M11 Wash

Early Childhood Development
Parental Coaching Level – II

Based on November 2023 Curriculum Version- II
Module Title: Water, Sanitation and Hygiene for ECD

Module code: HLT ECD02 M11 1122
Nominal duration: 30 Hours
Prepared by: Ministry of Labor and Skill
December, 2023
Addis Ababa, Ethiopia
Table of Contents
Introduction to the Module......................................................................4
Unit One: Household Water Treatment and Food Hygiene.................................7
1.1. Sources of drinking water contamination...............................................8
1.2. Water-associated diseases and prevention methods...................................8
1.3. Household water treatment and safe storage.........................................11
1.4. Principles of food hygiene and safety..................................................13
1.5. Food utensils and equipment cleanness................................................16
Unit Two: Latrine Utilization and Management.............................................18
2.1. Features of properly designed latrine..................................................19
2.2. Latrines utilization........................................................................19
2.3. Misconceptions that affect the latrine use............................................20
Unit Three: Personal Hygiene..................................................................21
3.1. Practice of major components of personal hygiene..................................22
3.2. Common hygienic practices..............................................................24
3.3. Major public health importance of personal hygiene................................26
Unit Four: Solid and Liquid Waste Management............................................29
4.1. Explain Solid and liquid waste...........................................................30
4.2. Public health importance of solid and liquid waste..................................31
4.3. Sources of Solid waste and its management process.................................31
Ministry of Labor and Skills Water, Sanitation and Version -2

Page 2 of 36 Author/Copyright Hygiene for ECD December 2023
Acknowledgment
The Ministry of Labor and skill wishes to thank and appreciation to MoLS leaders and experts,
Addis Ababa City Administration training and technology development bureau and industry
experts who contribute their time and professional experience to the review of this Training
module for Early Childhood Development Parental Coaching Program level II. We also thank
Ministry of Health, AACA Mayor office, Addis Ababa City Administration Health Bureau, Big
Win, BVLF, and PATH for their technical and financial support..

Introduction
Access to Water, sanitation and hygiene (WASH) are vital indicators to healthy living and safe
environments for child development and it is a prerequisite for a healthy child. Not only do
WASH services benefit the immediate dignity and safety of the child and mother, they also
provide long-term health, social and economic benefits. the positive impacts of health
interventions for children in one area are undermined by lack of WASH in another, for example:
Nutrition programmes often focus on food and nutrient intake and neglect factors that hinder
nutrient absorption such as recurrent diarrhoea, intestinal worms and other enteric infections
associated with dirty water and unsanitary conditions. Children may be de-wormed, but then
quickly and continuously be reinfected through poor WASH in schools and at home.
Poor protective behavioural practices and inadequate WASH standards are associated with
increased morbidity and mortality, particularly in low socio-economic areas globally; diarrhoea
remains one of the leading causes of death in children below 60 months of age. Evidence also
indicates that inadequate WASH conditions can negatively impact on growth in children,
especially in relation to childhood stunting. Accordingly, the provision of good quality water
sources, sanitation and adequate hygiene practices are essential for the survival and development
of children. Sustainable WASH services within households and communities, healthcare
facilities and schools are fundamental basics underpinning almost every aspect of early
childhood development. It is therefore essential that WASH services are considered a key
component of early childhood programmes in order to support the development of a happy,
healthy child and mother.

This module covers the units:
 Household Water Treatment and Food Hygiene practice
 Latrine Utilization and Management
 Personal Hygiene, a healthy living environment and practices
 Solid and Liquid Waste Management
Learning Objective of the Module
 Describe proper latrine utilization and management approaches
 Demonstrate proper household water management and food hygiene practices
 Demonstrate proper personal hygiene, a healthy living environment and practices
 Explain proper solid and liquid waste management approaches at household level
Module Instruction
For effective use this modules trainees are expected to follow the following module instruction:
1. Read the information written in each unit
2. Accomplish the Self-checks at the end of each unit
3. Perform Operation Sheets which were provided at the end of units
4. Do the “LAP test” giver at the end of each unit and
5. Read the identified reference book for Examples and exercise.

Unit One: Household Water Treatment and Food Hygiene
This unit is developed to provide you the necessary information regarding the following content
coverage and topics:
 Sources of drinking water contamination
 Water- associated diseases and prevention methods
 Household water storage and treatment methods
 Principles of food hygiene and safety
 Diseases associated with food
 Food preservation methods
 Food utensils and equipment cleanness
This unit will also assist you to attain the learning outcomes stated in the cover page.
Specifically, upon completion of this learning guide, you will be able to:
 Describe sources of drinking water contamination
 Explain water- associated diseases and prevention methods
 Demonstrate household water storage and treatment
 Explain principles of food hygiene and safety
 Explain diseases associated with food
 Demonstrate food preservation methods
 Demonstrate food utensils and equipment cleanness

