21.3  Motivating people to change their behaviour

Health education is frequently delivered by someone lecturing about hygiene and sanitation in health facilities and community gatherings. However, such an approach is not recommended as the sole means to achieve individual behaviour change. Because human behaviour is influenced by the surrounding environment and social context, specific messages instead of universal messages of hygiene and sanitation are more important. Hygiene messages must be contextually and culturally suitable, and comfortable, for your community.

If you are trying to change behaviour by targeting individuals, you need to consider not only their prior experience but also their learned behaviours. These are the habits gained by social learning channels, i.e. from parents, friends and opinion leaders in their community. Each individual has their own beliefs, values and knowledge about health practices. People may ask themselves, before adopting a new behaviour, if the new practices are going to fit with their ideas and way of life. They need to be convinced that there will be important benefits from changing their behaviour.

Different motivational techniques can be used to good effect (see Box 21.1).

Box 21.1  Case study: Reasons for building latrines

In villages of Achefer woreda, different promotional techniques were used to encourage households to build pit latrines. Community members were asked which of these techniques was most effective. They were asked to choose the three most important reasons out of seven techniques that had been used. Table 21.1 shows the responses from 300 people.

Table 21.1  Reasons for building latrines in Achefer woreda.
1House-to-house promotion of latrine building9231.3
2Coffee ceremony to bring people together for discussion7324.8
3Rewarding good practice with a coloured flag to be publicly displayed3913.3
4Government enforcement3612.2
5Influence of friends and neighbours (peer pressure)279.2
6Video show that demonstrated positive behaviour by others237.8
7Fear of being publicly shamed41.4

House-to-house promotion by Health Extension Practitioners and health promoters, and holding coffee ceremonies specifically for hygiene promotion, were more effective than other methods in Achefer. Health promoters, including you, should use all possible ways of hygiene promotion in order to bring positive behaviour at community level.

(Source: adapted from WaterAid in Ethiopia, 2007, The colour of change)

In order to have an impact on health, any change in health practice needs to be adopted by many individuals in your community. Shared behaviour is only achieved when the community members themselves feel there is a problem, and are motivated to solve the problem by jointly taking actions that would permanently improve health conditions.

21.2.2  Handwashing facilities

21.3.1  Using model households