Water supply and sanitation in Tanzania

Access to improved water sources and sanitation in Tanzania remains limited, particularly in rural areas, where infrastructure challenges and funding constraints continue to hinder progress.Determining data on access is particularly difficult because different definitions and sources are used, which results in significant discrepancies. In 2015, 50% of the population had access to "at least basic" water, 79% and 37% of urban and rural areas, respectively. In Tanzania, around 26 million people, in 2015, lacked access to "at least basic" water. Regarding sanitation around 40 million, in 2015, lacked access to "at least basic" sanitation. In Tanzania, in 2015, only 24% of the population had access to "at least basic" sanitation, 37% and 17% in urban and rural areas respectively. According to a report, household surveys regularly return lower rural water supply coverage than estimates by the Ministry of Water and Irrigation (which are collected by district water engineers and urban water and sanitation authorities). For urban areas, survey data are consistently higher because they also include households that are not connected to the formal water supply network and access water from neighbours, protected wells or boreholes. Estimates from the Joint Monitoring Programme for Water Supply and Sanitation (JMP) show a different trend. They show a slight decline in access from 55% in 1990 to 53% in 2010. According to these figures, access in rural areas stagnated, while in urban areas it decreased from 94% to 79% over the same period. The JMP estimates rely on extrapolations using, among others, data from the Household Budget Survey 2000/2001 and 2007, the Census of 2002 and the Demographic and Health Surveys of 1999, 2005 and 2010. Sanitation. National Household Budget Surveys ask respondents about the type of sanitary facility they have. In 2007 93% of Tanzanians responded that they had some form of latrine, but only 3% had a flush toilet. International statistics that monitor the achievement of the Millennium Development Goal for sanitation are based on these numbers, but only after making some important adjustments in an effort to achieve comparability across countries. The Joint Monitoring Programme for Water Supply and Sanitation (JMP) defines improved sanitation as excreta disposal systems that are private and that separate human excreta from human contact. Shared latrines or open pit latrines are excluded from this definition. The JMP estimates that only about half the latrines in Tanzania can be considered improved sanitation systems. Based on that definition, access to improved sanitation is much lower than the population with access to any type of latrine. According to the JMP definition, access to improved sanitation was only 10% in 2010, up from 8% in 1990, with an increase in urban areas and a slight decrease in rural areas. == Service quality ==

Continuity of supply. Of the twenty Urban Water Supply and Sanitation Authorities (UWSSAs) that operate in Tanzania, three are able to provide continuous water supply (Arusha, Songea and Tanga). In eleven other cities water is supplied for at least 19 hours. In Babati and Mtwara there is water supply for 12 hours per day. The lowest figures (5 hours per day) come from the cities of Kigoma, Lindi and Singida. In Dar es Salaam water is supplied on average for 9 hours per day. Wastewater treatment. Of the twenty major urban water utilities, 11 provide some access to sewer connections. In Moshi the reported connection rate is 45% (although this also includes some industrial connections), in Morogoro the reported rate is 15% and in Dodoma and Iringa it is 13%. In Dar es Salaam the length of the sewer network is estimated at 188 km, although only 4% of households have access to it. Starting in 1998, constructed wetlands were introduced in Tanzania. Ten units have been built for residential houses and institutions such as schools, prisons and colleges. They serve about 12,000 people. In addition, wastewater treatment plants are reported to operate in the municipalities of Morogoro, Dodoma, Iringa, Arusha and Songea and in the cities of Dar es Salaam and Mwanza. Wastewater samples are collected from these wastewater treatment plants. The result of the analysis of 250 samples showed that national standards for effluent prior to discharge were met in 88% of cases. == Water resources ==

As a whole and on average, Tanzania has extensive water resources. According to the Food and Agriculture Organization (FAO), in 2008 Tanzania had 96.27 km3 of renewable water resources per year (by comparison, estimated world water resources are in the order of 43,750 km3/year). This corresponds to 2,266 m3 per person and year. Water resources are however distributed unevenly - both in time and space. During the dry season, which usually lasts from June to October, even large rivers can dry up or their flow declines substantially. Some parts of the country receive, on average, up to 3,000mm of rain per year, while in other regions (such as the Dodoma Region or the Rift Valley) yearly rainfall averages 600mm. Projections indicate that by 2025 Tanzania will experience water stress (defined as average per capita water resources below 1,500 m3) due to population growth and the resulting increase in consumption. As of 2002, water use for municipal water supply in mainland Tanzania was about 493 million m3/year, or 0.5% of total renewable water resources. Tanzania has been divided into nine administrative units corresponding to the nine major river or lake basins. Basin Water Offices (BWOs) are responsible for regulating and planning the use of water resources, based on the Water Resources Management Act Nr. 11 of 2009. The water resource management section of the Water Sector Development Programme requires that their activities be carried out in line with the principles of Integrated Water Resources Management. It has however been noted that BWOs suffer from severe institutional weaknesses: they often lack necessary information, clear development plans to guide investments and support monitoring and are largely characterised by weak human capacity. == History ==

