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DAWLADDDA PUNTLAND GOVERNMENT OF PUNTLAND EE SOOMAALIYA SOMALIA

Ministry of Health

HYGIENE AND SANITATION POLICY

Supported by

UNICEF SOMALIA

February 2013

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Contents

ACRONYMS .................................................................................................................................................. I

FOREWARD ................................................................................................................................................ II

ACKNOWLEDGEMENT .......................................................................................................................... IV

EXECUTIVE SUMMARY ............................................................................................................................ V

1.1 Introduction ........................................................................................................................................ 1

1.2 Public Health Services ....................................................................................................................... 1

1.3 Disease Trends ................................................................................................................................... 1

1.4 Hygiene and sanitation situation ...................................................................................................... 2

1.5 Rationale and Context for Policy Development .............................................................................. 2

Hygiene and Sanitation Policy challenges ............................................................................................ 3

UNIT 2: PUNTLAND HYGIENE AND SANITATION POLICY ............................................................ 4

2.1 Policy Vision ....................................................................................................................................... 4

2.2 Policy Mission .................................................................................................................................... 4

2.3 Policy Goals ........................................................................................................................................ 4

2.4 Policy Objectives ............................................................................................................................... 4

2.5 Policy Principles ................................................................................................................................ 5

2.6 Policy Strategy .................................................................................................................................... 6

UNIT 3: INSTITUTIONAL FRAMEWORK, ROLES AND RESPONSIBILITIES ................................. 11

3.1 INSTITUTIONAL FRAMEWORK ........................................................................................ 11

3.2 ROLES AND RESPONSIBILITIES ...................................................................................... 11

WAY FORWARD ....................................................................................................................................... 15

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ACRONYMS

CSOs – Civil Society Organizations

INGOs – International Non-Governmental Organizations

MOH – Ministry of Health

NGO (s) – Non-Governmental Organization (s)

ODF – Open Defecation Free

UN – United Nations

UNICEF - United Nations Children’s Fund

WHO – World Health Organization

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FOREWARD

The United Nations has declared that access to safe water and sanitation is a human right

that applies in times of peace and in emergencies. The Puntland faces multiple challenges in

the hygiene, sanitation and water sectors. The proportion of the population with access to

toilets is only 26% and less than 5% in rural areas have sanitation facilities. There are no

reliable country-wide data on hygiene and sanitation practices. Therefore, political and

financial commitment of the Government of Puntland is a prerequisite for achieving

progress in the hygiene and sanitation sector. Generating momentum from political

commitment, concerted effort from all the sector partners will achieve a significant progress,

especially in relation to hygiene and sanitation coverage and ‘eradication of open defecation’.

The benefits of improved hygiene and sanitation can be summarized as follows:

Health - diarrhea prevention, mortality decreased, curative care reduced and nutrition

improved.

Socio-economic - fitter workforce, less time caring for the sick, less money spent on

treating sickness.

Educational – enhanced girl child school attendance and attaining higher levels of

education

Social – privacy, dignity, safety and a cleaner environment.

Gender – women stand most to gain from improved sanitation and hygiene benefits.

This is the basic policy document that will govern the Hygiene and Sanitation sector. This is

a ‘living’ document which has been developed through consultation with the Ministries of

Health, Public Works, Interior, Education, Environment, Women Development and Family

Affairs as well as donors, UN agencies and NGOs. The document is designed to bring

together policy guidelines and lessons learnt to help forge consensus among the many

stakeholders on the development of a ‘Policy’ which will lead to 100% adoption of improved

hygiene and sanitation which is the process where people demand, develop and sustain a

hygienic and healthy environment for themselves by erecting barriers to prevent the

transmission of diseases, primarily from fecal contamination.

The implementation of improved hygiene and sanitation is the responsibility of all

individuals, households, and communities. In short it is the responsibility of all Puntlanders.

