Approaches to Handwashing Improvement in Africa Global Scaling Up Handwashing Meeting Toubab Dialaw, Senegal, May 30, 2007

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Country Overviews

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Observed HW Behavior Households

Focus on physical dirt, lack of water, 70-84% awareness of importance of HW, soap in all households, diarrhea part of growing up, soap placement Disgust, Conformity, Safety for children, keep healthy, feel clean (Comfort), belonging

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Observed HW Behavior School Aged Children 6-12

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Status

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Kenya Partner Contributions MOH as the lead agency with other public agencies MOE, MOWI,MOLG, MOGCSSNGOs: NETWAS, AMREF, Plan International, Practical AidPrivate Sector: Unilever, Bidco, Kentainers, RotoUNICEF, WHO and UN HabitatFunding EU $1.1 million starting FY08WSP $200k to date

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TanzaniaThe first partnership meeting held in Mar 06,Followed by Dec 06 meeting to devise CHARTERPartners: GoT, private sector, development partners, NGOsThe lead actors: MoW/MoH/WSPMoW:Dedicated US$10K for HW promotion for each districtAn institutional home for HW within the Sanitation and Hygiene Working Group of the WSDP MoHDevelop policies and guideline for hygiene promotionCoordinates hygiene promotion in all districts through DHOForming the National Steering Committee for S&HWSPProvide the seed funding for the TZ HWIProvides the coordination of the PPPHWTechnical Advice, guidance

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TanzaniaOther PartnersGovernmentMoEVT: responsible of the school hygienePMO-RALG: Coordinates implementation of government programme through the LGAs

Private sectorAquaSan: Provides HW sample facilities, e.g., plastic facilitiesTarmal: Provides promotional materials, e.g., soap samples

International OrganisationsUNICEF: Provide funds for development of promotional messages, links to additional districtsPSI: Doing behavior change promotion Water Aid: Funding CBOs doing facilitation of DCC, links to additional districts

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TanzaniaChallengesSustainability is the major challenge due to;Institutional arrangement-MoW, MoHSW, PMO-RaLG,MoEVTLack of capacity at the LGA levelLack of ministerial collaborationWeak representation of private sectorLack expertise at the local level

OpportunitiesFitting in existing programmes RWSSP,School Health Programme,Village Health ProgrammeGetting the PMO-RALG more involved in bridging the gap between the stakeholder ministriesGetting the HW to the parliament

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UGANDA HWSC was formed in 2005 as a sub-group of the National Sanitation Working group.Chaired by MoH/EHD; Unicef, Danida, Plan International, WaterAid, UWASNET, AMREF, GTZ, DWD / MoWE & MoES are members

ProgressWrote initial HW Proposal & secured Danida seed fundingGive guidance & managerial oversight to the HW campaign in UgandaCreated enabling environment for Donor funding thus attracted DFID, UNICEF and WSP funds (Danida USD 740,000, DFID USD 640,000, UNICEF USD 80,000, WSP 100,000)A strong participation of private Sector Unilever & Mukwano Industries

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UGANDA Constraints / ChallengesImplementing partner (UWASNET) wants more independence in implementation & handling funds (procurement), which HWSC is opposed toPolitical interference - State house involvementTime-tied funds Must spend DFID funds by 15th August 2007

What can be done better?The roles of the implementing partner and the steering committee need to be clarified

Role of lead Government AgencyUWASNET established by DWD, Danida, WaterAid & 2 other WATSAN NGOs.UWASNET has over 130 members who are visualized to incorporate HW into their work plans and coordinate HW activities with District structures

Experience of WASH Ethiopia movement to promote HW

Andreas Knapp

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BackgroundBased on the global WASH campaign a group of like minded organizations coordinated by Water Aid decided to form the Ethiopia WASH movement2 main objectives: Advocacy movement, social mass mobilizationEvery year the movement focused its attention on a different motto:2004/2005 your health is in your hands Reasons why hand washing was chosen as the first topic: a simple intervention to promote with direct messages; it builds on established common practices and can have a high impact on diarrhoeal diseases. 2005/2006 lets use latrine for our health and dignity 2006/2007 keep water safe

