hygiene promotion in emergencies

7/30/2019 Hygiene Promotion in Emergencies

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Hygiene Promotion inemergencies

Orientation package

December 2007(amended graph December 2008)


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Hygiene Improvement Framework


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Exercise 1 (15 minutes total)

In small groups provide examples of whatmight be included under enablingenvironment, hygiene promotion, and

access to hardware (10 minutes)

Each group calls out a few examples for each

Clarify and discuss using completed exampleon next slide


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Hygiene Promotion

Hygiene promotion is the planned, systematicattempt to enable people to take action to preventor mitigate water, sanitation, and hygiene relateddiseases.

It can also provide a practical way to facilitatecommunity participation and accountability inemergencies.

It involves ensuring that optimal use is made ofthe water, sanitation, and hygiene enabling

facilities that are provided.


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Terminology Hygiene education

The provision of education and/or information toencourage people to maintain good hygiene andprevent hygiene related disease.

It remains a part of Hygiene Promotion and is often most

effective when undertaken in a participatory orinteractive way.

Health promotion

The process of enabling people to increase control over,and to improve, their health.

The focus is on broader health issues rather than justthose associated with water and sanitation.


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Why do we need HygienePromotion?


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Transmission of diarrhoeal disease


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The priority focus of Hygiene Promotion in an

emergency is the prevention of diarrhoea

through:

The safe disposal of excreta

Effective handwashing

Reducing household drinking water contamination

Why do we need Hygiene Promotion?


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Data leads to some controversy, partly due to the difficulty of splitting impacts of interventions. For example:

* Hand-washing is not possible without a water supply, so hand-washing is in fact water supply and hand-washing

** Water quality at household will also have involved some hygiene promotion when setting up the household watertreatment processes

WASH interventions critical for child survivalSource: Meta-analysis by Fewtrell & Colford, 2004; Handwashing data

by Curtis & Cairncross, 2003, Updated sanitation data by Cairncross,

2008

44

42

39

36

23

0 10 20 30 40 50

Handwashing

Hygiene

Water Quality

Sanitation

Water Supply

% reduction in morbidity from diarrhoeal diseases


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Why do we need Hygiene Promotion?1. Optimal use of facilities

Facilities may not be used

or may be used in a way

that was not intended

Discussions with users can

ensure the best possible

design of facilities

Systems that ensure the

cleanliness and

maintenance of facilitiesneed to be set up


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Why do we need Hygiene Promotion?3. To monitor the acceptability of facilities

and impact on health


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Sphere & Hygiene PromotionStandard 1:

All facilities and resources

provided reflect the

vulnerabilities, needs, and

preferences of the affected

population.

Users are involved in the

management and

maintenance of hygienefacilities where appropriate.


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Team integration

Team goals and objectives

Joint work planning and systematic sharing of

information

Joint field visits and training where possible

Shared monitoring and reporting systems

Joint interagency meetings


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Hygiene Promotion is not justabout message disseminationand behaviour change


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Effective Hygiene Promotionemphasises:

action and dialogue


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Exercise 2 (20 minutes total)

In groups of 3, brainstorm some Hygiene

Promotion activities (10 minutes)

Discuss in plenary (10 minutes)


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Components of Hygiene Promotion

Communication

with

WASH

stakeholders

Selection

& distributionof hygiene

items

Community

participation

Monitoring

Use & maintenance of

facilities

Community

& individual action

HygienePromotion

inemergencies


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Hygiene Promotionactivities

Feedback to engineers on design and acceptability of facilities

Establish a voluntary system of cleaning and maintenance, or

train latrine attendants

Identify, organise, and train water and sanitation committees

(with engineers) and/or latrine attendants

Expected outcome:The toilets provided are used by men, women, and children incomfort and safety, and are kept clean.

Use & maintenance offacilities


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Hygiene Promotionactivities Consult with affected men, women, and children on design of

facilities, hygiene kits, and outreach system

Support community organisations, organisers, andcommunicators

Carry out a basic gender analysis and disaggregate

assessment data

Identify and respond to vulnerability (e.g. disabled people,

elderly people)

Example expected outcome:People with disabilities are identified and solutions are found to ensure theirimproved access to water and sanitation facilities.