It will be achieved through collective responsibility with mutually reinforcing roles played at

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each level. While sector professionals have responsibility to create the enabling environment,

success will depend on committed political, administrative and budget support. Under the

umbrella of the national policy, regions will engage district administrations in ‘performance

contractual agreements’ to drive the process through sectoral desks supported by an

intersectoral coordination forum all tiers of government. While the primary focus is on

communities empowering themselves through individual and collective behavior change to

own and lead sanitation improvements, the districts will take responsibility for developing

the right mix of mobilization, promotion and sanctions to achieve 100% coverage. The

district administration enables the process with support from the regional coordinating

forum which, in turn, is supported at the national level. Public Private Partnerships (PPPs)

will be fostered through the development of local service providers and district support

groups.

As with other policy papers, this document shall be subject to periodic review to keep pace with all relevant developments in the nation and internationally and with the development of situation of hygiene and sanitation in Puntland.

The Ministry of Health deeply appreciates the United Nations Children’s Fund (UNICEF)

for the financial and technical support.

I am confident that MOH as the government’s focal agency for Hygiene and Sanitation

programming will provide the leadership in the implementation, monitoring and evaluation

of this Policy for this hopefully guarantee that the human health and dignity prevails in

Puntland.

Hon. Ali Abdullahi Minister of Health ----------------------------------

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ACKNOWLEDGEMENT

The journey towards the preparation of the Puntland Hygiene and Sanitation Policy has been

made possible by the close support received from international and national organizations

and individuals involved in reviewing various drafts, making constructive inputs and active

participation in consultation workshops and meetings. Field visits also ensured substantial

inputs from the Health, Water and Education.

The Ministries of Health, Environment, Public Works, Education, Interior and PASWEN

Agency were also consulted and made valuable contributions.

Our profound gratitude goes to Professor Abdirisak Mohamed Ali who has supported

development and translation of the policy document. The Ministry acknowledges with

thanks the professional work of Professor Abdirisak and his commitment to the quality of

the document in terms of content and alignment with the socio-cultural reality in Puntland.

Shiva…. is thanked for the extensive technical support and advice he provided throughout

the policy drafting process.

UNICEF as a key player in the hygiene and sanitation field provided funding support and

professional guidance to the development of this policy. The UNICEF Staff has made

invaluable contributions throughout the process and finalization of the document..

I am confident that the adoption of this Policy will enhance the overall programming and

coordination of the Hygiene and Sanitation interventions in Puntland.

ABDIRISAK HERSI

DIRECTOR GENERAL

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EXECUTIVE SUMMARY

This policy reflects the need for major change in the Hygiene and Sanitation programs in

Puntland. Instead of being a minor element, hygiene and sanitation become critical elements

of the health, environment, education and water projects. The policy clarifies approaches to

promoting women’s empowerment and ensuring alertness to the needs of the most

vulnerable; priorities regarding hygiene and sanitation issues and engagement with the media.

The core of this Hygiene and Sanitation Policy can be summarized in terms of a move away

from a model of supply to demand-driven focused approach, to one based on four key

points:

1. Adoption of Community Led Total Open Defecation Free as the main mobilization strategy to achieve significant transformation and impact

2. Attention to hand-washing and promotion of personal hygiene practices

3. Working with whole communities, prioritizing attention to WASH at household level and in all schools of those communities, but also ensuring that the Community led Total Sanitation (CLTS) method addresses WASH concerns for all other institutions within the community

4. Maintaining strong links with health, environment, Women Development and family Affairs, education and water ministries as well as with all the other partners working in the WASH sector in Puntland, with a view to maximizing harmonization of programs.

Local government and communities shall be the focus of all activities relating to hygiene and

sanitation. All other stakeholders including the private sector, NGOs and development

partners shall provide inputs into the development of the sector within the purview of

overall government policy with the Department of Public Health ensuring coordination.

Government’s willingness to work in partnership with NGOs, development partners, civil

society, media and private organizations will provide a wider platform for forming multi-

stakeholders partnerships that can play a catalytic role in the sanitation sector and create a

synergistic effect in achieving the goal of sanitation for all. This partnership will help a lot in

mobilizing resources that are needed for the sector.

Finally, the policy lays out the roles and responsibilities of different partners, highlights

follow-up points and summarizes steps going forward.

