Category Archives: Hygiene Promotion

Who Delivers without Water? A Multi Country Analysis of Water and Sanitation in the Childbirth Environment

Who Delivers without Water? A Multi Country Analysis of Water and Sanitation in the Childbirth Environment. PLoS One, Aug 2016.

Authors: Giorgia Gon, María Clara Restrepo-Méndez, et. al.

Background and Objectives – Hygiene during childbirth is essential to the health of mothers and newborns, irrespective of where birth takes place. This paper investigates the status of water and sanitation in both the home and facility childbirth environments, and for whom and where this is a more significant problem.

Methods – We used three datasets: a global dataset, with information on the home environment from 58 countries, and two datasets for each of four countries in Eastern Africa: a healthcare facility dataset, and a dataset that incorporated information on facilities and the home environment to create a comprehensive description of birth environments in those countries. We constructed indices of improved water, and improved water and sanitation combined (WATSAN), for the home and healthcare facilities. The Joint Monitoring Program was used to construct indices for household; we tailored them to the facility context–household and facility indices include different components. We described what proportion of women delivered in an environment with improved WATSAN. For those women who delivered at home, we calculated what proportion had improved WATSAN by socio-economic status, education and rural-urban status.

Results – Among women delivering at home (58 countries), coverage of improved WATSAN by region varied from 9% to 53%. Fewer than 15% of women who delivered at home in Sub-Saharan Africa, had access to water and sanitation infrastructure (range 0.1% to 37%). This was worse among the poorest, the less educated and those living in rural areas. In Eastern Africa, where we looked at both the home and facility childbirth environment, a third of women delivered in an environment with improved water in Uganda and Rwanda; whereas, 18% of women in Kenya and 7% in Tanzania delivered with improved water and sanitation. Across the four countries, less than half of the facility deliveries had improved water, or improved water and sanitation in the childbirth environment.

Conclusions – Access to water and sanitation during childbirth is poor across low and middle-income countries. Even when women travel to health facilities for childbirth, they are not guaranteed access to basic WATSAN infrastructure. These indicators should be measured routinely in order to inform improvements.

 

 

The Sustainable Sanitation Alliance (SuSanA) at the World Water Week 2016 in Stockholm

The World Water Week 2016 in Stockholm is lying ahead and the Sustainable Sanitation Alliance (SuSanA) will be Co-Convener of several exciting events related to WASH and Sustainable Sanitation. Moreover, the 22nd SuSanA Meeting (27th of August) as well as several SuSanA Working Group Meetings will take place during the SWWW. Make sure to take a look at the official SWWW SuSanA Flyer (link below) to find out more about the event topics and their schedule.

Apart from the events themselves the Sustainable Sanitation Alliance will be hosting an official SuSanA Booth (Booth No. 44) where you can have interesting conversations on the topic or simply read through some of the latest SuSanA publications.

For all people that are interested but not able to join the SWWW there will be a Live Stream of the SuSanA events as well as live Twitter updates using the hashtag #22susana

If you want to register for the SuSanA events at the SWWW you can find the registration link as well as more information here: http://www.susana.org/en/events/susana-meetings/2016/505-22nd-susana-meeting-stockholm

Lastly, if you have any questions or comments you can post them on the SuSanA Forum (after registration): http://forum.susana.org/forum/categories/232-susana-meetings/18372-22nd-susana-meeting-27-august-2016-and-susana-events-at-world-water-week-in-stockholm

SuSanA_Events_SWWW2016_Flyer

 

Nudge for good: How insights from behavioral economics can improve the world— and manipulate people

Nudge for good: How insights from behavioral economics can improve the world— and manipulate people | Source: World Bank Blog, Aug 16 2016 |

Richard H. Thaler is a world-renowned behavioral economist and professor of finance and psychology. Recently, he was interviewed by The Economist. The discussion covers some of the fundamental studies in the field, like “save more tomorrow” which encourages people to save more by signing up to increase their savings rate every year and auto-enrollment for pensions that have drastically increased employee participation in pension funds. thaler

Thaler also suggests, in the interview, that behavioral economics has the ability to influence human behavior for both good and bad.  He argues that much of what behavioral economics does is remove barriers.

The goal is not to change people but to make life easier, but that idea can be skewed by organizations or individuals looking to capitalize on the biases of people. Whenever he is asked to sign a copy of his book Nudge, he writes “nudge for good” which is a plea, he says, to improve the lives of people and avoid insidious behavior.

The list of ways companies nudge behavior is endless, and I would love to hear more examples from you all in the comments section. In the meantime here are a few- I’ll let you judge which ones “nudge for good”:

  • Waterborne diseases such as cholera cause widespread illness, especially among children, in developing countries without nation-wide water and sanitation networks. In Kenya, chlorine tablets are distributed by NGOs and other organizations, and people generally understand that the tablets disinfect their water, protecting them from disease. Nevertheless, usage rates are often low. Cost is not the barrier here, convenience is because routinely purifying water requires energy and attention. Michael Kremer of Harvard University and his colleagues found, through a series of randomized controlled trials conducted in Kenya, that providing chlorine as a concentrated liquid at prominently displayed dispensers at local water sources dramatically increase the rate of disinfection. The dispensers provided a visual reminder when and water was collected and made it easy to add the right does. Along with promotion by community members, this approach increased chlorine use by 53%. Thus, making it easier to disinfect water increased the rates at which tablets are used.

