Learning about behavioral determinants of handwashing with soap: What do we know?

Transcription

1 Learning about behavioral determinants of handwashing with soap: What do we know? Global Scaling Up Handwashing Project Annual Meeting Quy Nhon, Vietnam November 2, 2009

2 Session Objectives By the end of the session, participants will: Be aware of learning on behavioral determinants of HW Be aware of learning around enabling products for HW Have identified opportunities to learn more about determinants 2

3 Using FOAM As Framework Focus Opportunity Ability Motivation Target behavior Access/availability Knowledge Beliefs & attitudes Outcome expectations Product attributes Threat Target population Social norms Social support Intention 3

4 Evidence Base Formative research studies Vietnam monitoring household surveys Senegal doer/non doer Peru IE baseline and intercepts (in progress) Tanzania segmentation study (in progress) Other studies/literature 4

5 Challenges/Limitations Not all determinants poured into all surveys Doer non doer in Senegal affected by data collection issues Space/time constraints in IE surveys Developing reliable factors designed to measure determinants (social norms in particular) 5

6 Behavioral Determinants Correlated with HWWS Focus Opportunity Ability Motivation Access/availability Beliefs & attitudes HWWS Peru (most zones) Senegal Knowledge Peru (1 zone) Peru (all zones) Outcome expectations Product attributes Threat Caretakers Social support Social norms Intention 6

7 Other Findings SES, water source and sanitation status also found to be correlated with HWWS (IE Peru) Habit, motivation (personal/house cleanliness) and a lack of cognitive concern about the cost of soap use correlated with HWWS in Kenya (Aunger, Coombes et al) 7

8 Behavioral Determinants Being Targeted by Project Focus Opportunity Ability Motivation HWWS Access/availability Peru Senegal Vietnam Product attributes Knowledge All Beliefs & attitudes All Outcome expectations Vietnam Tanzania Threat Caretakers Social norms Tanzania Social support Peru Intention Senegal 8

9 What Effect Are We Having? Change in determinants = leading indicator for HW and in Results framework Planned surveys: Vietnam monitoring, Tanzania tracking survey and Senegal doer-non-doer Limited data points Need to maximize use of planned surveys 9

10 Potential Role of Enabling Products Having soap in proximity of latrine is predictor of HW Having a designated place for HW is significantly associated with HW in Senegal and Peru An association was found between increase rates of HWWS after latrine use and ownership of washstand (Biran, 2005) Given emergent learning on opportunity/access, we are examining role of enabling products such as tippy-taps and HW stations 10

11 What Do Not We Know About Enabling Products What outcomes/results were achieved from the use of enabling products? What has limited scale and take-up of existing enabling products and what are other lessons learned? Can enabling products facilitate scale up and sustainability of HW? Can social/commercial marketing approaches be used to scale up enabling products? 11

12 Learning Action Plan For Enabling Products Landscape of existing products underway with view of posting a searchable database by January 2 case studies planned by June 2010 Duraplast HW station in Peru plans for a mobile one Rough design of HW station in Vietnam 12

13 Learning on HW Stations from Vietnam Multiple iterations and testing are needed to get design right No one model fits all The mechanics of HWWS are complex Appearances count Size does matter A station is a possible cue to action 13

14 Summary Growing evidence that opportunity determinants are significant Having a designated place has been found to be correlated with HW Learning on enabling products will inform us on potential role to help scale up and sustain HW 14