1.1. Sources of drinking water contamination
Potential pollution sources that threaten drinking water are open-field defecation, animal waste,
plants, economic activities (agricultural, industrial, and business) and even waste from residential
areas as well as transportation systems. Any water source, especially older water supply systems,
hand-dug wells; spring-fed systems (including treatment plants, reservoirs, pressure breaks, pipe
networks, and delivery points) are vulnerable to such contamination. Systems with casings or
caps that are not water-tight are most vulnerable.
1.2. Water-associated diseases and prevention methods

1.2.1. Water-associated/related diseases
Water-associated disease is related to water supply and sanitation. Many of the water-related
illnesses arise due to lack of adequate clean water for drinking and cooking purposes. Other
diseases are caused due to inadequate sanitation facilities and poor personal hygiene practices
that are directly connected to the lack of clean water.
The two major causes of water-related diseases are:
1. Pollution
High levels of chemicals, nitrates, and other heavy metals are mixed in water resources
due to industrial pollution and/or the over-use of agricultural chemicals, which adversely
affects human health.
2. Dirt and contamination
Bacteria, viruses and parasitic organisms invisibly contaminate water and cause diseases.
Most of the water-related diseases occur due to coming in contact with animal or human
waste.

There are four categories.
Figure 1.1: Images show disease related to water
A. Water-borne disease
Water contaminated by feces is a common way for humans to get a number of intestinal illnesses
and enteric infections. All significant pathogen types, such as bacteria, viruses, protozoa, and
parasitic worms, are excreted in water by an infected individual. Water acts as a passive vehicle
for the infectious agent.
Figure 1.2: Images show drinking water source

B. Water-washed diseases
These diseases are linked to a lack or scarcity of water for personal hygiene. Examples are:
scabies, trachoma, typhus and relapsing fever. Lack of good personal hygiene and inability to
wash clothes encourages the proliferation of lice and the problems associated with their presence
(itching, scratching, skin sores).
Figure 1.3: Images show water sources for personal hygiene activity
C. Water-based diseases
These are caused by infectious agents that are spread by contact with water. The essential part of
the life cycle of the infecting agent takes place in an aquatic animal. Typical examples are
schistosomiasis and dracunculiasis (guinea worm).
D. Water-related diseases
These diseases are spread or transmitted by insects which form habitats on stagnant water
sources. For this reason, the disease they cause aren’t as related to water as those more directly
transmitted by water. Some water-related insect vector disease includes malaria, filariasis, yellow
fever, and river blindness. The most common of these, malaria, is transmitted through the
mosquitoes which breed on fresh or brackish water.
Figure 1.4: Images show typical breeding site for mosquitoes

1.2.2. Water-borne diseases prevention methods
 At home:
 Boil/filter or disinfect water using approved disinfectant to ensure that
water used is free from microorganisms.
 Always clean water storage materials.
 Use narrow-necked storage materials.
 Always cover containers used for storing of water.
 Adequate and clean water supplies.
 Improve the quality of drinking water at source, tap, and storage vessels.
 Increase the quantity of water available.
 Proper waste disposal
 Dispose organic and animal waste properly to avoid flies.
 Proper disposal of human feces will reduce the number of cases of water-
borne illnesses.
1.3. Household water treatment and safe storage
Household water treatment and safe storage can improve water quality at the point of
consumption, especially when drinking-water sources are distant, unreliable, or unsafe. It is
intended for people who have no access to improved drinking water sources; those with access to
improved sources outside their home or premises (i.e., when contamination can occur during
transport and storage); people who have unreliable piped supplies and must store water to bridge
the gaps between deliveries; and for people in emergency situations.
1.3.1. Household water treatment and safe storage method
 Before treating the water it is better to check if the water source at community level is
protected.
 Disinfection
One of the approaches to treating water in the home is to kill or inactivate pathogens
through disinfection. The most common methods used by households around the world to
disinfect drinking-water are:
 Boil/filter or disinfect water using approved disinfectant to ensure that water used
is free from microorganisms (Solar, Ultraviolet light, Boiling)

 Household Safe water storage
A safe water storage container should:
 Always clean water storage materials
 Narrow-necked storage materials
 Always have cover
 Have a strong and tightly sealed lid or cover
 Be durable and strong
 Be easy to clean
Other safe water handling practices include:
 using a separate container for storing treated water
 regularly cleaning the storage container with soap
 storing treated water away from animals
 pouring treated water from the container instead of scooping the water from it
 using the water as soon after treatment as possible, preferably on the same day
Figure 1.5: Images show water treatment method at home (Boiling and filtration)
 Adequate and clean water supplies:
 Improve the quality of drinking water at source, tap, and storage vessels
 Increase the quantity of water available
 Proper waste disposal
 Dispose organic and animal waste properly to avoid flies
 Proper disposal of human feces will reduce the number of cases of water-borne
illnesses

