Transcript Hygiene & Sanitation Promotion WCAR Programme Communication Network Meeting April 2008 WASH interventions Water Supply Sanitation Hygiene promotion Hand washing Safe disposal of child feces HWTS WASH in Schools WASH in Emergencies.

Hygiene &
Sanitation
Promotion
WCAR Programme
Communication
Network Meeting
April 2008
WASH interventions
Water Supply
Sanitation
Hygiene promotion
Hand washing
Safe disposal of child feces
HWTS
WASH in Schools
WASH in Emergencies
10 million children U5 die each year
Poor hygiene, lack of
access to sanitation
and unsafe drinking
water together
contribute to about
88% of diarrhoea
deaths
Malaria
8%
Measles 4%
Diarrhoea
17%
HIV/AIDS
3%
Pneumonia
19%
Injuries, 3%
>50%
Attributable to
Undernutrition
Other, 10%
Neonatal
37%
Causes of Mortality among under-five Children
Disease & disability
4 billion cases of diarrhoea each year
10% of the developing world suffer from
intestinal worm infections
6 million people are blind from
trachoma
200 million people in the world are
infected with schistosomiasis
Diarrhoea Risk Reduction
Reduction in diarrhea morbidity (%)
70
Previous reviews
Fewtrell et al. (2005)
60
50
40
30
20
10
0
(a) Sanitation
(b) Water
availability
(c) Water
quality
(d) Hygiene
promotion
Previous reviews:
a–d
Esrey SA et al. (1991) Bull WHO 69 (5): 609-621
e
Curtis V, Cairncross S (2003) Lancet Inf Dis 3: 275-281.
Fewtrell L et al. (2005) Lancet Infect Dis 5(1): 42-52.
(e) Hand
washing
Severe and moderate stunting could be reduced by 39%.
Improved hygiene
behaviours would
decrease the risk
of stunting in one in
three children who
are already
vulnerable
Without improved
hygiene behaviours
four in ten children
will not reach their
full educational
potential
 Maintaining a
healthy environment
through hygiene
improvements is
essential to safe
guarding the health
and quality of life
of people living with
HIV/AIDS.
 AHI – hand washing
one of the four key
messages
Evidence Base – Quick Wins
Hand Washing – Correct hand washing
at critical times can reduce diarrhoea by
42 -47%.Children Under 15 - 53% lower
incidence of diarrhoea.
New evidence shows that it can also
reduce ARI’s by over by 6-44% (Lower
risk by 50%)
Evidence Base – Quick Wins
Handwashing is cost effective, HW
campaigns avert one DALY per
US$3.35 spent. Which places the costeffectiveness of hand washing at the top
of child survival interventions
MBB – economic data, Hand washing
$0.39 per person
Cost effectiveness
Interventions against diarrhoeal disease
Cost-effectiveness
ratio (US$ per DALY
averted)
Cholera immunizations
1,658 to 8,274
Rotavirus immunizations
1,402 to 8,357
Measles immunization
257 to 4,565
Oral rehydration therapy
132 to 2,570
Breastfeeding promotion programs
527 to 2,001
Latrine construction and promotion
≤270.00
House connection water supply
223
Hand pump or stand post
94
Water sector regulation and advocacy
47
Latrine promotion
11.15
Hygiene promotion (including hand washing)
3.35
Source: Disease Control Priorities in Developing Countries, 2nd edition
2006 (www.dcp2.org) – Chapter 41
It’s all about Partnership . . .
.
 National and local Government structures
 NGO’s, CBO’s, FBO’s
 Religious & Community leaders
 Development Partners & Donors
 Media
 Private Sector
 Voluntary Groups & individuals
 One common logo – joint ownership
Advocacy and Promotion . .
..
Advocacy with decision makers,
leaders, donors, private sector, leaders
and the media.
Promotion at community, school,
household and individual levels
Common Messages . . . .
Avoid different and sometimes
conflicting messages
Simple practical messages that
everyone can use
One theme to maximise impact –
handwashing, sanitation, water quality,
etc.
Build on existing knowledge & practices
RESOURCES
Recruitment
of mass
Human
media, press
Financial
events.
