Guidance on communication with respect to safe drinking water and household hygiene World Health Organisation Alison Parker Cranfield University All photographs ©James Webster 1

Aims of guidance WHO can influence policy and programme decision makers Powerpoint accompanies guidance documents Aims: – To develop a commitment to protect public health – To support the health sector in effectively addressing water-related disease burden – To assist non-health sectors in understanding and acting on the health impacts of their actions 2

WHAT IS COMMUNICATION? The exchange of information– conveying AND receiving In a way that ensures other people understand the information shared And so that the information received influences the receiver’s attitudes and / or behaviour 3

COMMUNICATION – THE BASICS Why? - what, ideally, do you want to achieve (Objectives) Who? – who do you want to reach (audiences) What? – what do you want to ‘say’ (Messages) When? – what’s the timescale or deadline How? –the best ways of getting to the message to the audience And… Resources. Staff, budget, time. 4

WHAT THIS PRESENTATION COVERS This presentation outlines a systematic rationale and process for developing effective communication strategies for safe drinking water and household hygiene. We have developed an easy-to-follow five step process. This is intended to guide policy makers to develop a successful communication program. 5

WHY THIS PRESENTATION IS IMPORTANT Global importance of the water and hygiene related diseases Routes of disease transmission are known A number of communication and behaviour change strategies have been developed that are effective in reducing water and hygiene related disease: – Improving water quantity and quality reduces disease – Handwashing has health benefits: Diarrhoea and Respiratory disease 6

THE SCALE OF THE PROBLEM 884 million people lack access to safe water; 2.5 billion lack basic sanitation and nearly 1.2 billion practise open defecation. At any one time, half of all hospital beds in developing countries are filled with people suffering from water-related diseases. Almost one tenth of the global disease burden could be prevented by improving water supply, sanitation, hygiene and management of water resources Improved sanitation could prevent 1·5 million deaths from diarrhoeal illnesses a YEAR million of which are preventable child deaths Every dollar spent on sanitation generates economic benefits worth between $3 and $34. 7

WHAT WE ARE TRYING TO ACHIEVE That targeted groups of people: understand the cause of water and hygiene related illness recognise the illness has implications for them, the household and the community believe that they can do something to prevent water and hygiene related disease and act to improve water quality and household hygiene 8

BEST PRACTICES - WHAT WE KNOW We can change attitudes and behaviour if we: Understand our audience, Use language they understand Use effective tools to help communicate the message (TV, health workers) Communicate in a way audiences can relate to through their own experiences 9

Step 1 – Evidence Based Design: Analysis Identify and use information that can provide a clear picture of the problem Identify and understand the health problem Identify the behavior(s) that needs to occur to improve the health problem Identify motivations and barriers to address desired changes by the communication strategy Carry out or commission research to learn about target audiences HOW TO DESIGN A COMMUNICATION STRATEGY: A 5-Step Process 10

Step 2 - Design of the Communication Strategy Determine the audience(s) Define desired behavior changes and outcomes through SMART objectives Select the “key factors” (behavior change model) for message design Determine the communication approaches, mix of communication channels and community mobilization processes Develop a creative brief Draw up an implementation plan Develop a monitoring and evaluation plan HOW: 5-Step Process 11

Step 3 - Development and Testing Communication Products and Messages Develop materials Test concepts, messages and materials with stakeholders and with the intended audiences Revise and if needed, retest HOW: 5-Step Process 12

Step 4 - Implementation & Monitoring Launch the communication program Mobilize key participants and stakeholders Manage and monitor the communication plan HOW: 5-Step Process 13

Step 5 - Evaluation & Replanning Measure outcomes and assess impact Disseminate results and plan for next stage of the communication program HOW: 5-Step Process 14

UNDER WHAT CIRCUMSTANCES The context may change, but the process should remain the same Need context specific information / best practices for each context – what does the evidence tell us re: communications in these contexts This 5-step process can be applied to different situations in developed and developing countries: – Long term chronic and – Shorter term emergency risks 15

Long term chronic risks Those relating to chronic or long-term problems of water supply, water quality, poor hygiene or inadequate sanitation Examples of these situations include: – Groundwater chemistry that is harmful to health (e.g. arsenic and fluoride) – Poor hygiene behaviours 16

Shorter term emergency risks Those relating to outbreaks of disease, associated with sudden changes in water quality delivered to consumers Examples include: – Waterborne Disease Outbreak (e.g. E.coli, Giardia and Cryptosporidium) – Refugee situations 17

Conclusions Communication is a key part of promoting safe water and household hygiene For best results: Think strategically. Keep it simple. Know your audience. 18