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Shifting school-based sanitation behaviours

Research and development of hygiene and sanitation (HySan) behaviour change of Schoolchildren in the Philippines, by IWC, The London School of Hygiene and Tropical Medicine, and UNICEF.

While the Philippine government is investing to increase coverage of toilets in schools, local stakeholders acknowledged that it remains unclear to what extent poor operation and maintenance of toilets is limiting use and associated positive impacts from improved sanitation, especially for girls.

In 2013 the International WaterCentre (IWC) and London School of Hygiene and Tropical Medicine partnered with UNICEF and its development partners in the Philippines to explore current understanding of handwashing and toilet use behaviours of school children, and to develop interventions to improve these practices.

The project use formative research to inform the design and development of tools. Tools were then piloted in a small number of schools. Finally evaluations were conducted to assess the ability of the interventions to further encourage independent handwashing with soap before eating and after toileting, to improve toilet use behaviours and to improve in school maintenance strategies for toilets.

Hysan storyboard

Image from the HiFive for HySan story board – linking fecal contamination from unwashed hands after toilet use to a common “HiFive’ gesture in a school play grounds. The girl looking on is imaging the germ transferred!

 

During the formative research stage, interviews in the schools revealed that toilet cleaning was sometimes reported as a form of punishment for students. This creates a negative association with toilets and stigmatizes toilets as something bad or dirty. This in turn can influence how students behave and utilise toilet facilities. The rate of malfunction in school toilets was commonly associated with the heavy ware and tare by students. School teachers lamented the speed a which toilet bowls, taps and locks could all be broken and cost of constant repairs to try a keep toilet functioning.

Through the project a set of tools entitled ‘HiFive for HySan’ were developed to help shift norms away from associating toilet cleaning as a form of punishment and towards creating a sense of shared responsibility and pride in the maintenance of toilets. The tools included a guidebook for teachers and a storyboard, a song, murals, hygiene and sanitation games for kids. Activity sequentially introduced series of messages that re-enforced through different learning channels through stories, song, visual prompts and games aiming to creating a cluster of activities that assisted children link together cause and effect from different hygiene and sanitation related behaviours.

 

Schoolchildren washing hands

Photo: School children conducting group handwashing in the Philippines. Photo: Declan Hearne, IWC

 

The project did not promote one single approach for improving toilet maintenance but respected the different approaches that existed in different schools. In some cases teachers worked with parents to clean toilets, other classrooms had institutionalised daily cleaning schedules where student took turns keeping their toilets clean. In urban schools some Parent Teacher Associations contributed to the cost of hiring a janitor to clean the school toilets.

With a diversity of ongoing toilet maintenance approaches the HiFive for HySan messages had be carefully tailored to ensure existing approaches were reinforced. Teachers were provided the HiFive for HySan tools to guide the development of lesson plans that would help students reflect on how their individual use affected the state of their toilets and focused on encouraging better toilet use behaviours.

Students were invited to think about and discuss their school toilets and how they can be improved. Worksheets were used to help students thinking about how they help to avoid dirty and smelly toilets and how their use and behavior in toilets affects the functionality of toilets, urinals and taps.  This subtle change helped teachers consider how student use can be guided to slow the rate of ware and tare in toilet facilities and not just focusing on who or how the toilet are to be cleaned or maintained. Of course children alone are not expected to repair broke fittings but the project pointed how they can be engage in helping to ensure toilet fittings, when working, stayed working for longer. 

Hysan worksheet

Worksheet for getting student to think about how their behaviours impact on the state and functionality of a school toilet block.

 

Hysan flowchart

HiFive for HySan flowchart for mapping progress as hygiene and sanitation facilities and behaviours are improved overtime.

 

 

 

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