Hygiene Promotion - IRC International Water and Sanitation Centre

understanding of the importance of improved hygiene behaviours and not just see it asan add-on to water and sanitation. Such advocacy can take a number of formats, butin Zimbabwe probably the most successful advocacy tool was demonstration - both ofthe processes and the impact. National level policy makers were exposed to themethods and tools and not just informed about them; and training institutions wereincluded in the training. Over time this resulted in PHE being seen as an integral partof the Integrated water and sanitation Programme, it was a tangible aspect whichcould be planned for and measured and projects would not be approved without sucha component. National training institutions included it in their curricula and it becamean examinable subject. However most importantly communities and community groupsstarted to demand more hygiene education, they felt that the processes used allowedthem to participate and use their own knowledge and experiences to improve their ownhealth.• Impact monitoring is not always easy and staff can get very bogged down in thedevelopment and measurement of indicators. “At one stage we had so many indicatorsthe implementers would have had a full time job just monitoring impact!” (ThereseDooley) The reality is that monitoring is a very simple process and the tools andtechniques themselves are actually very good monitoring tools. The changes inknowledge and attitudes can be seen when using the tools and behaviour change isreflected within the communities. Communities themselves can monitor the changesand will tell you the impacts. In Zimbabwe in addition to the changes in attitudes of theproject implementers, the greatest impact the project has had to date was the changesin hand-washing practices throughout the country. Handwashing was widely practisedin Zimbabwe before the project ever commenced, but this was predominantlycommunal handwashing (that is, all in the same bowl) and through projectinterventions this changed to pour and wash methods. What may seem on the surfaceto be a simple change in behaviour was in fact very difficult to achieve as the projectsought to change an ingrained cultural practice. There were many other impacts invarious parts of the country, some of which could be directly attributable to PHE andothers which combined PHE with other interventions and these include scabies andschistosomiasis reduction.• Care should be taken not to try and cover too many issues at once -focus on what'simportant to the community.This Case Study was a contribution to the HIF E-conference, by Noma Nyoni, IWSD (emailnoma@iwsd.co.zw) It was amplified in a further contribution by Therese Dooley(tdooley@eircom.net).Additional information from http://www.wsp.org/publications/af_zimbabwe.pdfIRC International Water and Sanitation Centre 41