Hygiene Promotion - IRC International Water and Sanitation Centre

3. Learning from experiences and research3.1 Lesson 1: Hygiene promotion works best when combined withparticipatory improvements in water supply and sanitationservicesIt can be argued that hygiene promotion is most important when people lack good waterand sanitation services. Certainly that is when health risks are great, especially when thereis not enough water easily available for personal and domestic hygiene and excreta are leftin the open, in particularly in and near crowded areas and in humid conditions.People may be able to find enough water to wash their hands frequently and soap may beon sale locally. The aim is then to achieve actual handwashing at critical times: afterdefecation, before eating and preparing food, and after cleaning the bottoms of babies andtoddlers.But also when water and sanitation facilities are improved, good hygienic habits do notfollow automatically. The problems arise when hygiene promotion is handicapped bymisguided or inappropriate “improvements” in water and sanitation facilities. Hygienepromotion can do a lot, but it cannot put right mistakes in the delivery of basic WSSservices. Water supplies, sanitation facilities and hygiene behaviour work together as anintegrated package, and the quality of the approach in all components determines theoutcome.If users find the “improved” facilities inappropriate or unsuitable, hygiene promotion alonecan often not persuade them to pay for them, look after them, or make effective use ofthem. Here a few of the kinds of other things that can go wrong and so counteract theeffects of hygiene promotion:Design is not appropriateThere are so many complex factors involved in selecting the right range of facilities fordifferent socio-cultural settings. Designs that have not been chosen and tested with thecommunity have little chance of acceptance. Foot pumps may be rejected because theycannot be used by children or pregnant women; latrines will not be used in some places ifventilation slits mean that users’ feet are visible; unless latrine slabs can be easily cleanedand water is conveniently available for doing so, they will soon become filthy and fall intodisuse.Sections of the community are excludedCombating diarrhoeal disease means involving all the community in better hygienebehaviour. In turn, that means finding water and sanitation systems that are appropriate forwomen, children and men in all socio-economic groups. If any group is left out of thedecision-making process, the health impact of the new facilities will be seriouslydiminished. For acceptance, upkeep and use, programmes and projects need to enablemen and women in the distinct community groups to make informed decisions about theIRC International Water and Sanitation Centre 11