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Results

Chart2

Chart1

19862212000.079

19872464000.088

882688000.096

892884000.103

903164000.113

913444000.123

923724000.133

933920000.14

944340000.155

954480000.16

9621000000.75

Year

Number

Percent

Year

Percent

Trend in Sanitation

Sheet1

SNNPR SANITATION TREND 1986-1996

Year19861987888990919293949596

Households2,800,0002,800,0002,800,0002,800,0002,800,0002,800,0002,800,0002,800,0002,800,0002,800,0002,800,000

Number22120024640026880028840031640034440037240039200043400044800021000002,800,000

Percent0.0790.0880.0960.1030.1130.1230.1330.140.1550.160.75

YearNumberPercent

1986221, 2007.9

1987246,4008.8

1988268,8009.6

Sheet1

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00

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Number

Percent

Years (86-96)

Number of Pit Latrines

Trend of Sanitation Coverage

Sheet2

Sheet3

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Regional Overview

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Link with improved water supply

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Availability of handwashing facilities

It is essential that all latrine designs factor in a safe durable facility for handwashing.

- Draft 10 YEAR UGANDA, IMPROVED SANITATION AND HYGIENE PROMOTION FINANCING STRATEGY UGANDA

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Kenya HW initiative influencing infrastructure operations in schools.

WSP facilitating Schools Infrastructure Management Unit (SIMU) dialogue $13m from DFID to design and build pit latrines for all 18,976 public schools in Kenya

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Link with the soap market

Laundry Bars/Multipurpose Toilet Soaps 50% of revenueMost of target audience is at the bottom of the pyramidInitiative can be used to:- bring new consumers onto toilet soap brands- link multipurpose soaps with handwashing

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Private Sector Support Why is it win-win?

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How and Why Lifebuoy is leading hand washing?

BRAND VISIONMake 5 billion people feel safe & secure by meeting all their personal care hygiene & health needs.

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Why are we doing this?Its not philanthropy. Its business with a purpose:

It helps us build our business in Africa, in existing and new marketsHandwashing campaigns are all about positive outlooks of what Africa can be

Influences people...to change their behaviour (& their attitude)

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Which means Habit changesBrushing with toothpaste twice a day//Handwashing before food

& Brand choiceChoosing OMO washing powder instead of the competition

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Through a 6 Step ProcessSet TheChallengeUnderstandWhat is(really)GoingOnWritethePersuasiveArgumentGeneratetheComm.IdeaDeveloptheComm.CampaignImplementtheCampaignChangeHistoryAudience Role andTime Frame Effect Risk and constraints

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This Process & The Tools

Are always doing 2 things

1. Set the Challenge

Set TheChallengeUnderstandWhat is(really)GoingOnWritethePersuasiveArgumentGeneratetheComm.IdeaDeveloptheComm.CampaignImplementtheCampaignChangeHistoryAudience Role andTime Frame Effect Risk and constraints

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Two things weve learned from a Behaviour Change perspectiveIf you pick one audience and one behaviour you have more chance of making change happen Get as clear as you can be at this stage of:

Exactly what it is people do NOW Exactly what it is youll want them to do in the FUTURE

2. Understand What is (really) Going on

Set TheChallengeUnderstandWhat is(really)GoingOnWritethePersuasiveArgumentGeneratetheComm.IdeaDeveloptheComm.CampaignImplementtheCampaignChangeHistoryAudience Role andTime Frame Effect Risk and constraints

If we dont get Triggers that go deep enough into peoples lives, we wont come up with an argument with the power to persuade people to change.

3. Write the Persuasive ArgumentSet TheChallengeUnderstandWhat is(really)GoingOnWritethePersuasiveArgumentGeneratetheComm.IdeaDeveloptheComm.CampaignChangeHistoryAudience Role andTime Frame Effect Risk and constraints ImplementtheCampaign

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Persuade/ v.tr. & refl.

1. (often followed by of, or that + cause) to cause (another person or oneself) to believe.

4. Generating the Communication IdeaSet TheChallengeUnderstandWhat is(really)GoingOnWritethePersuasiveArgumentGeneratetheComm.IdeaDeveloptheComm.CampaignImplementtheCampaignChangeHistoryAudience Role andTime Frame Effect Risk and constraints

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What does a Communications Idea look like ? Singular: one big idea for maximum impactVersatile: works across different channels Persuasive: to encourage the sustained behavior change we want among our core target audience.

