Focus

Published on: 29/06/2011

Know your Focus groups

• Understand the environment in which practices occur. Programs should begin with research or should assist communities to do self-assessments of their situation. The research and assessments lead to identifying good and bad practices, coming up with solutions and making plans to promote the good and change the bad. This is in line with the concept of targeted hygiene: identifying high-risk situations for transmitting pathogens in homes and communities and promoting feasible and appealing practices. Use this information to design programs and monitor behaviour change.
• The research and assessments also ask: Who can influence and support behaviour change? What would motivate behaviour change? What drivers motivate change other than health? Whose behaviour are we trying to change? Mothers? Fathers? Men? Children? Adolescents? Select one or a few focus groups.
  Case study 17; Case study 23; Case study 26; Case study 28
• Consider gender. Who controls finance for hygiene and sanitation in households? Are men committed to improving hygiene? Hygiene promotion for men can result in more support for hygiene in the household and more recognition of the hygiene-related work undertaken by women in the home. Related issues are: Are women heard in planning and committees? Are there male and female field staff?
  Case study 2; Case study 12; Case study 13

Prioritise practices and avoid message overload

• Four clusters of hygiene practices are known to have the greatest impact on people’s health, especially children’s: (1) handwashing with soap, (2) safe disposal of human excreta by all, (3) keeping drinking water safe from source to mouth, and (4) using enough water for hygiene. As hygiene is context-specific, other practices may also be important in a particular situation, for example, food hygiene, control of animals around the home, disposal of the dead.
• An important lesson learned is the value of focusing on a single or a few behaviours at a time. Fewer practices are more effectively integrated into people’s lives.
  Keynote paper 1; Keynote paper 2
• A campaign or social-marketing approach is suitable for promoting one specific hygiene practice such as washing hands with soap. A campaign needn’t always be organised at a national level, it can be delivered to a smaller target population such as at the district level.
  Case study 16; Case study 17
• Most of the community-based programs work for improvement in several hygiene practices, using participatory methods with target groups. Community members are helped to discuss, negotiate, and jointly identify problems and solutions for adoption of priority hygiene behaviours. For behaviour change, the idea is to focus not on messages, but on active understanding of high risk behaviours and good practices. The participatory activities and communication need to be of good quality, to motivate and empower the target groups, including the poor.
• Behaviour change programs such as PHAST (and others such as SARAR and MPA Methodology for Participatory Assessments) can be adapted to the local context. PHAST does not have to rely on health messages alone, but should instead focus upon target behaviours that will resonate strongly with the local audience.
  Case study 2; Case study 5; Case study 8; Case study 25
• Many projects combine some elements of mass media and campaigns together with interpersonal community-based approaches to promote improved practices. For example, the Vietnam Handwashing Initiative is an example of an evidence-based communication campaign for handwashing with soap which also has interpersonal communication activities with mothers and participatory school programs with children. The community-based BRAC program used mass communication channels through religious institutions and through theatre groups.
  Case study 7; Case study 18
• Several case studies focused on the management of menstrual hygiene. These cases combine intensive education with the development of small scale enterprises for the production and sale of menstrual products. As with other programs, it is important to invest time in finding out about current practices and identify what can be changed and how.
  Case study 11; Case study 12; Case study 22; Case study 30