Hygiene Promotion

This Thematic Overview Paper (TOP) covers the the topic of hygiene promotion which includes how to:

• reduce the main risky hygiene practices and conditions for women, children and men - in a measurable way, to a significant level, in a pre-set period and within available resources.
• provide alternative approaches to hygiene promotion programmes that have a "better chance of success." Because individual programmes have limited impact, there are pointers on how to spread the hygiene promotion messages more widely.
• monitor and evaluate hygiene promotion initiatives.

According to the authors, the focus of hygiene promotion should be on "changing key behaviours. These include handwashing after defecation and before handling food, use of latrines, and keeping water free from faecal contamination."

The report notes that educating the intended audience about hygiene is not necessarily effective because health benefits are not the motivating reason for people to improve their hygiene. "There is thus the paradox that for the quickest and widest adoption of good hygiene practices it is often more cost-effective to rely on social ambitions rather than health arguments to motivate people to adopt better hygiene…"

"Different transmission patterns for different diseases mean that improvements may depend on large numbers of people changing a wide range of risky behaviours and conditions." The report states "baseline research at the community level is important to determine what the key behaviours are and for determining how to accomplish change and if change has occurred…"

Mass campaigns can be helpful, according to the authors, "if the messages reach, and meet the interests and means of, the chosen audience segments (e.g. poor women and men in different age groups)." One issue the report raises is that some hygiene promotion programmes consist only of disseminating health information material. Campaigns include the use of printed materials such as "brochures, pamphlets and posters or broadcast via the press, radio, television, folk theatre groups and wall paintings." The report indicates that the "costs of such campaigns are relatively high when balanced against their effects at the community level..." In terms of reaching people, "poor people in general, and poor women in particular, have the lowest levels of literacy, so printed materials do not reach them. They do have increasing access to television, but the programmes then need to be carefully timed to reach the different groups and be targeted to their interests and resources. Radio is a medium with a wide approach, but transistor radios are often owned by the men in the family who may take them to their work…."

The paper also mentions that school hygiene education is a key part of hygiene promotion and that children are powerful agents of change. A separate TOP covers the subject of school sanitation and hygiene education including linkages to home improvements and better public hygiene.

The paper asserts "there is no disputing the evidence that the greatest health impacts come from a package of measures that combine hygiene promotion with appropriate improvements to water and sanitation services."

In the paper, alternatives for encouraging wide replication of good hygiene practices are provided. A number of case studies are offered and are organised by region. Following them is an overview of participatory methods, toolkits and resources.

Click here for the paper in PDF format.