The history of water supply and sanitation in Tanzania is a byproduct of colonization that has shaped water inaccessibility, beginning with German and British administrative practices. From 1889 to 1914 in German East Africa, wells, sewage, and drains were constructed for the sole use of German settlers who lived in compounds in the eastern regions of Tanzania. Sanitation services existed for a low fee within zones, created along racial lines, for German and Indian settlers. At the same time, Tanzanians in the western region lacked access to drains and sewage systems and were also denied waste collection; they lived in poor living conditions and had inadequate sanitation facilities, such as pit latrines accompanied by boreholes. These areas did not express public civic engagement around the lack of water infrastructure. In the 1950s the few settlements with piped water supply charged for water sold at water kiosks or through residential connections. In rural areas systems were operated and maintained by cooperatives, such as the Makonde Water Development Cooperation in the Mtwara Region of Southern Tanzania. One of the promises of the independence movement at that time was to provide water for free, a promise that was kept when Tanganyika gained independence in 1961. Top-down projects and free rural water supply (1964–1991) After the union of the former British colonies Tanganyika and Zanzibar to form the United Republic of Tanzania in 1964, then President Julius Nyerere implemented a policy of African socialism called Ujamaa. This included the forced resettlement of dispersed rural smallholders to collective farms. One of the stated objectives of the resettlement was to facilitate the provision of education, health services as well as water supply. In the spirit of the Ujamaa the government launched a 20-year Rural Water Supply Programme (RWSP) in 1971 with the aim of providing access to adequate and safe water supply within a walking distance of 400 meters from each household by the year 1991. Under this programme, water was provided free of charge in rural areas, while moderate tariffs were charged for house connections in urban areas. Implementation was highly centralized: In 1972 the central government abolished local government authorities that were replaced by central government representatives in committees at the district and village level under a policy that was ironically labelled "decentralization". According to a report by WaterAid, "the resulting water projects were unsustainable and left a legacy of distrust among villagers for government programmes". Villages were selected based on purely technical criteria by the district water department without consultation with communities. Deep boreholes were drilled and equipped with pumps and diesel engines that should have been maintained by the government using central funds. This did not work well and many of the pumps were inoperable. Community participation and management (1991–present time) island, once the pride of East German development cooperation, illustrates the challenges to properly maintain infrastructure and leverage the current infrastructure to pave way for new and green field projects (see open manholes in the foreground) The socialist policy of Ujamaa was gradually phased out when Nyerere handed power over to Ali Hassan Mwinyi, first as president in 1985 and then as head of the ruling party in 1990. The government initiated political and administrative reforms, as part of which the first National Water Policy was approved in 1991. At the core of the reforms was the Local Government Reform Programme aimed at decentralising power by devolving resources and responsibility for service delivery to district and municipal councils, including transfers of conditional and unconditional block grants to the councils. The National Water Policy emphasized community participation in the selection of projects and in operating and maintaining them through water committees that charged for water. Villagers also had to make a cash contributions towards capital costs and contributed time and labour, local materials and hospitality for visiting government staff. They also undertook hygiene education and serve on health committees. A pilot for the new policy was initiated by WaterAid in Dodoma Urban District together with the district government. An innovative feature of the project was that the water department worked closely with the community development department and the health department. Both had previously not been involved in water projects. Using the acronyms of the three departments and of WaterAid the integrated team was called WAMMA, giving the project its name. Each of the three departmental teams had to have both men and women among its staff, although this was difficult to implement because of a shortage of female staff. Unlike before, communities were selected based on a needs survey. To implement these reforms in urban areas, the Waterworks Act, Cap 272 was introduced in 1993. Its aim was to regulate the supply of water through urban public authorities. In 1996 new guidelines for the National Water Policy were released, which were inspired by guidelines developed under the WAMMA program. Concerning rural areas they state that villages are responsible for all operation and maintenance costs and that cost sharing is expected for capital costs. == Responsibility for water supply and sanitation ==