Figure 1.6: Images show proper disposal of human excreta using improved pit latrine and water
for hand washing
1.4. Principles of food hygiene and safety
Food hygiene is a subject of wide scope. It aims to study methods for the production,
preparation, and presentation of foods that are safe and of good keeping quality. It covers not
only the proper handling of many varieties of foodstuff and drink but also all the utensils and
apparatus used in their preparation, service, and consumption. The principles of food hygiene
and safeties are described as follows:
 Cook foods thoroughly, especially milk and meat because this will help kill any
microorganisms that might be present in the food.
 Meat is nutritious but can become unsafe if not handled properly.
 Eat foods immediately after they are cooked. Delays in eating cooked food can lead to the
growth and reproduction of microorganisms in the food.
 Store cooked food carefully at an appropriate temperature. It should either be kept cold,
ideally in a refrigerator, or hot. If food must be reheated, be sure to reheat it thoroughly.
 Avoid contact between raw and cooked food.
 Wash hands properly before handling food and eating. Keep all kitchen surfaces and
utensils meticulously clean.
 Protect food from insects, rodents, and other animals. Use safe water in food preparation
and for washing fruits and vegetables to be eaten raw.
 Cloths that come into contact with dishes and utensils, and that are used to cover
food, need to be changed daily and boiled before use.
 All dishes, glasses and utensils must be kept clean by regular washing in clean
water, and clean utensils should be kept covered

1.4.1 General principles of food protection and safety
Food protection and food preservation are intended to prevent contamination and spoilage of
foods. Food protection measures are taken to protect food from being contaminated by any agent.
All food must be protected at all times during storage and preparation from the following
contaminants:
 Any water that is not known to be safe, including overhead leaks and drips
 Dirty hands, dust, and soot
 Coughing, sneezing, and cigarette smoke.
 Flies, rodents, and other vermin
 Insecticides and other chemicals (which should be clearly labeled) and
 Unclean utensils and work surfaces
To keep food safe follow these four simple steps:
A. Clean: Wash hands and food contact surfaces and utensils often, between tasks, and if
they have become contaminated. Effective cleaning involves:
 Removing soil and debris
 Scrubbing with hot soapy water and
 Rinsing using potable/drinking water.
 Sanitizing involves the use of high heat (e.g., a dishwasher) or chemicals (e.g.,
chlorine bleach) to eliminate or reduce the number of microorganisms or germs to
a safe level.
B. Separate: To prevent cross contamination (the transfer of harmful bacteria from
uncooked food products (e.g., raw meat, fish, poultry) or unclean individual, countertops,
and kitchen equipment to ready-to-eat foods (e.g., fruits, vegetables, prepared foods)).
C. Cook: foods thoroughly and if possible use a thermometer to verify the proper
temperature is reached.
D. Chill cool foods promptly. Cold temperatures slow the growth of harmful bacteria. Cold
air must circulate to help keep food safe, so do not over-fill the refrigerator.
1.4.2. Key Facts about food safety
 There is an unbreakable relationship between food security, nutrition, and safety.

 An estimated 600 million – almost 1 in 10 people in the world – fall ill after eating
contaminated food and 420 000 die every year.
 US$ 110 billion is lost each year in productivity and medical expenses resulting from
unsafe food in low- and middle-income countries.
 Children under 5 years of age carry 40% of the food borne disease burden, with 125 000
deaths every year.
 Food-borne diseases obstruct socioeconomic progress by costing healthcare systems and
harming international trade, tourism, and national economies.
1.4.3. Diseases associated with food
Food-borne disease, infection, poisoning, toxic infection, chemical poisoning, adulteration,
misbranding, and food spoilage are among the result of contaminated food consumption. Food
borne diseases are caused by contamination of food and occur at any stage of the food
production, delivery and consumption chain. They can result from several forms of
environmental contamination including pollution in water, soil or air, as well as unsafe food
storage and processing. Food borne diseases encompass a wide range of illnesses from diarrhoea
to cancers. Diseases causing diarrhoea are a major problem in all countries of the world, though
the burden is carried disproportionately by low- and middle-income countries and by children
under 5 years of age.
1.4.4. Food preservation methods
The most common methods of food preservation are:
 Heat treatment - cooking, canning, bottling sterilizing, pasteurizing
 Low temperature - freezing and refrigeration
 Drying (dehydrating) - fish, meat, fruit, vegetables, soup
 Chemical preservation -Salting
 Vacuum sealing/packing - meat, fish, poultry
 Smoking - fish, meat, cheese
1.5. Food utensils and equipment cleanness

Food preparation facilities must have rules and systems to follow them to:
 Ensure appropriate maintenance, cleaning, and sanitizing of facilities and equipment
 Control pests

 Remove waste
 Monitor and record the effectiveness of maintenance and sanitizing procedures
 Prevent disease-causing organisms from contaminating food and water
1.5.2. Proper dish washing process

