1WHO/SEARO Technical Notes for Emergencies Technical Note No. 10

Essential hygiene messagesin post-disaster emergencies

WHO Regional Office for South-East Asia

This fact sheet outlines some of the key activities indealing with hygiene promotion in post-disasteremergencies.

What is hygiene promotion?The goal of hygiene promotion is to help people tounderstand and develop good hygiene practices, soas to prevent disease and promote positive attitudestowards good health practices.

Focus of hygiene promotion inemergenciesYour aim in carrying out hygiene promotion inemergencies is to:

Lower high-risk hygiene behaviour

Sensitise your target population to appropriateuse and maintenance of facilities

This latter point is important. Your efforts should bedirected at encouraging people to take action toprotect their health and make best use of thefacilities and services provided.

Hygiene promotion is not simply a matter ofproviding information. It is more a dialoguewith communities about hygiene and relatedhealth problems, to encourage improvedhygiene practices.

In carrying out hygiene promotion, you will need tocarry out the following activities:

Evaluate current hygiene practices

Plan what you need to promote

Implement your plan

Monitor and evaluate your plan.

Evaluate whether current hygienepractices are good/safeYou will need to identify the key hygiene behaviourrisks and judge the probable success of anypromotional activity. The main risks are likely to be:

Excreta disposal

Use and maintenance oftoilets

Lack of hand washing withsoap or alternative

Unhygienic collection andstorage of water

Unhygienic preparation and storage of food

Prioritise these by choosing those which pose thegreatest health risk. You should look at the resourcesavailable to your target population taking intoaccount local behaviours, knowledge and culturalnorms. The needs of vulnerable groups should begiven particular attention.

Plan which good hygiene practicesto promoteThe understanding you gain from the aboveevaluation should be used to plan and prioritiseassistance. Give priority to targeting thosebehaviours which pose the greatest health risks.Target a small number of practices for each usergroup: sustained and repeated messages covering asmall number of practices are likely to have greaterimpact than a large amount of promotional messagescentred on several practices. The key is to identifythe most harmful practices in each user group andfocus on these.Community meeting

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Essential hygiene messages in post-disaster emergencies

Implement a health promotion programme that meetscommunity needs and is understandable byeveryone.

Target specific audiences: it is important that youknow who your audience are and that you directmessages at groups responsible for carrying out theactivity being referred to.

It is desirable that all gender groups (women, men,children and those with disability), should receiveequal attention. There are reasons why this does notalways happen. Women for example will shoulderdomestic responsibilities in most households. As aconsequence most promotion activities are directedat them on the premise that if they understand,accept and act upon the messages, the benefits willbe immediate. Men on the other hand mightunderstand and accept the messages but not actupon them for not being involved in domestic duties.

Identify motives for behavioural change: peoplemay change their behaviour not necessarily forhealth benefits but for totally unrelated reasons.

It is important to identify and understand culturalnorms and use this knowledge as a basis forarticulating motives for change.

Hygiene messages need to be positive: hygienemessages should be presented in a positive lightmaking use of humour wherever possible. Nobodylikes being lectured to: people will be much morereceptive to positive messages.

Identify appropriate communication channels: youneed to know how your different target audiencesprefer to receive information and any cultural aspectsto this. Do they listen to the radio, pick up informationthrough informal discussions, use health facilities,rely on religious functions, theatre and dance and soon.

For example, messages about diarrhoea inchildren should be directed at those involvedin childcare.

Certain behaviours may be seen to conferstatus within the community and be adoptedfor this reason. For example:

Fatima built a utensils drying rack for afternoticing her neighbour Zainabu, who is ateacher, had one.

A woman may adopt the correct disposal ofchildrens’ faeces upon seeing a health workerdoing so.

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Essential hygiene messages in post-disaster emergencies

A reasonable standard of education and anenthusiasm for community work are desirable. Theyshould be aware of the constraints that may causepeople not to adopt good practice.

Staff may be recruited from among elders with a lotof life experience, teachers, community leaders,health workers, religious leaders, traditional birthattendants and so on. Although there are no hardand fast rules, a ratio of one facilitator to every fivehundred people or one hundred families isrecommended.

It is usually more effective to use the channel thatyour audience identifies with and regards astrustworthy.

Monitor and evaluate the programmeto see whether it is meeting targetsYou will need to review your hygiene promotionprogramme regularly. Ideally, members of thecommunity should be involved thus ensuring issuesimportant to them are covered.

The review should evaluate members’ feelings aboutthe hygiene message and whether they need moreinformation. Reviews should also mean you gainfeedback about how to improve your programme. Itwould be a good idea to have members decide thefrequency of reviews. All information gathered duringmonitoring and evaluation should be shared with thewider community and interested stakeholders.

Mix your communication channels: a messagereceived through a variety of channels is more likelyto be remembered. However, there are costs to takeinto account. Broadcast media is less expensive percapita than is say, face-to-face communication.However, information provided one-to-one hasgreater impact than an impersonal messagereceived through the media. You therefore need tobalance the costs of using a channel against itseffectiveness.

Materials: These should be designed in a way thatmessages will reach illiterate members of yourpopulation. Participatory methods and materials thatare culturally appropriate offer opportunities forgroups to plan and monitor their own hygieneimprovements.

Facilitators: Facilitators are the people you will useto implement your plan, working with the community,face-to-face. It is important to select the right peopleas facilitators as they are the single most importantfactor for the success of a hygiene promotioncampaign. Generally speaking, facilitators should beselected from among the target population. Theyshould be able to communicate in the local languageand where possible, be people who are respectedwithin the community.

4 WHO/SEARO Technical Notes for EmergenciesTechnical Note No. 10

World Health OrganizationRegional Office for South-East AsiaMahatma Gandhi MargNew Delhi, 110002,India

This information has been prepared by WEDCAuthor: F. Odhiambo Series Editor: R. A. Reed Design: G. McMahon Illustrations: R. J. ShawWater, Engineering and Development Centre, Loughborough University, Leicestershire, UK.Phone: +44 1509 222885 Fax: +44 1509 211079 E-mail: WEDC@lboro.ac.uk www.lboro.ac.uk/wedc

Phone: (+91-11) 2337-0804Fax: (+91-11) 2337-8438E-mail: wsh@whosea.org

http://www.whosea.org

Essential hygiene messages in post disaster emergencies

ResourcesHarvey P., S. Baghri and R. A. Reed, 2002.

Emergency sanitation, assessment andprogramme design. WEDC, Loughborough.

Healthy villages: a guide for communities andcommunity health. November 21, 2003 http://www.who.int/water_sanitation_health/hygiene/settings/healthvillages/en/