Clean Hands, Better Health. Om Prasad Gautam, PhD, MPH, MA Technical Support Manager Hygiene

Transcription

1 Clean Hands, Better Health Om Prasad Gautam, PhD, MPH, MA Technical Support Manager Hygiene

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

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

4 Improve hygiene behaviours Hands may not be washed Food continue to be polluted WA understands that unless the benefits of good hygiene is fully realised and ingrained as a social norm Toilets may not be used Dignity will be compromised Water continue to be polluted

5 Target settings for handwashing Households/communities Schools Policy settings Health care

6 Target groups My baby has worms. She often 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

7 Design Hygiene Intervention Assessment and or Formative Research 6. Financing 1. Hygiene behaviours / practices 5. Hygiene policy / advocacy 2. Presence of Institutional mechanism 4. Technical Sustainability Programme design, implementation & sustainability 3. Environmental Determinants Deliver and monitoring Evaluate (baseline, follow-up, sustainability assessment)

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

9 WaterAid and partners use multiple approaches to promote handwashing behaviours

10 Child-to-child approaches

11 Child-to-child: school curriculum development

12 Group events/mothers group events Social drama

13 Handwashing facilities

14 Puppet shows

15

16 Cultural events and theatre

17 Handwashing demonstration

18 Using social and commercial marketing techniques

19 Hygiene promotion through routine immunisation Fan Mirror Bib

20 Number of people WASH new users by year (n=26 CPs) 6,000,000 5,000,000 4,000,000 3,000,000 2,000,000 Each year, ~ 4 million people exposed with hygiene intervention through WA programme 2,144,921 1,911,135 1,673,410 3,014,060 2,799,606 5,136,064 1,873,665 1,918,801 3,067,330 1,000, Hygiene Water Sanitation

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

22 Global Handwashing Day: breaking records in India, 2014

23 Behaviour change: an example from food hygiene trial 5. Water treatment 1. Cleanliness of child food serving utensils using ash/soap Sequentially targeted 5 behaviours: 239 HHs with young children 2. Handwashing with soap before feeding child (by mother) and before eating (by child) 4. Thorough re-heating of leftover/stored food (Maintain re-heating temp 0 3. Proper storage of cooked food in container with tight lid

24 Nurture Disgust Affiliation Status Delivery (D): 6 + 6

25 Innovation and creativity in behaviour change: changing settings The script in peoples heads The physical infrastructu re and the objects Social norms belonging to that setting

26 Mothers practicing all key behaviours (%) 70 Outcomes (intervention trial) Intervention (n=120) Control (n=119) months intervention in intervention group 43 % difference = 42% Before (baseline) After (follow-up) Effect size : 42% (difference of differences) (P = 0.020)* % difference = 0% Key food hygiene behaviours before and after intervention, by study group Source: Gautam, O et al, 2014

27 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

28 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

29 Thank you!