Project report

Project background

In Timor-Leste over 80% of healthcare facilities (HCFs) do not have the basics such as:

• a water supply on site;
• toilets for staff, men, women and people with a disability;
• places to wash hands with soap;
• cleaning protocols; and
• safely managed healthcare waste.

To address this crisis, WaterAid is building on the progress towards ending open defecation in Liquica and Manufahi, to strive towards the next level identified in the National Sanitation Policy: Hygienic Status, requiring sustainable Water, Sanitation, and Hygiene (WASH) services in HCFs.

WASH is essential for delivering quality care, particularly for women and newborns during the vulnerable time of childbirth. With only 34% of women accessing HCFs in rural areas for childbirth, clean and safe HCFs will play an important role in increasing demand for, and trust in, services and reducing the risk of potentially deadly infections for mothers and their newborns during childbirth. Furthermore, safe WASH can result in cost savings from infections averted and more efficient service delivery.

Key project activities 

WaterAid has worked with local partners, and government to conduct the following activities: 

• In Likisa, WASH data was collected and used to plan improvements at two health posts, resulting in the Likisa Association of Water User Groups providing a grant to the relevant Water User Group to repair their community water supply system, which also supplies the health post.
• WASH in HCFs data shared at municipal health and WASH sector quarterly coordination meetings drove consensus that water supply coverage of HCFs would be considered in government’s selection of locations for integrated rural WASH activities. 
• WaterAid supported Municipality Association of Water User Groups in Manufahi and Liquica, in collaboration with government subdistrict facilitators, conducted 10 training sessions for 42 Water User Groups (WUGs) on managing their systems as per the national guidelines. Operations and maintenance grants were given to 6 groups to make small repairs to their systems;
• WaterAid and partners worked hand-in-hand with municipal staff throughout the HCF upgrade and integrated rural WASH community projects, enabling increased understanding of technical and social inclusion requirements and progressing development of an integrated application.

Key project outcomes

• Access to basic water, sanitation, hygiene and waste management provided in four rural health posts, two in Manufahi and two in Liquica;
• Rural water supply systems which meet the World Health Organization's water quality standards were installed in two rural communities, Tobauk and Mausiga where nearly 30% of its population is vulnerable, enabling all households to access improved water sources (previously just 0% and 8% of households respectively had access). Open defecation was eliminated and all households now have handwashing stations and safe water storage containers;
• Seven Municipal WASH forums and Quarterly Health Meetings were held, and one national WASH Forum was supported; and
• Three Tetum learning products were produced and shared with the WASH sector and government on WASH monitoring and Association of Water User Group activities, including the integration of WASH in HCFs into existing processes. 

Community involvement 

Working in collaboration with and engaging the community from the start of any project is part of WaterAid’s approach to ensure buy-in and sustainability. 

The chief of the Community Health Center in the Manufahi Municipality, Mr. Jose is so proud of the ongoing collaboration with partner NGOs like WaterAid and local implementing partners in several health posts. He is especially proud of the Sanitation and WASH in Healthcare Facilities Program and the establishment of accessible and user-friendly public toilets equipped for people living with a disability at healthcare facilities in Manufahi municipality.

“I’m very thankful to our partner organisations like WaterAid and its implementing partners; for their collaboration”. 

Asking about any changes or benefits from this collaboration, Jose confirmed there is a significant change this year in these healthcare facilities. “As we have put in action the inclusivity in our services in the facilities, there is no discrimination to people with disability in accessing toilets in the HCF, and by having these accessibilities, our community can imitate the same type of accessibility for their relatives who might be living with a disability.”

What's next?

Our program in Manufahi and Liquica continues in 2021, and works towards achieving the below priorities: 

• Increasing use of WASH data for planning and improvement of healthcare facilities by municipalities;
• Improving, inclusive and sustainable WASH in target rural communities and healthcare facilities; 
• Improving preparedness of target healthcare facilities for COVID-19 response; 
• Documenting lessons learned to galvanise action from stakeholders to improve WASH in healthcare facilities.