The aim of any water and sanitation programme is to promote good personal and environmental hygiene in order to protect health. Hygiene promotion is defined here as the mix between the population's knowledge, practice and resources and agency knowledge and resources, which together enable risky hygiene behaviours to be avoided. The three key factors are 1) a mutual sharing of information and knowledge, 2) the mobilisation of communities and 3) the provision of essential materials and facilities. Effective hygiene promotion relies on an exchange of information between the agency and the affected community in order to identify key hygiene problems and to design, implement and monitor a programme to promote hygiene practices that will ensure the optimal use of facilities and the greatest impact on public health. Community mobilisation is especially pertinent during disasters as the emphasis must be on encouraging people to take action to protect their health and make good use of facilities and services provided, rather than on the dissemination of messages. It must be stressed that hygiene promotion should never be a substitute for good sanitation and water supplies, which are fundamental to good hygiene.

Hygiene promotion is integral to all the standards within this chapter. It is presented here as one overarching standard with related indicators. Further specific indicators are given within each standard for water supply, excreta disposal, vector control, solid waste management and drainage.

Key indicators (to be read in conjunction with the guidance notes)

Guidance notes

1. Assessing needs: an assessment is needed to identify the key hygiene behaviours to be addressed and the likely success of promotional activity. The key risks are likely to centre on excreta disposal, the use and maintenance of toilets, the lack of hand washing with soap or an alternative, the unhygienic collection and storage of water, and unhygienic food storage and preparation. The assessment should look at resources available to the population as well as local behaviours, knowledge and practices so that messages are relevant and practical. It should pay special attention to the needs of vulnerable groups. If consultation with any group is not possible, this should be clearly stated in the assessment report and addressed as quickly as possible (see Participation standard, and the assessment checklist in Appendix 1).

2. Sharing responsibility: the ultimate responsibility for hygiene practice lies with all members of the affected population. All actors responding to the disaster should work to enable hygienic practice by ensuring that both knowledge and facilities are accessible, and should be able to demonstrate that this has been achieved. As a part of this process, vulnerable groups from the affected population should participate in identifying risky practices and conditions and take responsibility to measurably reduce these risks. This can be achieved through promotional activities, training and facilitation of behavioural change, based on activities that are culturally acceptable and do not overburden the beneficiaries.

3. Reaching all sections of the population: hygiene promotion programmes need to be carried out with all groups of the population by facilitators who can access, and have the skills to work with, different groups (for example, in some cultures it is not acceptable for women to speak to unknown men). Materials should be designed so that messages reach members of the population who are illiterate. Participatory materials and methods that are culturally appropriate offer useful opportunities for groups to plan and monitor their own hygiene improvements. As a rough guide, in a camp scenario there should be two hygiene promoters/community mobilisers per 1,000 members of the target population. For information on hygiene items, see Non-food items standard 2.

4. Targeting priority hygiene risks and behaviours: the objectives of hygiene promotion and communication strategies should be clearly defined and prioritised. The understanding gained through assessing hygiene risks, tasks and responsibilities of different groups should be used to plan and prioritise assistance, so that misconceptions (for example, how HIV/AIDS is transmitted) are addressed and information flow between humanitarian actors and the affected population is appropriate and targeted.

5. Managing facilities: where possible, it is good practice to form water and/or sanitation committees, made up of representatives from the various user groups and half of whose members are women. The functions of these committees are to manage the communal facilities such as water points, public toilets and washing areas, be involved in hygiene promotion activities and also act as a mechanism for ensuring representation and promoting sustainability.

6. Overburdening: it is important to ensure that no one group is overburdened with the responsibility for hygiene promotional activities or management of facilities and that each group has equitable influence and benefits (such as training). Not all groups, women or men have the same needs and interests and it should be recognised that the participation of women should not lead to men, or other groups within the population, not taking responsibility.