Community participation


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Hygiene Promotionactivities Consult on content and acceptability

of items for hygiene kits and adviselogistics personnel

Ensure optimal use of hygiene items(e.g. potties, ITNs)

Example expected outcome:Men, women, and children use hygiene itemseffectively to improve hygiene

Selection &distribution ofhygiene Items


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Train outreach system of hygiene promoters to conduct

home visits

Organise community dramas and group activities withadults and children

Use available mass media e.g. radio to provideinformation on hygiene

Individual &community action


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Example expected outcome:75% of (men, women, and children)wash their hands with soap after

using the latrine, within 4 months

of starting the intervention

Individual &community action

Example expected outcome:Communities are mobilised todig drainage ditches around

their shelters

Photo: IRCPhoto: IFRC


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Collaborate with governmentministries and personnel

Train womens groups/

co-operatives, faith basedinstitutions, government

workers, and national NGOs

Example expected outcome:

Programming is designed to maximise the

use of local skills and capacities

Communicationwith WASH

stakeholders

Photo: IFRC


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Collect, analyse, and use data on:

Appropriate use of hygiene items

Optimal use of facilities

Community satisfaction with facilities

Monitoring

Photo: OXFAMExample expected outcome:

Systems are in place to ensure the regular collection of

information to identify whether the indicators for each standard

are being met e.g. in relation to disability (Example from Sphere)


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Project Cycle and Hygiene Promotion steps


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Hygiene Promotion first steps

Work in close liaison with other members of WASH team

including engineers/technicians/logisticians, andcoordinators.

Conduct rapid assessment and identify high risk practices anddisease burden

and positive practices and motivation for these. Explore community organisation and dynamics

including opinion leaders and influential men, women, andchildren.

Identify channels of communication (traditional and modern):

use a mix of directive and message based (mass media)

methods and interactive methods that encourage feedbackand discussion. Set objectives and indicators and collect baseline data

in conjunction with engineers and other team members. Monitor process and action taken

in conjunction with engineers and other team members.


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Communication approaches

Child to child


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PHAST?

Faster PHAST

CHAST


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Social marketing?

Campaigns

Peer education



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Communication methods

Radio Programmes

TV/Video

Leaflets

Posters/Notice boards


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Hygiene Promotion systems in emergencies

Structure will depend on context. Alternatives are: Community Health Clubsor Water and Sanitation Committees

Sphere recommends at least 2 outreach workers per 1,000 population and

WHO 1:1000


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Participation and Accountability


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Participation Ladder

Empowerment

Information

Partnership

Consultation

Involvement


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Disaggregation of data

0

20

40

60

No. of cases

Sex

Sex Distribution

No. of cases 34 58

M F

Sex distribution of cholera cases,Kiryandongo Refugee Camp, Masindi, 2002 - IRC


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Activities to promote participation

Listen to men and women separately and analyse theirdifferent perspectives and needs

Identify those who might be vulnerable (e.g. women,young children, elderly, those with disabilities, or minorityor excluded groups) and ensure access to facilities,information, and education

Feed back information to those affected (e.g. from

surveys or meetings)

When possible, allow people to set their own objectivesfor action and to determine the success of the

intervention


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Improving accountability

Facilitating participation

Monitoring intervention includingsatisfaction and acceptability and impact on

health

Link between those affected and other actors


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Exercise 3: 15 minutes

In small groups consider what you can do in

this context to ensure:

1. that women, men, and children participatein the WASH emergency response

2. that WASH initiatives are accountable to theaffected community


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Practical accountability

Feed back concerns of the affectedcommunity and advocate for these to be

addressed

Ensure men and women are aware of theirrights and entitlements (e.g. with regard to

hygiene kits)

Ensure monitoring system is in place and thatit is used to inform future activities

Monitor satisfaction and participation

hygiene promotion in emergencies

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