Category Archives: Hygiene Promotion

Learning, progress and innovation: Sanitation and hygiene promotion in Madagascar

Learn how the Global Sanitation Fund-supported programme in Madagascar is promoting sustainability and achieving strong sanitation and hygiene results trough a cycle of learning, progress and innovation.

Download the complete case study or explore the sections below:

The national context

Photo: Members of a local sanitation and hygiene advocacy group in the fokontany of Anjalazala celebrate achieving open defecation free status. Credit: FAA/Nirina Roméo Andriamparany

Photo: Members of a local sanitation and hygiene advocacy group in the fokontany of Anjalazala celebrate achieving open defecation free status. Credit: FAA/Nirina Roméo Andriamparany

The latest report from the Joint Monitoring Programme of the United Nations Children’s Fund and World Health Organization highlights revealing statistics on Madagascar’s sanitation and hygiene situation. Approximately 12 percent of the country’s population have access to improved sanitation, while 18 percent have access to shared sanitation that is unimproved, and 30 percent have access to other types of unimproved sanitation. Furthermore, 40 percent defecate in the open. Ensuring improved sanitation and hygiene for all remains a major challenge in the country, but innovations from local partners supported by the Global Sanitation Fund (GSF) are vigorously helping to transform this situation.
Learn more

The CLTS journey

Photo: ‘Triggering’ children in the commune of Mangarano, using the open defecation mapping tool. Credit: FAA/Fano Randriamanantsoa

Photo: ‘Triggering’ children in the commune of Mangarano, using the open defecation mapping tool. Credit: FAA/Fano Randriamanantsoa

In rural Madagascar, CLTS is the preferred approach for eliminating open defecation, and these actions also drive overall improvements in sanitation and hygiene. CLTS was introduced in the country in 2008, following its success in Asia. The crux of the approach lies in creating an enabling environment in which communities become self-reliant and improve their own sanitation and hygiene situation without external help.

Video: CLTS ‘triggering in action

CLTS focuses on igniting change in sanitation and hygiene behavior within whole communities, rather than constructing toilets through subsidies. During this social awakening, or ‘triggering’ process in Madagascar, the community looks for visible faeces in their environment. When people realize they are eating faeces this provokes disgust, shame and impacts on dignity. The community then makes and immediate decision to end open defecation. These steps are highlighted in the above video.
Learn more

Innovations in sanitation and hygiene behaviour change methods
As the first GSF programme, the Fonds d’Appui pour l’Assainissement (FAA) was the testing ground for various approaches based on the essence of CLTS, which helped to drive the programme’s learning and sharing culture. Sub-grantees have utilized a range of approaches within local communities, sharing their challenges and success with the larger FAA team. Through FAA’s strong learning and sharing system, many of these approaches have been evaluated for their potential to be implemented on a larger scale, and some have become best practices, both within and outside of Madagascar. This case study highlights three best practice approaches evaluated and utilized by the FAA programme: Follow-up MANDONA, local and institutional governance and sanitation marketing.

Follow-up MANDONA
Mandona-visual
Inspired by CLTS triggering approaches, Follow-up MANDONA is aimed at helping communities speed up their achievement of open defecation free status and initiate the development of local governance mechanisms for sustainability.
Learn more

Read the full article on the WSSCC website.

WASHplus Weekly: Focus on Global Handwashing Day 2015

Issue 209 | Oct. 9, 2015 | Focus on Global Handwashing Day 2015

Global Handwashing Day occurs each year on October 15. It is a global advocacy day dedicated to increasing awareness and understanding about the importance of handwashing with soap as an effective and affordable way to prevent diseases and save lives. This issue contains links to handwashing resources from WASHplus, the Global-Public-Private Partnership for Handwashing, recent studies, reports, and videos.  Blue-Raise-a-Hand-300x300

RESOURCES

Global Public-Private Partnership for Handwashing (PPPHW)
This coalition of international stakeholders works explicitly to promote handwashing with soap and recognize hygiene as a pillar of international development and public health. Just a few of the partnership’s resources include the PPPHW website with links to webinars, fact sheets, andmember organizations. Also the Global Handwashing Day Social Media Toolkit features sample messages, blog ideas, and resources to help celebrants and handwashing champions spread the word about Global Handwashing Day.