5. Develop the communications campaign Set TheChallengeUnderstandWhat is(really)GoingOnWritethePersuasiveArgumentGeneratetheComm.IdeaDeveloptheComm.CampaignImplementtheCampaignChangeHistoryAudience Role andTime Frame Effect Risk and constraints

Grabs Attention rather than assumes it will be given

Has a single idea that can be integrated across many channels

Meaningfully communicates the argument

A strong integrated campaign does 3 things

6. Implement the CampaignSet TheChallengeUnderstandWhat is(really)GoingOnWritethePersuasiveArgumentGeneratetheComm.IdeaDeveloptheComm.CampaignImplementtheCampaignChangeHistoryAudience Role andTime Frame Effect Risk and constraints

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Implementation means

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Delivery Approach based on skills development by UMALearn by doing to increase retention and address risk of pull out: Coaching for each country Live support at key program juncturesAll key events are regional (working towards regional triggers/and regional briefs)

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FACTS What is or isnt happening?

TRIGGERWHY is this going on?Uganda Trigger Workshop

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FACTS What is or isnt happening?

Formative researchImmersion

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FACTS What is or isnt happening?

WHYS Why is this going on?

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TRIGGERUganda Trigger Workshop6 triggers4 selected for qualitative validation 2 emerged1 won process and gut feeling

You educate your children to help you when you are old She said she learned to raise chickens/collect reeds so that she could trade and sell to have a better lifeFather is absentee parent & mum does all including paying feesI hope my children go to school and become successful, get good jobs & take care of meSpends 1st on her children then on herselfShe said childs education is high on her priority listMany womens meetings in each villageWomens empowerment movement in Uganda strong and supported by governmentMothers want the best for their children and will do everything in their power to achieve itThey focus on education as they want their children to get out of the slums as they believe this will give them a better futureShe sees hope for the future in her childrenUgandan women are strong women who have overcome and still live with significant hardship and povertyWomen are surprisingly innovative when it comes to seeing to her familys welfare despite their strong belief of if its meant to be it will happenWomen are seen to be important in the development of the countryMamma the Power is in Your Hands

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CommunicationsIdeaPR SponsorshipIn Communities

TVPromotion

Outdoor Events RadioLeafletsPrint

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Channel Exploitation Workshop

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Achievements Focused communication rooted in consumer understanding Integrated campaign development Core team confidence and motivationBuy in from key partners no more bad diarrhea communications Framework for regional innovationRegional motivations and insights

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Challenges Acceptance of learning from private sector expertise among broad HW community Integration of BC models and frameworks Linking national, health, WSS, marketing M&E systemsMore focus on sustainability More knowledge sharing with other countries starting HW programs, ie Benin, Ethiopia

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Planned Regional Activities FOAM Validation Workshop in Dar JulyContinuation of In Safe Hands - Kenya and Tanzania Trigger workshops Development of monitoring and evaluation frameworkAnalysis of African HW determinants

11.30 So now we know what we want to do and have our Charter we are clear what were doing and are aligned as a team.1.45 2.202.50Main objective to

KICK OFF MEETING: Generate CHARTER and agree major milestones May find you need to find out more PROJECT PLAN Clear about what you want to do and by when put money into it.

STAKEHOLDER build it in not something you do on the aside need to book time in their diaries and interview them.

Teamwork is difficult but you cant do this on your own to be great you need people.

KICK OFF MEETING: Generate CHARTER and agree major milestones May find you need to find out more PROJECT PLAN Clear about what you want to do and by when put money into it.

STAKEHOLDER build it in not something you do on the aside need to book time in their diaries and interview them.

Teamwork is difficult but you cant do this on your own to be great you need people.

KICK OFF MEETING: Generate CHARTER and agree major milestones May find you need to find out more PROJECT PLAN Clear about what you want to do and by when put money into it.

STAKEHOLDER build it in not something you do on the aside need to book time in their diaries and interview them.

Teamwork is difficult but you cant do this on your own to be great you need people.