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UNIT 1: BACKGROUND AND RATIONALE

1.1 Introduction

Access to clean water and good sanitation is basic to life, and by extension significant to the protection of the fundamental right to life. Availability of water and sanitation is strongly related to other human rights such as health, education and work. Various studies have indicated that improvement in water services alone will not bring the health improvements. When water improvement is combined with improvement in hygiene and sanitation the impact on health especially on reduction in diarrhea almost doubles. Puntland state is engaged in the analyses of hygiene and sanitation in order to take stock of the factors that have contributed to the health related miseries amongst its population. This desire has been activated by the low level of achievement in the area of hygiene and sanitation as per which only 26% of population has access to toilets and the situation in rural areas are more precarious with less than 5% population having access to sanitation facilities. The lack of proper and safe toilets in school premises is one of main reasons for students’ poor performance in school and school drop-out rates, especially among girls. Lack of sector policy and plans have hampered the efforts of the Government of Puntland and other stakeholders to accelerate actions for improving on hygiene and sanitation. The poor perception of hygiene and sanitation by the people, as evidenced by low hygiene and sanitation awareness and education are some of the challenges facing the Ministry of Health in its efforts to forge ahead with hygiene and sanitation tasks. 1.2 Public Health Services

The Ministry of Health is mandated to ensure that the country’s health agenda is set on a platform of improving people’s health through various interventions. It is against this background that the Ministry of Health has the role of carrying out hygiene and sanitation promotion geared towards improving the peoples’ standard of living. There are many tasks outlined in the mandate, but the systematic implementation of this mandate has been hampered by many factors, one of which is the absence of key sector policies and legislations. 1.3 Disease Trends

Approximately 80% of hospital and clinic attendance in Puntland is due to preventable diseases. 50% of these diseases are related to unsafe water and poor hygiene and sanitation. The status of environmental sanitation has been declining due to the rapid increase in population, especially in the urban areas. The available statistics indicate that the most prevalent diseases are Diarrhea, respiratory complexities, malaria, poliomyelitis, malnutrition, tuberculosis, sexually transmitted diseases, Pneumonia and Hypertension.

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1.4 Hygiene and sanitation situation

The Government and its partners have done remarkable job in raising resources for water improvements. At the household level, families’ main priorities and funds are focused more towards accessing water supplies than on hygiene and sanitation. Various assessments/studies have shown that although investments in water supplies alone can result in significant health improvements in a community, such health benefits are massively increased by relatively small investments in accompanying measures to improve hygiene behavior and basic sanitation facilities. The status hygiene and sanitation both in households and in institutions (schools/MCH and public institutions) have been poor. Some notable situation related hygiene and sanitation is summarized below:

Approximately 80% of hospital and clinic attendance in Puntland is due to preventable diseases. 50% of these diseases are related to unsafe water and poor hygiene and sanitation.

Approximately 26% of Households have access to toilets.

Less than 5% of rural households have access to toilet and 40% have access to sanitation in the urban areas.

The hygiene and sanitation activities are undertaken as responses to health emergencies rather than a preventable intervention as part of overall health intervention.

Like other sectors, the hygiene and sanitation sub-sector of the WASH has thus been mostly funded by external support agencies due to low public investment and poor economy of the country.

Almost more than 75% of sanitation facilities provided in schools are not functional; and less than 50 percent of sanitation facilities in MCHs are found to be functional.

In situations where sanitation has been prioritized, the responses are very centralized and do not reach the lowest administrative levels, with the result being that they are unresponsive and do not meet the preventive health demands despite the presence of the large international community operating in Puntland.

Since sanitation is such a cross cutting issue related to housing, water supply, sewage disposal, solid waste management, maintenance of gullies and drains, healthcare, environmental management, poverty and education, its management poses challenges that cannot be addressed single Ministry or Agency.

Puntland is not on track to meet the MDG related to sanitation.

1.5 Rationale and Context for Policy Development

Lack of sector policy and plans have hampered the efforts of the various partners in contributing effectively and to its full potential for improving hygiene and sanitation in Puntland. Due to the high prevalence of preventable diseases the nodal Ministry for hygiene

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and sanitation,the Ministry of Health and its partners are striving to ensure that environmental health issues is accorded due priority. Developing a state policy on hygiene and sanitation will create an enabling environment and set in a process in which the Government, the community and other stakeholders, who play a critical role in promoting hygiene and sanitation, will be able to collaborate together. Hygiene and Sanitation Policy challenges

The government has not developed any policy on hygiene and sanitation; though the state is

in process for finalizing sector policies for Education and Health and Environment. The

state has developed a policy for water. While these policies also attempt to tackle few issues

related to hygiene and sanitation; there are very specific challenges that are being faced in the

area of hygiene and sanitation.

