WASHplus Benin Carries Out Experimental Urban CLTS

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WASHplus with local implementing partner ABMS/PSI improves hygiene conditions through behavior change and community mobilization in two peri-urban neighborhoods of Cotonou, the largest city of Benin. Wedged between the Atlantic Ocean and lagoons, Cotonou is floodprone and its slum neighborhoods experience cholera outbreaks during the rainy season. After promoting handwashing with soap and chlorination of household drinking water in 1,700 households, the pressing issue of open defecation came up time and again. The few public latrines are rickety structures built over the lagoons, but most residents prefer open defecation to these unsafe facilities. WASHplus connected with the provincial office of the Ministry of Health (MOH) responsible for sanitation in these zones to join in a first-ever (for Benin) experiment in community-led total sanitation (CLTS) adapted for peri-urban settings.

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After adapting and testing CLTS tools for this new setting, all decision making and influential (social, religious, and governmental) persons from the two target neighborhoods were invited for an institutional “pre-triggering” prior to involving the entire community. They saw results of a simple survey situating the open defecation spots and public and household toilets. Community triggering was carried out on May 13. About 75 residents assembled in an open space, and two trained MOH facilitators led the group through the mapping exercise and a calculation of health-related household expenses. The Walk of Shame was not carried out as the event was far from the open defecation place. The result in urban areas is not necessarily a decision to construct latrines, and in this case, the group decided to create a special task force to follow up the decisions to destroy the open defecation places and work with the rest of the community to come up with solutions, especially concerning work with managers for the improvement of public latrines. The residents expressed a desire for modern toilets and said they were prepared to pay for them.

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CLTS in this setting is different from rural settings, where the local chief has the power to convene and order people to implement decisions. These neighborhoods are extremely heterogeneous. Also, open defecation is forbidden by law, and the residents were reluctant to admit to the practice or to identify the open defecation places, thus the pre-survey came in handy. The participation of the “chef quartier,” the highest ranking local official, provided assurances that the decisions will receive strict follow-up. Plans are underway to replicate the triggering in the other zones of this very extensive neighborhood.

WASHplus Year Five Annual Report, October 2015

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In its Year Five Annual Report, WASHplus has stories to tell, results to share, events to celebrate, and studies that add to the evidence base. WASHplus activities serve as the backdrop for many stories: the Zambian school girl who has access to privacy and menstrual supplies when she needs them, the Malian household that can now build an improved latrine on their rocky soil, the mother in Bangladesh who understands the importance of a feces-free environment, the Nepali home breathing cleaner air as it trials an improved cookstove. And perhaps more compelling than the individual stories are the results the project is beginning to record through endline data collection in Kenya and formative research on school enrollment and in Zambia. Providing water, sanitation, and hygiene (WASH) infrastructure to schools is having a notable impact on enrollment. Community-led total sanitation (CLTS) may be inoculating communities exposed to cholera. Numbers also tell the story of the project’s impact. Look for a snapshot of those figures throughout the report.

The conclusion of field activities in Uganda and Zambia this year provided opportunities to reflect, celebrate accomplishments through end-of-project (EOP) events, and share lessons learned. Several articles were published this year in peer-reviewed journals and others submitted on topics ranging from consumer preferences and willingness to pay for improved cookstoves to habit formation and costing of handwashing. WASHplus also played a key role in preparing the joint document on WASH and nutrition for publication and distribution.

WASHplus’s focus on integrating WASH into other development initiatives enabled the project to get in on the ground floor on subjects that are gaining traction at USAID and globally, such as WASH and nutrition, neglected tropical diseases, and MHM. This integration focus dovetailed nicely with the project’s mandate to serve a technical leadership role, and project staff had many opportunities this year to share its work and lessons from the field on a global stage, strategize with partners on important advocacy issues, inform policy, and develop guidance in multiple countries. Also toward that end, WASHplus launched its first two learning briefs on small doable actions and WASH and nutrition. This series details the variety of approaches WASHplus uses to improve WASH and household air pollution (HAP) across its portfolio of countries.

And finally, it’s been an exciting year for innovation with pilot projects underway in Ethiopia and Bangladesh focusing on sanitation marketing and sand envelopment. These two efforts will add to WASHplus’s body of knowledge on sanitation innovation and aligns closely with USAID’s global interest on the topic. WASHplus is also documenting its fecal sludge management work in Madagascar to tell the next chapter in that story.