Water and sanitation policies and strategies are defined by Ministries at the national level; economic regulation of services provision is undertaken by a national authority and environmental regulation by a National Council; service provision is the responsibility of various local entities. Policy and regulation Legal framework The legal framework for water supply and sanitation is based on the Water Supply and Sanitation Act Nr. 12 enacted in May 2009. The Act outlines the responsibilities of government authorities involved in the water sector, establishes Water Supply and Sanitation Authorities as commercial entities and allows for their clustering where this leads to improved commercial viability. It also provides for the registration and operation of Community Owned Water Supply Organisations and regulates the appointment of board members. Responsibilities of institutions at the national level Ministries. The Ministry of Water and Irrigation (MoWI) is the agency responsible for overall WSDP policy setting, co-ordination, monitoring, evaluation and regulating community water supplies. In this, they are advised by the Prime Minister's Office - Regional Administration and Local Government (PMO-RALG). PMO-RALG plays a key co-ordination role in planning and capacity building for local authorities. It is also responsible for allocating resources for service delivery. The Regional Secretariat provides technical support to LGAs and monitors their activity. Economic regulation. Commercial water service providers are regulated by the Energy and Water Utilities Regulatory Authority (EWURA) established in 2001 by the Energy and Water Utilities Regulatory Authority Act, Cap 414. EWURA is responsible for licensing, tariff review and approval, performance monitoring and standards. It started operating in the water sector in 2006. Environmental regulation. Screening of possible environmental impacts on proposed project sites is carried out by the National Environment Management Council (NEMC) as part of the Environmental and Social Management Framework. NEMC is responsible for setting standards and issuing permits for the discharge of effluents into the environment, including into water resources. NAWAPO aims to achieve sustainable development in the sector through an "efficient use of water resources and efforts to increase the availability of water and sanitation services." It is guided by the principles of decentralisation and localisation of management and services. The National Rural Water Supply and Sanitation Program (NRWSSP) 2006-2025 aims to provide a policy framework for provision of equitable and sustainable water access to 65% of the rural population by 2010, 74% by 2015, and 90% by 2025. The NRWSSP is the second iteration of the Rural Water Supply and Sanitation Project (RWSSP) that was piloted in 2002. The program is run by the Ministry of Water and includes goals for institutional reorganization as well as a focus on data collection and monitoring through a Management Information System. As of 2008, challenges related to insufficient capital, bureaucratic delay, and lack of local oversight have resulted in minimal progress. The importance of water supply and adequate sanitation is recognised in the second cluster of MKUKUTA ("Improvement of quality of life and social well being"). Here, one of the primary goals is to achieve "increased access to clean, affordable and safe water, sanitation, decent shelter, and a safe and sustainable environment." Service provision Urban areas In Dar es Salaam and two districts of Pwani Region the responsibility for water supply and sanitation is split between an asset holding company that is responsible for capital investments (the Dar es Salaam Water and Sewerage Authority - DAWASA - with a staff of about 60) and an operating company that runs the water and sewer system on a daily basis and bills the customers (the Dar es Salaam Water and Sewerage Corporation - DAWASCO - with a staff of about 1,500). DAWASCO operates under a 10-year lease contract with DAWASA that is almost identical to the lease contract that DAWASA had signed with a foreign private company in 2003 as part of a failed privatization attempt. The institutional separation between asset ownership and operation thus is a legacy of the privatization attempt. In Dar es Salaam, insufficient piped water supplies, especially in poor squatter settlements and neighborhoods, has forced residents to resort to complementary water systems to meet their daily needs. These include illegal connections, illegal pumping, and purchasing water from pushcart vendors that resale at 15-25 times the official price. In other cities, the operation, maintenance and development of water and sewerage infrastructure is carried out by Urban Water and Sanitation Authorities (UWSSAs). UWSSAs