Combining Collective and Individual Paths to Behavior Change?Presentation Transcript
Combining Collective and Individual Paths to Behavior Change? GHPN Brownbag February 16, 2012 Julia Rosenbaum and Orlando Hernandez
PresentersOrlando Hernandez Julia Rosenbaum Renny Seidel (intro)
This presentation• What is a ‘collective behavior’?• The program in Ethiopia• Results• Discussion
What is a ‘collective behavior’?
“Yo dude!!!” Examples of group/mass behaviors: are there any collective?• Running for shelter during the rain• Church attendance on Sunday• Labor strikes• Joining the Green Movement, joining the Tea Party• Communal protection of fish sanctuaries in fishing villages
Characteristics of ‘collective behavior’Schaefer: spontaneous unstructured reaction to ambiguous situation unpredictable source of social changeLe Bon: abandonment of current responsibility, surrendering to contagious crowd emotionsSearle: ‘we intend’ vs ‘I intend’ collective intentional behavior ≠ summation of individual intentional behavior…..action which is neither conforming (actors follow prevailing norms) nor deviant (actors violate those norms).
At scaleHygiene and Sanitation Improvement in the Amhara Region of Ethiopia through “Learning by Doing”
Start Changes at grassroots The Districts12 Step Pathway Broken into 3 phases Plan Mobilize and Act Monitor & Evaluate
Learning by Doing Program in AmharaMulti-Stakeholder Meeting identified Common Action Agenda – brought the Whole System to the Room @Regional Behavior Change Strategy• including advocacy• strengthened household visits• community ignition and action• multiplying the message with communication and media• demonstration latrines and HW stations• increased access and affordability of products through private sector involvement
Implementing a hybrid of …COMMUNITY-LED TOTAL BEHAVIOR CHANGE IN HYGIENE AND SANITATIONembedded in a national and regional process..• National Hygiene and Sanitation Strategy• National Protocol for Implementation of …Built around Health Extension Programme,and carried out by HEWs.. Among other actors…
COMMUNITY-LED TOTAL BEHAVIOR CHANGE IN HYGIENE AND SANITATION• Systems Approach to Change – engaging the multiples• (Community-led) Total Sanitation• Strengthened Home Visits Negotiation of Improved Practices/MIKIKIR• Robust WASH Friendly Schools component
Characteristics of an At Scale Effort Systems-Approach Looks at the whole Involves multiple sectors, actions, options, stakeholders Hygiene Improvement Framework Considers hardware, promotion, institutional capacity Behavior FIRST Focuses on consistent and correct PRACTICE of key hygiene behaviors Prioritizes sustainability Coverage
Community led Total SanitationCommunities are “ignited”Total coverage, each and every member of the community shall have toilet and stop open defecation. Category Users of Prevalence of Latrine (%) diarrhoea (%) Open defecation prevalent 29 38 villages Almost open defecation-free 95 26 villages Open defecation-free villages 100 7 Source: Formative research by WSP-Knowledge Links for IEC Manual in Himachal Pradesh, 2005
Disg ust F ear Sha me
Shit calculation – Calculating the amount to feces produced (week, month and annually, etc.) to illustrate the magnitude of the sanitation problem. – One ‘evacuation’ = 150 grams – Number of evacuations a day– Volume of feces per person/day – Number of people in room – Volume of feces a day, a week, a year – ? WHERE DOES IT ALL GO????
Results Were we effective? Did we achieve scale?Did combining individual and collective action work?
M&E Framework for Learning by Doing, AmharaSO At scale of hygiene and sanitation in Amhara RegionIntermediate Partnerships to Institutional capacity Hygiene and Adoption of WASH facilitate coordinated in public and civil sanitation program practices at HH andresults action at regional and society partners at woreda level institutional levels district level fostered developed expanded increased # nat’l, reg., or district level % trainees mastering # of targeted woredas that % households using policies, strategies, program knowledge/skills for newly implemented WSRs improved sanitation or projects advanced developed guidelines facilities meeting through “learning by doing” minimum standards byIllustrative initiative woredaIndicators # of woredas developing % annual budget spent by % targeted woredas % households with hw integrated annual plans with targeted woreda implementing integrated supplies at hw stations contributions form all hygiene promotion partners actions to complement hardware investments
Pre- / Post- Stratified Random Sample PRE High Medium Lown=2000 (Focal) (Direct) (Indirect) High Low POST (Focal) (GOE)N=1378 No real controls
ETHIOPIAPractices: Access to Sanitation FacilitiesBaseline-Endline Comparison: All Respondents
Predictors of Latrine Ownership Endline Dimensions Factors p Odds Ratio Community participated in walk of .00 2.23 Intervention shame Characteristics Household visited by health work to .05 1.75 improve sanitation Having a latrine contributes to the .00 2.6Intervention -related community’s health Perceptions Having a latrine contributes to the .00 1.8 community’s development ALL of THESE …………………………………………….. >> 8.38 **Source: Amhara LBD Evaluation Report, USAID/HIP-WSP/WB-AF, November 2010
Presence of HWStations at Latrines 17% 16%
Accomplishments & Challenges 5.8 million people in Amhara Regional State reached 3.8 million more people stopped practicing open defecation and now use a basic pit latrine Challenge is to improve the quality of these latrines to acceptable standards Develop and integrate sanitation marketing strategies Focus on promoting fixed handwashing stations (tippy tap) at latrine and ‘commonly used’ place Model being used as essential part of national scale up…