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Schistosomiasis in Tanzania: Challenges, Interventions, and Community-Led Solutions

Schistosomiasis in Tanzania is a devastating parasitic disease caused by Schistosoma worms, transmitted through contaminated freshwater.

With 90% of global cases occurring in sub-Saharan Africa, Tanzania has the second-highest prevalence after Nigeria, affecting nearly 15 million people—about a quarter of the population. The disease thrives in rural areas with poor sanitation, particularly near Lake Victoria, where fishing and daily water use increase exposure.

Why Schistosomiasis Persists in Tanzania

Schistosomiasis remains entrenched in Tanzania due to a dangerous interplay of environmental, infrastructural, and socioeconomic factors. While the parasitic disease is preventable, decades of development challenges—from water infrastructure projects to unequal access to sanitation—have allowed transmission cycles to flourish.

Below, we examine the root causes that sustain schistosomiasis in Tanzania, from man-made waterways that boosted snail populations to daily survival practices that force communities into contact with contaminated water.

1. Environmental and Infrastructure Factors

  • Irrigation & Dams: Expansion of agricultural water systems in the 1970s–80s created ideal habitats for parasite-carrying snails.
  • Lake Victoria Dependence: In the Rorya District, communities rely on the lake for drinking, bathing, and fishing, leading to frequent reinfection.

2. Socioeconomic Barriers

  • Limited WASH Access: 40% of Tanzanians lack safe drinking water; 60% lack proper sanitation.
  • Occupational Hazards: Fishermen, farmers, and women fetching water face unavoidable exposure.

Current Interventions Against Schistosomiasis in Tanzania

Tanzania’s fight against schistosomiasis employs a dual strategy: medical treatment to combat existing infections and community empowerment to break the cycle of transmission. While mass drug administration reaches thousands, lasting success hinges on addressing the gap between clinical care and real-world behavior.

This section explores how Tanzania’s approach—from nationwide Praziquantel campaigns to grassroots education by organizations like Maji Safi Group—is evolving to meet these challenges, backed by data proving what works.

1. Mass Drug Administration (MDA) – A Partial Solution

The WHO recommends Praziquantel distribution, but challenges remain:

  • Reinfection: People return to contaminated water sources.
  • Low Adherence: Misinformation and lack of awareness reduce treatment uptake.

2. Maji Safi Group’s Community-Driven Approach

Since 2012, MSG has combated schistosomiasis in Tanzania through:

  • Community Health Educators (CHEs): Local trainers educate villages on prevention, symptoms, and WASH practices.
  • Participatory Research: Collaborations with fishermen (via Beach Management Units) to co-design solutions (2017).
  • Hospital Partnerships: Joint testing/treatment campaigns with Shirati KMT Hospital (2022), reaching 2,000+ people.

3. Data-Backed Success: Health Screenings (2015–2019)

  • 25,000+ tests revealed higher-than-national prevalence in Shirati.
  • Proven Impact: Communities engaged in MSG programs showed significant infection reductions.

The Future of Schistosomiasis Control in Tanzania

Eliminating schistosomiasis in Tanzania demands more than temporary solutions—it requires systemic change. As the limitations of mass drug administration become clearer, the path forward lies in integrated, sustainable strategies that combine medical innovation, community-driven WASH programs, and policy reform.

This section explores Tanzania’s next-phase battle plan: from genomic research fine-tuning local interventions to global partnerships transforming sanitation infrastructure. The goal? To break the cycle of reinfection for good, ensuring that today’s treatments translate into lasting protection for future generations.

1. Beyond MDA: Integrated Strategies

  • WASH Hubs: Community centers providing clean water + education on occupational risks.
  • Genomic Research: Partnering with universities to study local transmission patterns.

2. Policy & Global Collaboration

  • Aligning with UN Sustainable Development Goals (SDGs).
  • Advocating for national WASH infrastructure investments.