WASHplus RESOURCES

Small Doable Actions: A Feasible Approach to Behavior Change Learning Brief, 2015. Link
A small doable action is a behavior that, when practiced consistently and correctly, will lead to personal and public health improvement. It is considered feasible by the householder, from HIS/HER point of view, considering the current practice, the available resources, and the particular social context. This brief takes a look at how WASHplus has applied this approach to a range of activities—handwashing, water treatment, improved sanitation, menstrual hygiene management, and food hygiene.

Handwashing and the Science of Habit, 2014. Webinar
This webinar features panelists David Neal, Catalyst Behavioral Sciences; The University of Miami; Jelena Vujcic, Catalyst Behavioral Sciences; The University of Buffalo; Orlando Hernandez, WASHplus, FHI360 and Wendy Wood, The University of Southern California.

Continue reading

Boosting dialogue on sanitation and hygiene behaviour change and sustainability: WSSCC and SuSanA launch online learning event

The WSSCC Community of Practice on Sanitation and Hygiene in Developing Countries (CoP) and the global Sustainable Sanitation Alliance (SuSanA) launched an online learning event today on the topic, ‘Sanitation and hygiene behaviour change programming and sustainability: habit formation, slippage, and the need for long-term programming’. The learning event runs for three weeks from 22 September to 12 October on both the WSSCC CoP and SuSanA online discussion forum. People interested in the topic are encouraged to join and participate in the learning event.

Both platforms have over 5,000 members each working in water, sanitation and hygiene (WASH) and other related sectors. The learning event is therefore an opportunity to bring together these two global communities to share learning and ideas, identify best practice and explore links between research and practice on behaviour change. This is the first time the two networks have come together to host an online collaborative learning event.

The learning event is taking place simultaneously on both platforms, with a coordinator ensuring that content is shared across both communities. Discussions will look at a number of key issues relating to sanitation and hygiene behaviour change programming and sustainability. The main topic for discussion is divided into three inter-linked sub-topics, to further explore how behaviour change can be better understood and improved to ensure health and WASH outcomes are sustained. The sub-topics are:

  • Programming for scale, including the following key questions: What are some examples of successful scale-up? How did these models address the issues of inclusion and equity? In the cases of successful scale-up, were programmes initiated and sustained by governmental or non-governmental actors?  What is the role of the private sector in implementing sanitation at scale?
  • Sustainability for behaviour change, including the following key questions: How can behaviour change become systematized and sustained? What are the behavioural determinants and behaviour change techniques we should be aware of? What constitutes an enabling environment for sustainability?
  • Open defecation free (ODF) and slippage, including the following key questions: How is ODF defined? What are some of the local strategies in place to strengthen sustainability of ODF – within communities and beyond? What are the patterns of slippage? How and when can slippage be monitored in large-scale programmes? Are there more innovative ways looking at not only the physically visible aspects – what about the health impact and the perceptions and views of communities?

WASH sector experts leading the discussion include, among others:

  • Tracey Keatman, Senior Associate, Partnerships in Practice (learning event coordinator)
  • Suvojit Chattopadhyay, Consultant, focused on monitoring and evaluation
  • Poy Dy, Project Coordinator, Santi Sena (a Global Sanitation Fund (GSF) sub-grantee in Cambodia)
  • CLTS Knowledge Hub, Institute of Development Studies, University of Sussex
  • Clara Rudholm, Senior Programme Officer, Global Sanitation Fund
  • Carolien van der Voorden, Senior Programme Officer, Global Sanitation Fund
  • Matilda Jerneck, Programme Officer, Global Sanitation Fund

Weekly summaries of discussions will be posted on both the WSSCC CoP and SuSanA forum. In addition, a summary report of each topic, along with an overview of all issues generated from the discussions, will be available in late October on both platforms.