Cleaning and sanitizing equipment and utensils should be separate processes. A surface must be
thoroughly cleaned before it is sanitized.
A. Cleaning: Cleaning is a process for removal of contaminants such as food residue,
dirt, grease, and bacterial film from a surface. It is achieved by the use of water and
proper detergent and the following steps.
 Pre-scrape utensils and surfaces and rinse with clean water to remove most of
the food residues, dirt, and debris.
 Wash with warm water and detergent by agitation to loosen the remaining
food residue and dirt.
 Rinse with clean water to remove the loosened food and detergent residues.
B. Sanitizing After cleaning, sanitize food contact surfaces of equipment and utensils
by:
 Immersion in boiling water for at least one minute
C. Drying
 All cleaned and sanitized equipment and utensils should be thoroughly air dried.
D. Storage
 Store cleaned and sanitized equipment in a cupboard that is protected from dust
and pests

Figure 1.7: Images shows proper dishwashing procedures

Unit Two: Latrine Utilization and Management
 Features of properly designed latrine
 Latrines utilization
 Misconceptions that affect the latrine use
 Describe features of properly designed latrine
 Promote latrines utilization
 Explain misconceptions that affect the latrine use

2.1. Features of properly designed latrine
Improved Latrine: designed to hygienically separate human excreta from human contact.
For a latrine to be classified as ‘improved,’ it should satisfy the following requirements:
 Be safe to use (the pit may need to be lined)
 Have a structurally sound and cleanable slab floor
 Have hand washing facilities with soap
 Not be contaminated with ground or surface water
 Have a squat hole fitted with a lid so that excreta is not accessible to flies or other
creatures
 Be free from odors and unsightly conditions
 Not require people to handle excreta
2.2. Latrines utilization

The need for latrine construction and use
 It is reported that up to 60% of the current disease burden in Ethiopia is attributable to
poor latrine conditions. 15% of the total deaths are from diarrhea, mostly among the
large population of children under five.
 Fecal contamination at the household level is thought to account for 30% of the
disease burden in developing countries.
 It is estimated that an average child in a developing country without the benefit of
sanitized environment will suffer 10 attacks of severe diarrhea before the age of five
and 1 in 10 will die as direct result.
2.2.1. The Five "F" Shows Transmission routes of excreta related diseases.
Not using properly constructed latrine causes transmission of excreta related diseases by the
agents excreted with excreta.

The method of transmission is shown in the figure below
Figure 2.1:- Mode of transmission of excreta borne/related diseases.

2.2.2. Importance of latrine facility
Using properly constructed latrine and burying excreta in proper pit has the following
advantages:-
 Helps to avoid direct contact with faeces
 Avoids pollution of soil, water, air, animals and vegetables by human excreta
 Helps to prevent contact of flies, rodents, and other insects etc with faeces.
 Avoid foul odor from the environment, hence helps to maintain beautiful surroundings.
2.3. Misconceptions that affect the latrine use
Misconceptions that affect the latrine use
 Don’t consider children’s feces to be a potential health hazard/ children’s latrine use is
unimportant.
 Discouraging household members from night use because of fear that ‘evil’ or ‘devils’
inhabit the latrine during that time.
 Urban residents are more aware than rural of effects of poor sanitation facilities and
improper latrine use.
 Most urban residents use quality latrines
 Evil things may follow if mother who gave birth goes out to use latrine

Unit Three: Personal Hygiene
 Practice of major components of personal hygiene
 Common and frequent hygienic practices
 Major public health importance of personal hygiene
 Basic requirements of a healthy housing
 Risk factors associated with poor housing
 Explain practice of major components of personal hygiene
 Demonstrate common hygienic practices
 Describe major public health importance of personal hygiene
 Explain basic requirements of a healthy housing
 Demonstrate risk factors associated with poor housing

3.1. Practice of major components of personal hygiene
Sanitation and hygiene are critical to health. Diarrheal diseases are common and largely
preventable. Children are at particular risk for diarrhea and other diseases related to poor water,
sanitation, and hygiene. Proper hygiene education is a critical step in reducing illness and death
from diarrheal disease.
Hygiene generally refers to the set of practices associated with the preservation of health and
healthy living.
Personal hygiene is defined as a condition promoting sanitary practices to the self. Generally,
the practice of personal hygiene is employed to prevent or minimize the incidence and spread of
communicable diseases. It includes cleanliness of hair, body, hands, fingers, feet, clothing,
menstruation, and clothes.
Hygienic behavior is behavior that manifested when people transform themselves to demand,
develop, and sustain a hygienic and healthy environment for themselves by erecting barriers to
prevent the transmission of diseases derived from fecal contamination.
3.1.1. Role of ECD-PC workers on the demonstration of personal hygiene:

As an ECD-PC worker, educating/counseling the caregivers on personal hygiene is one of your
duties. Components of personal hygiene include but not limited to Body/skin, Oral, Hand and
face washing, Ear and hair, Clothes, Menstrual, Children.
 Body hygiene
The body has nearly two million sweat glands. Moistened and dried sweat and dead skin cells
from the dirt that sticks to our skin and underclothes. Bacteria decompose the sweat, thereby
generating bad odor and irritating the skin. This is especially observed in the groin, underarms,
feet, and in clothing that has absorbed sweat. Skin infections such as scabies, pimples, and
ringworm are results of poor body hygiene. Bathing or showering using body soap at least
weekly is very important to ensure that your body stays clean Bathing should be everyday or
after periods of sweating or getting dirty. The genital and the anal regions need to be cleaned
well because of the natural secretions of these areas.
 Clothes washing

Underwear must be washed more frequently than outer layers of clothing. If possible, washed
clothes should be ironed to help the destruction of body lice and nits. Boiling water or
insecticides can be used to destroy clothes infestation.
 Face washing
Face hygiene includes all parts of the face. The most important area to keep clean is the eyes.
The organic substance of the eye discharge can attract flies and this is dangerous because the fly
is a carrier (vector) of trachoma and conjunctivitis. It is not advisable to share a face towel
because some diseases, such as conjunctivitis and trachoma, can be transmitted easily from
person to person in this way
 Oral hygiene
The mouth is the area of the body most prone to collecting harmful bacteria and generating
infections because it is at the optimum temperature (37°C) and is often rich in food particles that
support bacterial growth. The decaying process that takes place on the surface of the teeth
eventually produces a build-up called plaque (a sticky deposit on which bacteria grow) that is
then converted into tartar (a hard, yellowish, calcified deposit on the teeth, consisting of organic
secretions and food particles). The result is tooth decay. In addition, unpleasant smelling breath
(halitosis or stinking odor), and tooth and gum infections can result from poor oral hygiene.
Advice for keeping the mouth clean:
 Rinse the mouth after each meal.
 Brush your teeth with a fluoride-containing toothpaste twice a day – before breakfast and
before you go to bed. Cleaning the mouth with twigs is possible if done carefully.
 During the day, fill your mouth with water and swish it around to get rid of anything
sticking to your teeth.
 In addition to regular brushing, you should floss your teeth at least once a day, usually
before you go to bed.

Figure 2.2: Images shows children’s proper personal hygiene practice

3.2. Common hygienic practices
Hand washing can help prevent diarrhea and pneumonia, two of the leading causes of death in
children around the world. Heavy diarrhea or intestinal parasite loads in early childhood have
been linked to delays in development. However, proper hand washing before meals and after
going to the toilet can lower exposure to germs. This can lessen the chances of illness and
chronic inflammation—leading to better nutrition intake, more energy available for growth and
development, and better attendance at school.
The following steps ensure that the hands are properly washed.
1. Wet your hands with clean water and lather with a bar of soap.
2. Rub your hands together vigorously and scrub all surfaces up to your wrists.
3. Clean under your finger nails.
4. Continue for 15–30 seconds or about the length of a little tune (for example, the ‘Happy
Birthday’ song). It is the soap combined with the scrubbing action that helps dislodge and
remove germs.
5. Rinse your hands well with clean running water (pour from a jug or tap).
6. Dry your hands in the air to avoid recontamination on a dirty towel. Do not touch
anything until your hands are dry.
Figure 2.3: Images shows proper hand washing steps

Key Message
1. Soap + water = Cleaner bill of health and disease prevention in children
2. Children who got hand washing promotion reached developmental milestones 6 months
earlier than those who did not.
3. Expand education to families and caretakers across society so that all children can obtain the
health benefits from proper hand washing, and society can obtain the productivity benefits
of a healthier population.
3.2.1. Critical times for hand washing

The following are critical times for hand washing፡
 Before and after contact with a wound
 After contact with blood or body fluids (e.g., vomit)
 Before and after dressing wounds
 Before giving care to an ‘at risk’ person (e.g., attending delivery, attending a baby)
 After giving care to an infected person and/or handling any type of waste
Figure 2.4: Images shows critical times for hand washing

3.3. Major public health importance of personal hygiene
The knowledge and practice of personal hygiene are vital in all our everyday activities.
The Benefits include:

 Prevents fecal - orally transmitted disease
Fingers easily get contaminated with one’s own feces, either directly or indirectly.
Careless practices during defecation and child bottom-washing are opportunities for
finger contamination that facilitates infection transmission.
 Aesthetics
A person with clean hands is proud when eating because s/he is confident that s/he is
preventing disease transmission. A school teacher is always happy to see students with
clean faces, eyes, and clothes. A mother is happy when she feeds her infant with clean
hands because she is preserving the child’s health. Generally, cleaning oneself produces
pride, comfort, and dignity at home and in public places. Taking caring with the way you
look increases self-esteem.
 Promotes positive social interactions
A person who has poor personal hygiene may be isolated from friendship because telling
the person about the situation can be awkward and culturally difficult.
Key Messages
1. Washing our hands properly with water and soap will reduces the risk of diarrhea,
parasites, worms, trachoma, and upper respiratory disease by half.
2. Washing our hands with water and soap in critical times will reduce diarrheal diseases by
halves.
3. It is simple and inexpensive for us to wash our hands thoroughly during critical times,
and by doing so, we significantly reduce the risk of contracting a number of diseases.
3.4. Basic requirements of healthful housing