are autonomous legal entities that are meant to operate on the basis of commercial principles. They have been established in 19 major urban cities in accordance with the Waterworks Act No. 8 of 1997. The 19 UWSSAs are divided in three categories from A to C in declining order of cost recovery (see below for more details). As of 2010 they were classified in the following categories: Category A (13 utilities): • Arusha, • Iringa, • Shinyanga, • Songea, • Mbeya, • Morogoro, • Moshi, • Mwanza, • Musoma, • Tabora, • Tanga, • Dodoma, and • Mtwara. Category B (4 utilities): • Bukoba, • Kigoma, • Sumbawanga, and • Singida. Category C: • Babati, and • Lindi. In districts and small towns there are about one hundred small public service providers, the District Urban Water Supply and Sanitation Authorities (DUWSSAs). In 2007, MoWI initiated a process of clustering them with the aim to increase the quality and efficiency of service. The main source of capital investment are block grants to local government authorities, disbursed by the Regional Secretariat. There are two main types of COWSOs: Water Consumer Associations (Vikundi vya Huduma ya Maji), who are responsible for drinking water supply, and Water User Associations (Vikundi vya Watumiaji Maji), who are responsible for water resources and for solving conflicts among water users. As of 2006, 121 Water User Associations have been established. As of 2009, water supply remained continuous and water quality good. The water committees remained financially sustainable with more than 90% of the customers paying their water bills. Interface Between Formal and Informal Institutions. In rural areas that lack formal water systems or water management, traditional forms of water resource management and sanitation practices are passed down generationally as traditional ecological knowledge. Here, distrust between the government and indigenous groups stemming from the failed Free Water policy results in a lack of compliance with formal regulations. For example, water conflicts at the village level are often resolved informally, rather than being brought to primary and district courts that they find time-consuming, expensive, and unjust. Instead, informal water management practices are carried out at a grassroots level by traditional village elites, such as the mwanamijie in Sonjo villages. Rules including when and where water can be collected as well as punishments or fines when these rules are broken are closely connected to local religious beliefs, customs, and cultural values. Civil society Civil society actors also participate in the water and sanitation sector. In 2008 they have set up TaWaSaNet, a network that aims at strengthening civil society participation in the water and sanitation and securing that policies are carried out in an equitable way. Among the NGOs active in the Tanzanian water sector (and mentioned in a report by MoWI) are: WaterAid, The Netherlands Development Organisation (SNV);Concern Worldwide, Plan International, WWF, Shahidi wa Maji, Daraja, and MSABI. ==Investment planning and decision-making==

Water investment planning for rural areas is done at the district level by the respective water departments. In 2009 the NGO WaterAid studied the local government planning process for water investments in four of the country's 99 rural districts, namely in Mpwapwa, Kongwa, Iramba and Nzega. Planning begins with long wish-lists based on demands from the village level. Since real priorities are difficult to identify, one selection criterion used is the balance of money held in the village water fund. This is seen as a sign of community ownership and can be easily explained to councillors and villagers. Other purported criteria are health statistics and data collected from a waterpoint mapping exercise, but they are not given high priority in practice. Selection is done in such a way that water projects are equally divided between the constituencies of the district's Members of Parliament. Furthermore, councilors steer projects to villages in their wards, with more dynamic councillors exerting greater influence. Another de facto criterion is the previous track record in caring for infrastructure: In some areas handpumps have been stolen, making it hard to justify new investments. Communities close to town, located on main roads or with existing social services have an advantage in the decision-making process, since officials visit them more often and the cost of providing infrastructure is lower. The WaterAid report suggests that if there was better availability of data on rural water supply infrastructure this could help the representatives of underserved communities to lobby on behalf of their constituents. ==Public opinion==

The Afrobarometer Survey 2008 collected information about Tanzanians' opinions about the water sector. The disparity in access to safe and clean water between rural and urban areas is illustrated by the responses: 51% of urban residents were satisfied with government efforts to deliver water and sanitation services, compared to 39% in rural areas. Accordingly, the water sector is considered as a higher priority for government action by rural Tanzanians. 44% of respondents in rural areas cited water supply as one of the three most pressing issues that the government should address (for 16% it is the single most important problem). In urban areas water supply came third behind economic and health concerns in 25% of responses. Issues of corruption in the water sector were also examined by the Survey: 4% of respondents admitted that they had to pay a bribe, give a gift, or do a favor to government officials in order to get water or sanitation services in the past year. == Economic efficiency ==

