Preventing sanitation failure by using evidence-based behaviour change

Mass media campaign with loudspeaker rickshaw, Bangladesh. Photo: Eawag

Evidenced-based methods are more cost effective than traditional NGO awareness raising approaches to ensure sustained behaviour change in the WASH sector, says environmental psychologist Prof. Hans-Joachim Mosler.

Prof. Mosler

Two of his presentations on evidence-based behaviour change are now available online.  An accompanying guideline for behaviour change [1] was published in June 2012.

Mosler begins his first presentation with examples of failed sanitation and water projects. What they have in common is that they focus on hardware and neglect behaviour change. In one striking study, the construction of new school latrines actually increased health risks among girls because hygiene behaviour did not improve [2].

Behavioral Determinants of Handwashing with Soap in Senegal and Peru: Emergent Learning

A new Water and Sanitation Program (WSP) Learning Note found that beliefs and ease of access to soap and water were correlated with handwashing with soap behaviors for given proxy measures among mothers and caretakers in Peru and Senegal.

“Behavioral Determinants of Handwashing with Soap Among Mothers and Caretakers: Emergent Learning from Senegal and Peru,” is based on survey data from nearly 3,500 households in Peru and 1,500 households in Senegal. This data was analyzed using FOAM, a conceptual framework developed by WSP to help identify factors that might facilitate or impeded handwashing with soap practices at critical times.

The analysis revealed that the impact of different determinants varies depending on the chosen proxy measure, such as the presence of a handwashing station or its distance from kitchen or latrine facilities. Given this variability, the Learning Note found that program managers must clearly define the exact behavior they seek to improve before choosing which determinant to focus on in their formative research.

Research-Based Campaign Messaging is Critical for Sustaining Handwashing Behavior Change

Using data from formative research to focus messaging on mothers’ aspirations for their children and fine-tuning activities based on feedback from the field and household survey data have been key to developing and implementing a handwashing with soap behavior change program in Vietnam.

A new Learning Note, Vietnam: A Handwashing Behavior Change Journey for the Caretakers’ Program published by the Water and Sanitation Program (WSP), describes the steps that were taken to design, implement, and monitor the program to aid program managers in developing other handwashing and hygiene promotion efforts.

Working closely with the Woman’s Union, the program’s activities in Vietnam reached 540 communes in 10 provinces. The project also trained more than 15,000 community motivators who reached more than 1.76 million women through interpersonal communications activities. As the Learning Note reports, these activities evolved over time based on information from the monitoring systems.

“As the target audiences move beyond knowledge to intention to handwash with soap, behavior change messages must also be modified,” the report found, adding that as the project progressed, opportunities arose to “fine-tune the interpersonal communications activities based on feedback from the field and from the household monitoring data.”

Introducing SaniFOAM : a framework to analyze sanitation behaviors

Devine, J. (2009). Introducing SaniFOAM : a framework to analyze sanitation behaviors to design effective sanitation programs. (Learning to scale up. Working paper). Washington, DC, USA, Water and Sanitation Program. 28 p.

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SaniFOAM is a conceptual behaviour change framework that can be used both in community-led and in sanitation marketing approaches. It is designed to help program managers and implementers to promote sanitation at all stages of their interventions, from program design through implementation to monitoring and evaluation.

The paper describes the four elements of the framework and provides examples from formative research findings and field-based experiences.

The elements of SaniFOAM are:

F for Focus: What are the desired sanitation behaviors, and who is the target population?
O for Opportunity: Does the individual have the chance to perform the behavior?
A for Ability: Is the individual capable of performing it?
M for Motivation: Does the individual want to perform it?

SaniFOAM is one of the tools being developed in the Global Scaling Up Sanitation Project, implemented by the Water and Sanitation Program (WSP). The project is currently applying SaniFOAM in three countries: Tanzania, Indonesia and India. Most notably, in East Java, Indonesia, the SaniFOAM framework has been used to design qualitative and quantitative surveys, develop communication materials supporting community-led efforts aimed at eradicating open defecation and design a strategy aimed at strengthening the supply of sanitation products and services.

India: Going Beyond Sanitation in Andhra Pradesh

What started as a campaign to improve rural sanitation in Andhra Pradesh, has galvanized communities to address through collective behavior change a broadening range of issues, from planting tress to improved management of disposed plastics.

Andhra Pradesh has benefited from both the national Total Sanitation Campaign and the Nirmal Gram Puraskar (clean village award) program [...], but the most impressive progress has come over the past year, after the state adopted its own state awards program for sanitation, the Shubhram Awards for cleanliness:

Read more: WSP Access, Aug 2008