Julia Rosenbaum and Orlando Hernandez

Combining Collective and Individual Paths to Behavior Change?

GHPN BrownbagFebruary 16, 2012

Presenters

Orlando Hernandez

Julia Rosenbaum

Renny Seidel (intro)

This presentation

• What is a ‘collective behavior’?

• The program in Ethiopia

• Results

• Discussion

What is a ‘collective behavior’?

Examples of group/mass behaviors: are there any collective?

• Running for shelter during the rain

• Church attendance on Sunday

• Labor strikes

• Joining the Green Movement, joining the Tea Party

• Communal protection of fish sanctuaries in fishing villages

“Yo dude!!!”

Characteristics of ‘collective behavior’Schaefer: spontaneous

unstructured reaction to ambiguous situation unpredictable source of social change

Le Bon: abandonment of current responsibility, surrendering to contagious crowd emotions

Searle: ‘we intend’ vs ‘I intend’collective intentional behavior ≠ summation of

individual intentional behavior …..action which is neither conforming (actors follow prevailing norms) nor deviant

(actors violate those norms).

At scale Hygiene and Sanitation Improvement

in the Amhara Region of Ethiopia

through “Learning by Doing”

Start Changes at grassroots

The Districts

12 Step PathwayBroken into 3 phases

Plan

Mobilize and Act

Monitor & Evaluate

Learning by Doing Program in Amhara

Multi-Stakeholder Meeting identified Common Action Agenda – brought the Whole System to the Room @

Regional Behavior Change Strategy• including advocacy• strengthened household visits• community ignition and action• multiplying the message with communication and media• demonstration latrines and HW stations• increased access and affordability of products through private sector involvement

COMMUNITY-LED TOTAL BEHAVIOR CHANGE IN HYGIENE AND SANITATION

embedded in a national and regional process..• National Hygiene and Sanitation Strategy• National Protocol for Implementation of …

Built around Health Extension Programme,and carried out by HEWs

.. Among other actors…

Implementing a hybrid of …

• Systems Approach to Change – engaging the multiples

• (Community-led) Total Sanitation• Strengthened Home Visits Negotiation of

Improved Practices/MIKIKIR • Robust WASH Friendly Schools component

COMMUNITY-LED TOTAL BEHAVIOR CHANGE IN HYGIENE AND SANITATION

Systems-Approach Looks at the whole Involves multiple sectors, actions, options,

stakeholders Hygiene Improvement Framework

Considers hardware, promotion, institutional capacity

Behavior FIRST Focuses on consistent and correct PRACTICE of key

hygiene behaviors Prioritizes sustainability Coverage

Characteristics of an At Scale Effort

Community led Total Sanitation

Communities are “ignited”

Total coverage, each and every member of the community shall have toilet and stop open defecation.

Category Users of Latrine (%)

Prevalence of diarrhoea (%)

Open defecation prevalent villages

29 38

Almost open defecation-free villages

95 26

Open defecation-free villages 100 7

Source: Formative research by WSP-Knowledge Links for IEC Manual in Himachal Pradesh, 2005

Disgust

ShameFear

–Calculating the amount to feces produced (week, month and

annually, etc.) to illustrate the magnitude of the sanitation

problem.

–One ‘evacuation’ = 150 grams

–Number of evacuations a day

–Volume of feces per person/day

– Number of people in room

Shit calculation

– Volume of feces a day, a week, a year

–? WHERE DOES IT ALL GO????

Were we effective?

Did we achieve scale?

Did combining individual and collective action work?

Results

M&E Framework for Learning by Doing, Amhara

SO At scale of hygiene and sanitation in Amhara Region

Intermediate results

Partnerships to facilitate coordinated action at regional and district level fostered

Institutional capacity in public and civil society partners developed

Hygiene and sanitation program at woreda level expanded

Adoption of WASH practices at HH and institutional levels increased

Illustrative Indicators

# nat’l, reg., or district level policies, strategies, program or projects advanced through “learning by doing” initiative

% trainees mastering knowledge/skills for newly developed guidelines

# of targeted woredas that implemented WSRs

% households using improved sanitation facilities meeting minimum standards by woreda

# of woredas developing integrated annual plans with contributions form all partners

% annual budget spent by targeted woreda

% targeted woredas implementing integrated hygiene promotion actions to complement hardware investments

% households with hw supplies at hw stations

Pre- / Post- Stratified Random SampleHigh

(Focal)

High(Focal)

PREn=20

00

POSTN=13

78 No real controls

Medium(Direct)

Low(Indirect)

Low(GOE)

ETHIOPIAPractices: Access to Sanitation Facilities

Baseline-Endline Comparison: All Respondents

Dimensions Factors p Odds Ratio

InterventionCharacteristics

Community participated in walk of shame

.00 2.23

Household visited by health work to improve sanitation

.05 1.75

Intervention -related Perceptions

Having a latrine contributes to the community’s health

.00 2.6

Having a latrine contributes to the community’s development

.00 1.8

ALL of THESE …………………………………………….. >> 8.38

Predictors of Latrine OwnershipEndline

**Source: Amhara LBD Evaluation Report, USAID/HIP-WSP/WB-AF, November 2010

Presence of HW Stations at

Latrines

17%

16%

Accomplishments & Challenges5.8 million people in Amhara Regional State reached3.8 million more people stopped practicing open

defecation and now use a basic pit latrineChallenge is to improve the quality of these latrines to

acceptable standardsDevelop and integrate sanitation marketing strategiesFocus on promoting fixed handwashing stations (tippy

tap) at latrine and ‘commonly used’ placeModel being used as essential part of national scale

up…

Discussion