Galvanizing Schools to Take Action in Benin

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Over the past few months, WASHplus through implementing partner ABMS/PSI has stepped up advocacy for latrine improvement in several public schools in Benin.  One school, with a student population of 1,500, has four latrine blocks that are unusable because they are full.  Even though WASHplus/ABMS and school officials successfully lobbied the Ministry of Education for a USD $200 line item for pit emptying, the urgency of the situation prompted the PTA to front the money and hire a pit empying service soon thereafter. The head of the PTA explained that joint meetings called by WASHplus/ABMS field staff to bring the group of teachers, the school director, and PTA members to the actual site of the latrine blocks and expose them to the extreme contamination “Woke us up.” WASHplus is supporting development of a sustainable usage and maintenance plan along with installation of handwashing facilities and possible additional latrine construction. Read the full story here.

 

 

 

Benin: Model Moms

Benin Model MomsA mother is interviewed as part of the model moms contest.WASHplus implementing partner in Benin ABMS/PSI conducted an informal assessment via simple questionnaire and observations of any hygiene behavior changes in the two peri-urban pilot neighborhoods of Cotonou. This allowed outreach workers to observe improvements in hygiene practices the project is advocating, such as handwashing and point-of-use water treatment, and to select candidates for “Model Mother.” Of the 300 mothers assessed, 123 had perfect scores on a scale of one to 10, with 72 others close behind. Winners will be announced soon with much fanfare to continue to motivate others.

Benin: Disappearing Tippy Taps, WASH Partout

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WASHplus’s peri-urban hygiene improvement project in Benin, being implemented by partner ABMS/PSI, encourages households to build their own tippy taps to facilitate handwashing. Outreach workers noted that tippy taps were disappearing shortly after installation. An inquiry revealed that children were appropriating the tippy taps to use as toys, for lack of better options. In a recent quarterly progress review meeting in two target neighborhoods, outreach workers consulted community leaders and household representatives to come up with solutions. As a result, the group decided to adopt more permanent handwashing stations using 25-liter jerry cans, and install them in the public toilets open to everyone, but which had lacked handwashing facilities.

In another development, in the spirit of “WASH Partout” (WASH Everywhere), the Benin program has branched out from promoting handwashing and water treatment at household level to promotion at the local schools. During a hands-on training, teachers learned how to make different models of tippy taps and incorporate handwashing into their hygiene lessons at school. The schools and staff from implementing partner ABMS/PSI seized the opportunity to formulate criteria and a point system to certify schools as WASH-Friendly.

Learning by Observation: Children and Hand Washing in Periurban Cotonou

armand picby Armand A. AGUIDI, WASHplus Coordinator in Benin

Although they are important beneficiaries of hand washing awareness raising campaigns, children are not directly targeted by community mobilizers unless the activities take place at schools. Household-based activities target primarily, and sometimes exclusively, mothers or children’s  caretakers. In fact when children attend these awareness-raising activities geared toward their parents, they are not always welcome. The organizers, and also the parents, don’t hesitate to chase away these “troublemakers” so attention can be focused on the adults.

However, my observation of community mobilization activities in periurban districts of Cotonou calls attention to the missed opportunities of this adult-centered approach.

Setting up a Hand Washing Device in Enagnon

During a tippy tap training organized at a youth center in Enagnon, one of the WASHplus intervention neighborhoods of Cotonou, two things captured the participant’s attention: demonstration of the various hand washing devices and the group of children gathered together to follow the activities. The gathering was particularly large during the fixed hand washing device testing, and these children attentively followed the way in which the trainees washed their hands. They were very disappointed when, at the end of the exercise, the device was moved from the doorway to the interior of the training center, preventing any access to it. The situation changed when one of the participants asked that the hand washing device be displayed again by the doorway and left within the children’s reach. We then observed the children moving automatically as a group toward the hand washing device.

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We may be tempted to attribute part of the children’s interest to curiosity, but we must nevertheless also recognize that this attitude demonstrates the potential for flexibility, maneuverability, and willingness of children, all important elements in behavior change activities.

Later in the day the same afflux of children was observed watching a hand washing with soap demonstration for mothers. Although they lacked permission from the hygiene promoters to participate in the demonstration, these children attentively followed the actions and gestures of the adults from start to finish. Imagine our surprise when we passed by the same house a few minutes later and saw the children gathered around the water giving each other a lesson in washing their hands with water and soap. They were inspired by the advice given to their parents a few minutes earlier. 

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Children Imitate and Learn

We observed that children gather around each time hygiene promoters visit households to present information. Often the adults chase them away or prevent them from having access to the tools utilized. But driven by curiosity, they resist in many cases and find ways to overcome their exclusion. They attentively observe the adults’ actions, they memorize and imitate them, and instruct themselves at the same time as the adults. Therefore, without knowing it, and also without meaning to, the hygiene promoters train both parents and children, killing two birds with one stone. The impact is thus amplified and increases in value.

