Hygiene Education: Building on local culture and priorities

Behaviour is not only influenced by available resources, but also by how people think and fee. Hygiene education that is not based on the local culture cannot possibly be effective in changing people’s behviour and practices. For example, frequent diarrhea may be taken as a fact of life, rather than as a disease. In promoting hygiene behaviour it is important to start from an understanding of what disease means to people, what diseases they recognize, and what their notions of prevention and cause are. The more hygiene education builds on local cultural values, the more chance there is that it is attractive and effective. As a merchant would say, you have to speak the language of your customers to sell your products.

Cultural values and beliefs also largely determine what people consider right or appropriate behaviour and practices. When this is not taken into account it will cause project failures. For example, in a solid waste removal programme, the wheelbarrow was introduced to transport household waste to the dump site. However, as women were responsible for this task, and it was considered embarrassing for women to push a wheelbarrow because it would show their breasts and buttocks, the programme had to be revised. Example about beliefs and practices in relation to hand washing was also highlighted.

Cultural patterns are hardly ever nationwide. Specific cultural values may even differ between nearby villages and between the same social, ethnic and economic groups. It is always important to investigate cultural values, even when hygiene education is given by a person from the area.

Behavioural change can gain an important impetus through the support and example of respected persons. If a respected key person is setting the example and promoting a certain behaviour, it is likely that more people will follow. The role models may be official leaders such as religious leaders and community representatives, but also individuals who are trusted and consulted for specific problems, or who live the life desired by many people. Which people are inclined to follow the example of which key persons, has to be investigated on a case by case basis, it is hardly ever the same for all community groups or for men and women. The reverse is also true. When hygiene behaviour is promoted by people who have neither status nor influence, it is unlikely that the new behaviour will take root among many people.

To encourage new behaviour, incentives may be used, such as little gifts or prizes when people switch over to new behaviour. Examples are prizes awarded to the cleanest village, the village with the best protected water source, or to the maily with the best constructed latrine in each village. Status and prestige may also act as incentives to the adoption of new facilities and practices. However, experience shows that status and prestige considerations are more helpful in getting facilities (eg. Latrines) constructed than in getting them properly used.

Behavioural change can also be promoted through formal and informal regulations and agreements. For example, it may be decided that households are only entitled to house connections when they make the necessary provisions for safe wastewater disposal. Social control can be an important mechanism for informally enforcing certain behaviour. For example, cleanliness around the tap site may be successfully based on social control principles.

Promotion of new behaviour is not just telling people what to do. After all, why should they believe you and why should they take the trouble when they do not see how it will make life easier or better. Changing behaviour requires active participation of both men and women in the community and the combined efforts of technical and social staff, supported by government authorities.

Changing practices through hygiene education and water and sanitation improvements requires a willingness in people to think about their ideas and behaviour and a willingness to take up new knowledge, to consider behavioural alternatives, to overcome reluctance and ingrained habits, and to decide and get used to new behaviour. This cannot be expected to happen overnight, it will necessarily take some time.

For project staff to facilitate behavioural change they have to understand why people act the way they do. For example, with a new water supply installed, the use of more water for personal and domestic hygiene is promoted through hygiene education. But this may be opposite tot what many people have learned to practice. Especially in dry areas, people usually have been brought up with the message that water is a precious and limited resource, and therefore they are used to taking as little water as possible. Changing from water saving behaviour for survival to water using behaviour to reduce water and sanitation related diseases can only be facilitated when there is an appreciation what this means to people. Educational staff have to realize that this will require motivation and support over a longer period of time with results coming gradually.

Effective hygiene education at community level presupposes the sensitivity of project staff and government officials to finding appropriate solutions to reduce health risks from poor water supply and sanitation. Effective hygiene education also requires an intimate knowledge and understanding of possible barriers and resistance to behavioural change and factors that may facilitate the adoption of new behaviour. This cannot occur without careful hygiene education planning and implementation, giving due attention to the various levels of influence. This cannot occur without careful hygiene education planning and implementation, giving due attention to the various levels of influence. This requires the set up of a participatory hygiene education programme in a suitable organizational setting.

Source:
Technical Paper Series, Just Stir Gently, International Water and Sanitation Centre, IRC, 1991