Hygiene Promotion - IRC International Water and Sanitation Centre

Large programmes need to focus. They therefore target only one or two specific conditionsor practices that constitute a particular risk. Examples in water or sanitation programmesare:• safe methods of human excreta disposal• proper handwashing habits by all at critical times• only using safe water sources, at least for drinking and food preparation• frequent washing of children's eyesFor expansion of reasons why these particular messages are important see Appendix 8.Tailoring the programmeThe people targeted in public health communication are not one homogeneous group.They consist of older and younger people, women and men, people with different class,ethnic and religious backgrounds, living and working in different environments. Althoughthe primary targets will be those carrying out the risky practices (e.g. mothers,schoolchildren, child carers for e.g. handwashing, adolescent boys who may not usetoilets), it is also important to reach others who can influence how they behave. So,fathers, mothers-in-law, neighbours and social contacts are “secondary” targets formessages that may exert peer pressure. Then come the opinion-formers and people inauthority in different walks of life. Teachers, religious leaders, government officers,politicians and community leaders are the “tertiary” targets for messages which improvetheir understanding of health impacts and other benefits from specific behaviouralchanges. Each group has its own and often different interests, responsibilities, skills andresources. The nature and places of risks, and possibilities to reduce risks are alsodifferent. Most importantly, the channels for communication will be different for the differentgroups. Some segmentation is needed with all target groups, whether primary, secondaryor tertiary. Segmenting the user groups is also a repetitive process. It happens in thepreparatory studies, the planning and implementation of the strategy, the monitoring andreadjustment, and the final evaluation. Assemblies and meetings are not an effective wayfor reaching poor mothers as they seldom go to general gatherings. However, they maywell be an effective way of giving health messages to politicians and government officials.McKee describes the process of bringing people together on the basis of their owninterests and willingness to act as Social Mobilisation. Unfortunately, in practice, it is notuncommon for social mobilisation to become a form of manipulation whereby some paidstaff in external agencies muster local people and groups as volunteers to help them reachtheir internal goals and targets. That should be avoided; it is the informed opinions of thegroups that lead to successful programmes.When planning a hygiene promotion programme, defining the answers to six questions iscentral. The answers need to come not just from the health and communication specialists,but also from the different user groups in the programme area:• What are the risk practices of the different groups, including as seen by them?• Who are the primary, secondary and tertiary target audiences?• What can motivate behaviour change of the target groups?22 Hygiene promotion