Feature: Designing community-centred behaviour change interventions in Papua New Guinea
In the last decade, WASH approaches have evolved from awareness creation to behaviour change that addresses sustainable ways of ensuring improved hygiene practices are adopted at a household level. Evidence shows, however, that the number of people reported to have moved up the water and sanitation ladders in the last decade may not have maintained their achieved level of access. There are a number of reasons that this may be the case, many of which have to do with unchanged social norms that do not provide an enabling environment for the improved practices to be sustained. An effective, sustainable behaviour change intervention has to be community-centred; addressing the psychological, social-cultural, physical factors to changing behaviours. This is the approach that the International WaterCentre (IWC) and partners, WaterAid (WAPNG) and United Church (UCPNG) in Papua New Guinea (PNG) have adopted in implementing behaviour change interventions in the past year.
Community-centred behaviour change in East Sepik
To ensure the Integration of a community-centred approach to behaviour change interventions formative research focused on understanding infant faeces management behaviours in East Sepik was undertaken during the design phase of the project. During this phase the IWC and WAPNG spent time with communities understanding current practices, drivers, social cultural and psychological/emotional factors that influence community practices for safe handling of infant faeces and handwashing with soap.
The results show that the concepts of nurture, cleanliness and disgust were strong drivers for mothers; they expressed the need to keep their families healthy, clean and free of ‘dirt’ were the main drivers for the practices they chose to adopt. Though hygiene decisions are made at the individual household level, there was little variation in the practices among households within and between communities; these practices are passed on from generation to generation in communities that live in close vicinity to one another. As a result of these findings this particular intervention is designed to communicate messages to mothers at a community level to support changes in social systems whose norms are closely linked.
When formative research isn't always feasible
As learnt in the United Church partnership in Milne Bay, formative research may not be feasible for all behaviour change interventions, particularly those that have limited financial resources and short timeframes. The approach here has been to adapt existing handwashing with soap promotion tools by using local artists and extensive community engagement in the adaptation process. A situation analysis through the rapid assessment of secondary data on community WASH needs, previous WASH programs and existing community non-WASH-health programs has supported the adaptation of the promotion tools used here.
For both cases, WAPNG and United church include community change agents as part of the design and implementation team whose first-hand understanding of the community dynamics allows for community voice in the outcome of the intervention design. It is evident through engaging communities throughout the design phase that for the interventions to have a lasting impact on changing behaviours, the hygiene promotion activities must be community led.
An effective monitoring, evaluation, response and learning (MERL) framework forms part of the intervention design and uses a mix of methods for assessing behaviour outcomes. These measures are applied starting from a community level where change agents track how the behaviour is adopted within households. Self-reporting and observations, used in these programs, have proven to be useful methods to measure outcomes of behaviour change interventions when applied at periodic times. Establishing a baseline at the beginning of the campaign, using formative research or situation analyses, gives partners an understanding of what the current practices are within the community. At the end of the campaign, using the same methods, it will also be possible to assess whether the campaign has resulted in improved behaviours. In responding to the outcomes from the monitoring data, the partners will use the lessons derived to make a decision on whether to scale up the campaign as it is or design the intervention.
Opportunities to learn and share
For the IWC this has been a learning experience on behaviour change tool design for communities in East Sepik, while also an opportunity to build the capacities of national professionals in PNG. For our partners WAPNG and United Church, who have taken the lead to design behaviour change tools that can be used by other WASH actors in PNG and other pacific countries, it has a been an opportunity to document practices and share lessons on designing behaviour change interventions.
Our partnership with WaterAid is part of the Civil Society WASH Fund, an Australian aid program initiative funded by Department of Foreign Affairs and Trade (DFAT). This project is delivered in collaboration with WaterAid Australia and PNG, as well as Divine Word University, South Seas Evangelical Church, and Integrated Rural Development Initiative.
The United Church project is also funded by the Australian Department of Foreign Affairs and Trade (DFAT).
For more information, contact:
Project Officer – WASH and Behaviour Change
Phone +61 7 3028 7602