Small doable actions targeting hygiene improvement in vulnerable households

HIP is a USAID funded programme in Kenya that was initiated in december 2009 under the Academy for Education & Development (AED) regional office of Eastern and Central Africa. This is a programme that came up due to an expressed need in hygiene practices improvement targeting vulnerable households that include but are not limited to the HIV infected and affected households which are predominantly poor in the urban and rural settings in Kenya. At the initiation of the HIP program in Kenya, there existed no programme that was specifically targeting the officers in the Ministry of Public Health and Sanitation who are trained in Public Health. The government approach has been traditionally to pass information to the communities and to expect them to carry out hygiene activities as stipulated by law. However, the HIP programme introduces a new approach to the promotion of hygiene - Small Doable Actions. This approach assesses the hygiene levels of the communities and encourages them to improve on hygiene through negotiations on small actions within the household that have been tried, tested and accepted in a given community. The biggest challenge to the HIP programme was the acceptance of the programme within the country as it is a “software” only program as compared to many traditionally implemented programs that focus on hardware with software considered “just an add-on”. Another challenge that the programme faced was the acceptance of the small doable approach – negotiation by the public health officers who are trained and oriented to enforcing law. A number of examples of small doable actions include: using leaky tins for hand washing stations, improvised commodes for weak but mobile patients, re-usable pieces of old clean fabrics for menstrual management; and using pots with spigots for safe storage and retrieval of water. In terms of lessons learnt, this approach is the start of attitude change related to hygiene practices. It is meant to facilitate behavior change leading towards a reprioritization of hygiene and improved practices in the household level. The way forward for this approach is integrating it into existing work and using the existing framework and personnel to ensure its sustainability. [authors abstract]

This three-day workshop aims to identify proven good practices in the sanitation and hygiene sector, as well as drawing lessons from failures to enter into the policy dialogue. It focuses on urban sanitation with an emphasis on learning and innovation in the sector. It was organised by : UNICEF, GTZ, WSSCC, WaterAid and IRC International Water and Sanitation Centre, and hosted by the Rwandan Ministry of Health.