases, with boarding schools like Rise and Shine benefiting from centralized implementation.
• Peer support, especially adapted at Rise and Shine, improved girls’ confidence and teacher communication.
• Revenue, including from kitchen gardens in schools, supported soap-making.
• Encouraging shoe-wearing and hygiene without financial contributions reduced jigger cases.
• Typhoid campaign amplified disease prevention, particularly in boarding settings.
• Poor toilets and water access, especially non-accessible facilities at Rise and Shine, limit impact.

3.0: CHALLENGES:

• Sanitary pad shortages remain a significant barrier, especially for girls with special needs at Rise and Shine. Additionally, the lack of disposal facilities undermines proper MHM, discouraging school attendance and increasing absenteeism. While class champions offer peer support, these gaps continue to undermine confidence and learning for menstruating girls.
• Water accessibility remains a major challenge across several schools. In at least five schools where they are leaking or poorly maintained water tanks limit the availability of clean water for drinking, handwashing, and general hygiene. This inconsistency affects the delivery of hygiene education and daily sanitation routines, undermining the overall impact of WASH initiatives. Without reliable water access, even well-equipped facilities and trained health clubs struggle to maintain safe hygiene practices.
• Several schools continue to struggle with poor toilet conditions, the latrines are either in poor condition or not inclusive, where the lack of accessible toilets limits participation for learners with special needs. These infrastructure deficits limit the effectiveness of WASH interventions and compromise student health and dignity.

4.0: RECOMMENDATIONS:

• Repair leaking water tanks and invest in borehole construction to ensure consistent access to clean water, particularly in affected schools like Khwikhondwe.
• Encourage schools to leverage alternative income-generating activities such as kitchen gardens to support the purchase of soap-making materials and other hygiene supplies.
• Establish partnerships with NGOs, government agencies, and well-wishers to provide regular sanitary pad supplies and training on reusable pads, tailored to meet the needs of all learners, including those with special needs.
• Install additional handwashing stations near toilets and classrooms, ensuring they are inclusive and accessible.
• Install a secure school gate at Khwikhondwe to prevent theft of hygiene materials, and repair potholed classroom floors to help prevent jigger infestations and enhance the learning environment

5.0: CONCLUSION

The WASH program in Mumias East has made significant strides in promoting key hygiene practices and strengthening school health clubs. Community sensitization, regular club meetings, and targeted interventions such as typhoid vaccination and teacher-led water treatment have contributed to improved student hygiene and a reduction in waterborne diseases. However, the program’s full impact is limited by persistent infrastructure challenges, including inadequate water access, poor toilet facilities, and shortages of soap and sanitary pads. For sustained progress, future efforts should focus on improving WASH infrastructure, ensuring reliable supply of essential resources, and deepening engagement at both school and community levels so as to enhance student health and educational outcomes.