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Health and Hygiene Promotion
Health and hygiene promotion is a holistic activity that includes the supply of water and help in building latrines as well as raising awareness of what hygiene is and what hygienic behavior can do for the community. Hygiene promotion starts before water supply construction. Baseline information about hygiene attitudes, knowledge and practices in the village, and the incidence of certain faecal-oral diseases, is collected using a combination of Participatory Rural Appraisal (PRA) and household questionnaire survey techniques. The collection of information is itself used to encourage discussion about the importance of factors such as proper sanitation, and to increase the awareness of villagers of their present situation, and the potential for change. Many people simply do not realize that their hygienic practice can have a big impact on the health of their family and the whole community. Recognition of this in itself can provide the motivation to learn more. One of the main components of hygiene promotion in NEWAH project is a semi- formalized system of education about specific topics related to hygiene.
The program is based on a number of simple messages and activities aimed at breaking the cycle of water borne and water wash diseases and will aim to establish a link in people's mind between unhygienic practices and diseases and to provide information about what constitutes hygienic behavior. A series of simple pictorial messages portray the most effective primary and secondary physical and behavioral barriers to the transmission of pathogens via faeces. Singing and dancing, role-play, puppets, games, story telling, videos, demonstrations, practical exercises, home visit are all used to help participants understand the information.
One or more health motivators (mostly women) are appointed from within the community for each project. Health motivators are recruited directly from the local community. They speak the local language or dialect, and know of any special cultural features. They are often more acceptable as educators than someone from outside. They are provided with extensive training (three weeks) both in the subject and how best to convey the message. They are provided with teaching materials and supported by health supervisor /educators, a long- term professional responsible for a number of project. In addition one community health volunteer (male or female) is appointed by each user group and also given 6 days training. Their knowledge remains in the community after project completion.
NEWAH supports the implementing partners to conduct health and hygiene promotion activities through community and school within the project areas. All adult women and men and children (who can not go to the school for education) from different caste, ethnic group and class will be involved in health / hygiene promotion activities in the community and school going children will also be included in school health education program.
The health and hygiene promotion is divided in to separate topics. The major topics are:
- The safe disposal of excreta (including from children) preferably through construction of household latrine which is kept clean.
- Hand washing at critical times- after defecation, after cleaning children's bottoms, before handling food, before eating and before feeding child.
- Disposal and use of waste water (link with kitchen gardening promotion.)
- How to handle safe water at home
- Food hygiene- protection by covering and use of dish drying rack.
- Attention to domestic and environmental hygiene- proper disposal of household refuse and housing of domestic animals.
- Knowledge of paths of infection and treatment of diarrhoea and oral rehydration therapy.
Monitoring and evaluation of the program is an integral part of the process. NEWAH health staff will evaluate the effectiveness of the work at each project community when all health education activities is completed. In order to know the overall impact (both positive and negative impact on women, men and children) of the project NEWAH carry out the impact study or research study and use the results of the study to review and modify future plans and activities. Similarly, the program policy and procedures will be revised and updated as per the requirement on the basis of the learning from the impact studies.
The following immediate impact of NEWAH's health promotion program can be witnessed in villages where schemes are completed:
- Improved personal hygiene
- Cleaned village surroundings and water points.
- Drying racks are constructed and used
- Latrines are constructed, used, and well maintained,
- Improved hand washing practice at critical times (hand washing with either ash or shop)
- Improved food and drinking water covering practice and safe water handling practice at home.
- Schools (which covered by project) have at least one latrine and one water point for safe drinking water. School teachers and children are involved in health and hygiene promotion through "child to child" approach.
- Garbage pit and manure pit is broadly adopted.
- Kitchen gardening is well in use and broadly promoted.
- Villagers live in hygienic environment.
Innovative approaches have been started to incorporate to make the program more effective.
Targeting out-of-school children for health and hygiene education,
Using children as change agents in the promotion of good hygiene behavior,
Training male community health workers (traditionally seen as a woman's role) to include male population in health and hygiene promotion program.
Providing refresher training and health education to ensure sustained hygiene practice
Major Activities
- Offer a health & hygiene promotion component to complement every water supply project.
- Link health with water and sanitation at all stages
- Plan and implement a health & hygiene promotion programme jointly with the people based on their perceived
needs identified problems and involvement.
- Begin the health & hygiene promotion programme together with the water and sanitation work and continue
up to two years (depending on the size and situation of the project.)
- Systematically encourage and promote the involvement of women, men and children
at all stages of the program.
- Regularly monitor the progress of each project community against the plan, concentrating on the quality of
achievements, not just specific numerical indicators.
- Periodically evaluate the effectiveness, efficiency and impact of the work at each project location and overall.
- Use the results of monitoring and evaluation to review and modify future plans and working methods.
Specific Activities
- Community health and sanitation baseline survey
- Selection and recruitment of Health Motivators by the implementing partners.
- Health motivators (HMs) first & basic training.
- Teacher's orientation from the selected schools for Child-to-Child program
- Selection of Community Health Volunteers (CHV) & formation of Users group in each water point.
- Formation of Community Child Health Group (CCHG) in the community- mostly it includes out school children
- Ceramic tile and site selection for the water point construction.
- Money collection from beneficiary household for domestic latrine construction.
- Planning & conductiing of training at community level:
- Community Health Volunteer (CHV) /Community Worker (CW) training
- Child Health Awareness Committee (CHAC) training
- Orientation to C to C Advisory Committee
- Training to CCHG members.
- Kitchen gardening training.
- Community health promotion programme:
- Waterpoint / tole teaching/ group teaching
- Home visits
- Mass activities (Public Health Awareness Camp, puppet/ video or drama show etc)
- School health/ hygiene promotion activities
- Domestic latrine construction and sanitation campaign / programme.
- Community Health Volunteer's workshop/meeting
- Supervision and monitoring of project activities on regular basis and annual program review meeting.
- 2nd and refresher training workshops of Health Motivators and Community Health Volunteers.
- Evaluation and handing over of the project to the villagers and partners.
- Impact study of the project after two years follow up.
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