Children’s Hygiene and Sanitation Training (CHAST) is an approach that targets primary school children. Through its step-by-step and participative process, it promotes good hygiene and sanitation practices in schools and at home by raising children’s awareness on transmission routes of waterborne and hygiene-related diseases as well as how to block them.

CHAST was first developed by Caritas Switzerland in Somaliland in 2002 and is inspired by the Participatory Hygiene and Sanitation Transformation (PHAST, F.6) approach. It is based on the premise that hygiene practices are largely acquired during childhood and it is therefore much easier to change children’s habits than those of adults. The latest edition of the Caritas CHAST kit contains a methodology outline explaining the basis of CHAST, a facilitator’s guide with step-by-step guidance and a CHAST flipchart with visualisation materials. CHAST drawings and materials have been adapted to different country contexts by Caritas Switzerland (Kenya, Somaliland, South Sudan and Ethiopia) and other organisations, including the Red Cross Red Crescent (Iraq, Solomon Islands, Rwanda, Pakistan, Vietnam). There is also an adaptation specific to trachoma reduction. 

CHAST offers a variety of educational games and practical exercises to ensure that each child can learn based on its preferred learning style and age. The materials to facilitate the activities and topics include puppets T.6, memory card games T.15 and posters T.19 among others. Hygiene topics covered include safe drinking water, use of well-maintained latrines, personal hygiene (including handwashing, face washing, tooth brushing and keeping clothes clean, covering food and washing utensils), environmental hygiene and Menstrual Health and Hygiene P.7. 

CHAST encourages ‘learning by doing’ and peer learning. It prompts the children to discuss among themselves, practise and learn from each other, thereby promoting the approach of Peer Education (Child-to-Child, T.29). It is intended to be participative and fun. CHAST also encourages the establishment of children’s clubs (often called School Health Clubs, F.1). A WASH in Schools (WinS) roadmap is also available, which provides the framework for project teams to implement CHAST, ensuring the engagement of all key stakeholders, buy-in from school actors and a Monitoring M.2 framework. 

Tools and Methods used

For lower primary school children

• Puppet Theatre T.6
• Pocket Chart Voting T.31
• Activities such as colouring
• Visual IEC T.19
• Three Pile Sorting T.51
• Role Play T.41
• Card Games T.15
• Songs and Stories T.47
• Discussions T.14
•  Transmission Routes and Barriers T.53
• Demonstration T.10
• Group Handwashing T.50
• Cues and Nudges T.9

Additional tools for older children

• Transect Walks T.52
• Competition T.8
• Community Events T.11
• Exchange Visits T.12

Applicability

CHAST targets students in primary schools, but it can also be implemented in the community for children that do not attend school. It is a longer-term process that requires commitment from school stakeholders, parents and government counterparts. As a result, it is not usually applicable in the early stages of the response and is more suited to longer-term and development contexts. For children to put the learning into practice, the school must have access to a reliable water source P.3, functioning sanitation P.4 and handwashing facilities P.2. CHAST provides detailed step-by-step guidance and a kit of materials; it can therefore be used in contexts where the teachers have limited understanding of hygiene practices and limited access to teaching materials.

Main Requirements / Investments Needed

To carry out CHAST at least one CHAST kit per school is required (value between 150-200 USD) and trained project teams able to train teachers. It also needs the buy-in from head teachers and teachers before CHAST is rolled out in their class. Rolling it out will depend on each school and context, but can take up to three months per class.

Evidence of Effectiveness

An impact assessment, jointly conducted by the Swiss Tropical and Public Health Institute and Caritas Switzerland on a larger CHAST programme in Ethiopia, found that the overall frequency of open defecation at school decreased from around 60% at baseline to less than 30% at the endpoint. Significantly more children used soap to wash their hands at the endpoint (90.4%) than at baseline (72.4%). A project evaluation in Ethiopia further found that CHAST (including a trachoma-specific training section) was able to decrease ocular discharge, nasal discharge and flies on the faces by 25%, 30% and 20% respectively among children aged 1-9 years.

Do

• Ensure buy-in from the local government, school stakeholders and parents

• Ensure training are as participative and practical as possible

• Engage all teachers from one school in CHAST, so that they all roll it out to their classes at the same time

• Promote exchange between schools, events with parents so that good practices can be transferred to communities

Don't

• Do not expect awareness-raising alone to lead to sustainable behaviour change! Approaches such as CHAST must be complemented by other activities that create an enabling environment and institutionalise good practices

• Do not rush: if you have limited time, choose a different method

• Do not overwhelm teachers - they have enough to do. Help them to find the best way to embed CHAST in the school programme

Practical Example

In Ethiopia, CHAST is one of the recommended approaches in the national WASH in Schools guidelines and has been rolled out in different regions in over 170 schools, with 700 teachers trained. CHAST is implemented as part of an integrated WinS project, with special attention paid to engaging government and school stakeholders during the design phase. Teachers play a central role in institutionalising good hygiene and sanitation practices; it is essential to train all the teachers from one school so that they can all train their class and reach all children. CHAST should come alongside WASH infrastructure improvements initiatives (if required) and other initiatives and nudges to ensure that the learning can be put into practice.