1. Making ‘what works’ work: Changing behaviour in sanitation and hygiene Wednesday 20 July 2011 Session jointly convened by LSHTM/SHARE, WSSCC, UNICEF and WSP Lessons from behaviour change approaches in other sectors Yolande Coombes Senior Sanitation and Hygiene Specialist, WSP
2. Key predictors of behaviour change Susceptibility – probability you can get it Severity – magnitude of the event Barriers and benefits to change – enabling and disabling factors Social norms – what most people think and do about this Behavioural intention – what you intend to do about it Response efficacy – effectiveness of the suggested intervention in preventing or dealing with the event Self-efficacy – an individual’s perception of their ability to perform the desirable response Habit - an acquired behaviour pattern regularly followed until it has become almost involuntary
3. Pre-requisites of Change Change must be self-initiated Behaviour must become important over a period of time Behaviour is not part of a person’s coping strategies Individual’s life should not be problematic or uncertain Social support is available Individual has skills to change
7. Other key behavioural predictors: Person must have formed a strong positive intention to perform behaviour No environmental constraints Person perceives more social (normative) pressure to perform behaviour Behaviour is consistent with person’s self image Emotional reaction to performing behaviour is more positive than negative Can perform the behaviour under a variety of different circumstances
13. Current Global BCC Trends Increased attention to communication theory. Focus on IPC for reaching rural populations through networks of community health workers. New media, including phones, wireless enabled phones, social networking and internet access through handheld devices. Reality media using a variety of channels, including not only traditional radio programming, but also diaries, reality shows, vlogs.
I will quickly take you through some examples from some different areasFrom transport on road safety From Health sector on reproductive health From FGM – as an example of a taboo subject (a bit like sanitation)
These are about perceived severity. Showing the negative consequences. Fear based messages.There is some evidence that fear messages can have a limited long term effect and are less useful in creating habits.However fear can be a useful initial cue to action and trigger – CLTS is essentially a way of showing the severity and susceptibility
This add was about kicking a habit of texting. Although many behaviors are about creating a habit (e.g. handwashing with soap) – others are about kicking the habits (like open defecation). Although for many people OD is because they don’t have access to a latrine, for many it is because it has become a habit. Breaking habits can be harder than creating new ones. One of the reasons that working with school children is so effective. Habits started as a child are likely to sustain into adulthood and children react more quickly to make something a habit
Self –efficacy and empowering people that they can do something to change is an important part of behavior change. Traditionally, a lot of communications focused on highlighting the problem without providing the solution.Second poster – reminds us that sometimes we have to give a voice to those taboo and unmentionable subjects as a first step to creating social norms which takes me to the last topic, a very taboo topic , but we must remember that for many sanitation and talking about shit, are still taboo topics
Contrast these two approaches – one is subtle about the benefits, the other is confrontational and designed to be emotiveOne thing that we have learned in all sectors is the need to communicate in different ways for different audiencesThis is the same for sanitation and hygiene and will be covered in next presentations
Perceived susceptibilityLike sanitation (open defecation) because it is about changing cultural practices
For sanitation and hygiene we are competing against messaging and campaigns from other sectors (I have mentioned 3) but just within the health sector there are very many other campaigns, family planning, vaccination, malaria, etc then we have other sectors such as education with campaigns.We are also competing against the private sector – our communications and behaviour change have to be able to compete and we need to learn from them about what is working and what is effective.