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These comments on the hygiene promoters relate primarily to the fact that no room is made for children within household behavior change activities. School seems to be the only environment for children to learn about these activities. In reality, children are also available when they are at home and must be included in, or at a minimum tolerated during, sessions held with their parents. Children should, from now, be considered as direct beneficiaries of household awareness-raising activities, and be invited to the household hand washing sessions in the same way as their parents. For this learning by observation, no particular effort is needed except to hold the sessions in places that facilitate children’s access.

In educational psychology, we say that learning by observation and imitation necessitate the presence of a model (in this case, the hygiene promoter) who demonstrates a behavior, and a trainee (in this case, the child) who observes. The model doesn’t necessarily have the intention of teaching; it is the trainee who decides to learn from the model.

Children Look for Models

In every society, human beings need a course of action, a model to follow, people to refer to. This need for a model is even more pronounced in children.

Where hand washing ins concerned, children also look to their parents as models. Parents must tell themselves that children want to see their parents adopt the promoted behaviors not just hear about them. When hand washing becomes a regular habit of the parents, the behavior will be reproduced by the children with significant benefits to everyone’s well-being.

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Children are Information Carriers and Awareness Raisers

Beyond the fact that children reproduce their parents’ gestures and in this way ensure the adoption of desired behaviors, children can also serve as information carriers to their families and with their friends. It is not rare to see children correcting their parents. In objecting, “Oh mom, you told us that we must always wash our hands before eating, but you didn’t do it,” the child points out the parent’s responsibility to model correct behavior and reminds her that her lesson was well absorbed by her child. Didn’t the poet say, “Each child that we teach is a person we win?”

It follows that children must not be expelled or excluded from household awareness-raising sessions. They must not be barred because in raising awareness with their mothers, we target them indirectly. Hygiene promoters will benefit from accepting them and letting them express themselves.

L’apprentissage par l’observation: les enfants et le lavage des mains en milieu périurbain de Cotonou

armand picArmand A. AGUIDI, Coordonnateur de WASHplus au Benin

Quoique faisant pleinement partie des bénéficiaires finaux des programmes de sensibilisation pour le lavage des mains les enfants ne sont directement visés par les animateurs que lorsque leurs activités sont orientées vers les écoles. Dans les maisons par contre, ils ciblent prioritairement et parfois exclusivement les mères ou les gardiennes d’enfants. Dans certains cas, lorsque les enfants viennent assister à ces actions de sensibilisation qui visent leurs parents, ils ne sont pas toujours les bienvenus. Les animateurs et même les parents n’hésitent pas à chasser ces « perturbateurs » qui s’attroupent autour d’eux avec incongruité afin d’accorder toute leur attention aux adultes.

Cependant, des expériences vécues ces derniers temps au cours de certaines actions de mobilisation  communautaire dans les quartiers périurbains de Cotonou, interpellent sur l’attitude  à adopter face aux enfants dans les actions de communication interpersonnelle à domicile.

La mise en place du dispositif de lave-mains à Enagnon

Lors de la formation des relais sur le tipi-tap organisée à la maison des jeunes de Enagnon l’un des quartiers d’intervention du projet USAID/WASHplus (Programme Péri-urbain d’Amélioration de l’Hygiène) au Benin, outre l’intérêt des participants pour les outils variés de lavage des mains qui leur sont proposés, le comportement d’un autre groupe a attiré l’attention des participants. Il s’agit des enfants massivement mobilisés pour suivre les activités et surtout les outils de lavage des mains montés sur place. La mobilisation de ce groupe a été  particulièrement plus grande lors de la phase d’expérimentation du dispositif et ces enfants suivaient avec beaucoup d’attention la façon dont les relais procédaient pour se laver les mains. Aussi, grande a été leur déception lorsqu’ à la fin de l’exercice le dispositif a été déplacé du portail du centre de formation vers l’intérieur leur empêchant tout accès. Mais la situation a changé lorsque l’un des participants a demandé que le dispositif de lave-mains soit exposé à nouveau au portail et laissé à la portée des enfants. En effet, nous avons observé un mouvement automatique et général des enfants vers le dispositif de lave-mains.

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Même si   on peut être tenté d’attribuer en partie cet intérêt des enfants à la curiosité, il faut cependant reconnaitre aussi  que cette attitude montre d’une certaine façon le potentiel de flexibilité, de maniabilité et de volonté chez l’enfant autant d’éléments qui comptent dans une activité de communication pour un changement de comportement.