Creation,
Existing
printing of
dissemination
promotional
mechanisms
materials,
MoH, MoE, MoWR, Recruitment,
NGO’s, FBO’s
activation &
participation
Regional Health,
of NGO’s,
Water & Education
FBOs,CBOs,
Bureaus
schools, &
Private Sector
community
leaders
WASH committees
INPUTS
ACTIVITIES
Mass Media
TV, Radio, print
Interpersonal
Communication
House to house
promotion with
decision makers,
caretakers &
children
Community
Mobilisation
Improve
knowledge
of 4 critical
handwashing
moments
among
caretakers
and children
Community,
religious &
educational
promotional events
OUTPUTS
OUTCOMES
CLTS/Total Sanitation
Open Defecation Free Communities
Community based process
Demand Driven
Technology choice secondary
Social change – pride and dignity
Community managed
CLTS/Total Sanitation
Asia – Cambodia, Bangladesh, India
Africa – Ethiopia, Zambia, Malawi,
Sierra Leone (Kaka free villages)
America’s – Bolivia
In total approximately 17 countries
SLTS – School Led Total Sanitation in
Pakistan
Dare to think differently. . .
Meet Captain Bubbles
PPPHW (www.globalhandwashing.org)
Concept Note available
Global level, the initiative seeks to raise the profile of
handwashing and created sustained interest in public and
private organizations.
Country level, the PPPHW advocates for, and assists in the
planning and implementing of large-scale country
handwashing programs. While programs tend vary with local
conditions, all share a common approach:
 Researching consumer needs to find out about handwashing
habits, barriers and drivers of behavior change, and the best
ways to communicate to the target audience;
 Designing appropriate and appealing messages;
 Implementing a promotion program making use of all suitable
channels, whether through outreach workers, citizen
networks, special events, soap distributors, schools, or mass
media;
 Measuring and evaluating results.
Private Sector
Soap Manafacturers/detergent makers
Unilever, P & G, Colgate, etc
Example: Unilever
Global MoU, Country LoA’s
In Safe Hands
Project Champion
CHAMPION
Our goal*
To make a contribution to MDG4 by promoting at
scale the essential link between hand washing with
soap and the health of Under 5’s by creating
engaging ways for school children to:
a)Influence behaviour change among
mothers/caregivers and siblings
b)Wash their own hands with soap at critical times.
* Taken from the CHARTER document agreed
between Unicef & Unilever /Lifebuoy in 2007
Our Beliefs
Getting poorer households across the
world to hand wash with soap is more
alike as a challenge than it is different.
Creating a program from scratch in each new
country (as is currently often done) wastes
valuable resource.
School children and schools – one of the few
common, stable and valued channels of influence
within poor rural and urban communities in
developing countries – can significantly influence
behaviour at home.
Program Development
Working in Africa (Uganda) & Asia (TBC)…
1. Scoping
2. Research
•
•
•
•
•
Clarify Task
Mine info &
knowledge
globally
Develop
hypotheses
•
2 countries
Experimental
& exploratory
High core
team
involvement
3. Insight &
Creativity
4. Programme
Design
•
•
•
•
Insight work
Ideas
Roadshow
Selective
testing
Involve
agencies &
experts as
necessary
The final program must work: at scale; across
continents; where kids have little say;
predominately through primary schools & primary
school children.
Current Areas of Interest...
•
•
•
•
Social Norms theory
Finding a unifying insight (i.e. attendance)
Grossology + Disgust
Identifying key role kids can play (energy,
channel, conscience, reminder, etc)
• ‘Things’ that change behaviour
• And more…
POP Intervention
Make Hands Happy
International Year of Sanitation
A once-off opportunity which we should seize!
UN Water – Task force on sanitation led by
UNICEF
Common messages and materials
Communication strategy – for all aspects
Matrix of interventions and activities
Increased funding
Advocacy
Focus on change not facilities
Useful Sites
Hygienecentral.org
EHP/HIP Website
CDC
WEDC – information notes
WELL
HWTSS
www.who.int
 Household Water Treatment and safe storage
 Waterguard – Chlorine based soln
 Pur/Watermakers
 Sodis
 Filters
 Social Marketing/product based
 PSI, CDC, and network
WASH in Schools
[email protected]
Global Network and forum
Working with Children on key
behaviours
Evidence base
Evaluations
WSSCC – It’s the big issue
www.wsscc.org
Water Supply and Sanitation
Collaborative Council
Advocacy
WASH Coordinators
WASH Campaigns/Movements
Access to
Services
Hygiene
Promotion
Hygiene Improvement
Diarrheal Disease
Reduction
Enabling Environments
Hygiene
Awareness
and
Promotion
• Behavioural & social
Change & Skills
• Family Mobilisation
• Social Marketing
• Community
Participation in Problem
Detection & Solutions
(TripleA)
Hygiene
Improvement
Framework
Evolution of Interventions:
from Pumps to Prevention
 Hardware focus - engineering approach
Sustainability focus - institutions,
policies, cost recovery, community
participation, private-sector involvement
Health impact focus - Address
improving hygiene behaviors as the key
to health improvement
Communicating for WASH
Behavioural Change
Social Change
Social Marketing