SUSTAINABLE HYGIENE

SWIFT conducted a number of hygiene-promotion activities in Kenya with the aim of changing behaviour; in particular, to encourage hand-washing with soap or a soap substitute.

Mass media campaigns

BBC Media Action partnered with local radio stations and supported them to produce public health broadcasts that are engaging and locally relevant.

Having conducted formative research across the Arid and Semi-Arid Lands (ASAL) counties and Nairobi’s informal settlements, BBC Media Action analysed the WASH information needs, levels of knowledge and existing attitudes and barriers to the adoption of improved hygiene behaviours among the target audiences.

BBC Media Action ‘mentors’ worked with six partner radio stations to build their capacity to incorporate WASH content in their programming; for example, by holding a production workshop at which they received training in producing WASH Public Service Announcements (PSAs). The radio stations include public-health messaging in the form of interviews, discussions, vox pops and news stories. You can hear some of the programmes that were produced here.

School health clubs and the ‘child-to-child’ approach

In rural areas of Turkana, Marsabit and Wajir counties, Oxfam, Concern and Practical Action supported hygiene promotion activities aimed at children through School Health Clubs.

These clubs use the Children’s Hygiene and Sanitation Training (CHAST) methodology endorsed by Kenya’s Ministry of Health. The approach involves interactive learning sessions with children that include puppet shows, role plays, poetry, games, songs and other creative ways of communicating hygiene messages.

SWIFT also trained teachers in Wajir in the ‘child-to-child’ approach, a similar method which facilitates children’s understanding of healthy behaviour and allows them to identify health priorities in a fun, challenging and interesting way.

‘Edutainment’ and the World Toilet Cup

When SWIFT partner Sanergy installs a Fresh Life Toilet in a school in Nairobi’s informal settlement of Mukuru, it provides a day of ‘edutainment’, a combination of education and entertainment, in collaboration with social impact organisation WASH United.

Activities include a giant board game, in which children roll a dice and pretend to wash their hands at the right moments to find the ‘Hand-washing Champion’, and a football-themed ‘World Toilet Cup’, which requires them to kick a brown ball into a ‘latrine’ (motto: ‘every poo needs a loo’).

Sanergy has also provided WASH training for teachers in 120 schools with Fresh Life Toilets.

Community Health Volunteers and Community-Led Total Sanitation

In Wajir and Turkana, Oxfam and Practical Action have trained Community Health Volunteers to conduct home visits to promote hygiene behaviours such as hand-washing (see the relevant sections on the Kenya page).

In the northern ASAL region, Oxfam, Concern and Practical Action have implemented the Community-Led Total Sanitation approach, which includes training community facilitators in hygiene promotion activities, and providing information, education and communication materials to trigger debate around health and hygiene messages (see ‘Increasing access to safe sanitation in Kenya‘).

SWIFT’s hygiene promotion activities were designed to achieve lasting behaviour change in different ways.

Its work to promote School Health Clubs and the child-to-child approach, as well as activities such as the ‘World Toilet Cup’, are based on the belief that children can be effective agents of change. Children are often responsible for caring for younger siblings, tending to animals, collecting water, and cleaning, and therefore have considerable potential to raise awareness about hygiene and achieve lasting behaviour change in both themselves and those around them.

BBC Media Action’s sustained mentoring work with local radio stations in Nairobi and the ASAL counties was designed to ensure that lasting skills were built to deliver relevant and effective health and hygiene promotion messages as part of engaging media content.

And by conducting hygiene promotion activities through the Community-Led Total Sanitation approach, SWIFT took advantage of the CLTS focus on behaviour and desire for collective change. CLTS aims to propel people into action and encourage innovation, mutual support and appropriate local solutions, thus leading to greater ownership and sustainability.

The VEA approach

In DRC, SWIFT partners Tearfund, HYFRO, YME Grands Lacs and AVUDS are continuing to implement hygiene promotion activities as part of the Villages et Écoles Assainis (Healthy Villages and Schools, or VEA) approach, a step-by-step process of village mobilisation (see ‘Increasing access to safe sanitation in DRC‘).

Among other things, SWIFT partners help the managing committees set up by villages to train ‘community motivators’ in hygiene awareness, and support the village to promote safe and culturally appropriate hygiene behaviours. Among the standards that must be met if ‘Healthy Village’ status is to be attained are that at least 60% of the population should wash their hands with soap or alternative cleanser before eating and after using the toilet, and at least 70% of households should understand routes of faecal-oral transmission of disease and how to avoid infection.

In semi-urban contexts, SWIFT is developing a new approach in some areas (see ‘Sustainable water in DRC‘ and ‘Sustainable sanitation in DRC‘), and is setting up Community Health Clubs in others (see below).

Community Health Clubs

In South Kivu, Tearfund worked with Africa AHEAD to set up Community Health Clubs (CHCs), which provide practical guidance to members on how to improve home hygiene and prevent most common diseases, as well as an opportunity for discussion, so the group can arrive at decisions together. The CHC approach has been implemented in semi-urban areas within the context of the VEA framework.

Membership of a CHC is voluntary, free and open to all, with between 50 and 100 people in each club. Members take part in weekly, two-hour training sessions on a number of health and hygiene promotion topics, such as the safe storage of drinking water, or making soap to ensure ready availability. Each week they are given practical assignments, such as digging a refuse pit, or making a dish rack to dry dishes off the ground. These are monitored, including through home visits, and members receive stamps and certificates for attending sessions and completing tasks.

Africa AHEAD trained CHC facilitators: people from target communities who have reading and writing skills and can help lead the clubs’ dialogue sessions.

SWIFT’s hygiene promotion activities in DRC are designed to be sustainable long after the programme has ended, because they empower people to take responsibility for their own health.

Community Health Clubs (CHCs) are both practical and participatory. Groups decide for themselves which homework they will do each week, choosing from around 50 recommended practices designed to ensure safe water, food, hygiene and sanitation, and support each other to complete their assignments through home visits. This ‘homework’ is monitored to ensure that real changes are made to households and hygiene practices.

Members enjoy attending CHC meetings and do so voluntarily because they gain knowledge that can help them prevent disease within their families – ranging from diarrhoea and cholera to malaria and Ebola, as well as skin and eye diseases. They receive social support from the group, and have fun during meetings.

Similarly, the VEA, or ‘Healthy Villages and Schools’ approach, and the new approach being developed for semi-urban contexts, have sustainability built in because they are community-driven. Villages must apply to take part in the process, and take responsibility for the changes needed to reach ‘healthy village’ status, including bringing about a change in hygiene behaviours.

In addition, a key step in ensuring the institutional sustainability of the process has been to facilitate the signing of agreements between implementing partners, community leaders and local government representatives, such as staff from local Health Zone offices in both rural and semi-urban areas.