Poor Awareness: Sanitation has been accorded low priority and there is poor awareness about its inherent linkages with public health. The Health intervention mostly focuses on curative aspects and less focus on preventive aspects.

Social and Occupational aspects of Sanitation: no attention has been paid towards the occupational hazard faced by sanitation workers also contributed by lack of proper legislation/laws

Fragmented Institutional Roles and Responsibilities: There are considerable gaps and overlaps in institutional roles and responsibilities at the, state, and local Government and community levels.

Lack of an Integrated Clean village Approach: Sanitation investments are currently planned in a piece-meal manner and do not take into account the full cycle of safe confinement, treatment and safe disposal and holistic approach for adopting sanitation as way of life

Limited Technology Choices: Technologies have been focused on limited options that have not been cost-effective, and sustainability of investments has been in question.

Reaching the Un-served and Poor: Urban poor communities especially the IDPs as well other residents of informal settlements have been constrained by lack of tenure, space or economic constraints,

Lack of Demand Responsiveness: Sanitation has been provided by public agencies in a supply-driven manner, with little regard for demands and preferences of households as customers of sanitation services. There has been undue focus on provisioning of individual toilets than promoting Open Defecation Free communities

Lack of adequate Financing: Very negligible finance from state budget is allocated for hygiene and sanitation and is mostly dependent upon external support

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UNIT 2: PUNTLAND HYGIENE AND SANITATION POLICY

2.1 Policy Vision

The policy envisions “Creation of an open defecation free society, able to safely dispose liquid and solid waste for clean family and community environment and adopt hygiene practices”

2.2 Policy Mission

The policy mission is “To build effective hygiene and sanitation promotion system for a sustainable behaviour change in hygiene and sanitation”. 2.3 Policy Goals

The overall goal of this policy is to transform Puntland into community-driven Open Defecation Free communities with adoption of key hygiene and sanitation practices.

2.4 Policy Objectives

To ensure an open defecation free environment, safe disposal of liquid and solid wastes, and the promotion of health and hygienic practices

To link and integrate sanitation programmes with state, regional and district plans, health, water, environment, housing and education

To enhance capacity building of government and civil society organizations for better sanitation and hygienic practices

To increase mass awareness and community mobilization on the importance hygiene and sanitation for healthy living of the society and development

Addressing the weak inter-sectoral collaboration and unstructured community involvement systems in hygiene and sanitation

The major objective of the Policy is to facilitate development of a Plan of Action which will contribute in achieving the development goals in general and health goals in particular and objectives through hygiene and sanitation interventions. Both the goal and the objectives are linked to specific Millennium Development Goals (MDGs).

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2.5 Policy Principles

Following are the overall principles upon which this policy is formulated:

Political Commitment: Increased and sustained political will is required at all levels to generate interest in hygiene and sanitation activities for improved coverage and proper usage. Appropriate legislation for the effective service delivery at all levels shall be enacted. Hygiene and sanitation enforcement agencies shall be empowered to deal with offenders of sanitation laws.

Sanitation as a Health Priority: Access to adequate basic sanitation facilities will improve human health and reduce infant mortality. Sanitation requires priority attention to enhance healthy living and overall development of the population.

Sanitation as a Right: The poor suffer most from lack of access to basic facilities and services. Access to sanitation for the poorest and most marginalized segments of the population shall be ensured as a means of improving equity and poverty reduction.

Holistic Hygiene and sanitation: Construction of sanitation facilities does not guarantee proper usage. Therefore, the policy recognizes the critical importance of hygiene and sanitation behaviour change for the achievement of sustainable health benefits. Hygiene and sanitation activities shall be developed through strategic cooperation of health, housing, education, water and environment sectors. All stakeholders shall be involved from the designing, planning and implementation to monitoring and evaluation stages.

