Hygiene Promotion

Hygiene Promotion (HP) in Emergencies is a planned, systematic approach that enables people to take action and encourages behaviours or conditions that prevent or mitigate WASH-related diseases. Hygiene promotion aims to support the dignity and wellbeing of emergency affected populations and no WASH intervention should be undertaken without including it. More in-depth information on all aspects of HP in emergencies can be found in the recently published Compendium of Hygiene Promotion in Emergencies – a comprehensive compilation of the most relevant and sector-reviewed HP components, tools, methods and approaches drawing on latest initiatives, materials and evidence. 

Key Actions

    • Understand the affected community’s different perspectives on sanitation and hygiene and involve them in decisions about the programme.

    • Listen and ask: It is vital to learn about sanitation practices and norms. For example: what do different people usually do? What is happening now and what has changed as a result of the emergency? What do different people need and want to ensure that sanitation facilities are effective and have an impact on health? What are the priority sanitation risks? Who are the most vulnerable and what support do they need to access sanitation services and facilities? Who can help e.g. the affected population (who also have skills and capacities), local agencies or government departments? It is important not to treat everyone the same but to identify different groups to work with e.g. youth, mothers and fathers of young children, religious leaders, primary school children, canteen workers, hairdressers etc.

    • Involve and enable action: Interactive discussions can be used to support different user groups to identify what they can do immediately to improve sanitation and hygiene. It is important to find out what is potentially stopping them from acting (the barriers and obstacles to improved sanitation and hygiene) and to find out what help they need, if any. By conducting surveys and differentiating between doers and non-doers, users and non-users of facilities, drivers can be identified that motivate action. Supporting community initiatives is also useful and can help to ensure that people motivate each other. A variety of interventions can help to respond to the immediate risks but will depend on the context e.g. interim sanitation solutions, tools for digging pits, soap or alternatives for handwashing, potties or nappies for children etc. Consider how sanitation and hygiene facilities will be maintained from the beginning and the community’s involvement in this e.g. through the formation of committees or user groups.

    • Focus on vulnerability: It is vital to identify people with specific needs (e.g. women and girls, older people, and people with disabilities) and find out what they feel and need to manage their sanitation and hygiene needs (e.g. Menstrual Hygiene Management). Incorporating Gender and diversity is particularly important. Ensuring that you have women on the team will mean they can talk more easily with other women. Finding out how babies’ and young children’s excreta is managed and asking mothers and caregivers what support they want to do this effectively, is also crucial. Work with local organisations representing vulnerable groups such as disabled people’s organisations. Involving a diverse group of affected people in discussions about the assessment findings and understanding their concerns early on is important to review plans and decide together on realistic and context-specific options.

    • Plan together: Setting practical objectives and indicators and compiling a WASH strategy with others involved in the WASH response are also key processes in an HP intervention. In this process, the ‘doable’ actions that can have an impact on sanitation and hygiene should be identified and how effectiveness will be monitored should be decided. The affected community should contribute to this strategy. The recruitment, training and support of existing and new team members will help to ensure that plans come to fruition.

    • Collaborate and coordinate to implement: A variety of methods and tools can be used to work with different groups to motivate action to improve and effectively use and maintain sanitation facilities and services for women and men, people in different age groups and with different abilities. Working closely with others involved in the response, especially the Government, international, national and local WASH actors and other relevant sectors, is crucial. It facilitates the timely delivery of WASH services and enables participation, reduces duplication and helps to prioritise interventions. It should be possible to undertake joint activities such as assessments or evaluations or HP outreach workers may focus on other priority health issues as well as hygiene.

    • Monitor and review: By means of observation (Do people use the facilities?) and surveys (Did people change their behaviour?) the effectiveness of HP and behaviour change efforts can be monitored. Continually seeking feedback from the population will enable adaptations in programming and improve effectiveness. It is also important to keep track of any rumours that might be detrimental and to respond to these as soon as possible e.g. by incorporating them into discussions with community groups or providing information on social media.

    • Be empathic with the affected population and try to understand their perspectives. Active listening is a vital component of communication; listening, rather than simply providing information, should be HP’s starting point.

    • Understand the preconditions and enabling factors of envisioned hygiene practices (such as access to facilities and markets) and be realistic about what is possible in their absence.

    • Recognise the importance of the social and behavioural determinants of hygiene. Assess and monitor barriers and motivators for change; most of the HP frameworks draw on a model of behaviour change. All these factors must be included in an HP programme.

    • Aim to understand the local context and existing capacity and find out who is affected, their needs and vulnerabilities, the affected communities‘ perceptions, existing norms, leadership structures and priorities. The coping strategies of the communities and their capacities can be mapped out so that interventions address gaps in hygiene facilities, services and corresponding behaviours.

    • Ensure the availability of HP personnel with appropriate communication and HP skills and expertise (whether volunteers or paid staff).

    • Include community capacity strengthening in the programme to enable sufficient levels of participation, engagement and skills. For all WASH facilities, at a community or institutional level, a feeling of ownership and management responsibility is critical for the continued functionality of the services.

Author(s) (1)
Rob Gensch
German Toilet Organization (GTO)

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