14.3.1 Rapid assessment of hygiene behaviour
As noted above, when responding to an emergency, the first step is to make an assessment so that the situation is understood. Rapid initial assessments will provide information about the nature and scale of the emergency and the likely need for external assistance (WHO, 2002). There will need to be detailed assessments to plan, implement and coordinate responses to meet basic needs for water, food, shelter and medical care. Part of this assessment will be a behavioural situation analysis, such as you encountered in Study Session 8. This will provide understanding of current hygiene behaviours and identify where change is needed and how behaviour change could be achieved. In particular, the assessment should try to identify any key practices that may be putting people at risk, and any alternative or safer practices which would help to mitigate such risks. It should identify any barriers that might prevent people from adopting safer practices and any key motivating factors that will enable change. It should also ascertain preferred communication channels for different participant groups and identify any particularly vulnerable or high-risk groups.
The World Health Organization (2004) recommends the following checklist of questions for a rapid assessment of the public health situation in a community affected by an emergency:
- What health-related behaviours are contributing to public health risks faced by the affected population?
- What are the common health-related practices among the affected population and how have these been affected by the emergency?
- What are the current practices on key hygiene behaviours such as:
- washing hands after defecation?
- disposal of children‘s faeces?
- storage and handling of water?
- storage and handling of food?
- How is the community disposing of their solid waste?
- Is there an understanding in the community of the relationship between water/sanitation/shelter/vectors and disease?
- Does the community have access to water containers with lids/cooking utensils/mosquito nets/soap/sanitary protection/blankets/bathing facilities?
- Are the users involved in the management and maintenance of water sources and latrines?
- What health promotion media are available/accessible to the affected population (radio, posters/leaflets, local folk media and others)?
The answers to these questions will help you identify the key hygiene behaviours in the community affected by the emergency and therefore to target the high-risk behaviours for public health promotion activities. While designing the hygiene promotion campaign in an emergency situation it is important to consider the community’s traditional practices and the facilities available, as well as the damage caused by the emergency. You should also pay special attention to the needs of vulnerable groups such as the sick and wounded, children, the elderly and pregnant women.
What are the main areas of concern for an emergency hygiene promotion programme?
There are many areas of concern, but the main ones are probably:
- safe disposal of faeces
- handwashing after defecation and prior to food preparation
- clean water use and storage
- control of flies and other insect vectors
- personal hygiene (particularly for women and girls)
- food hygiene.