Interests of Women and Children: The disease burden on families, especially children, as a result of poor hygiene and lack of sanitation facilities has direct impact on women. All sector activities shall be designed and implemented in a way to ensure equal participation and representation of men and women, and to pay due attention to the viewpoints, needs and priorities of women.

Environment Protection: Serious attention must be paid to the choice of any sanitation technology and its long term environmental impact. Waste disposal shall be planned and managed with a view to minimize environmental impact and ensure the protection of water resources.

Private Sector Participation: The sector shall create incentives for the private operators, which is the key strategy to enhance the sustainability of sanitation infrastructure. Enabling environment shall be created for business community participation in sanitation service delivery. The private sector shall be encouraged and supported in developing capacities for investment, construction and management in sanitation and solid waste management.

Demand Driven: People are willing to invest sanitation facilities for themselves if they understand the benefits and can afford the cost. The appropriateness of sanitation facilities, preceded by health and hygiene education, must depend on the ability of the users to pay for operation, maintenance and replacement, as at when

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necessary. Through awareness creation and promotion of hygiene practices, communities shall be empowered to demand and invest for improved sanitation.

Cost Recovery and Financial Sustainability: Construction, operation and maintenance costs of sanitation infrastructure shall be born by the users, in order to ensure sustainable service delivery. Affordability shall be addressed by the choice of appropriate technologies and by enhancing efficiency, not usually by granting subsidies. The polluter-pays and user-pays principles are to be applied in sanitation development.

Results-based Management: Monitoring and evaluation systems will be developed in conjunction with planning and budgeting procedures, involving decentralized actors (in particular the districts), in order to ensure that the activities and investments are in line with the defined sector strategic objectives and priorities.

2.6 Policy Strategy

In order to achieve the objective of the Puntland Hygiene and Sanitation Policy, the following Policy strategies shall be adopted: 2.6.1 Advocacy

a. Increased and sustained political will is required at all levels through persistent advocacy and mobilization and would be reflected in creating an enabling environment.

b. All stakeholders shall prioritize sanitation activities through effective hygiene and sanitation promotion in order to make up for the poor sanitation coverage in the region.

c. To ensure acceptability and funding of hygiene and sanitation, strategies shall be developed to engage all leaders (political, traditional, religious, opinion, etc) in the prioritization of sanitation.

2.6.2 Social Mobilization and inter sector convergence and coordination

a. Schools shall be used as focal points for promotion and empowering of children/youth to be agents of hygiene behavior change. This will include establishment of Health and Hygiene Clubs in schools and empowering Community Education Committees (CEC) to promote hygiene and sanitation Education in and through schools.

b. The community groups (viz: Community Health committees, WASH committees, Women Groups, Community Education Committees) will play active role in promoting hygiene practice.

c. Promotion of health education to ensure hygiene practices by users of public latrines/toilets in markets, motor parks, and other public sites.

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d. Sanitation programmes should take a gender sensitive approach by addressing the needs, preferences and behaviors of children, women and men.

e. Sanitation programmes shall take into consideration approaches that would improve the representation and voice of the poor and disadvantaged in policy discussions.

f. Sanitation programmes shall direct effort at setting up better communication and understanding for tackling the structural causes of poverty. Civil society including Non Government Organizations shall build networks and alliances that seek to promote awareness and enforcement of the basic rights, which entitle poor people especially the IDPs to a fair share of society's resources.

2.6.3 Capacity Building

a. Training (Human resource development) for relevant personnel shall be conducted through workshops, seminars, short and long courses, etc.

b. Intensive health and hygiene education shall commence with a strategy for adequately reaching all parts of the region.

c. Ministries of Education shall promote health and hygiene education as a compulsory subject in school curricula from the formative stage of life, through primary and secondary schools to tertiary institution ns especially teacher training institutions. Other informal school instructors shall be trained in basic health and hygiene education.

d. Health and hygiene education shall be an integral part of all community water supply and sanitation projects which will include education personal hygiene, hand washing at critical times, safe disposal of excreta, household water security, cleanliness of kitchen and food hygiene, domestic solid and liquid waste disposal and, community storm-water discharge.

e. Ministries of Health, Education, Environment, Water Resources, Agriculture, Public Works and Housing, Women Affairs and Youth Development and local Government at all levels shall make provision for health and hygiene education in all projects that will have direct impact on the community.

