Model Healthy Villages

The Problem

One of the greatest challenges in the rural areas of Madagascar is sanitation. Many villages lack sanitary latrines, potable water, water filters, and basic hygiene education. As a result, waterborne diseases account for more than 10% of the nation’s yearly death toll, and diarrheal illnesses are a major cause of death for children under five.

The Solution - The Model Healthy Village

The Model Healthy Village is a program designed to decrease illness by providing people with an understanding of safe hygiene practices, the tools to implement them, and the ability to maintain them. There are three components involved in the process of becoming a Model Healthy Village. They include: a sanitary latrine for each family in the village, hygiene education for the village, and a potable water filter for each home.

Hygiene education – This was achieved using the internationally recognized Community Led Total Sanitation program (CLTS.) This model requires that the village leaders endorse the program, and that everyone in the village participates and becomes a health advocate.


Sanitary latrines – Each family in the village helps build their own sanitary latrine. For every latrine, deep holes are dug in the ground and lined with cement. They create a composting system that is hygienic, and prevents flies and unpleasant odors.


Home water filters – Prior to the projects, the river was the source of drinking water for the village. Now there is a gravitational water system. Also, each family has their own water filtering system, a simple construction of plastic buckets and porcelain candles.


  • Geography – One challenge is logistics; many villages are isolated, with poorly maintained roads and bridges. To create the components for the latrines, gravel, cement, iron bars, and ceramic units need to be transported to the village. Sometimes this must be done by canoe or raft.
  • Local beliefs and practices – It can be difficult to teach the importance of a latrine in a village where illiteracy is high and open defecation is a common practice. Project team leaders, however, have effectively used humor and drama to get the message through.

A Success Story – The Model Healthy Village of Fontsimavo

In 2012, the people of Fontsimavo, like many other rural villages, were suffering from the impact of poor sanitation, unclean water, and the resulting illnesses and missed days of work. There was a community health workers who could give out medication, but without sanitation and clean water to drink, waterborne diseases continued to occur.

Jeanette Nirina led the project to work with the people of the village, including the leaders. She served as a teacher, technician, mentor and trainer, both to her colleagues and the people they work with.

ONG St Gabriel provided technicians to work with the villagers to create the parts for the latrines and aid in the installation. Then a group of villagers were taught to do maintenance and repair work.

Everyone in Fonsimavo learned about the importance of hand washing, and lessons of good hygiene are easily visible. Soap and water are outside every outhouse to reinforce the importance of hand washing in disease prevention.

As a result of community effort, hard work and sacrifice, Fontsimavo has reached its goal of becoming Model Healthy Village. Every family now has a sanitary latrine and clean water to drink, and health throughout the village has improved.

To date, CRMF has acquired funding for two Model Healthy Villages; Fontsimavo and Ampasimbola. A third village is going through the training process, funded with the support of a Rotary International Global Grant and support from several Cincinnati area Rotary groups. Currently 160 of the village’s 500 families have adopted the program to reduce the risk of water-borne disease.