1. Water and Sanitation Status in the Kilifi DSS. B.K.Tsofa

2. The Kilifi DSS Was set up by KEMRI-WTRP in 2000 to,  To establish a population framework for epidemiological studies of diseases of local importance  To measure mortality trends accurately over time (in the absence of accurate vital statistics)  To evaluate the impact of interventions of national public health importance Comprises of 80% of the clients who utilize KDH for health services Enumeration is done 3 times in a year

3. Introduction A total of 247,624 residents from 15 locations in the Kilifi DSS were involved in the water sources and sanitation survey none in the DSS round 19 enumeration. The question asked were; 1.What is the main source of water? 2.Do you(DSS resident) boil, treat, filter water before drinking? 3.What is the main type/mode of human waste disposal? 2299 (0.9%), 3931(1.6%) and 3003(1.2%) answered “don't know” to the first, second and third question mentioned above respectively Majority (82.62%) of DSS residents were resided in the rural areas

4. Water sources Overall, 80 % of Kilifi DSS residents had access to piped water 7.8 % of the residents used water from unprotected wells Ponds, dam, rivers, harvested rain water, and water vendors accounted for about 1 % Inter-location rates for piped water ranged between 44% in Junju location and 99 % in Sokoke location

5. Water sources by region in Kilifi DSS

7. Water Sources by location

8. Modes of Human Waste Disposal

9. Achievements-Triggered plus spill over DivisionNo. Villages Villages triggered No. ODF villages Villages below 50% Villages above 50% Latrine coverage Kikambala86905451% Chonyi57700771.9% Bahari10818051363.1% Jaribuni341818951.5% Ganze57402260.7% Vitengeni181701705360% Bamba87150 014% District61014118358848.5

10. DivisionPop. HHHH with latrines as at 1 st July 10 Latrine coverage (1 st July 10) HH with new latrines HH with latrines at 31 st …2010) % Cov. ForAug2 010 Chonyi572348776636672.523640673 Bahari121198174581068661.21071101663.1 Kikambal a 15736520707894243.230902443.58 Ganze210093047178558.634184960.7 Bamba5275213795188113.67193014 Vitengeni639987326368750.3525421657.5 Jaribuni181172497125250.19128751.5 District4916747360634599477353572848.5 Kilifi district latrine coverage by Division

11. Modes of Human Waste Disposal Approximately 49 % of the residents used covered pit latrines 37 % go to the bush for defecation 5.8 % used uncovered pit latrine 0.4 % used other modes like bucket latrines, main sewer, and cess pool, etc

12. Cont... Inter-location rates for pit latrine usage ranged between 15 % in Jaribuni location and 76.4 % in Ziani location The use of bush for defecation ranged between 10.8 % in Ziani location and 80.2% in Jaribuni location The coverage of VIP latrines ranged between 2.4 % in Roka location and 6.9 % in Ngerenya location

14. Pit latrine Coverage

15. ODF Prevalence

16. Water Treatment at Point of Use 93.4 % of the residents in the DSS did not treat, boil or even filter the water before drinking Only, about 6.6 % of all the residents reported to boil, treat or filter water before drinking More residents (4.84 %) treated water before drinking than they boiled water before drinking 1.25 %

17. Cont... Residents using water from improved water sources were 37 % less likely to disinfect drinking water compared to residents using water from unimproved water sources Those residing in the peri-urban areas were 73 % more likely to disinfect drinking water than those residing in the rural areas

18. Planned work Base line data for prevalence of water (fecal mater ) contamination Continuous monitoring of water contamination levels with improved sanitation Case –control studies for water-borne and water-washed diseases

19. Thoughts on CLTS in Kilifi Piloted in Jaribuni village, in July 2007,as a collaborative effort between MoH,Plan Kilifi and the community DHMT, all PHOs & PHTs and some Plan Kilifi staff were trained on the CLTS concept in May 2008 Lots of enthusiasms for scale up spearheaded by DHMT

20. Profiling Kilifi Sanitation We have profiled Kilifi and hosted all sorts of visitors Global media coverage; press media and internet network Positioned Kilifi on the ‘Global sanitation map’ Can we sustain this momentum and our position on the global sanitation map?

21.  Sustaining the momentum by the community after CLTS triggering, inadequate follow up of natural leaders and officers in triggered villages.  High water tables/collapsible soils/hard rocks requiring special latrine technology out of reach to the community.  Some CHWs and provincial administrators expected to be role models have not taken leading roles.  Termites infestation  Seasonality and its effect on community participation in CLTS e.g. prolonged drought and rains. Challenges as per Sigomaba’s Presentation

22. Opportunities Inherent capacity after the training of 2008 Dedicated and true partners, community members, community leaders, Plan Kilifi Established network of community leadership; CHWs, Village elders

23. Thoughts in Moving forward Lets empower the communities to take a lead role Who among us here went to trigger Ngamani. Village.??? Why are they ODF...??? Let the community engineers exercise their skills