Waste disposal – local information makes hygiene promotion more effective

Over three million children die from diarrhoea every year in developing countries and a third of the world’s population is infected with parasitic worms. Simple improvements in hygiene could drastically cut infection rates. But what is the best way to develop hygiene promotion programmes? How can health promoters identify target populations and risk factors?

Researchers from the London School of Hygiene and Tropical Medicine and Programme Saniya, Burkina Faso, developed a hygiene promotion programme to reduce childhood diarrhoea in Bobo-Dioulasso, Burkina Faso’s second city. Drawing on this experience, they have produced a toolkit to help programme planners design locally relevant hygiene interventions.

In Burkina Faso, the fight against diarrhoea has previously focused on promoting oral rehydration therapy and improving water supplies. Yet, diarrhoea still causes as much childhood illness and death in urban areas as malaria and respiratory tract infections. Hygiene promotion programmes could have a major impact but may fail if they are not based on up-to-date local information. Small-scale and carefully focused research can increase the effectiveness of hygiene promotion programmes and optimise use of scarce resources. The study showed that in Bobo-Dioulasso:

• Unsafe stool disposal and inadequate handwashing are the most widespread risk factors for childhood diarrhoea.
• The target audiences for promotion programmes should be mothers and older children caring for infants under 3 years, and school-age children.
• As local women do not associate poor hygiene with diarrhoea, the social virtue of cleanliness is more likely to motivate behaviour change. School children may respond to peer pressure.
• The best channels of communication are word-of-mouth, social gatherings, local radio and theatre. Due to illiteracy, print-media are not suitable.

The report outlines a toolkit consisting of simple research activities, which could be completed in three months. With the aid of this toolkit, health planners could:

• identify and select behaviours to target, based on the level of health risk and prevalence in the population
• determine the target audience who most commonly use risky practices
• find a motivation which will lead people to change their behaviour
• choose the best channels of communication and design health promotion materials for the target audience.

The study warns that this will only work if there is the political commitment to apply the results of such research, and if the research team receives appropriate training. It is also vital to monitor the impact of the programme on hygiene practices to learn the most effective strategies for the future.

Source(s):
‘Dirt and diarrhoea: formative research in hygiene promotion programmes’ by V. Curtis et al, Health Policy and Planning 12 (1997)
Related source: 'Happy, healthy and hygienic: how to set up a hygiene promotion programme' UNICEF Full document.

Funded by: The European Community; UNICEF; WHO; UK Department for International Development

id21 Research Highlight: 22 February 2001

Further Information:
Valerie Curtis
London School of Hygiene & Tropical Medicine
Keppel Street
London WC1E 7HT
UK

Tel: +44 (0) 20 7927 2628
Fax: +44 (0) 20 7636 7843
Contact the contributor: valcurtis@compuserve.com

London School of Hygiene and Tropical Medicine, UK

Other related links:
WHO has factsheets on various aspects of environmental health.

Search the WHO's site on Protection of the Human Environment for research and programmes.

Read this issue of the Bulletin of the WHO on environment and health.

See this related highlight.