To join and participate in the discussions, visit the WSSCC CoP and SuSanA forum.

Questions can be posted directly on the platforms or sent to the following addresses: shcopadmin@wsscc.org and info@susana.org.

SuSanA and WSSCC online thematic discussion: Sanitation and hygiene behaviour change programming and sustainability

The Water Supply and Sanitation Collaborative Council Community of Practice on Sanitation and Hygiene in Developing Countries (WSSCC CoP) and the global Sustainable Sanitation Alliance (SuSanA) are holding a joint 3-week thematic discussion on sanitation and hygiene behaviour change programming and sustainability starting on 22nd September:

Sanitation and hygiene behaviour change programming and sustainability: habit formation, slippage, and the need for long-term programming

The thematic discussion will take place concurrently on both platforms; with a coordinator ensuring that content is shared across both communities. The discussion will be split into three inter-linked sub-themes to further explore how behaviour change can be better understood and improved to ensure health and WASH outcomes are sustained. Thematic experts will frame and prompt debates each week on:

22-28 September – Theme 1: Programming for scale – What are some examples of successful scale-up? How did these models address the issues of inclusion and equity? In the cases of successful scale-up, were programmes initiated and sustained by governmental or non-governmental actors? What is the role of the private sector in implementing sanitation at scale?

28 Sep – 05 Oct – Theme 2: Sustainability for behaviour change – How can behaviour change become systematised and sustained? What are the behavioural determinants and behaviour change techniques we should be aware of? What constitutes an enabling environment for sustainability?

05-12 October – Theme 3: ODF and slippage – How is ODF defined? What are some of the local strategies in place to strengthen sustainability of ODF – within communities and beyond? What are the patterns of slippage? How and when can slippage be monitored in large-scale programmes? Are there more innovative ways looking at not only the physically visible aspects – what about the health impact and the perceptions and views of communities?

Join us for the discussion with some of the following thematic experts:

  • Tracey Keatman, Partnerships in Practice (Coordinator)
  • Suvojit Chattopadhyay, Consultant, focused on Monitoring and Evaluation
  • Mr. Poy Dy, Project Coordinator of Santi Sena (SSO), GSF sub-grantee, Cambodia
  • CLTS Knowledge Hub, Institute of Development Studies, University of Sussex
  • Clara Rudholm, Senior Programme Officer, Global Sanitation Fund
  • Carolien van der Voorden, Senior Programme Officer, Global Sanitation Fund
  • Matilda Jerneck, Programme Officer, Global Sanitation Fund

Weekly summaries of discussions will be posted on the SuSanA and CoP platforms as well as a synthesis report of overarching findings at the end.

To participate in the discussion, please join here:

SuSanA Forum: http://forum.susana.org/forum/categories/209-thematic-discussion-sanitation-and-hygiene-behaviour-change-programming-for-scale-and-sustainability

And

WSSCC CoP: https://www.linkedin.com/grp/home?gid=1238187 

We look forward to some constructive and in-depth discussions!

WHO strengthens focus on water, sanitation and hygiene to accelerate elimination of neglected tropical diseases

August 27, 2015 –  WHO strengthens focus on water, sanitation and hygiene to accelerate elimination of neglected tropical diseases | Source: World Health Organization

27 August 2015 –– The World Health Organization (WHO) today unveiled a global plan to better integrate water, sanitation and hygiene (WASH) services with four other public health interventions to accelerate progress in eliminating and eradicating neglected tropical diseases (NTDs) by 2020.