Conclusion: A Path Toward Elimination

Schistosomiasis in Tanzania is a complex crisis tied to poverty, water access, and behavior. While Praziquantel saves lives, long-term elimination requires:

  • Community-led education (e.g., MSG’s CHEs).
  • Improved sanitation (WASH Hubs, government policies).
  • Multi-sector partnerships (hospitals, researchers, NGOs).

With sustained effort, Tanzania can break the cycle of reinfection and reduce the burden of this neglected tropical disease.

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455 Marine Street
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Maji Safi Group is a registered international nongovernmental organization (INGO) in the United Republic of Tanzania. 
Maji Safi Group is a registered 501(c)3 in the United States.

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HEALTH SCREENINGS

A great public service and a metric to measure disease prevalence amongst current and potential program participants.

Health-Screenings-Maji-Safi

During the years 2015-2019, MSG conducted an annual Health Screening Campaign as a public service and a way to monitor the impact of MSG’s WASH education. Approximately 25,000 participants were tested for amoebas, intestinal worms, schistosomiasis (bilharzia), and malaria – all common water-related diseases. In cooperation with the Rorya District Medical Office and practicum students from the US, MSG screened participants and provided them with appropriate medications and educational flyers. The health screenings helped patients keep track of their well-being and provided an incentive for community members to get involved in MSG’s programs. In addition, the health screening results enabled MSG to compare the disease rates of our program participants to those of community members who had not received our education.

Learn More About Our Programs

Ree Pads

Ree Pads is a supplier of reusable pads to support MSG's Menstrual Hygiene Health programs.

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Afya Plus

Afya Plus is a supplier of reusable pads to support MSG's Menstrual Hygiene Health programs.

ReliefPad

ReliefPad supplies reusable pads to support MSG's Menstrual Hygiene Health programs.

Saalt

Saalt is a global company that provides reusable solutions for menstruation. Their products are donated to MSG to support our Menstrual Hygiene Health programs.

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AnuFlo

AnuFlo is a Tanzania-based social enterprise that manufactures reusable menstrual products. MSG utilizes AnuFlo products in our Menstrual Hygiene Health programs.

Women's Choice Tanzania

Women’s Choice is a social enterprise that manufactures and distributes low cost, affordable menstrual hygiene products – especially, reusable Salama pads.

Street Business School

Street Business School (SBS) empowers women to become thriving entreprenuers, lifting themselves and their families to a more vibrant future by teaching them tools they need to successfully start and grow microbusinesses. Several of MSG's employees are certifies SBS trainers who work with cohorts of women in the Mara region.

Swiss Midwife Project

MSG has been hosting midwifery students from the Bern University of Applied Sciences in Switzerland since 2021. The nurses come to learn and help at the Shirati KMT District Hospital’s maternity ward, while also supporting MSG’s Menstrual Hygiene Health program.

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Touro University, Program of Public Health

Touro University California is a non-profit institution of higher learning and professional education with programs in Public Health. In partnership with MSG, Touro is conducting research and mapping in the Rorya District to determine the prevalence of and need for increased services in non-communicable disease treatment and education.

Shirati College of Health Sciences

The Shirati College of Health Science partners with MSG to provide field work and practicum experience to local nurses. Nurses work alongside MSG's Community Health Educators to provide community health education.

Shirati KMT District Hospital

MSG was founded as a pilot program under the Shirati KMT District Hospital in 2012. Since then, the KMT has been a seminal partner with whom MSG continues to grow and share support. Today, the two organizations especially partner on running Disease Prevention Centers and providing nutrition education as well as schistosomiasis prevention and treatment.

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Project C.U.R.E.

Project C.U.R.E. is a US- based nonprofit dedicated to addressing the shortage of medical resources around the world. MSG and Project C.U.R.E. partner to provide critical medical supplies for clinics and hospitals in the Rorya District.

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AllPeopleBeHappy

AllPeopleBeHappy is a US-based foundation which supports projects that address the root causes of poverty and increase prospects for happiness and better livelihoods. MSG partnered with AllPeopleBeHappy to extend female hygiene health education to the Butiama District in 2022.