WHO has adopted four basic requirements to define healthy/adequate house:
A. Satisfaction of physiological needs
Human physiology (the functioning of our bodies): Our environment should supply the
necessary services and facilities to meet our physiological needs, including:
 Housing must allow adequate fresh air to get into the house and used air to get
out.
 Adequate light to see or look at an object and for reading and watching TV

 The housing structure should provide adequate space in the form of a bedroom
that is reasonably free from any environmental hazard that could disrupt sleeping.
We must ensure that our housing provides the necessary service and facilities to prevent
communicable disease and to protect our health.
B. Protection from accidents
 Poor housing can contribute to several types of accidents including burns and electric
shocks.
C. protection against infection
 Due to poor ventilation and crowding (eg. Tuberculosis)
 Due to indoor cooking smoke (eg. eye infection)
 Due to crowding as a result of limited housing space (eg. Skin infections)
 Due to over-crowding (eg. relapsing fever)
D. Protection from psychological and social stress
 Housing is more than shelter. Poor housing contribute to psychological and social
stress that may not be physically observed but may be revealed in the words people
use to describe how they feel. We know that stress is not good for people.
 Major facilities or services requirements for a healthy housing and living
environment;
 Water supply
 Toilet facility
 Bathing and laundry
 Waste disposal /liquid and solid
 Ventilation and illumination
 Utensils and food items kept off the floor
 Separate living rooms from animals and kitchens

Unit Four: Solid and Liquid Waste Management
 Solid and liquid waste
 Public health importance of solid and liquid waste
 Residential solid and liquid waste management process
 Explain Solid and liquid waste
 Describe Public health importance of solid and liquid waste
 Explain residential solid and liquid waste management process

4.1. Explain Solid and liquid waste
Understand Solid and liquid waste, its management and their public health importance
Solid waste: Is the unwanted or useless material generated from residential, industrial, and
commercial activities. It may be categorized according to its origin; its contents (organic
material, glass, metal, plastic, paper, etc.); or its hazard potential (toxic, non-toxin, flammable,
radioactive, infectious, etc.).
Liquid waste: means sludge resulting from, but not limited to, waste treatment works, air
pollution control facility, domestic, commercial, mining, institutional, agricultural, or
governmental operations; or other waste materials, including materials to be recycled or
otherwise beneficially reused; or septic tank, portable toilet, or oil and grease separator pump-
outs; or solvents, sewage, industrial waste, hazardous waste, semi-solid waste, or potentially
infectious waste; or any similar materials which would cause a nuisance if discharged to the
ground waters.
Waste management: Waste management includes activities and actions required to manage
waste from its inception to its final disposal. This includes waste collection, transport, treatment,
disposal, monitoring, and regulation. It also encompasses the legal and regulatory framework
that relates to waste management (guidance on recycling etc.).
Solid waste management: Solid waste management is the systematic administration for the
collection, source separation, storage, transportation, transfer, processing, treatment, recycling,
and disposal of solid waste.
Management of solid waste reduces or eliminates adverse impacts on the environment and
human health and supports economic development and improved quality of life.
Liquid waste management: Liquid Waste management is the proper containment and disposal
of wastes generated at household, industries, farms and institutions which may be hazardous or
just sullage from causing nuisance, infection, poisoning to people and animals

Figure 4.1: Images shows improper solid waste disposal system
4.2. Public health importance of solid and liquid waste

 Sources of human exposure to solid waste
 Ingestion of contaminated food and water
 Contact with disease vector
 Inhalation
 Dermal
 Impacts of solid waste on health, Animals and Environment
 Chemical poisoning
 Storm water runoff resulting floods
 Low birth weight
 Birth defect
 Nausea and vomiting
 Neurological disease
 Time, cost, health facility burden due to high illness
 Health effect on animals and aquatic life
 Causes climate change and more
4.3. Sources of Solid waste and its management process

Solid waste includes: Garbage, pesticides, insecticides, rubbish, metals, glass, ceramics, ashes,
laundry, animal dung, crop residue, kitchen residue, needles from health facilities, heavy metals
like lead, office waste like paper, etc.