La démonstration du lavage des mains avec les femmes mères d’enfants dans le quartier Enagnon

Au cours d’une séance de démonstration du lavage des mains à l’eau et au savon dans le quartier Enagnon dans la même journée, le même attroupement d’enfants autour des adultes s’est observé. Suivant attentivement, à défaut d’avoir été autorisé par les relais communautaires à participer aux côtés de leurs parents à la démonstration, ces enfants ont usé de patience pour suivre les faits et gestes des adultes jusqu’à la fin.  Quelle n’a pas été notre surprise de repasser une dizaine de minutes plus tard devant la même maison et de voir les enfants qui autrefois n’avait pas eu la possibilité de participer à la démonstration de lavage de mains rassemblés autour de l’eau pour s’offrir à leur tour leur séance de lavage des mains à l’eau et au savon. Ils se sont inspirés des conseils donnés à leurs parents quelques minutes plus tôt par les relais communautaires pour faire un lavage des mains dans les règles de l’art.

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Les enfants apprennent en imitant

L’une des remarques faites lors des différentes séances est que les enfants  se mobilisent massivement chaque fois que des informations doivent être transmises aux ménages par des  agents communautaires. Bien souvent aussi les adultes les chassent des lieux ou les empêchent d’y avoir accès ou encore d’avoir accès aux outils utilisés.  Mais poussés par la curiosité, ils résistent dans bien des cas et finissent par se trouver une place et à vaincre ainsi l’exclusion. Ils observent avec attentions les actions des adultes, les mémorisent et les reprennent, s’instruisant ainsi en même temps que ces derniers. Sans le savoir donc et même sans le vouloir, les relais communautaires forment parents et enfants faisant d’une pierre deux coups. Le travail s’en trouve amplifié et mieux valorisé.

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Les remarques faites plus haut sur l’attitude des relais communautaires est principalement due au fait qu’aucune place n’est faite aux  enfants dans les activités de communication pour un changement de comportement  à domicile. On s’imagine que l’école est le seul endroit où les enfants peuvent être touchés par ces activités. Mais en réalité, les enfants sont aussi disponibles quand ils sont à la maison et doivent être associés ou simplement tolérés lors des séances tenues avec leurs parents. Il est donc important désormais que les enfants soient considérés comme des bénéficiaires directs des actions de sensibilisation à domicile et qu’ils soient invités au même titre que les parents aux séances de sensibilisation pour le lavage des mains dans les maisons. Pour cet apprentissage par observation, aucun effort particulier n’est demandé sinon de tenir les séances dans des endroits qui leur facilitent l’accès.

En psychologie de l’éducation, on dit que l’apprentissage par observation et imitation nécessite la présence d’un modèle (en l’espèce le relais communautaire), qui produit un comportement, et d’un apprenti (en l’espèce l’enfant) qui observe. Le modèle n’a pas forcément l’intention de lui apprendre, c’est l’apprenti qui décide d’apprendre via le modèle.

Les enfants recherchent des modèles

Dans toute société, les êtres humains ont besoin d’une ligne de conduite, d’un modèle à suivre, de personnes de référence. Ce besoin de modèle est encore plus prononcé chez l’enfant.

C’est ainsi que démarre chez l’enfant le processus d’imitation. Dès son plus jeune âge, l’enfant cherche un modèle à imiter. C’est pour cela qu’on voit souvent les enfants qui   imitent leurs parents, leurs frères et sœurs ainés. Par ce fait, ils reproduisent leurs gestes et se les approprient.

Dans le domaine du lavage des mains aussi les enfants recherchent, en leurs parents, des modèles à imiter. Un grand défi se pose donc à ces derniers qui, pour assurer l’enseignement par l’exemple, ont l’obligation d’adopter les bons gestes et les bons comportements.  Chaque parent doit donc se dire qu’au-delà des  mots son enfant veut le voir adopter les comportements qu’il veut que son enfant adopte. C’est pour cela que le lavage des mains doit entrer dans les habitudes des parents afin d’être reproduit par les enfants pour leur bien-être physique.

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Les enfants sont des  vecteurs d’informations et des éveilleurs de conscience

Au-delà du fait qu’ils reproduisent les gestes de leurs parents et s’assurent par cette voie l’adoption des comportements souhaités, les enfants peuvent aussi être des vecteurs d’information dans leur famille et auprès de leurs amis. Il n’est pas rare de voir les enfants rappeler aux parents « déviants » les bons gestes que ces derniers leur ont appris eux-mêmes. En objectant « Ah maman, tu nous avais dit qu’on doit toujours se laver les mains avant de manger, mais tu ne l’as pas fait », l’enfant accroit la responsabilité du parent et lui rappelle que sa leçon a été bien assimilée par son enfant. Le poète n’a-t-il pas dit que « chaque enfant qu’on enseigne est un homme qu’on gagne »?

Il résulte de ce qui précède que les enfants ne doivent pas être renvoyés ni exclus des séances de sensibilisation à domicile. Ils ne doivent pas être empêchés de paroles alors même qu’en sensibilisant leurs mères, on les vise indirectement. Les animateurs gagneront à les accepter et les laisser s’exprimer.