New Approaches in Environmental Health

1. New Approaches in Environmental Health The Hygiene Improvement Project (HIP) Presented by: Lynne Cogswell/HIP, Eric Mintz/CDC and Brandt Witte/HIP

2. Overview • Learning about HIP • Establishing a Behavioral Context • Providing a Technical Overview of POU Treatment Options • Moving Forward Together to Improve Hygiene

3. The Problem Diarrhea is… • Serious: Over 1.6 million deaths in under 5s each year • Common: Almost 2 billion total cases per year • Costly: Health care and household burden The number of cases has not gone down in 30 years.

4. The Project HIP is: • a 5-year USAID-funded project (2004-2009) of AED, ARD, IRC, Manoff designed to achieve • at-scale hygiene improvement efforts • in 5 countries and through selected, strategic activities, • which are centered on 3 key hygiene practices 

5. Feces Disposal can reduce diarrheal diseases by 30% or more.

6. Hand washing can reduce diarrheal diseases by 40% or more.

7. Improving Quality of Water at POU can reduce diarrheal diseases by 30%-40%.

8. Key HIP Tasks • At-scale country implementation • Integration of hygiene into health and non-health platforms • Global leadership and advocacy around hygiene improvement • Support and liaison to PVOs, NGOs, and networks • Knowledge management to share best practices

9. Hygiene Behavior Context • Behavior First • Developing a Behavior Change Strategy • At-Scale Hygiene Behavior Change Efforts • Characteristics of At-Scale Efforts (HIP Priorities)

10. Behavior First If you consider “behavior first,” it allows you to: • Identify, promote and facilitate improved behaviors that: • Have significant positive impact on health and • Are feasible to achieve, i.e. people both willing and able to make changes. • Design program interventions that motivate and facilitate these improved behaviors. • Eliminate preconceived program designs.

11. Developing a Behavior Change Strategy (BCS) Step 1: Determine improved behaviors. Step 2: Determine what needs to happen to support improved behavior and assess what is presently happening. Step 3: Detail additional interventions necessary to encourage and sustain improved behaviors. FEASIBLE &IMPROVED Practiced Ideal

12. For Example: • Water Supply • Sanitation systems • Available Household Technologies and Materials • For Example: • Communication • Social mobilization • Community participation • Social marketing • Training Access to Hardware Hygiene Promotion Enabling Environment • For Example: • Policy improvement • Institutional strengthening • Financing and cost-recovery • Cross-sectoral coordination • Public/Private Partnerships Hygiene Improvement Diarrheal Disease Prevention BCS Development These all need to be taken into consideration to develop an effective BCS.

13. At-Scale Hygiene Behavior Efforts Ensuring Access to Technology, Hardware and Products Promoting Hygiene As behavior change potential & likelihood of sustained behavior increases, hygiene improves. Maximum potential for change exists here. Creating an Enabling Environment

14. CHARACTERISTICS Systems-Approach

15. All 3 key practices Integration

16. Multiple levels Multiple interventions

17. Multiple stakeholders Multiple options

18. POU Treatment Options • Options Available • Behavioral Implications

19. Behavioral Implication: CONVENIENCE

20. Behavioral Implication: ACCEPTABILITY

21. Behavioral Implication: ACCESS

22. Behavioral Implication: COST

23. Next Steps • What are the priority hygiene improvement needs of CORE members? • How can HIP help meet these needs? • What are possible collaborative efforts?

24. TOGETHER, we want to move the world from this….

25. to this!