MKAJI – Maji kwa Afya ya Jamii: Upgrading Water Supply in Health Facilities of Dodoma Region

Project completed
Dodoma, Tanzania © Simavi

Water and sanitation (WASH) is one of the most important social determinants of health. Upon request of regional authorities, SDC will upgrade water supply and sanitation systems in 100 primary health facilities in Dodoma region. This intervention will considerably reduce the high risk of infection transmission and improve quality of care in health facilities. Water management and hygiene promotion in and with communities will complement hardware investments.

Country/region Topic Period Budget
Primary health care
Basic health infrastructure
Drinking water and basic sanitation (WASH) (til 2016)
Water sanitation
Health systems strengthening
Infectious desease
Medical services
01.09.2012 - 31.12.2019
CHF 8'898'000

The current water situation in the Dodoma region poses a great health problem especially at the primary health care level where the majority (almost 70%) of the population seeks health care services. Out of the 402 primary health facilities in Dodoma region, 186 have no water at all. Sanitation and hygiene remain very low due to limited access to clean water and lack of adequate sanitation facilities. Operation and maintenance in water supply structures is neglected. Water sources are functional for a short period of time after construction or rehabilitation. Responsible authorities and local communities do often not see the value of maintenance and lack technical and financial capacities in water management. Whereas legal framework and policy guidelines on water management are existing, water management committees in some areas are not fully functioning. In many cases, ownership and roles and responsibilities in water management are not clearly defined. There is a lack of female representation in water governance structures.


To improve the quality of public health services provision by reducing the potential risk of transmission of communicable diseases and infections during routine patient care and treatment and improved maternity health care and service delivery

Target groups

Health facility staff, patients, care-givers and surrounding communities.

Medium-term outcomes

Improve access to water, sanitation and hygiene in 100 selected primary health facilities.


Results from previous phases:  

Between June and December 2013 SDC has conducted an in-depth assessment of the water situation and governance capacities in all 186 health facilities without water. This assessment has provided Dodoma regional authorities with up-to-date and accurate data on the water situation of the health facilities and proposed standard solutions for the water problem. Findings:

  1. Water quantity and quality are generally good. No specific treatment is required;
  2. Each of the 186 health facility without water has been visited; suitable and cost-effective solutions have been identified;
  3. Sanitation facilities available at the health facilities are in poor condition or inexistent;
  4. All health facilities are surrounded by local communities, including schools which could beneficiate from improved access to water.
  5. Communities are willing to participate in water management and ready to pay for water services, including operation and maintenance.

A costing of standard solutions (connection to existing network; borehole, water tank, surface water) has been done for all of the 186 health facilities, including upgrading sanitation systems. Results of the assessment was shared with regional and district authorities. It has been agreed that SDC will complement local investment and cover between 18-22 primary health facilities per year for the all region (7 districts). At the end of this phase 100 health facilities shall be rehabilitated.


Directorate/federal office responsible SDC
Credit area Development cooperation
Project partners Contract partner
International or foreign NGO
  • Other international or foreign NGO North
  • A consortium led by Simavi (Dutch foundation), including an engineer company (Witteveen+Bos) and three local partners for monitoring of construction works (CBHCC in Bahi, Chemba, Dodoma and Kondoa; UFUNDIKO in Kongwa, Mpwapwa and Chamwino); and training on hygiene, gender mainstreaiming and social accountability (PATUTA).

Budget Current phase Swiss budget CHF   8'898'000 Swiss disbursement to date CHF   8'763'825
Project phases

Phase 1 01.09.2012 - 31.12.2019   (Completed)