Hygiene Promotion - IRC International Water and Sanitation Centre

groups, and facilitators of participatory hygiene promotion need to be sensitive to theattitudes and culture of each group.Those in charge of programmes and projects often have problems in accepting this. Theyreason that if people know what makes them ill and how to prevent it, they willautomatically change their practices, no matter what that will cost them in money, time,conflicts and criticism. It is not like that in the real world. Convenience, status, esteem andfinancial gain are the stronger driving forces that affect people’s decisions on manyaspects of their lives.There are many more concrete and therefore more powerful incentives for water,sanitation and hygiene improvements than the promise of better health. These incentivesdiffer for different groups:• Women and children appreciate less hardship and more time for rest, play (children)and schooling.• Men sometimes discount such benefits on the basis that there is no need for schoolingof women and girls and idleness breeds laziness. Income-generating potential andpeer pressure are more important incentives for the men.• Among those in the higher socio-economic group, lower groups that are climbing up oraspire to do so, and groups with urban contact, increased social status and followingopinion leaders and trends are important motivating factors.• Willingness to pay for improved sanitation is much higher in densely settled areas thanin areas with lots of space and vegetation.In using motivating factors of the user groups themselves, promoters also need to beaware of countervailing forces. Often, the promoted hygiene behaviour also has certaincosts, such as requiring that women and girls invest resources that they are short of, andcannot control, such as time, money and criticism from other family members. Forexample, mothers-in-law or husbands have commented negatively on wasting water in drytimes, or money they spend on good hygiene has been seen as wasteful. In many cultures,women and girls generally already work longer hours than boys and men, and morehygiene work competes with other tasks. They can also often not impact behaviours ofother family members. A targeted approach in which the main goals are agreed, anddifferent groups for different practices are identified and are addressed through a family,peer group and community approach on is thus important for durable success.Specialist health communicators have developed models to try to encapsulate the ways toinfluence hygiene behaviour while respecting local cultures and beliefs. Two of thesemodels date from 1993, and may need to be updated to take account of more recentexperiences with participatory approaches. The concepts though are helpful when planninghygiene promotion activities.John Hutley relates influences and actions to a BASNEF Model (see table 1). BASNEFstands for Beliefs, Attitudes, Subjective Norms and Enabling Factors. It is an acronym thatdoes not exactly roll off the tongue, but is intended to include all the factors involved.IRC International Water and Sanitation Centre 15