Pathway 4 - Water, sanitation and hygiene

Pathway 4 - Water, sanitation and hygiene

This pathway contributes to change by:

Promoting integrated water resource management to ensure equitable access, as well as safe sanitation and hygiene practices for vulnerable women.

 See below for the specific sections of this pathway. For further information on each section please refer to the attached document.


  • Women living in poverty, as poverty often comes together with limited access to water and poor hygiene practices. When living in abject poverty, WASH can easily seem a low priority among other pressing needs.
  • Women with many children, among whom there is great potential to impact many children’s health situation through improved sanitation and hygiene practices.
  • Historically marginalized women, among whom awareness on good hygiene and sanitation practices is often low. Combined with their extreme poverty this leads to a high health risks related to poor hygiene and sanitation.

CARE Rwanda is committed to work in partnership. In this pathway, our strategic partners are:

  • The Ministry of Infrastructure, who is responsible for the management of potable water resources, with focus on its implementing body the Energy, Water and Sanitation Authority (EWSA).
  • The Ministry of Natural Resources, who is responsible for the management of non-potable water resources. Within this ministry the focus is on the Rwanda Natural Resources Authority (RNRA).
  • The Ministry of Health, focusing on the promotion of hygiene and sanitation.

CARE Rwanda’s work on this pathway will be informed by the Government of Rwanda’s policy context. Of specific importance to this pathway are:

  • The Environmental Health Policy (MINISANTE, 2008) gives guidance on how to implement sanitation and hygiene activities.
  • The National Policy for Water Supply and Sanitation Services (MININFRA, 2010) and its strategy promote hygiene, sanitation and access to safe water.
  • The Health Sector Strategic Plan III (MINISANTE, 2012) identifies the ministry’s 5 year priorities, including hygiene promotion and access to improved sanitation. The implementation of the Community-based Environmental Health Promotion Programme (CBEHPP) is to contribute to this priority.
  • The Water Resource Management Subsector Strategic Plan 2011-2015 (MINIRENA, 2012) provides the framework for putting in place an institutional structure for water resource management.

CARE’s approach to WASH is mainly focused on the ‘software side’, and does typically not include the direct construction of water points or sanitation facilities. If certain interventions necessitate this kind of intervention, partnership is sought with others who have the necessary technical skills in house to implement these kind of activities. CARE Rwanda and its partners use a combination of well-tested models and innovative approaches, including the following:

  • Community-Based Environmental Health Promotion. This program is being implemented by MINISANTE to promote behavioral change around hygiene and sanitation and uses a PHAST (participatory hygiene and sanitation transformation) approach. The Community-Based Environmental Health Promotion Program (CBEHPP) uses Community Hygiene Clubs (CBCs), in which each household of a village is represented.
  • Sanitation marketing. Sanitation marketing is a public-private partnership approach to sanitation, which combines social motives with commercial sustainability. The assumption is that the set-up of a supply-chain that provides affordable and qualitative sanitation products, in combination with awareness raising on the importance of these products, leads to sustainable availability as well as increased demand for these products.
  • Water governance. In order to ensure sustainable and equitable management and use of water sources, CARE Rwanda promotes structures that use integrated water resource management in a way that promotes participation of and accountability to water users.

The following indicators are used to measure impact at the level of this pathway:

  • % of HH (population) using an improved sanitation facility.
  • % of HH practicing appropriate recommended (according to MoH guidelines) hygienic practices.
  • CWASA project (2008-2011) has had positive influences on water management and use in Musanze and Gashaki sectors in Musanze district.
  • The RIWSP project, which uses the innovative Sanitation Marketing and Water Governance approaches, has so far carried out a market analysis study, has identified commercially viable sanitation products and has produced mobilization tools on latrine technologies and water governance.
  • CWASA (Community Based Water and Sanitation)
  • RIWSP (Rwanda Integrated Water and Sanitation Project)

To continuously improve its work, CARE Rwanda is committed to learning. In the light of this pathway, it seeks answer the following questions:

  1. To what extent can public-private partnership contribute to the efficiency and sustainability of sanitation promotion and integrated water resource management?
  2. How can we better deal with the gender aspects of sanitation marketing? For example: using VSL as an entry point, we reach especially women with our awareness raising efforts. Yet men play a crucial role in making important decisions such as the construction of a latrine.
  3. How can we deal with the cultural barriers, fears of health risks and lack of technical knowledge related to the use of human waste as manure?