Hygiene Promotion in Emergencies
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Transcript of 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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Hygiene Promotionactivities
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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Hygiene Promotionactivities
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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Hygiene Promotionactivities
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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Hygiene Promotionactivities
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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Communication approaches
PHAST?
Faster PHAST
CHAST
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Social marketing?
Campaigns
Peer education
Communication approaches
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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