2.6.4 Community Led Sanitation: Community Ownership and Management

a. Community approaches to achieve Open Defacation Free (ODF) will be promoted

wherein they will make choice to decide on sanitation after appropriate sanitation awareness programmes have been carried out. No subsidy approaches for a home toilet will be encouraged ensuring ownership, use and management of sanitation facilities

b. Major stakeholders shall support initiatives that help the poor and the disadvantaged people at household and community levels especially in IDPs and the periurban settlements to address their basic and immediate sanitation needs.

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2.6.5 Robust financial framework

a. Arrangement for funding sanitation projects in rural, semi-urban (small towns) and urban areas and IDP shall be clearly and equitably spelt out.

b. While it is recognized that funding for home toilet for individual families should be borne by the families; funding support to stimulate demand and strengthen supply chain through production centres managed by women groups for sanitary products should be vigorously pursued for a sustainable change and creating local employment opportunities as well.

c. Funding support for provisioning of gender sensitive and differentially disabled people sensitive sanitation facilities in public institutions will be mobilized. The nodal Ministry for hygiene and sanitation in collaboration with related Ministries will set up norms and standards of hygiene and sanitation facilities including hand washing facilities in education, community institution (school, MCH, HP, Urban market place, IDP settlement and other community centres).

d. All Government institutions/Ministry office premises should have provisions of adequate, gender sensitive and differentially disabled sensitive hygiene and sanitation facilities and a system of proper maintenance of these facilities is put in place. These premises should present themselves as model of cleanliness.

e. The solid waste (e.g. including hospital wastes – and appropriate measures to deal with plastic bags) generated especially in urban areas need to be converted into source of wealth. Appropriate measures including updated technology should be deployed for solid waste management.

f. The Ministry of Health, Education, Local Government, Women Affairs, local Government and other ministries will allocate resources for adequate sanitation facilities in the institutions managed by these ministries.

g. Funds shall be sourced from Development Partners to promote implementation of hygiene and sanitation programmes.

h. Capital investment for sewerage, storm water, on-site sanitation systems in public places and institutions shall involve cost sharing at various levels between state Government/Ministry/user communities

i. Government shall provide an enabling environment for private sector, NGOs, to participate in hygiene and sanitation programmes.

2.6.7 Strong Service Delivery

a. States and Local Governments shall reinforce the functions of well-trained and motivated Environmental Hygiene and sanitation Officers at community level to inspect and apply necessary sanctions to sanitation defaulters on a regular basis.

b. Generally on site disposal of excreta will be promoted. Adequate and regular supply of water shall be ensured before introducing water borne systems like septic tanks and sewerage.

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c. Government shall provide an enabling environment for effective partnerships with private sector to enhance local capacity and business opportunities towards sustainable sanitation development.

d. Sanitation improvement shall be approached incrementally based on safe local beliefs and practices. Wholesale introduction of new systems shall be adopted where appropriate.

e. Implementing agencies shall ensure safe citing of sanitary facilities to prevent the contamination of water sources.

f. Due consideration shall be taken while choosing Sanitation Systems to avoid negative impacts on the environment.

g. A choice of technology options will be promoted to satisfy demands of communities and individuals, based on their capability to pay for operation, maintenance and replacement, as at when necessary.

2.6.8 Award and Recognition

State will set up a clean village/city, clean school system as per agreed standard which may include:

a. A communalized system of recognition/ incentive for clean village/city and clean schools will be promoted.

b. Individuals will be recognized for their contribution in making schools village 2.6.9 Monitoring and Evaluation

a. The three tiers of government and communities shall make financial contributions to and be engaged in the monitoring and evaluation of sanitation programmes within their areas of jurisdiction.

b. All stakeholders shall regularly monitor the environmental impact of an adopted sanitation system

2.6.10 Legislation

a. All tiers of government shall review existing laws and by-laws which relate to sanitation.

b. The State Governments shall enact laws that will promote sustainable sanitation activities in their areas of jurisdiction.

c. Local Governments shall formulate and pass bye-laws to regulate sanitation in their areas of jurisdiction.