International Trachoma Initiative (ITI)

International Trachoma Initiative (ITI)

“Millions suffer from devastating WASH-related neglected tropical diseases – such as soil-transmitted helminthiasis, guinea-worm disease, trachoma and schistosomiasis – all of which affect mainly children” said Dr Maria Neira, WHO Director for Public Health, Environmental and Social Determinants of Health. “Solutions exist, such as access to safe water, managing human excreta, improving hygiene, and enhancing targeted environmental management. Such improvements not only lead to improved health, but also reduce poverty.”

Related links

Targeted water and sanitation interventions are expected to bolster ongoing efforts in tackling 16 out of the 17 NTDs, which affect more than 1 billion of the world’s poorest and most vulnerable populations.

Continue reading

Sept 23, 2015 – Creativity in Behavior Change Symposium

Whether it be washing hands with soap, driving sanitation demand, or purifying water, almost every area of public health requires behaviour change. The field of behaviour change is transforming.

There is a growing evidence base to suggest that traditional health education messages are insufficient to achieve sustained change and that more might be achieved by being more creative, for example by learning from product marketing, psychology and behavioural economics. logo

The ‘Creativity in Behaviour Change Symposium‘ will bring together behaviour change practitioners from academia, government and the private sector with the ambition of sparking an ongoing network of collaborators.

In addition to creative case studies and provocative discussions the event will feature interactive activities throughout the day, a ‘behaviour change cinema’ which will screen materials from creative projects from around the globe and there will be a ‘soap box’ where anyone can share their big ideas for the future of behaviour change.

For those who are not in the UK, all the sessions will also be filmed and available on our website at ehg.lshtm.ac.uk

The disgust box: a novel approach to illustrate water contamination with feces

Below are links to 5 Aug 2015 studies on digust, handwashing and maternal mortality, handwashing and NTDs, water quality awareness and breastfeeding and household characteristics and diarrhea.

The disgust box: a novel approach to illustrate water contamination with feces. Health & Science Bulletin, June 2015.

Link: http://goo.gl/3xDeen

Inadequate drinking water, sanitation and hand hygiene are responsible for approximately 800,000 deaths per year in low and middle-income countries. We evaluated the benefits of a behaviour change communication method to motivate water treatment practices in urban low income communities in Dhaka. We used a device called the ‘Disgust Box’ to provide a vivid demonstration of how piped water is contaminated with faeces to motivate people to chlorinate water. Most of the respondents were able to recall the demonstration at both four-month and one year qualitative assessments. At four months, the majority of participants stated that they still felt disgusted by the demonstration and mentioned it as a motivator for water chlorination. However, after one year, despite being able to recall the demonstration, disgust was no longer mentioned as a motivator to chlorinate water. The Disgust Box has the potential to be an effective communication method to motivate water treatment but additional research is necessary to establish a more sustainable approach to reinforce behaviour change.

Using Observational Data to Estimate the Effect of Hand Washing and Clean Delivery Kit Use by Birth Attendants on Maternal Deaths after Home Deliveries in Rural Bangladesh, India and Nepal. PLoS One, Aug 2015. Authors: Nadine Seward, et al.

Link: http://goo.gl/02uiRi

Our evidence suggests that hand washing in delivery is critical for maternal survival among home deliveries in rural South Asia, although the exact magnitude of this effect is uncertain due to inherent biases associated with observational data from low resource settings. Our findings indicating kit use does not improve maternal survival, suggests that the soap is not being used in all instances that kit use is being reported.

Assessment of water, sanitation, and hygiene practices and associated factors in a Buruli ulcer endemic district in Benin (West Africa). BMC Public Health, Aug 2015.

Link: http://goo.gl/CZvJPJ

BU is an important conditions in the district of Lalo with 917 new cases detected from 2006 to 2012. More than 49 % of the household surveyed used unimproved water sources for their daily needs. Only 8.7 % of the investigated household had improved sanitation facilities at home and 9.7 % had improved hygiene behavior. The type of housing as an indicator of the socioeconomic status, the permanent availability of soap and improved hygiene practices were identified as the main factors positively associated with improved sanitation status.

Continue reading