The HESAWA programme began in 1985 on the basis of a Specific Agreement between
Tanzania and Sweden on cooperation concerning rural water supply, environmental sanitation
and health education. The programme area covers the Lake Zone, made up of Kagera, Mara and
Mwanza regions, which border Lake Victoria.
The overall aim of the programme is to improve the welfare of the rural population through
improved health education, environmental sanitation, drinking water supply, community
participation, and capability and capacity building at village and district levels. The
pillars or Principles on which HESAWA activities are funded include: Affordabillity,
Sustainability, Replicability, Credibility, Cost-efficiency.
The overall aim of the programme is to improve the welfare of both rural and urban
populations of the regions that border Lake Victoria, through improved health education,
environmental sanitation and drinking water supply. Over the years these were seen to
deteriorate as shown by a survey of school children's health situation. The studies
indicated that most of the pupils suffered from lack of clean water and basic sanitation
due to waterborn diseases.
SCOPE AND METHODOLOGY
The government discovered that the high occurrence of water borne diseases among children
was a community problem which could only be tackled through high community awareness and
participation through capability and capacity building at village and district levels
ensuring long-term sustainability. The programme, developed in July 1995 by the
Governments of Tanzania and Sweden, covers the Kagera, Mwanza and Mara Regions in the lake
zone involving a total of 730 villages in all the 15 districts in 1993. There were some 32
villages in the pilot project in 1985. Coverage has increased more than 26 times since
The HESAWA programme has grown large and complex over time and covers a wide geographic
area of the lake zone whose total population exceeds 4 million people.
THE PROGRAMME OBJECTIVES
According to the 1990-93 Plan of Action (POA) the operative goals of the programme are:
Improved Water Supply
Make water supply reliable and continuous, of improved quality of greater quantity, more
accessible and valuable for various household purposes (also financially
Improved Health and Environmental Sanitation
This was to be achieved by:
i) increasing people's awareness as to how to maintain the quality of water from source to
ii) increasing popular participation, especially the participation of women,
iii) health and environmental sanitation education directed towards water and hygiene -
iv) Construction of sanitary latrines which are socially and culturally acceptable,
v) Improving vector control through improved drainage and waste disposal (also promoting
full village coverage of household latrines - 1994/98 Plan of Action)
Capacity and Capacity Building and Strengthening at All Levels
This was to be done by:
i) Overall human resources development (especially with emphasis on women - 1994/98 Plan
ii) legislative backing for management at village level
iii) improving managerial capacities at village and other levels
iv) Imparting technical skills to the grassroots level (Also increasing gender awareness
at all levels - 1994/98 Plan of Action)
ACHIEVEMENTS OF THE HESAWA PROGRAMME (AN IMPACT ASSESSMENT)
Since 1995 when the project was started, HESAWA has produced a marked impact in meeting
its objectives, most of which is qualitative, given the nature of the programme aimed at
creating a qualitative change of attitudes regarding Health through Sanitation and Water
(HESAWA) using local resources.
To date, HESAWA has undertaken activities in more than 600 villages, spread over more than
180 wards. All 15 districts in the Lake Zone are undertaking HESAWA activities to some
degree or other. The programme has expanded significantly during the past year or so. On
the basis of village and other studies carried out the major achievements of the HESAWA
Programme can be summarized as follows:
- The creation of an improved potential for the reduction of diseases and the achievement
of general health and hygiene improvement, recognized and acknowledged by the villages
- Increase coverage of improved water supply in the Lake Zone;
- Acceptance by both government workers and villagers of more appropriate, affordable, and
sustainable water supply technologies, including rainwater harvesting systems and improved
traditional water sources;
- Positive steps forward in promoting and operationalizing community-based approach;
- Impacts at village level in terms of greater convenience and quantity of water supply,
cleaner and safer water, time, gains, reductions in the burdens of women, and
opportunities to improve nutrition through garden watering;
- Increases in knowledge, skills and capacities at regional, district and village level
for planning implementing and operating and maintaining water supply improvements and, to
a lesser extent, hygiene and health activities; and,
- Progress in transferring implementation responsibility from regions to districts,
through the use of inter-departmental promotion teams working at village level.
DIRECT OR POSITIVE IMPACT ON THE LIVING ENVIRONMENT
Alleviation of Povery and Job Creation
HESAWA provides health education to improve the environment. Improved health indirectly
enables people to actively participate in economic activity leading to improved incomes
and reduction of poverty. About 1289 new jobs have been created, most private local
consultants. With the recent shift in government policy towards higher private sector
involvement more jobs are foreseen in the supply of spares and carrying out of drilling
operations of boreholes. No study has been undertaken to measure change since 1985.
Reduction of Pollution and Improving Environmental Health
The programme has provided its services to urban dwellers in Mwanza Municipality as well
as other regional centres. It is soon launching special programmes for the small towns of
Mugumu, Ngudu and Bihalamulo. The increased use of pit latrines and protected water
sources in the rural areas has greatly reduced the dangers of faecal pollution. The
reduction in water borne and pollution related diseases has not been quantified so far for
lack of baseline data.
Extension of Safe Water Supply and Sanitation
This is the major preoccupation of HESAWA in about 730 villages by 1993, through health
education and water supply. As a result 1797 wells have been constructed, 289 wells
rehabilitated, 65 piped water schemes constructed or rehabilitated, 850 traditional water
sources improved and 1798 village health workers, both men and women (50%), trained.
