1. There are functioning community participation structures.

2. There is access to district health expertise including the services of an environmental health officer.

3. Reduce the under 5 mortality rate by 30%.

4. Reduce the mortality of children under 5 due to diarrhea by 50%.

5. Eradicate poliomyelitis by 2002.

6. Reduce the prevalence of underweight for age among children under the age of 5 to 10%.

7. Reduce the prevalence of stunting among children less than 5 to 20%.

8. Reduce the prevalence of severe malnutrition in children under 5 to 1%.

9. Eliminate micro deficiency disorders.

10. Ensure 9.5 liters of water per person per day.

11. The maximum distance that a person has to cart water to their dwelling is 200m.

12. The flow rate of water from the outlet is not less that 10 liters per minute and water is available on a regular daily basis.

13. A water service does not fail due to drought more than once in 50 years and there is no more than one week’s interruption in supply per year.

14. Once minimum quality of water is available, health related quality is important and in accordance with currently acceptable minimum standards with respect to chemical and microbial contaminants and acceptable to consumers in terms of its potability.

15. Adequate basic provision of sanitation is one well-constructed VIP toilet to agreed standards per household.

16. Phase out the bucket system over 5 years.

17. Responsibility for sanitation services lies with the local authority or, if not, the local water committee is the vehicle for sanitation development.

1. The capacity building hygiene education and training of the community health committee is achieved through linkage with the health sector as well as other development sectors such as water affairs and forestry.

2. The EHO working with the community has the following competencies and hence able to:

2.1 Work with other sectors in development projects.
2.2 Work with local clinic staff for teamwork in motivating community committees to improve water and sanitation.
2.3 Work with health staff of clinics, NGOs and local government structures if present to provide hygiene education and training and build capacity of communities.
2.4 Empower committee through training, technical advice and continuing support and monitoring to undertake and manage their own development including water and sanitation.
2.5 Provide information to schools on undertaking water and sanitation and personal and public health.
2.6 Monitor that sanitation and water systems do not create environmental problems.
2.7 Assist communities develop the capacity to use the cycle of participation --- assessment, analysis, and action -- and provide particular assistance in preliminary assistance through environmental surveys.
2.8 Work with DWAF personal to explain to communities through individual leadership dialogue or community, workshops the contents of the White Paper:

2.8.1 Water supply and Sanitation Policy 1994
2.8.2 National Sanitation Policy White Paper Oct. 1996, Guidelines for ground water protection for Community water supply and sanitation programme.

3. Through education, training and improved communication communities develop the following competencies and hence are able to:

3.1 Get rid of human excreta, dirty water and household refuse in a sustainable way without harm to the environment.
3.2 Improve personal habits and behavior relating to water and sanitation.
3.3 Relate diarrhoeal disease and its effects on nutrition, growth and development of children, skin disease, trachoma, periodic outbreaks of diarrhoea, dysentery, worm infections (including schistosomiasis) to poor water and sanitation in their community.
3.4 Through women’s groups work together to achieve both water and sanitation norms for their community and be more competent in rearing their children with good hygiene behavior.
3.5 Ensure that sanitation systems in their community do not pollute rivers, dams and underground water supplies.
3.6 Understand the reasons for and be able to pay for maintenance of their water and sanitation services.
3.7 Conduct assessments or surveys of the state of water supply and sanitation in their own community.
3.8 Analyse the behavioural, cultural and socioeconomic factors leading to their health problems related to inadequate water and sanitation.
3.9 Through community based education (through schools, churches, groups) ensure that the transmission pathways of disease from waste and excreta are known. These are hands, flies, food, fluids, and soil. The ways of blocking transmission by personal hygiene, household and community hygiene are also known.
3.10 Achieve community hygiene through a high percentage of homesteads improving household hygiene so that there is no environmental contamination from excreta, dirty water and solid waste.
3.11 Improve community hygiene by food vendors and other food handlers being educated about food hygiene based on the WHO Ten Golden Rules for Safe Food Preparation.
3.12 Be aware of community problems created by keeping animals next to homes and of problems arising from blocked drains.

4. Clinical staff working with the EHO have the following competencies and are thus able to:

4.1 Ensure that health facilities are models for the community with respect to water and sanitation including patient toilets, staff toilets, and hand washing facilities.
4.2 Lead school or community programme in environmental cleaning days.
4.3 Provide health education on personal hygiene and health to patients, community groups, pre schools and schools.
4.4 Initiate behaviour change dialogue with the community on the use of toilets and use of water to improve health.
4.5 Feedback to the community information of the burden of water / sanitation related illness in the community as shown by analysis of the health information system.
4.6 Ensure that all schools in the catchment area of the clinic are health-promoting schools (good toilets, good water supply, hygienic school feeding programme, hand-washing facilities, continuing education on hygiene).
4.7 Work with community committees to ensure improved sanitation facilities at churches, sports grounds, markets, bus stops and crèches.
4.8 Assist communities obtain government subsidies after having organized themselves and planned a project.
4.9 Provide advice to farmers on improvement of water and sanitation to their workers while also providing hygiene education to the workers.

5. Clinic teams and District Health Management Teams have the capacity to work with local NGOs in sanitation programmes and to assist them

5.1 In their training and capacity building,
5.2 In helping communities plan and implement projects,
5.3 provide health and hygiene education,
5.4 Prepare communication material.