2011年-世界发展银行全球_Tanzania___A_Handwashing_Behavior_Change_Journey_8页_2mb

Global Scaling Up Handwashing Project: Summary of Tanzania's Handwashing Behavior Change Journey

Core Content

The Global Scaling Up Handwashing Project in Tanzania aimed to increase handwashing with soap among women and children, especially at critical times, to reduce the incidence of diarrheal diseases and acute respiratory infections. The project was designed and implemented using a multi-channel, evidence-based behavior change approach, involving formative research, creative concept development, and community engagement through Front-Line Activators (FLAs), Direct Consumer Contact (DCC) events, and Interpersonal Communication (IPC) activities.

Main Objectives

• Increase handwashing with soap among women and children.
• Improve knowledge and understanding of the importance of handwashing.
• Promote the use of enabling technologies like the tippy-tap.
• Ensure the sustainability and scalability of the program through community-based approaches.

Key Findings

• Behavior Change Framework: The FOAM framework was used to analyze behavioral determinants and guide communication objectives.
• Multi-Channel Approach: Combining mass media, DCC, and IPC proved effective in reinforcing messages and changing social norms.
• Evolving Behavior Change: Behavior change occurs through a multi-phase process, with evolving objectives that support long-term shifts in habits.
• Community Engagement: FLAs, as unpaid volunteers, played a crucial role in delivering messages and promoting hygiene practices within local communities.

Implementation Strategy

Integrated Channels

• Mass Media: Radio was used to deliver consistent messages, including soap operas and call-in shows, which emphasized emotional benefits like being a good mother.
• Direct Consumer Contact (DCC): Events were held in both small and large communities, using entertainment, skits, and demonstrations to raise awareness and promote the tippy-tap.
• Interpersonal Communication (IPC): FLAs conducted home visits, school and health center activities, and distributed educational materials like a comic book on building tippy-taps.

Creative Concepts

• "Mother is the Pillar of the Home" (Mama Nguzo): Recognized mothers for their role in raising children and promoting hygiene.
• "Heroes Make Heroes": Focused on the emotional appeal of being a hero mother through handwashing.
• "Asante Mama": A campaign concept that integrated emotional and practical messages to inspire handwashing.

Phased Campaign

• Phase I (Awaken & Inspire): Focused on increasing knowledge and awareness of handwashing with soap and critical times.
• Phase II (Empower & Amplify): Aimed to make handwashing an intrinsic behavior by reinforcing social norms and improving skills.

Challenges and Lessons Learned

• Geographic Dispersal: Poor transportation and remote locations made it difficult to deliver training and monitor progress.
• Creative Development Time: Developing an effective, emotive campaign took longer than expected, impacting the timeline and materials.
• FLA Motivation: Unpaid volunteers faced challenges in sustaining their efforts, highlighting the need for better recognition and support.
• Data Collection: FLA forms were often incomplete or not submitted, affecting the accuracy of monitoring and evaluation.
• Message Creep: DCC events sometimes drifted from core messages, necessitating independent supervision and message checklists.

Monitoring and Evaluation

• Mass Media Monitoring: A local firm tracked radio and soap opera broadcasts, ensuring consistent messaging.
• IPC Monitoring: FLAs submitted self-reported forms, but only 67% did so, raising concerns about data completeness.
• DCC Monitoring: Event data was collected through forms and validated using spot checks and Event Impact Surveys (EISs), which assessed audience reception and changes in knowledge and intention.
• Results: By December 2010, the project exceeded targets for mass media and DCC, and reached 52% of the IPC target.

Conclusion

The Tanzania handwashing project demonstrated the importance of a multi-channel, emotionally resonant, and community-driven approach to behavior change. It also highlighted the need for better support and motivation for volunteers and more robust data collection systems to ensure the program's long-term success and scalability. The lessons learned will inform future hygiene promotion efforts in other regions.