2.6.11 Research and Development

a. Government shall encourage research by relevant agencies to address a wide range of sanitation issues and propose solution for addressing them.

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b. Key stakeholders shall conduct operational researches to establish effective and sustainable sanitation systems in the country.

c. Recycling and other waste minimization methods shall be given first consideration in adopting any waste management approach.

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UNIT 3: INSTITUTIONAL FRAMEWORK, ROLES AND RESPONSIBILITIES

The successful promotion of a sanitation hygiene programme requires that all stakeholders be involved from pre-planning through implementation, to monitoring and evaluation. The roles and responsibilities of various stakeholders in the promotion of hygiene and sanitation shall be clearly defined. 3.1 INSTITUTIONAL FRAMEWORK

3.1.1 Central Level

a. There shall be a Steering Committee on hygiene and sanitation. Ministry of Health being the nodal Ministry for hygiene and sanitation will be convener of the committee with participation of representative from Ministry of Water, Ministry of Environment, Ministry of Education, Ministry of Public Works and Housing, Ministry of Women Affairs, Ministry of Information, Ministry of planning, Ministry of Finance, Ministry of Interior and representative from UN, and NGOs.

b. Establishment of a Hygiene and sanitation Department with in Ministry of Health which will facilitate the implementation of the Hygiene and Sanitation Policy by coordinating and collaborating with other key line Ministries the Local Government and External support agencies and other development partners and setting up a robust monitoring and evaluation mechanism and system.

3.1.2 Local Government

a. There shall be Local Government Steering Committee on hygiene and sanitation with membership of all departmental heads and representatives of religious leaders, traditional leaders, civil societies, women groups, youth groups etc.

b. Establishment of a Sanitation Unit at Local Government to co-ordinate and facilitate the planning, implementation and management of sanitation and collaborate with the State Steering Committee on hygiene and sanitation to actualize the 100% total sanitation programme at the Local Government level.

3.2 ROLES AND RESPONSIBILITIES

3.2.1 Ministry of Health

a. Shall take the lead in developing policies, strategies, standards, Guidelines, plans on hygiene and sanitation for Puntland in consultation with all stakeholders.

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b. Shall integrated hygiene promotion in Health communication activities (Child Health Day, Community Health Committee capacity building and any other Health and Nutrition related initiative)

c. Shall establish and appropriately fund the Hygiene and Sanitation Division of the d. Responsible for ensuring hygienic environment in Health institutions (Hospitals

MCH/HP/OTP) with adequate arrangement of hygiene and sanitation including medical waste management system.

e. Shall engage in the training and capacity building of government personnel and civil society organizations (NGOS) to be involved in sanitation at the State level including environmental health officers, monitors, enforcers and administrators.

3.2.2 Local Government

a. Will develop annual plan for Hygiene and sanitation and will finalize under the guidance of nodal Ministry of Health.

b. Local Government will be responsible for implementation of hygiene and sanitation activity in the urban areas and IDP with in the overall planning with nodal Ministry of Health.

c. Shall make appropriate bye-laws to support the planning, implementation and monitoring of hygiene and sanitation programmes under the overall framework provided by Ministry of Health.

d. Shall source funds from internal and external sources for the promotion of sanitation programmes.

e. Shall engage in the training and capacity building of government personnel (environmental health officers, monitors, enforcers and administrators) and community artisans to be involved in water sanitation at the Local government and community levels.

3.2.3 Ministry of Education The roles of Ministry for Education are development of children and building a generation which much more aware and sensitized to importance of hygiene and sanitation is critical. The specific role of Ministry of Education would be:

a. Shall promote health and hygiene education as part of the curricular /co-curricular and extracurricular activities and promote hygiene and sanitation practices

b. Ensure provision/upgrading of hygiene and sanitation facilities including hand washing facilities in schools which are gender sensitive, child friendly and differentially abled as per the standards and provide adequate resource for provisioning as well as maintenance of the facilities empowering the Community Education Committees ( CECs)

c. Working closely with Ministry of Health develop annual plan for hygiene and sanitation promotion in schools and through schools.

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d. Ensure setting up a mechanism for proper maintenance of hygiene and sanitation facilities including hand washing facilities and provision of soap in schools for hand washing with community contribution.

