Technical Support Manager Hygiene Where we work? WA is an - - PowerPoint PPT Presentation

Om Prasad Gautam, PhD, MPH, MA Technical Support Manager – Hygiene

Clean Hands, Better Health

Where we work?

WA is an international WASH focused development organisation working in 26 countries around the world: Asia, Africa and Pacific region

Our vision is a world where everyone, everywhere has safe water, sanitation and hygiene

WA understands that unless the benefits of good hygiene is fully realised and ingrained as a social norm 

Hands may not be washed Food continue to be polluted Toilets may not be used Water continue to be polluted Dignity will be compromised

Improve hygiene behaviours

Target settings for handwashing

Schools

Households/communities

Health care Policy settings

Target groups

“My baby has

• worms. She
• ften has

vomiting and

• diarrhoea. I walk

2 km to this water point. This water is free but it breaks down two to three times a year”.

Different target groups in different settings

• 1. Hygiene

behaviours / practices

• 2. Presence of

Institutional mechanism 3. Environmental Determinants

• 4. Technical

Sustainability

• 5. Hygiene

policy / advocacy

• 6. Financing

Programme design, implementation & sustainability

Assessment and or Formative Research

Deliver and monitoring Evaluate (baseline, follow-up, sustainability assessment)

Design Hygiene Intervention

Handwashing intervention focus

Motivating people (Knowledge ) Sustaining practices in key moments Handwashing facilities Behavioural products (soap, water ) Creating social norms

WaterAid and partners use multiple approaches to promote handwashing behaviours

Child-to-child approaches

Child-to-child: school curriculum development

Social drama Group events/mothers group events

Handwashing facilities

Puppet shows

Cultural events and theatre

Handwashing demonstration

Using social and commercial marketing techniques

Hygiene promotion through routine immunisation

Mirror Fan Bib

WASH new users by year (n=26 CPs)

1,911,135 3,014,060 5,136,064 1,673,410 1,873,665 1,918,801 2,144,921 2,799,606 3,067,330

• 1,000,000

2,000,000 3,000,000 4,000,000 5,000,000 6,000,000

2012-13 2013-14 2014-15 Number of people Hygiene Water Sanitation

Each year, ~ 4 million people exposed with hygiene intervention through WA programme

Bangladesh PIMS 2014: handwashing facilities in use, with soap of any kind (n=2,849 HHs): an example

Global Handwashing Day: breaking records in India, 2014

• 1. Cleanliness of child

food serving utensils using ash/soap

• 2. Handwashing with

soap before feeding child (by mother) and before eating (by child)

• 3. Proper storage of cooked

food in container with tight lid

• 4. Thorough re-heating
• f leftover/stored food

(Maintain re-heating temp at least at 700c)

Sequentially targeted 5 behaviours: 239 HHs with young children

• 5. Water

treatment

Behaviour change: an example from food hygiene trial

Delivery (D):

6 + 6

Nurture Disgust Affiliation Status

Innovation and creativity in behaviour change: changing settings

The script in peoples’ heads

Social norms belonging to that setting The physical infrastructu re and the

• bjects

1 43 2 2 10 20 30 40 50 60 70 Before (baseline) After (follow-up)

Mothers practicing all key behaviours (%)

Intervention (n=120) Control (n=119) 3 months intervention in intervention group

Effect size : 42% (difference of differences) (P = 0.020)*

% difference = 42%

Key food hygiene behaviours before and after intervention, by study group

% difference = 0%

Outcomes (intervention trial)

Source: Gautam, O et al, 2014

WA’s learning on hygiene promotion

• We need to move away from knowledge focused

approaches to innovative and creative approaches for creating sustained behaviour change, targeting emotional drivers (nurture, disgust, affiliation, status, comfort etc.), social marketing, and behavioural determinants and settings.

• Behaviours basically linked to social norms and settings
• Possible to alter multiple hygiene behaviours including

HWWS using emotional drivers and changing environment however: – Sustaining behaviours is a big challenge – Ensuring behavioural products is a challenge

WA’s learning on hygiene promotion cont...

• Being an expert on WASH does not make us

experts on designing innovative package therefore: –Formative research should inform the design process –Using creative process and team is imperative

• Hygiene promotion package need to be simple,

innovative and also feasible to contextualise for scalability!

• Monitoring behavioural outcomes in large scale

programming still needs improvement

Thank you!