4.3.1. Sources and types of Solid waste
 Sources of solid waste
 Residential: generated from households (kitchen, ketema, and ash). Generally non-
hazardous.
 Agricultural: food and crop residue, dung, etc. Usually non-hazardous and negligible
in rural Ethiopia.
 Commercial: generated from business establishments (restaurants, offices, shops, etc.)
Generally non-hazardous waste (e.g., paper, cardboard, wood, metals and plastic.
 Industrial: depends on the type of industry and kind of raw material involved. Often
include toxic and hazardous waste that has adverse effects on the environment.
 Institutional: generated from public and government institutions (offices, religious
institutions, schools, universities, etc.); generally not hazardous.
 Hospital: discarded, unwanted solid wastes from hospitals. It consists of both non-
hazardous and hazardous waste. The above classification helps to identify whether the
waste is hazardous or not
 Types of solid waste
 Infectious: wastes that arise from health institutions, like needle, safety box, goose,
etc
 Hazardous: heavy metals, chemicals pesticides and insecticides, etc.
 Non-hazardous: Garbage, rubbish, ashes. If not properly managed and stored beyond
the expected length of time/days they will cause air, land and water pollution and
adversely affect humans, animals and the environment.
4.3.2. Solid waste management stages:

Solid waste management stages described as follows:
 Onsite handling, storage, and processing
 Onsite handling: Concerns solid waste at the place where the waste is generated.
 Onsite storage: The temporary collection of waste at the household level. It is important
that waste is stored in proper containers.

 Onsite processing: Some waste needs processing before the next steps. For example, in
areas where false banana (enset) is used as a staple crop, byproducts should be chopped
into pieces before composting to hasten decomposition.
 Collection: Waste is collected and held at central transfer stations and store before transport
to final disposal site.
 Transfer and transport
 Resource recovery and processing: A range of processes for recycling materials or
recovering resources from waste, including composting and energy recovery.
 Disposal: Waste need to be disposed at final waste disposal site or area using different waste
disposal options or methods.
Sanitary methods including controlled tipping or controlled burial, incineration and sanitary land
fill (Open field dumping is the most unsanitary method of disposal and is most likely to cause a
health hazard.)
Figure 4.2: Images shows waste minimization hierarchy

4.3.3. How to minimize risks when disposing solid waste:
 Disposal site should be 30 meters from water sources to prevent contamination.
 Do not mix radioactive materials and explosives.
 Fence the site to keep scavengers out.
 Cover all surfaces of the dump.
 Dump all waste in compacted layers.
 Disposal site should be 500 meters from residential area.

4.3.4. Residential solid and liquid waste management process
 Sources of liquid waste and its management
 Residential: generated from households (bath and laundry water, human excreta).
 Commercial: waste generated from business establishments (food establishments,
shops, offices), that generate waste water from dishwashing systems, laundries, bath
etc.
 Industrial waste: varies by type of industry and kind of raw material involved. Often
toxic and hazardous with adverse environmental effects.
 Institutional: generated from schools, hospitals, youth centers, prison etc.
 Liquid waste disposal options/methods
 Connecting into sewerage system: This is the method of liquid waste disposal
directly disposing into the sewerage system in areas where there is sewer line access
 Cesspool: It is a large diameter hole dug in the ground to receive waste matter from
kitchen and toilets.
 Connecting to latrine pit – this is a method similar to cesspool but the pit is the one
used for latrine
 Soak away pit: In its simplest form is a hole dug in the ground filled with stones,
broken bricks etc. (Soak) or lined with bricks or stone masonry (seepage), to receive
any Grey water or liquid effluent from septic tanks, kitchen or lavatory.
 Seepage pits: This option may not be necessarily built in the same manner with soak
pits. Seepage pit is not filled with rocks or bricks rather it is lined with open joints. In
this system the liquid is assumed to infiltrate through the soil.
Figure 4.3: Images shows seepage pit or soak pit

Self check
1. Which one of the following water-associated disease is water acts as a passive vehicle for
the infectious agent?
A. Water-based diseases
B. Water-borne disease
C. Water-washed diseases
D. Water-related diseases
2. Water-washed diseases are linked to a lack or scarcity of water for personal hygiene.
A. True B. False
3. To break the chain of transmission of water-related diseases; disturbing the breading site
for mosquitoes is one method.
A. True B. False
4. Poor housing is associated with a wide range of diseases.
A. True B. False
5. What are the main requirements for the properly designed/constructed latrine?
6. What is improved latrine?
7. List the critical times for hand washing?
8. List at least two reasons why urban community members didn’t use latrines or people
defecate openly?
9. Write at least three major components of personal hygiene?
10. Write the most common misconceptions on hand washing?
11. 1 Describe sources of drinking water contamination?
12. Describe method of prevention of contamination of drinking water
13. Describe the major sources of solid waste
14. Describe the major sources of liquid waste
15. Describe the major types of solid waste
16. Describe the major types of liquid waste

