Participatory science and innovation for improved sanitation and hygiene: process and outcome evaluation of project SHINE, a school-based intervention in Rural Tanzania.
Diarrheal disease is a major cause of mortality and morbidity in low and middle income countries with children being disproportionately affected. Project SHINE (Sanitation & Hygiene INnovation in Education) is a grassroots participatory science education and social entrepreneurship model to engage youth and the wider community in the development of sustainable strategies to improve sanitation and hygiene.



Based in rural and remote Tanzania, this pilot study engaged pastoralist high-school students and communities in the development and evaluation of culturally and contextually relevant strategies to improve sanitation and hygiene. Using a train-the-trainer approach, key activities included teacher workshops, school-based lessons, extra-curricular activities, community events and a One Health sanitation science fair which showcased projects related to water, sanitation and hygiene in relation to human and animal health. The process and outcome of the study were evaluated through qualitative interviews and focus group discussions with diverse project participants, as well as pre- and post- questionnaires completed by students on knowledge, attitudes and practices concerning sanitation and hygiene.



The questionnaire results at baseline and follow-up showed statistically significant improvements on key measures including a decrease in unhygienic behaviors, an increase in the perceived importance of handwashing and intention to use the toilet, and increased communication in the social network about the importance of clean water and improved sanitation and hygiene practices, however there were no significant changes in sanitation related knowledge. Qualitative data highlighted strong leadership emerging from youth and enthusiasm from teachers and students concerning the overall approach in the project, including the use of participatory methods. There was a high degree of community engagement with hundreds of community members participating in school-based events. Sanitation science fair projects addressed a range of pastoralist questions and concerns regarding the relationship between water, sanitation and hygiene. Several projects, such as making soap from local materials, demonstrate potential as a sustainable strategy to improve health and livelihoods in the long-term.



The Project SHINE model shows promise as an innovative capacity building approach and as an engagement and empowerment strategy for youth and communities to develop locally sustainable strategies to improve sanitation and hygiene.
Cumming School of Medicine, University of Calgary, TRW 3rd Floor, 3330 Hospital Dr. NW, Calgary, AB, T2N 4N1, Canada.
Erin
E
Hetherington
Maastricht University, School for Public Health and Primary Care (Caphri), P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
Matthijs
M
Eggers
National Institute for Medical Research, P.O Box 1462, Mwanza, Tanzania.
Joyce
J
Wamoyi
Cumming School of Medicine, University of Calgary, TRW 3rd Floor, 3330 Hospital Dr. NW, Calgary, AB, T2N 4N1, Canada.
Jennifer
J
Hatfield
Weill Cornell Medical College in Qatar, Education City, Qatar Foundation, P.O Box 24144, Doha, Qatar.
Mange
M
Manyama
Faculty of Veterinary Medicine, University of Calgary, Health Sciences Centre, 3330 Hospital Dr. NW, Calgary, AB, T2N 4N1, Canada.
Susan
S
Kutz
Cumming School of Medicine, University of Calgary, TRW 3rd Floor, 3330 Hospital Dr. NW, Calgary, AB, T2N 4N1, Canada. sheri.lee.bastien@nmbu.no.|Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences, Post Box 5003, Akershus, 1432, Ås, Norway. sheri.lee.bastien@nmbu.no.
Sheri
0000-0002-4351-5704
S
Bastien
D000293:Adolescent; D055812:Community-Based Participatory Research; D005260:Female; D006801:Humans; D006920:Hygiene; D062069:Inventions; D008297:Male; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010865:Pilot Projects; D015397:Program Evaluation / Q000706:statistics & numerical data*; D012424:Rural Population; D012499:Sanitation / Q000379:methods* / Q000706:statistics & numerical data; D012572:School Health Services / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013636:Tanzania