Following an outbreak of cholera in 2010/11, a three-year project was undertaken by WHO to address WASH in health care facilities in cholera hotspot areas of Chad. Globally, cholera is on the rise, with an estimated 3–5 million cholera cases and 100,000–120,000 deaths reported each year. Effectively reducing cholera and diarrhoeal diseases in a sustainable way will require a strong focus on long-term preventative interventions, including facilitating access to safe drinking-water, sanitation and hygiene and empowering local communities and health care facilities to manage WASH services.
The project has targeted thirteen facilities in two districts (N'djamena and Bongor) and focuses on behaviour change, water safety and community engagement. During the three year project (2013-2015) evidence-based behaviour change interventions will be developed and tested along with the distribution of hygiene kits. In addition, health and WASH officers will be training in conducted water quality testing as part of the development and implementation of water safety plans to effectively assess and manage risks.
In July 2015, two 3-day training workshops were held by WHO, the Ministry of Health and CSSI a partner NGO on WASH FIT. Nearly 40 staff including clinical and non-clinical staff from the 13 facilities were trained. Chad is the first country to receive training on the WASH safety plan methodology. An evaluation of the effect of this training was undertaken by MoH and CSSI, in which each facility received 2-3 visits to discuss progress on WASH FIT, highlight barriers to implementation and identifying additional resource needs.
Two one-day workshops were held in March 2016 to mark the completion of the project. The first workshop consisted of staff from the 13 facilities, and involved reflection on the project as a whole, the training and next steps. The participants unanimously agreed that the project should continue and asked for support to help make continuous improvements to their WASH infrastructure. The second workshop was a national-level meeting with members of the Ministry of Health, UNICEF, WHO, the EU, CSSI and other partners which focused on WASH as a means of strengthening health systems, and how it can be linked with initiatives such as surveillance, communication, maternal and child health and nutrition.