Through the programme, thousands other participants have been trained in various human
resource development activities. Based on this success, the government has decided to
introduce the HESAWA approach in other regions. With the support of UNDP, a strategic
workshop was undertaken in Arusha in 1992 for this purpose.
OTHER ACTORS INVOLVED
HESAWA is implemented through the local government system who provide both, money and
personnel also some materials. The contribution of funds from the local government varies
with status at 5% or 3% of total budget. Provide office space and workers housing.
They are the HESAWA managers (coordinators)
Non-Governmental Organisations (NGOs)
HESAWA works with Religions organisations, hospitals, relief organisations such as CARITAS
and local environmental NGOs e.g. TAHARE. These are useful for local mobilization and
provide experts for training programmes at all levels.
The programme utilises the services of the private sector right from provision of
consultancy services by Business Care Services to supply of materials by other outlets.
More future role of the private sector is planned.
The programme utilizes the services of Hifab, SIDA, AMREF for various specialised services
while training is done at ESAMI and other universities abroad.
HESAWA produces its own newsletter and plans a radio programme with a newly established
Radio Free Africa of Mwanza.
Women are involved at all levels of the programme development. Gender awareness raising is
part and parcel of the programme. Noticable changes are showing up whereby men are taking
up roles traditionally in the women's domain. Free gender discussions are carried out. The
water projects are reducing women's workloads, distance travelled and liberate time for
women who now can participate in other activities. Women have made a sustainable
contribution to the programme, mainly taking up roles based on the social division of
labour. However, this is changing as both men and women have equal access to training to
become village health workers and water pump care-takers on a basis of equal
HESAWA provides for water source protection to protect its water schemes. However, it
works closely with environmental NGOs in afforestation. Also the programme promotes
fuelwood efficient technologies. The now-popular mud-stoves help reduce fuel wood
consumption leading to long-term conservation effects.
HESAWA works on the principle of involving the people in planning and decision making
It is a result oriented programme whose outcomes are helping to solve health problems
facing the people;
People in the target areas are finally responsible for maintaining facilities to ensure
HESAWA promotes local independence in decision making on the use of funds.
It also promotes increased cooperation among actors to speed up success.
As a response to the SIDA Evaluation Report of 1993, HESAWA is now working on data banking
to develop its monitoring capacity and the necessary indicators for planning and
2150 wells have been constructed.
336 wells have been rehabilitated.
1077 piped water scheme domestic points have been constructed or rehabilitated.
921 traditional water sources have been improved.
447 institutional latrines have been constructed.
5401 household latrines have been constructed.
1128 village health workers have been trained.
Thousands of participants have been trained in other HRD activities.
Besides these measurable achievements, other notable accomplishments are for exampled:
community participation at village level in planning, financial management by opening
HESAWA accounts and more women participation in HESAWA committee.
As a result of these achievements the Tanzanian Government has decided to introduce HESAWA
also in other regions. In 1991/92, with the support of UNDP. HESAWA started in Arusha
region. A strategic workshop in Arusha marked that take-off.
HESAWA prints the by-laws and distribute to the people to make their rights known. Most of
HESAWA activities are covered in the by-laws hence it only plays the role of
SOCIAL POLICIES AND STRATEGIES
The programme strategy is to achieve change of attitudes towards project ownership at
local level. As a result village accounts have been opened as a step towards project
maintenance and purchase of spares.
The educational approach towards sanitation, participatory evolvement of projects and the
establishment of schools water clubs aims at sustainable results of the programme
involving both men and women.
DECISON-MAKING PROCESSES AND MANAGEMENT PRACTICES
The water committee at village level is comprised of 3 men and 3 women. These make
decisions of the day to day activities and some are signatories to the village water
account. Expenditures are approved by the village water committee. One signatory to the
account is drawn from district level. The HESAWA office in Mwanza is the overall
coordinator of the programme.
REVENUE UTILIZATION AND ALLOCATION
The programme is jointly financed by the governments of Tanzania and Sweden. Whereas
Tanzania provides local funds, personnel, offices, housing, access to institutions and
equipment, Sweden throug SIDA, supplies the foreign funds needed. The Swedish support
contribution has been around 37 million Swedish Kronor per year since 1985. In 1994 this
amount stood at 41 million Swedish Kronor or approximately 6 million US Dollars. Budgets
are prepared at all levels based on needs from below:
In ensuring sustainability, HESAWA puts more emphasis on the following:
(i) Integrating HESAWA activities into existing government structures;
(ii) Human resource development at the village, ward and district levels;
(iii) Instituting community-based operation and maintenance by ensuring that each HESAWA
- Bank A/C to cater for future operation and maintenance of HESAWA interventions;
- Functional HESAWA committee to ensure management of the installed facilities;
- two trained well-caretakeres (at least one woman) to undertake service and repair of
- the use of appropriate technology.
Mr. Makerere, HESAWA
P.O. Box 604
(255 68) 50718/42184; Fax: 50248/50564
Ministry of Community Development, Women Affairs & Children (MCDWC), Tanzan
Ministry of Community Development, Women
Dar es Salaam
255 51 31301-5
Embassy of Sweden/Sida, Dar es Salaam
Lars Norvik, Embassy of Sweden/Sida
P.O. Box 9274
Dar es Salaam
255 51 33581; Fax: 255 51 46928
Mr. Mtui, HESAWA Director
P.O. Box 604
(255 68) 50718/42184; Fax: 50248/50564
Margaretha Sundgren, Sida Sweden