Published: April 19, 2016 / Published by Global Handwashing Partnership
All presentations available for download here.
To explore how emotional motivators can be used to drive forward hygiene behavior change, Katie Greenland (London School of Hygiene and Tropical Medicine) presented research from LSHTM that demonstrated how emotions, including affiliation, disgust, and nurture, were used to drive sustained behavior change in Zambia, Indonesia, India, and Nigeria. She argued that behavior change interventions should employ motivational mapping and adopt powerful “levers” to enact change, and that there is a need to harness a greater “creative capacity”, and find new approaches toward formative research.
To consider the impact of modifying behavior settings to drive handwashing behavior change, OmPrasad Gautam (London School of Hygiene and Tropical Medicine/WaterAid) described how modifying physical settings for handwashing behavior in his food hygiene project in Nepal triggered handwashing and achieved behavior change. Then Yolande Coombes, with the Water and Sanitation Program (WSP) at the World Bank, explained how principles of human-centered design can be used to help design handwashing stations that are attractive, affordable, and meet the unique needs of local populations.
David Neal, from Catalyst Behavioral Sciences, gave a presentation via video exploring how the science of habit can be used to drive handwashing behaviors. Based on his work in conjunction with USAID/WASHplus project, this presentation discussed six practical ways in which the science of habit can be leveraged for hygiene behavior change and integrated into handwashing programs. You can read more about this concept on our habit key topic page.
We delivered a follow-up discussion at AfricaSan two days after the Think Tank, examining the challenges of bringing hygiene improvement to scale, and presenting three components of scaling up: policy, partnerships, and integration. Katie Greenland (LSHTM) presented the equity argument for scaling up handwashing; Anila Gopal (Unilever) shared how Unilever scaled up their handwashing program to reach 254 million people; Ousmane Toure (National Institute for Research in Public Health, Mali) discussed how a food hygiene program in Mali was scaled up to other countries; Chimwemwe Nyimba (UNICEF Malawi) described the successful integration of handwashing into CLTS, and finally Hanna Woodburn (PPPHW) addressed how the Sustainable Development Goals have the potential to help scale up handwashing by driving government commitment, monitoring, and reporting. This session supported the Think Tank input.
We invited Think Tank participants to submit their own “big ideas” based on their in-country experience, and received responses from 25 participants representing twelve countries including ten African countries. The main themes put forth were around new ways to trigger behavior change; the importance of engaging young people in delivering change; the key barriers that need to be addressed (with a focus on hardware issues); the need for integration of handwashing programs with other sectors; and the need for better approaches to engage governments. Participants also emphasized that in many places the challenge of sustainable water and soap supply remains and that more local research is necessary to inform local approaches.
Think Tank participants also called for further research around ways to demonstrate the link between handwashing and diarrhea at the local community level; innovations in handwashing hardware (including zero-contact handwashing technologies, water-conserving devices, and accessible handwashing stations for the physically challenged including the visually impaired); costing of handwashing interventions; and local motivators, including feasibility of associating hygiene behaviors with religious practices.
Think Tank presentations were followed by a rich period of questions and reflections. While these discussions covered the whole range of topics examined in the formal presentations, some commonalities included:
It is clear from the PPPHW AfricaSan Think Tank 2015 that while initiating handwashing behavior change is not a novel concept, there is still much to learn about how it can be made a habit practiced regularly. There is much to consider to ensure interventions are relevant, appropriate and impactful in different settings, and for different populations, over time. The Three Big Ideas put forth by the PPPHW resonated well with those working in-country on handwashing policies and programs.
There was recognition that we need to prioritize hygiene at all levels of program planning and implementation. This includes governments agreeing to hygiene indicators, program directors ensuring integration of the latest handwashing research into projects on the ground, and all of us driving further research to deliver the big ideas that will achieve the scale up of handwashing. The PPPHW’s first Africa-based Think Tank event will help focus the work of the PPPHW and others working in handwashing going forward.
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