The rights and principles set out in the articles of the Constitution form the basis of government policy. In the health sector there are a number of different policy, strategy and programme documents that are relevant to WASH.
Health Policy (1993)
The Health Policy of 1993 outlines the need for strategies linked to the democratisation and decentralisation of the health system, and inter-sectoral collaboration. It specifies the need for ‘accelerating the provision of safe and adequate water for urban and rural populations’, ‘developing safe disposal of human, household, agricultural and industrial wastes and encouragement of recycling’, and ‘developing measures to improve the quality of housing and work premises for health’ (Transitional Government of Ethiopia, 1993). The Health Policy has led to several health-related programmes and strategies.
Health Sector Development Programme
The Health Sector Development Programme (HSDP) guides the development of national long-term plans in the health sector including those concerning water, sanitation and hygiene. The current programme, HSDP IV, covers the years 2010 to 2015 and is the fourth in a series of five-year programmes. It set targets at the national level for latrine access, household use of water treatment and safe water storage practices, and achievement of open-defecation-free (ODF) status in villages (MoH, 2010).
The Health Extension Programme (HEP) is an innovative community-based primary care system developed under the HSDP. Health Extension Workers deliver community-based antenatal and postnatal care as well as basic health information about WASH (Figure 15.2).
Health Extension Workers (HEWs) are often drawn from the communities they serve. What do you think are the advantages of this?
The HEW will understand the community and its cultural practices and will be better equipped to adapt the health messages to the community’s situation. The HEW is also likely to be trusted by the community as one of their own.
National Hygiene and Sanitation Strategy
The National Hygiene and Sanitation Strategy (NHSS) of 2005 was developed by the Ministry of Health to complement the Health Policy. Figure 15.3 shows the image on the front cover of the document. This clearly illustrates the links between health and the three components of WASH.
The strategy starts with a ‘Sanitation Vision for Ethiopia’, which is: ‘100% adoption of improved (household and institutional) sanitation and hygiene by each community which will contribute to better health, a safer, cleaner environment, and the socio-economic development of the country’ (MoH, 2005). The strategy first describes the current situation, as it was in 2005, and then sets out objectives and plans for achieving the goal of the Vision Statement, which are being carried forward in various programmes and projects.