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mWater

mWater is a women-owned small business provider of data-driven project management. The MSG team uses the mWater platform to track project data collection, monitoring, and evaluation.

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The Center for Affordable Water and Science Technology (CAWST)

The Center for Affordable Water and Science Technology (CAWST) is a Canadian charity and professional engineering consultancy dedicated to teaching people how to bring safe drinking water, sanitation, and hygiene to their homes, schools, and clinics via simple, affordable technologies. CAWST supports MSG with capacity building in a training-of-trainers model. Together, we are increasing the capacity of MSG’s staff to provide critical WASH education and training across East Africa, including in Tanzania, Kenya, Uganda, and Ethiopia.

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The Roddenberry Foundation

Roddenberry is a global foundation that supports bold ideas. MSG is a proud recipient of the Roddenberry Catalyst grant.

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Rotary Club of Southeast Denver & Rotary Club of Northwest Spirit

Rotary International is a member-driven organization and network made up of over 1.4 million neighbors, friends, leaders, and problem solvers who see a world where people unite and take action to create lasting change. MSG is fortunate to partner with two Rotary chapters: the Rotary Club of Denver Southeast (US-based) and the Rotary Club of Northwest Spirit (Canada-based). These two chapters have supported MSG's focus in Menstrual Hygiene Health and WASH in Health Care Facilities with multiple grants.

Grow and Know

In 2009, Grow and Know launched the very successful Vipindi vya Maisha, a book about female puberty. The book received positive responses from girls, women, mothers, teachers – even fathers and male peers. MSG’s Community Health Educators use this book as a resource in our Female Hygiene Program.

University of Colorado at Boulder

The University of Colorado is the alma mater of co-founder Bruce Pelz and home to the Mortenson Center in Engineering for Developing Communities. MSG has participated in the Center’s annual WASH Symposium since 2015 and has hosted several CU students in Tanzania. In 2016, MSG hosted professor Beth Osnes; together, we conducted research on the vocal empowerment of women.

Washington University in St. Louis

Since 2013, MSG has partnered with the Brown School of Social Work at Washington University in St. Louis by providing practicum opportunities for graduate students studying Social Work and/or Public Health. In 2017, MSG hosted Professor Carolyn Lesorogol and twelve graduate students focusing on participatory development tools.

Heatherwood Elementary School

MSG started collaborating with Heatherwood Elementary on read-a-thons in 2018. Participants spread awareness and raise contributions for MSG by recruiting sponsors for each book they read. This win-win grassroots partnership with Heatherwood promotes reading and teaches social responsibility and helping others through personal effort. The money raised has benefitted our Tanzanian youth projects and most recently the construction of a school latrine.

Posner Center For International Development

MSG is a member at the Posner Center in Denver, Colorado. The Posner Center convenes, connects and catalyzes the international development community to collaborate for greater impact. In 2018, MSG and the African School Assistance Project (ASAP) received an International Collaboration Grant from the Posner Center.

The Generous View Studio

The Generous View Studio is a privately owned meeting space in Boulder, Colorado, dedicated to spreading awareness of global issues in general and MSG’s work in Tanzania in particular. Through professionally taught art classes and informal gatherings, the studio supports the creative community in Boulder and generates revenue for non-profits.

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Paul Horton Visuals

Paul Horton Visuals is a creative company focused on providing digital and print media solutions. They support MSG with video and media content.

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REACH Shirati

REACH Shirati runs Tina’s Education Center (TEC) for primary school students in Shirati. When MSG started, REACH Shirati was our parent organization. Together, we have made TEC a stronghold for students to learn and grow through our programs. Today, MSG and REACH Shirati collaborate on the Binti na Shule (Girls in School) program, a mentorship program to improve girls’ performance in schools.