Some common indicators of the economic efficiency of water and sewerage utilities are billing efficiency, the level of non-revenue water and labour productivity. On the basis of these indicators the economic efficiency of urban service provision in the water sector in Tanzania is low. Billing efficiency. Government data indicated that urban water utilities have relatively high levels of billing efficiency (never below 70%). == Financial aspects ==

Tariffs and cost recovery The national water policy NAWAPO identifies utilities as commercial entities that provide an economic and social good. It thus promotes operational and maintenance (O&M) cost recovery as basis for sustainable services. Rural Water and Sanitation Authorities are expected to meet full O&M costs and 5% of capital costs. Investment and financing Investment. According to the Ministry of Water and Irrigation, the total budget for the water and sanitation sector in fiscal year 2008-2009 was TSh 286.5 billion, equivalent to US$220 million. Of these, US$175 million were actually spent. The budget approved for fiscal year 2009-2010 is TSh 309.6 billion, or US$238 million. 40.1% has been allocated to rural water and sanitation and 43.9% to urban water and sewerage. Water resources management and institutional development and capacity building have been allocated 8.5% and 7.4% of the budget respectively. The UN Water Country Brief for Tanzania, however, shows an estimate for average annual drinking water and sanitation expenditures in the period 2002–2011. According to that report, government investment expenditures were only US$30 million per year plus official development aid disbursements of US$82 million per year, about seven times less than the government figures for fiscal year 2008–09. Expenditures fluctuated substantially from year to year, with a peak in 2008–09. The Public Expenditure Report of the Water Sector provides a detailed analysis of the patterns of budget spending. It appears that in the water sector large part of the budget is made up of development expenditures and only 15% are recurrent expenditures (compared to the 55% share of development expenditures in the total government budget). Moreover, as a result of the decentralization policy of the government, the budget allocated to local government authorities and regions has increased rapidly. In fiscal year 2008-2009 LGAs had a share in the total water sector budget of about 25%, while the figure was 20% for regions. Conversely, an increasing part of central government budget is devoted to feasibility studies: this reflects the co-ordinating and policy setting role to which MoWI is shifting. This includes assistance in the form of grants, concessional loans and debt relief. Aid management in Tanzania is guided by the Joint Assistance Strategy (JAST) approved in 2006 and aimed at implementing the principles of the Paris Declaration on Aid Effectiveness. JAST advocates the integration of all development funds into the government budget, fosters national ownership and promotes a "division of labour" between donors. The Public Expenditure Report however suggests that not all spending in the water sector is included in the government budget. A comparison between OECD and Ministry of Finance data on bilateral aid shows that there is a gap between the two sources. This indicates that there has been off-budget financing of about 26% of total bilateral aid in the past five years. According to data published by MoWI, of the funds budgeted for the water and sanitation sector for fiscal year 2009–2010, about 88% will be provided from foreign transfers. == External cooperation ==

Tanzania receives external support from several donor agencies. They are organised in the Development Partners Group (DPG) which aims to improve donor harmonisation and aid effectiveness. Sector dialogue between DPG and the Ministries responsible for water is carried out through four thematic working groups that cover water, sanitation and hygiene issues. The five major donors in the Tanzanian water and sanitation sector are: the African Development Bank, the European Commission, Germany, the Netherlands and the World Bank. Within the scope of JAST, the Government of Tanzania the World Bank, Germany, and the Dutch government contribute to the WSDP Basket Fund which is a form of a Sector-Wide Approach (SWAp). The Monduli District Water Supply Project was approved in 2003 with the aim of securing adequate and sustainable access to safe drinking water to the population of eighteen villages in Monduli District. AfDB provided a grant of about US$10 million that covered 90% of the project costs. Since 2006, the AfDB together with other donors is contributing to the Rural Water Supply and Sanitation Program. The program aims at improving rural communities' access to water and sanitation services and improving institutional capacity - both at district and government level - to carry out demand based rural water and sanitation projects. European Commission The European Commission provides support to the Tanzanian water and sanitation sector through the resources of the European Development Fund National Indicative Programme (NIP) and the EU Water Initiative. At the end of 