Read the complete article.

Penn project aims to stop open defecation by changing social norms

Penn project aims to stop open defecation by changing social norms | Source: Penn Current, July 21 2016 |

Cristina Bicchieri’s work is not for the faint of heart.

The Penn professor of philosophy, legal studies, and psychology looks at how social norms affect community behaviors. Recently, she has been studying open defecation and trying to shift what is acceptable in developing countries.

Bicchieri

Cristina Bicchieri, the S. J. Patterson Harvie Professor of Social Thought and Comparative Ethics in the School of Arts & Sciences.

This fall, through a new three-year grant from the Bill and Melinda Gates Foundation, her work will take her to India, a country where 48 percent of the population engages in this practice, according to UNICEF.

Open defecation is a well-established traditional practice in India, deeply ingrained from early childhood, UNICEF reports. This is partly because it is socially taboo to discuss sanitation, so few people do, and also because poverty means other life necessities get prioritized over toilets.

“It’s very unsanitary; it spreads diseases,” says Bicchieri, the S. J. Patterson Harvie Professor of Social Thought and Comparative Ethics in the School of Arts & Sciences.

Despite attempts by the Indian government to curb the problem with incentives to build latrines, the practice continues, polluting water and food. To better understand why, Bicchieri will conduct research in villages and cities in the states of Tamil Nadu and Bihar.

Continue reading

Sundara Fund: Attacking Hygiene Inequality Through Innovative Hand-Washing

Sundara Fund: Attacking Hygiene Inequality Through Innovative Hand-Washing | Source: Browngirl Magazine, July 8 2016 |

sundara-fund

[Photo Courtesy of Sundara Fund]

The impetus for launching Sundara was born back in 2013 when founder Erin Zaikis was working with organizations and schools fighting child trafficking in rural northern Thailand, on the border of Myanmar. During one school visit, she watched as teenage children entered and left the restroom without washing their hands.

Making the several-hour trek to the closest store that sold soap, she bought roughly 150 bars costing $30. “Cigarettes were much more expensive, but cigarettes were bought by almost everyone in the community…The problem did not lie in the cost of soap, but rather the education,” Zaikis says.

While conducting an impromptu hand-washing workshop at a school one day, she “watched in horror” as one child tried to bite the soap, some scratching it with their nails, and yet others smacking their faces with it—unsure of what to do.

Zaikis says, “Here I was, meeting children who had lived their whole lives without something I took for granted every single day of mine. Reeling from the inequality of this situation and feeling like no one else was putting attention on it, I decided I had to help.”

Read the complete article.

Nudging and Habit Change for Open Defecation: New Tactics from Behavioral Science

Nudging and Habit Change for Open Defecation: New Tactics from Behavioral Science, March 2016. 

Authors: David Neal, Ph.D. (Catalyst), Jelena Vujcic, M.P.H. (Catalyst), Rachel Burns Ph.D. (Catalyst), Wendy Wood, Ph.D. (University of Southern California) and Jacqueline Devine, MBA (World Bank, Water and Sanitation Program)

In this working paper, we draw on basic scientifc fndings from psychology, cognitive science, and behavioral economics to propose a framework of 8 System 1 Principles to support the initiation and maintenance of OD behavior change.

In doing so, we build from the general framework advanced in the World Bank Group’s (2015) World Development Report: Mind, Society, and Behavior, which emphasized three core insights from behavioral science, namely that people think (a) automatically, (b) socially and (c) using mental models that channel their decision-making.

 

Drivers of sustained hygiene behaviour change: A case study from mid-western Nepal

Drivers of sustained hygiene behaviour change: A case study from mid-western NepalSocial Science & Medicine, August 2016.

Authors: Celia McMichael, Priscilla Robinson

Behaviour change is central to the prevention of many population health problems, yet it is typically difficult to initiate and sustain. This paper reports on an evaluation of a water, sanitation and hygiene (WASH) intervention in mid-western Nepal, with particular focus on the drivers and barriers for handwashing with soap/ash and elimination of open defecation.

The research was conducted during October–November 2014, two and half years following the intervention’s end-point. Qualitative data were collected from the target community (n = 112) via group discussions, interviews and drawings/stories of ‘most significant change’. Households’ handwashing/water facilities and toilets were observed.

Analysis was informed by a model that highlights environmental, psychosocial and technological factors that shape hygiene behaviours across multiple levels, from the habitual to the structural (Dreibelbis et al. 2013). Findings indicate the intervention has supported development of new norms around hygiene behaviours.

Key drivers of sustained hygiene behaviour were habit formation, emotional drivers (e.g. disgust, affiliation), and collective action and civic pride; key constraints included water scarcity and socio-economic disadvantage. Identifying and responding to the drivers and constraints of hygiene behaviour change in specific contexts is critical to sustained behaviour change and population health impact.