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Friends of Tanzania

Friends of Tanzania (FOT) is a non-profit charitable organization that has provided funding to grassroots organizations in Tanzania since 1991. FOT was started by former Peace Corps workers in Tanzania (or Tanganyika at the time). FOT has supported MSG since 2018 and has provided funds for multiple projects, including an Arborloo Toilet pilot project, SAFI toilet construction, and Menstrual Hygiene Health Labs.

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Beyond Our Borders

Beyond Our Borders is a group-advised fund under The Women's Foundation of Colorado. Its mission is to strengthen families and communities, while advancing and amplifying opportunities for women to reach economic self-sufficiency. BOB has supported MSG’s Female Hygiene Program.

LUSH Charity Pot

The LUSH Charity Pot offers grants to grassroots organizations that are in an optimal position to make a difference with limited resources. LUSH has been a committed partner of MSG since 2018, supporting a diversity of programs, including cholera prevention, home health visits, and WASH in health care facilities.

Tanzania Menstrual Hygiene Health Coalition

The Tanzanian Menstrual Hygiene Health Coalition is a network of Tanzanian governmental, non-governmental, and civil society organizations working to improve MHH in Tanzania. MSG was a seminal organizer of the original coalition in 2018. The mission is to increase knowledge sharing between MHH stakeholders and combine efforts to increase policies and services at the national level. Current collaborations include organizing the annual National Menstrual Hygiene Day celebration and increasing awareness of MHH issues.

Tanzania Water and Sanitation Network

TAWASANET is a network of Tanzanian civil society organizations in the water and sanitation sector. MSG has been a member of TAWASANET since 2014 and is the Zonal Coordinator for the Lake Zone. MSG participates in annual general meetings and provides advocacy and leadership in the network.

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School Health Clubs

MSG started its School Health Club programming in 2013 with the mission to improve community health outcomes through hygiene and health education at the student level. To date, MSG partners with 39 schools in the Rorya, Butiama, and Bunda Districts.

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WASH Health Care Facilities

MSG started its WASH in Health Care Facilities focus area in 2021 with the mission to improve community health outcomes through partnership with local health institutions (hospitals, clinics, and dispensaries). To date, MSG partners with 14 HCFs in the Rorya District.

RUWASA

MSG’s partnership with the Tanzania Rural Water and Sanitation Agency (RUWASA) is critical for implementing and growing rural water supply and access across the Rorya District. In 2024, MSG specifically launched a partnership with RUWASA, whereby the MSG WASH Hub supplies water to surrounding communities managed and operated by RUWASA.

Tanzania Government Logo

Local Government Authorities (LGAs)

MSG works closely with LGAs to provide services at the village and community level. LGAs are paramount to gaining community access, understanding community priorities, and providing valuable services. All programs are implemented hand-in-hand with community leadership and authorities.

Tanzania Government Logo

WASH Pillar

MSG participates in nationwide update meetings with the Ministry of Health and other WASH stakeholders on a regular basis. These meetings focus on providing updates on progress related to various disease outbreaks and allow stakeholders to share their initiatives.

HEALTH SCREENINGS

A great public service and a metric to measure disease prevalence amongst current and potential program participants.

Health-Screenings-Maji-Safi

During the years 2015-2019, MSG conducted an annual Health Screening Campaign as a public service and a way to monitor the impact of MSG’s WASH education. Approximately 25,000 participants were tested for amoebas, intestinal worms, schistosomiasis (bilharzia), and malaria – all common water-related diseases. In cooperation with the Rorya District Medical Office and practicum students from the US, MSG screened participants and provided them with appropriate medications and educational flyers. The health screenings helped patients keep track of their well-being and provided an incentive for community members to get involved in MSG’s programs. In addition, the health screening results enabled MSG to compare the disease rates of our program participants to those of community members who had not received our education.

SINGING AND DANCE GROUPS

Using cultural customs to teach WASH and empower rural youths
to be change makers in their communities.

