Global Handwashing Day: Promoting behavioural change

How can you incentivise people to change longstanding behaviours? Most people know that keeping their hands clean is one of the most important steps for preventing the spread of germs and disease; however, in Europe, up to 50 per cent of people do not wash their hands after using the toilet. If this is the case in locations where people have easy access to running water and soap, the challenge is greater in communities that do not have this access and therefore may never have learnt these behaviours. Encouraging the use of proper handwashing techniques is a crucial part of all Raleigh Tanzania’s water, sanitation and hygiene (WASH) projects in rural schools. With research linking good hand hygiene to a 40 per cent reduction in the rates of diarrhoea – the second most common cause of child mortality worldwide – having clean hands is highly important for keeping children healthy and in education. In just a few weeks, a Raleigh ICS WASH project in the rural village of Bwawani, Kilombero, will conclude, but thanks to strategies implemented by volunteers and the community, it’s legacy will continue to have a positive impact on behaviour related to handwashing long after the project ends. Over the course of six months, two teams of volunteers have built 18 new toilets (nine male and nine female). These include one disabled toilet of each gender and a menstrual hygiene management room in the girls’ block. Alongside the new toilets that offer improved sanitation, the pupils and wider community were also taught how to build tippy taps – a simple instrument for cleaning hands with running water and soap that can be built with cheap and recycled materials. These were installed next to the school toilets and outside homes. ‘Previously there were no tippy taps or handwashing facilities. People just used water,’ said the village executive officer, Pendael Gadiel Mbise.

At the same time as constructing the new facilities, the volunteers used various techniques to engage children and encourage new behaviours towards hand hygiene. Lessons were added to the children’s normal school curriculum to help them understand the importance of keeping their hands clean and were taught the stages of handwashing, which is the same technique doctors use to wash their hands in hospitals. These lessons were designed to be participatory, interesting, and fun to encourage children to think for themselves and be creative, and to make their own decisions regarding hand hygiene. An example of a lesson was to using glitter to demonstrate how easily and quickly germs can spread. ‘Before, students were taught that hand washing is important but only theoretically not practically,’ said Emmanuel Mwelase, a teacher who has worked at the school for 10 years. Another way the volunteers engaged the children was through a ‘SWASH club’, which is an extracurricular activity led by students, designed to mobilise youth to change their own environment and communities. The club will continue after the project ends and will empower students to come up with their own ways of raising awareness of issues concerning hygiene to ensure that the WASH situation of the school is constantly improving and being maintained.

The volunteers also made sure to engage families and the community in the lessons and construction, so children were more likely to apply their knowledge and approaches to hygiene at home. Research has shown that young people are more likely to adopt new ways of thinking and doing, which means they have a greater capacity to influence their peers and empower communities to change behaviours. Involving different members of the village in the project also promotes a sense of ownership for the community, which is a necessary prerequisite for sustainability. According to the village executive officer, the results of the project have been extremely positive. ‘The health of the village has already increased and will continue to do so. Last year a cholera outbreak happened in a neighbouring village and our good hand hygiene helped to prevent the disease from spreading to our village,’ said Pendael, adding that in the past, diseases in neighbouring villages have always spread to their community. The village leadership set up Village Health Committee has been set up in Bwawani to make sure that the changes will be maintained once the project concludes. ‘[Handwashing] is a new system for most villagers, so if the information is not passed down through the generations then it will be forgotten. The Village Health Committee are tasked with maintaining education about hand hygiene… and to ensure every toilet has a tippy tap next to it,’ said VEO Pendael. In addition, village members are making small financial contributions to make sure there is always enough water to wash hands and flush the pour toilets. ‘It was decided during a village meeting that each parent will contribute a small amount each year (1000tsh) to pay for fuel for the generators which can pump water. This must be maintained by the village leadership,’ said Pendael. Raleigh volunteers and the community alike are confident that these positive changes in behaviour will be maintained for the next generations.