Community health workers like Maria ‘Mama Choo’ key for community-wide sanitation uptake in Tanzania

Community health worker, Maria, speaking with the FINISH Mondial Tanzania team (2020).

A safely managed toilet in the construction phase in Tanzania (2020).

Community health worker, Maria, speaking with the FINISH Mondial Tanzania team (2020).

Maria Kisili, 44, is one of Tanzania’s community health workers (CHWs) working with the FINISH Mondial Tanzania programme. Upon receiving training from Amref Health Africa Tanzania in 2018, Maria’s area of work has been at Stand Kuu ward in Serengeti district where, alongside other CHWs, she conducts home awareness campaigns on sanitation and hygiene about the dangers of contagious diseases caused by poor access to improved sanitation and hand washing practices.

In addition to creating awareness, CHWs are also knowledgeable about quality and sustainable construction. “The training I received has not only built my confidence in educating people about hygiene, but also has equipped me with hand-on skills on how to build toilets using locally available materials,” Maria says with confidence. “I have also been taken to training at Busia County in Kenya and where I learned how to build toilets using local materials… [how to] teach society and the community has received it well,” she adds. Maria’s efforts have started bearing fruits. In just two years, she has managed to mobilise her community to build sustainable toilets.

It was not easy to convince people to shun the old practice of open defecation which, according to Maria, was a deeply cultural issue. Traditional myths were some of the main obstacles. “In the beginning, the community had negative beliefs. For instance, the Kurya tribe believed that men should not share toilets with their daughter in-laws. This situation made men reluctant to build toilets. Family members preferred to defecate in the nearby bushes.”

However, with FINISH Mondial Tanzania, the situation has gradually changed over the last two years. Awareness and education by CHWs have been the key driving force for behavioral change.

Local approach

Local government has played a key role in the uptake of the FINISH Mondial Tanzania programme. The local chairperson and other leaders call for village meetings which are used as platforms for driving change.

In order to make the project more attractive to those who did not have the resources available, a micro-credit component, where some members are financially enabled by the banks to access loans specifically for sanitation.

‘Mama Choo’

Like any other project, Maria has also encountered some challenges. Some people lack resources to buy the materials for toilet construction. Some people have dug pits and left them because they say that they do not have money to buy the materials…” Meeting the ambition for safe sanitation with access to sufficient resources is one of the FINISH Mondial programme’s great objectives.

Courtesy of the project, Maria’s importance in the community has totally been elevated. People have opted to nickname her “Mama Choo”, which she tells us means a mother who cares much about toilets, borne of her relentless efforts aimed at ensuring that every home has access to safe sanitation. She has become known across the whole ward. “I have accepted the nickname…and they normally call me when they have completed digging their pits for the toilets so that I may check their progress. FINISH Mondial Tanzania has been very crucial to the community.”