Singing-and-Dancing

Over the years, MSG has used these dances, songs, and skits extensively to teach students and spectators how to:

  • avoid water-related diseases,
  • practice proper handwashing,
  • prevent fecal-oral disease transmission, and
  • practice proper menstrual hygiene management.

MSG no longer runs a specific Singing and Dance Program, but this effective way of disseminating knowledge about WASH, behavioral change, Menstrual Hygiene Health, etc. is still widely used in our programming.

RoryasGotTalent

Song and dance are of great cultural importance in Tanzania. They are perhaps the most effective medium for communicating disease prevention to a community. In MSG’s Singing and Dance Group, students learned life-saving lessons in a fun and memorable manner, developed their talents, and became community leaders. Following WASH lessons, students worked together to create songs, dances, and skits to perform for their families, friends, and community members at MSG events.

Sing and Dance

Rorya’s Got Talent

For many years, the Singing and Dance Group held annual auditions for the Roya’s Got Talent competition.

Participants wrote songs and skits and performed choreographed dances to communicate their WASH knowledge to peers and members of the community.

Once the best 10 participants had been chosen, MSG hosted a semifinal event and then a final event, each attracting over 1,500 community members.

AFTER SCHOOL PROGRAM

After School Program

CHEs taught WASH and disease prevention lessons in a fun, nurturing environment. Art, games, puzzles, and other activities encouraged students to develop their creative and cognitive skills. This way, the things they needed to learn became things they wanted to learn! In addition, their knowledge trickled down to their families. Over the academic year, students learned about:

  • sanitation,
  • personal hygiene practices,
  • waterborne and water-related diseases,
  • water treatment,
  • the fecal-oral disease cycle,
  • bilharzia, and
  • the benefits of preventing diseases.

To enable proper WASH techniques, MSG provided schools with demonstration ceramic drinking water filters and handwashing stations. At the end of the program, our staff artist painted a large WASH-related mural to serve as a reminder of lessons learned and as an inspiration to future students.

The After School Program was one of MSG’s very first programs, started in 2013. Its purpose was to teach students about water-related disease prevention and proper WASH behaviors, so they could stay healthy and succeed in school. In 2015, the District Education Office approved MSG to teach in all 125 primary schools in the Rorya District.

Over time 6,000+ students attended this program.

After School Program 2
After School Program 3

MAJI SAFI CUPS

Maji Safi Cup 1

Combining disease prevention education and team sports to promote a healthy and cohesive community.

Football (soccer) is a popular pastime in Tanzania. Organized tournaments are a common occurrence, and each game attracts hundreds of spectators. This community tradition affords a unique educational opportunity.

For several years, our CHEs would organize a month-long Maji Safi Cup on a biannual basis. These tournaments also included netball matches for women and girls. Before each football or netball game, teams must attend a one-hour lesson about WASH and disease prevention. Combining athletics and education promotes overall wellness and makes lessons more memorable and thus more effective.

The winners of a Maji Safi Cup were awarded school supplies and WASH products. Although only one team was crowned as champions, all tournament participants benefited from team-building and pre-game lessons!

LEARNING TOOLS

MSG is proud of its creative and original curricula, songs, art, games, outdoor murals, and train-the-trainer programs.

Learning Tools_Mural 3

Maji Safi Group’s unique learning tools have become the catalyst for healthy WASH lifestyles and disease prevention. From education on common water-related diseases and treatments to menstruation and proper handwashing, our learning tools are fun, engaging and specifically designed to accommodate the varying literacy levels among our participants. 

MALE HYGIENE PROGRAM

Teaching young men and boys about male and female anatomy, puberty, adolescent body changes, and personal hygiene.

MaleHygieneProgram
Male-Hygiene_-3

Male Hygiene Groups

The Male Hygiene Program began in 2016. It empowers boys and young men to respect themselves, girls, and women and lead a culture of change. The program also helps young men be part of the movement to break the stigma and silence around menstruation, help girls stay in school, and close the gender inequality gap.