3.2.4 Ministry of Public works and Transport/PSAWEN

a. While planning for any mini piped water system, it will have provisions for water system in schools/MCH/public institutions situated in the village/area.

b. Extend technical support to other ministries in capacity building in water quality monitoring and surveillance

c. Introduce appropriate technology in close collaboration with MoH

3.2.5 Ministry of Women and Family Affairs (MOWDFA)

Ministry of Women and Family affairs have critical role in hygiene promotion utilizing the vehicle of Women Groups in Puntland. The specific roles are:

a. Orient the Women Group member on hygiene and sanitation b. Working closely with Ministry of Health utilize opportunity for initiating income

generation activity for hygiene and sanitation (e.g managing production centre for sanitation product e.g bio sand filter/ soap manufacturing/sanitary napkin production/toilet slabs)

c. Mobilize women Groups for achieving Open Defecation Free communities 3.2.6 Ministry of Environment Hygiene and sanitation impacts the environment substantially. The Ministry for environment working in collaboration with the Nodal Ministry will identify critical elements to be taken care of while planning for Hygiene and sanitation programme. In addition, it will have specific role in:

a. Carry out Environmental Impact assessment of hygiene and sanitation activities b. Provide technical guidance on environment related issues and advise nodal ministry

on any environmental concerns c. Develop environmental standards for providing guidance on planning hygiene and

sanitation programme. d. Extend technical support

3.2.7 Communities

a. Communities especially women group shall have a say in decision making process of

any sanitation programme.

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b. The community shall, with the aid of sanitation promoters, establish sanitation norms that must be accepted by all members.

c. The community while considering their norms shall establish structures and systems for self-monitoring and self-appraisal to ensure that agreed targets, and goals of hygiene and sanitation are achieved.

d. The community shall sanction members that do not observe the accepted sanitation norms.

3.2.8 Household/Individual

a. Each household/individual shall be available for health and hygiene education for adopting hygiene and sanitation practices.

b. Each household shall be responsible for owning, appropriate use and maintenance of a sanitation facility for the disposal of human waste.

c. Individuals must recognize the dangers of breeding disease vectors in their environment and shall ensure prevention of such situation.

d. Every household/individual shall observe accepted sanitation norms and sanctions for defaulting.

3.2.9 Non-Governmental Organizations NGOs shall make use of their presence and acceptability in the community to supplement government efforts in promoting sanitation programmes especially health and hygiene education. In particular, the NGOs shall be involved but not limited to the following:

a. Advocacy and mobilization b. Health, hygiene education and sanitation promotion in the community. c. Training and capacity building of the community. d. Developing communication materials that are easily understood and accepted by the

community. e. Bridging existing gaps between government and communities.

3.2.10 Private Sector Participation Activities of the private sector are usually run on a sustainable basis using sound business principles. The attributes of the private sector shall be incorporated in the development of sanitation programmes. In specific terms, the private sector shall participate in the provision of the following services amongst others:

a. Setting up and managing supply chain for easy access of knowledge , skills and materials needed for adoption fo hygiene and sanitation practices

b. Large and small-scale construction.

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5.2.11 Development Partners The role of the Development Partners in raising public awareness of the problems of poor sanitation is noted. Their assistance in the development and implementation of functional sanitation policies for Puntland shall include but not limited to the following:

a. Promotion of sanitation programmes through health and hygiene education. b. Operational research in sanitation issues. c. Funding and technical assistance. d. Capacity building. e. Monitoring and Evaluation of water sanitation projects and programmes.

WAY FORWARD

a. Develop 5-years (2014-2018) Strategic Plan following approval of the Policy to achieve Open Defecation Free in Puntland.

b. Develop joint 2014 hygiene and sanitation sector Annual plan

c. Disseminate widely the policy and the Strategic Plan through the media and workshops.

d. Facilitate enactment of relevant laws and bylaws at the three tiers of government to ensure full implementation of this policy

e. Review and make Institutional adjustments at the three tiers of government

f. Allocation for resources by respective Ministries for Hygiene and sanitation (MoH, MoWDFA, MOE, PASAWEN, MoI)