framework to operationalise behavioural determinants for planning, - - PowerPoint PPT Presentation

Using FOAM to scale up HWWS - a framework to operationalise behavioural determinants for planning, implementation and results

Yolande Coombes

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(a) Sanitation (b) Water availability (c) Water quality (d) Hygiene promotion (e) Hand washing

Reduction in diarrhea morbidity (%)

Previous reviews Fewtrell et al. (2004)

Diarrhea is one of the major killer of children under 5

Why Handwashing ?

One of the most cost- effective intervention for improving child survival

Source for cost-effective ratios: Second Edition of Disease Control Priorities in Developing Countries, World Bank (2006) Source: Cairncross “The Health Impact of Sanitation” presentation to the Rural Water and Sanitation Thematic Group in August 2004. a – d Esrey SA et al. (1991) Bull WHO 69 (5): 609-621; e Curtis V, Cairncross S (2003) Lancet Inf Dis 3: 275-281. 2750 850 94 47 11 3 500 1000 1500 2000 2500 3000 Cholera or Rotavirus immunization Breastfeeding promotion Water supply through hand pump or standpost Water supply through house connection Sanitation Promotion Hygiene promotion (i.e. HWWS)

Cost Effective Ratios Mean US$/DALY

Gain one year of life free of disease and disability for $3 if you promote HWWS for $2750 if you promote cholera immunization

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Cost Effectiveness of Hygiene and Sanitation compared to other public health interventions

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SCALE and SUSTAIN: 5.4 Million Women and Children

Peru, Senegal, Tanzania Vietnam Behavior Change Interventions Enabling Environment

• Share Evidence and Learning
• Build capacity of governments and partners
• Develop and Strengthen HWWS behavior change programs.

Performance Monitoring/ Impact Evaluation Learning

Global HWWS project

Behavior change strategy* Integration of promotion into existing services

Capacity Building and Incentives

Convenient access to water & soap Mass Media Promotional events Community mobilization/ interpersonal Demand-driven HW stations Communications Campaigns

Background

Deliverables

Preparation Implementation

Enabling Environment Action Plan Institutional Assessment Formative Research*

Strengthening the EE Performance Monitoring

*Guided by FOAM framework

Why do we need a framework?

• 1. To help us decide where the need is

greatest

• 2. To help us understand why people behave
• r don’t behave
• 3. To help us plan how to support them to

behave

• 4. To help us identify what we do and don’t

know about and what we need to know more about.

The AOM framework and its causal relationship

Opportunity Ability Motivation Behavior

Using FOAM As Framework

Focus

Target behavior Target population

Opportunity

Access/availability Product attributes Social norms

Ability

Knowledge Social support

Motivation

Beliefs & attitudes Outcome expectations Threat Intention

Vietnam

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Focus

Target behavior Target population

Peru

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Opportunity

Access/availability Product attributes Social norms

Senegal

Ability

Knowledge Social support

STOP DOING Potential Activities to be addressed

• ther than through

Communication

How can we priortise FOAM to take forward for communication development ?

Ability to influence with Communication Ability to change peoples behavior Strong Communicable habit changers – do now ! Consider for tactical

• pportunities

High High Low

Social Support

How can we priortise FOAM to take forward for communication development ?

Ability to influence with Communication Ability to change peoples behavior

High High Low

Social Norms Attitudes and beliefs Intentions Expectations Access / Availability Product Attributes Knowledge incl existing resource usage Threat Opportunity Ability Motivation

Advertising Public Relations Partnerships Experiential Response Consumer Promotions Purpose Salience Credibility Association Engagement Relationship Conversion Roles Persuasion via salience Influence via credibility Relevance via association Engagement via experience Relationship via recognition Conversion via incentive Channel Use Image Immediacy Reassurance Stature Trust Rapid Response News Endorsement Values Content Endorsement Prestige Interaction Immersion Depth Participation Trial Loyalty Personifications Reward Trial Urgency Proximity Reward Awaken Phase Radio and print on key junctures for HWWS, and importance of soap; Wall branding News coverage of campaign in newspapers Promoting buy-in; training local, national government on HWWS DCC and IPC on key junctures and importance of soap, constructing tippy taps and washing hands Inspire Phase Radio phone-in with HWWS experts Soap packaging with messages Radio phone-in with HWWS experts Promotional items DCC and IPC – constructing tippy taps and winning promotional items Empower Phase Radio Soap opera IPC and DCC promoting mother as heroes; Tippy Taps comic Tippy Taps comic Radio Soap

• pera

DCC events for mothers as heroes ready for competition Amplify Phase Radio Sponsorship for Asante Mama News coverage of Asante Mama Radio spots of Famous people saying why their mothers are heroes; HWWS ambassador Engagement through media, DCC and IPC on Asante Mama – nominating mothers as heroes Asante Mama through media, DCC and IPC Asante Mama through media, DCC and IPC Sustain Phase Radio spots and soap opera Soap packaging IPC

Opportunity

Access/availability Product attributes Social norms

Ability

Knowledge Social support

Motivation

Beliefs & attitudes Outcome expectations Threat Intention

Tanzania

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