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FEMALE HYGIENE PROGRAM

Menstrual Hygiene Management in Tanzania

Though all residents face WASH issues, it is necessary to look at the situation through the lens of gender in particular. In Tanzania, female hygiene has traditionally been a taboo subject, and most schools lack adequate facilities for young women. Without access to proper sanitary materials and fearing ridicule for bloodstains on their skirts, many girls miss school during menstruation. Lower attendance rates severely limit academic potential and contribute to a cycle of disempowerment. Maji Safi Group, through our work to promote public health, seeks to establish a more comprehensive approach to menstrual hygiene management in Tanzania. We lift the stigma around female hygiene to empower girls and help them reach their full academic potential and become strong leaders.

Menstrual Hygiene Health

Together Women Rise

Influencing Menstrual Hygiene Management in Tanzania (MHM)

Female Hygiene Groups

Young women, ages 11-18, meet with CHEs in after-school groups to learn about female hygiene, health, and puberty. All groups, as well as girls from surrounding communities, are also invited to attend Saturday meetings at MSG’s office. The girls:

  • learn about female health,
  • share stories,
  • seek advice, and
  • engage in peer-to-peer education.

Participants also receive reusable sanitary products to promote proper hygiene and prevent absences from school. MSG strives to offer several different options, such as reusable pads, period panties, and menstrual cups.

Together-Women-Rise

The Decent Girl Competition

Female-Hygiene-Menstrual-Hygiene-Management-in-Tanzania-Maji-Safi--1

COMMUNITY OUTREACH

Interacting with the community and spreading WASH awareness to every age group.

Participating in one’s community is crucial to bringing about positive change. To be heard, one must first be seen.

CHEs organize and host activity days to establish a presence and promote change in their community.

Local-Market-Days

Youth Field Days

Community Outreach_Salon

Food Safety

Schistomiasis Education

Government Collaboration

Community Outreach

Local Market Days

People of the Mara Region gather on market days to trade goods. CHEs take advantage of the large crowds by setting up Disease Prevention Awareness booths and selling crucial WASH materials, such as WaterGuard chlorine tablets for water treatment.

Youth-Field-Days

Shops and Salons

Community Outreach_Food Safety

Schistosomiasis Campaigns

Government Collaboration
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Tanzanian Government

MSG works closely with the Tanzanian government at all levels: district, regional, and national. Relevant offices include Community Development Offices (district and regional), Medical Office (district and regional), Education Office (district and regional), Health Office (district and regional), Ministry of Health (national), Ministry of Education (national), and Ministry of Community Development Gender, Women, and Special Groups (national).

HOME VISITS

Homevisit-Program-Page

Community Health Educators

For these reasons, CHEs meet with primarily female heads of households to assess their family’s WASH situation. Lessons are tailored to the specific needs of each family, but general topics include: 

  • the economic benefits of preventing diseases,

  • water treatment and storage,

  • toilet use,

  • handwashing,

  • fecal-oral disease cycle,

  • food preparation and storage,

  • personal hygiene,

  • bilharzia, and

  • other neglected tropical diseases.

Delivering WASH knowledge to doorsteps.

In Tanzania, women are typically in charge of WASH-related activities such as, water fetching, cooking, cleaning, and bathing. This makes them the most crucial stakeholders in disease prevention. Educating women empowers them to become change makers in their homes and leaders in their communities. Our CHEs visit individual families to inspire action and transform communities—one home at a time.

Visits to a home are prioritized based on:

  • interest,
  • family size,
  • number of young children,
  • neighborhood disease rates, and
  • local government input.

Family Meetings

Based on initial assessments and rates of progress, CHEs meet with families three to five times over six to 10 weeks. Within the following year, CHEs will revisit families to ensure that good habits are sustained. Home Visits provide each household with equal attention and access to life-saving information. They also foster personal relationships between CHEs and participants. If residents have any questions following the visits, they know there is a friendly face or hotline ready to help. Building trust, confidence, and community is the way to stop disease from continuing.