WASH infrastructure without behaviour change isn’t WASH!

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By Regina Souter*

The importance of ensuring everyone has access to sustainable clean water, safe sanitation, and is able to practice safe hygiene (or WASH as it is commonly known) is widely accepted. Sustainable Development Goal 6 is the most recent global agreement recognising and prioritising this need.

Historically, WASH projects focused on providing access to infrastructure, on the assumption that if facilities exist people will use them. However, the behaviour of users‒women, men, children, the elderly, those living with disabilities, and the families, households and communities of which they are part‒must also be considered in order that those improved services can deliver the greatest benefits.

The importance of behaviour, defined as “the way in which a person or group acts or conducts themselves in response to a particular action or stimulus”, to positive outcomes has been acknowledged for decades. The WASH sector has traditionally been dominated by engineers, whose training and skills are rarely grounded in the behavioural sciences–practice has, too often, not followed the understanding of the need.

What are WASH behaviours and why are they important?

There are a range of behaviours that are important if WASH infrastructure is to be used in the way intended, to deliver benefits to individuals and communities. These include:

  • water access, transport and storage–ensuring no contamination at any stage of securing/using water
  • operation and maintenance of toilets–ensuring faecal matter is safely contained
  • handwashing with soap (especially at critical times: contact with faeces, prior to handling food/water)–minimising spread of disease
  • infant faeces disposal–ensuring safe containment of faeces and minimise spread
  • menstrual hygiene management–minimising possible negative social (e.g. withdrawal from school) and health problems (e.g. reproductive tract infections)

Without promotion of safe WASH behaviours, facilities can be misused or quickly become disused. Habits, including those related to how we handle human waste and keep ourselves, our dependants and our immediate environment clean, are learned by early experiences and are deeply ingrained. Even with new facilities, it is easy to return to personal, traditional, habitual behaviours, and therefore to negate the health and wellbeing benefits that were intended.

How can we influence WASH behaviours?

To influence peoples’ WASh behaviours, we need to draw on knowledge about human behaviours, in particular our understanding about what influences human behaviours and how habits form. Several frameworks explaining the drivers of WASH behaviours and opportunities for influencing them have been developed, including Evo-Eco, FOAM/SaniFOAM, IBM-WASH and RANAS. From such knowledge, we can identify that peoples’ WASH behaviours are influenced by several factors:

  • knowledge about the behaviour (what, why, when, how?)
  • access to facilities/resources required to practice the behaviour
  • intention to practice the behaviour–which is determined by social norms, formal rules (e.g. regulations), cues/reminders, expected social roles, and their personal motivations relating to the behaviour (social/emotional drivers, beliefs & attitudes).

Recent experience indicates that interventions aiming to change behaviours require a mix of cognitive knowledge, infrastructure and emotional aspects to achieve lasting behaviour change (the forming of new habits). All such approaches must be based on a good understanding of the local socio-cultural, economic and physical context.

WASH programmers and practitioners are increasingly aware of the need to consider how people will use and interact with WASH infrastructure; many WASH programs now incorporate specific behaviour change projects to complement infrastructure components. Despite this awareness, and the building the understanding and evidence of theories to support changing WASH behaviours, the skills to design, deliver and monitor behaviour change campaigns are not widespread amongst WASH practitioners and programmers.

Building behaviour change capabilities amongst WASH practitioners

The International WaterCentre’s (IWC) Online Training course “WASH & Behaviour Change” aims to build practical skills of WASH practitioners and programmers to guide the integration of behaviour change into WASH programmes.

During this eight-week course, IWC draws upon its expertise and experience in WASH to deliver a highly practical course drawing on lessons from working with organisations to improve WASH outcomes. The course offers individuals and organisations an opportunity to develop the necessary skills in behaviour change interventions to diversify their WASH programmes to include evidence-based behaviour change interventions and contribute to successful delivery of water and sanitation.

The key topics include understanding the need for, and role of, behaviour change integration into WASH programmes, alternatives to education and awareness strategies for changing behaviours, planning and designing interventions that address risky WASH behaviours, and implementing and evaluating behaviour change interventions within WASH programmes.

*Regina Souter is Program Manager-Capacity development, Training, Research for the International WaterCentre. Regina helps to formulate and manage research ideas and teams, and to translate research to application for water and WASH practitioners.