2008, thirteen projects co-funded by the Water Initiative were under implementation, for a total of €20.08 million. EU cooperation in the water and sanitation sector focuses on poor populations in urban and peri-urban areas. Between 2003 and 2007, the EU committed round €33 million to the Water Supply Programme to Regional Centres, jointly financed by German financial cooperation. The main objective of the programme was to improve the access to sustainable quality water supply and wastewater management services in the three regional centres of Mwanza, Iringa and Mbeya. Further funds of about €6.6 million were provided for the Mwanza Sewerage Rehabilitation Project between 2000 and 2004, whose aim was to prevent the overflow of raw sewage from Mwanza to Lake Victoria. Rural water and sanitation is supported through the EU general budget line for co-financing NGOs in developing countries. Germany is a town where German development cooperation supports improved access to water supply and sanitation. Since the 1970s, Germany has been cooperating with the Government of Tanzania in its attempts to improve the water supply and sanitation situation in the country. German Development cooperation is carried out mainly by KfW and GIZ. Between 2007 and 2009, KfW provided EUR17.25 million for the Water Basket. In addition, KfW is active in several national and regional projects in Tanzania. For example, in 2003 KfW provided 21 million euros for the project ''Supporting Regional Center's Water Supply and Sewerage'' in the rapidly growing towns of Mbeya and Mwanza. A feasibility study and investment plan were also prepared for Iringa, where implementation begun in 2006. The objective of the project was to improve the water supply, sanitation and sewerage services by strengthening the capacity of autonomous urban water supply authorities. To achieve this, water supply facilities have been extended and rehabilitated, sanitation facilitates have been upgraded and capacity building measures have been carried out, including improvement of IT systems used for billing. GIZ develops local capacities in the sector, including in the Ministry, EWURA and in commercial service providers, such as those in Tanga and in Kilimanjaro Region. India In 2012 the Indian government provided a US$178 million loan for the implementation of water projects to alleviate water scarcity in Dar es Salaam "by 2014". The loan will finance an increase in the capacity of the Upper Ruvu plant to 196,000 cubic meters from the current 82,000 cubic meters a day and to construct a new transmission line from the plant to the city. As of 2012, some parts of the city received water twice a week while others did not get any. The Netherlands The Government of the Netherlands provided funding for the WSDP Water Basket (through a mandate to KfW). In addition, the Netherlands Development Organisation (SNV) provides support in three main areas of the water and sanitation sector: (a) improving the functionality of existing water points through water point mapping (carried out in cooperation with WaterAid), (b) support to water, sanitation and hygiene activities in schools, and (c) capacity building in IWRM. United States The US provides a US$66.3 million grant to finance the expansion of the Lower Ruvu Plant that supplies Dar es Salaam with water from 180,000 to 270,000 cubic meter per day, as well as to reduce non-revenue water and to rehabilitate two treatment plants in Morogoro next to Dar es Salaam. Additionally, USAID/Tanzania funded a 3-year $15 million Tanzania Integrated Water Supply, Sanitation and Hygiene (iWASH) program which included complementary support from the Water and Development Alliance (WADA) partnership between USAID and The Coca-Cola Company. The program began in January 2010 and funding was extended first through 2013, and later through 2015 (with additional financing of $4.6 million). A 2-year supplemental program, WADA II, began in September 2010 and was extended to August 2013 through funding with the Global Environment and Technology Foundation (GETF). This integrated program (iWASH)works to support sustainable, market-driven water supply, sanitation, and hygiene services to improve health and increase economic resiliency of the poor in targeted rural areas and small towns within an integrated water resource management framework. World Bank The World Bank provides extensive support to Tanzania. In December 2009, it approved the Seventh Poverty Reduction Support Credit (PRSC): the fourth in a series of five annual budget support operations to the implementation of MKUKUTA. The Seventh PRSC entailed a commitment of US$170 million. In the water sector, the World Bank committed US$200 million to the Water Sector Support Project for the years 2007 to 2012. The project has four components: a) strengthening institutional capacity for improving the management of water resources; b) providing support to local governments in the scaling up of the provision of rural water and sanitation services in pursuit of the MDGs; c) giving support to Dar es Salaam, all regional and district capitals, and gazetted small town utilities in the scaling up of provision of urban water and sanitation services; and d) providing support in institutional capacity building, including sector coordination and policy re-alignment. The World Bank-administered Water and Sanitation Program is also active in Tanzania where it provides support in the areas of sanitation and hygiene. ==See also==