Reviewer profile
No Name Institution Position/title Telephone Email
1. Sindu Mekuria AACAHB MCD Director 0913276961 sindu.mekuria@yahoo.com
2. Woynishet Kerebih AACA ECD coordination 0911462606 woynishetkerebih52@gmail.co
m
3. Dr.Abebe Negesso MOH National child health expert and ECD 0923978395 abebe.negesso@moh.gov.et
focal abe.nagi47@gmail.com
4. Mr. Amsalu Tilahun AARHB Capacity building & training advisor 0911702617 amsaluyeshi@gmail.com
5. Mr. Samuel Yeshewawork PATH ECD Coordinator 0911944936 sabebe@path.org
Abebe samiwhzhd@gmail.com
6. Mr. Girmaw Tilahun A.A TVET bureau OS and Cm team leader 0937460296 girmawdesta@gmail.com
7. Mr. Yonas Biset Lideta Sub City H o ECD focal 0910519796 yonasbiset2012@gmail.com
8. Mr. Faris Ahmed AARHB ECD PC Coordinator 0913006360 farisahmed20016@gmail.com
9. Mr. Abreham Fikru Selam fire h.c ECD focal person 0921799762 fikiruabraham@3gmail.com
10. Mr. Michael Solomon Gulele A.G.H.C Health center reform team leader 0913679304 msd.michael1@gmail.com
11. Mr. Solomon Tariku Kolfekeraniyo woreda MCD Department head 0929306560 solishman143@gmail.com
01 HC
12. Sr. Dagmawit Sisay Saris health center Midwifery 0912463501 dagi12sisay@gmail.com
13. W/ro Debrework Mesfin MOLSE Curriculum Expert 0911710753 dibor5399@gimail.com
14. W/ro Kidist Gululat MOLSE Curriculum expert 0913440017 kidgulilat@gmail.com
15. Mr Engdaye Mersha MOLSE OS Expert 0963128468 engd98@gmail.com


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Early Childhood Development

Parental Coaching Level – II

Module Title: Water, Sanitation and Hygiene for ECD

Ministry of Labor and Skills Water, Sanitation and Version -2

Ministry of Labor and Skills Water, Sanitation and Version -2

Ministry of Labor and Skills Water, Sanitation and Version -2

Ministry of Labor and Skills Water, Sanitation and Version -2

Ministry of Labor and Skills Water, Sanitation and Version -2

1.2. Water-associated diseases and prevention methods

Ministry of Labor and Skills Water, Sanitation and Version -2

Figure 1.1: Images show disease related to water

Figure 1.2: Images show drinking water source

Ministry of Labor and Skills Water, Sanitation and Version -2

Figure 1.4: Images show typical breeding site for mosquitoes

Ministry of Labor and Skills Water, Sanitation and Version -2

Ministry of Labor and Skills Water, Sanitation and Version -2

Ministry of Labor and Skills Water, Sanitation and Version -2

Ministry of Labor and Skills Water, Sanitation and Version -2

Ministry of Labor and Skills Water, Sanitation and Version -2

1.5. Food utensils and equipment cleanness

Ministry of Labor and Skills Water, Sanitation and Version -2

1.5.2. Proper dish washing process

Ministry of Labor and Skills Water, Sanitation and Version -2

Ministry of Labor and Skills Water, Sanitation and Version -2

Ministry of Labor and Skills Water, Sanitation and Version -2

2.2. Latrines utilization

Ministry of Labor and Skills Water, Sanitation and Version -2

Figure 2.1:- Mode of transmission of excreta borne/related diseases.

Ministry of Labor and Skills Water, Sanitation and Version -2

Ministry of Labor and Skills Water, Sanitation and Version -2

3.1.1. Role of ECD-PC workers on the demonstration of personal hygiene:

Ministry of Labor and Skills Water, Sanitation and Version -2

Ministry of Labor and Skills Water, Sanitation and Version -2

Ministry of Labor and Skills Water, Sanitation and Version -2

Figure 2.3: Images shows proper hand washing steps

Ministry of Labor and Skills Water, Sanitation and Version -2

3.2.1. Critical times for hand washing

Figure 2.4: Images shows critical times for hand washing

Ministry of Labor and Skills Water, Sanitation and Version -2

3.4. Basic requirements of healthful housing

Ministry of Labor and Skills Water, Sanitation and Version -2

Ministry of Labor and Skills Water, Sanitation and Version -2

Ministry of Labor and Skills Water, Sanitation and Version -2

Ministry of Labor and Skills Water, Sanitation and Version -2

4.2. Public health importance of solid and liquid waste

4.3. Sources of Solid waste and its management process

Ministry of Labor and Skills Water, Sanitation and Version -2

4.3.2. Solid waste management stages:

Ministry of Labor and Skills Water, Sanitation and Version -2

Figure 4.2: Images shows waste minimization hierarchy

Ministry of Labor and Skills Water, Sanitation and Version -2

Figure 4.3: Images shows seepage pit or soak pit

Ministry of Labor and Skills Water, Sanitation and Version -2

Ministry of Labor and Skills Water, Sanitation and Version -2

Ministry of Labor and Skills Water, Sanitation and Version -2

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