In February 2011, AIDSTAR-One, with support from the Ministry of Public Health and Sanitation (MOPHS) piloted a training curriculum in Kenya that aims to address water, sanitation, and hygiene (WASH) at health facilities to improve the quality of life of people living with HIV and their families. To determine the impact of the training and to provide guidance on how to improve WASH knowledge and practices at the facility level, AIDSTAR-One, with support and leadership from the MOPHS, conducted a mixed-methods assessment in February 2012 examining the evidence in seven MOPHS health facilities in Kenya one year after AIDSTAR-One’s WASH training. Collecting both qualitative and quantitative data, the assessment examined existing WASH approaches at the seven clinic sites focusing on overall integration into the health clinic operations while also collecting baseline data for integration into the technical area of nutrition assessment, counseling, and support services to examine if integration into a technical area produces more sustainable WASH results.
Increased availability of handwashing and drinking water at the health facilities was a key measurable impact of the AIDSTAR-One pilot. At the training, participants from each health facility were asked to select small doable actions (SDAs)—simple, easy-to-adopt WASH-related activities or practices to reduce the risk of diarrhea and other opportunistic infections in people living with HIV—to implement upon return to their facilities. Of the 25 SDAs chosen, 17 (68 percent) were fully implemented, 5 (20 percent) were partially implemented/not sustained, and 3 (12 percent) were not implemented. All of the participants reported that the knowledge gained at the training and the implementation of the SDAs assisted in improving WASH standards at their facilities. These results include four facilities that provided a dedicated drinking water tank post-training, that were previously without drinking water. These results demonstrate the effectiveness of identifying SDAs during the actual training as they hold participants accountable to implementing actions learned during the training.