Hygiene Promotion - IRC International Water and Sanitation Centre

process. Check TOP Contacts for contacts near you, or consult the Streams of KnowledgeCoalition (SoK) for help in tracking one down.Financial resources extend beyond the costs of salaries, training and transport. Alsoimportant is some seed money for pooling with local resources to finance smallcommunity-designed projects. In contrast, costs of educational materials are low.Community groups and workers rely on group work and home visits. Any material used forparticipatory activities (such as for PRA sessions and self-surveys) is locally available andhas low or no costs. Other important items are resources for programme management andsupport (backstopping) to communities and for building up a programme knowledge baseto summarise the situations and achievements in individual communities over time.Financial support for hygiene promotion is sometimes difficult to get. The problem is not somuch the amount of money needed as the extended timescale and the results and impactsobtained with the funds. Demonstration of what is being achieved with the funds can helpmake hygiene promotion more attractive.Outputs: measuring behaviour changeAlthough water and sanitation professionals are generally sensitive to the need forpatience in assessing the benefits of hygiene promotion, their agency rules maysometimes demand early results from impact analyses. However, it makes no sense to tryand measure impacts. Even if reliable health statistics are available, impacts will only beginto show up after a critical mass of behaviour change has been achieved. Esrey, citedabove, showed that 75% adoption of key hygiene conditions and practices has worked assuch a critical mass for diarrhoeal diseases. Work is therefore done on monitoringtechniques that measure impacts on hygiene behaviour prior to attempts to detect impactson health. The book Actions Speak documents initial work done in this area.http://www.irc.nl/page/1836Before impacts can be assessed at all, information on outputs is needed. Outputs are anumber of operationally described improved conditions and/or practices as defined fromthe identification of risky conditions and practices. (Some also call these effects).There are a number of methods to measure effects in conditions and behaviour(behavioural change). The methods are often used in combination to test for consistency tosee whether outcomes are reliable. The most common ones are:• Structured observation of hygiene conditions and practices, e.g. observing whetherfacilities for the behaviour are in place and observing and recording behaviour e.g.during water collection, storage and drawing;• Structured observation of proxies of hygiene behaviour, e.g. the absence of excreta inyards and on rubbish heaps as an indication of the safe disposal of young children’sexcreta, or well-trodden paths and excreta in pits as indicators of latrine use;• Questioning of the ones who are most likely to know, which requires techniques todeal with interventions from others with less knowledge, who may nevertheless take30 Hygiene promotion