Which hygiene practices can be targeted?

Updated - Monday 03 December 2007

Below is a table showing various hygiene practices, falling under four different categories: sanitation, water, food and environment.

Hygiene Domain	Relevant conditions and practices
Sanitation	Location of defecation sites Latrine structure and cleanliness Disposal of children's faeces Use of cleansing materials Number of users of facilities Sanitation habits of different groups
Water	Placement of latrines in relation to water sources Different water sources used, and daily and seasonal patterns Average distance to water Amount of water used per person per day Water quality at source and home Water storage practices Methods of water treatment Water handling in the home Water use and re-use Hand washing (including religious rituals)Bathing (children and adults) Clothes washing Previous experience of water source management
Food	Food handling and preparation Food storage practices Food reuse practices Breast-feeding, weaning practices and beliefs Washing and drying of utensils
Environment	Household refuse disposal Disposal of household wastewater Condition of stormwater drains Management of domestic animals Evidence of stagnant water around dwelling or water point Vector control problems Slaughtering facilities Burial of the dead

Sources:

Ferron S., et al, (2000). Hygiene promotion - a practical manual for relief and development, London, UK, ITDG Publishing

Almedom et al., (1997). Hygiene evaluation procedures: approaches and methods for assessing water- and sanitation-related hygiene practices, Boston, MA, USA : International Nutrition Foundation for Developing Countries

Not all of these conditions and practices may be locally important, felt to be priorities, and/or be easy to change, so you'll have to evaluate them through prioritization with the different community groups.

Bathing, for example, may have a higher priority in areas with a water shortage and a high incidence of skin and eye infections. Swimming by children, and bathing and clothes washing whereby women and girls stand in the water to rinse out the soap, may be risky practices in areas where schistosomiasis is prevalent.

Diarrhoeal disease is often the main hygiene-related health risk. Stools are the main source of diarrhoeal pathogens. Practices which stop faecal material contaminating the domestic environment are vital, especially for children. The priorities for public health in behaviour-change programmes are therefore likely to include hand-washing with soap or soap substitutes (such as ashes, certain plant materials, (clean) sand, and firm rubbing of both hands during rinsing), after stool contact and the safe disposal of stools, especially children's stools, preferably in latrines.

Potential risky practices need to be documented and their frequencies assessed. Practices which occur often and which allow faecal material into the domestic environment are likely to be candidates for behaviour change. The target practices, to replace the risk practices, are developed in collaboration with the target audiences.

Adapted from: LSHTM/WEDC (1998). Guidance Manual on Water Supply and Sanitation Programmes. Published by WEDC for DFID

According to the World Health Organization (WHO), the following three hygiene behaviours lead to greatest reduction in diarrhoeal morbidity:

Safer disposal of faeces, particularly faeces of young children and babies and people with diarrhoea.
Handwashing, after defecation, after handling babies' faeces, before feeding and eating, and before handling food.
Maintaining drinking water free from faecal contamination, in the home and at the source.

Source: R. Sawyer, et al.(1998).PHAST Step-by-Step Guide: a participatory approach for the control of diarrhoeal disease , WHO, Switzerland, Geneva, (WHO/EOS/98.3)

A fuller list of water, sanitation and hygiene facts and figures can be found in the IRC TOP on Hygiene Promotion (Appendix 4).

Next question

List of questions