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Public-private partnership to
promote handwashing in Ghana
What was
new about the program?
The Ghana handwashing program made contamination
visible to the ordinary Ghanaian for the first time,
effectively communicating a hygiene message using
commercial marketing techniques..
Background
In Ghana, diarrhea accounts for 25 percent of all
deaths in children under five and is among the top
three reported causes of morbidity. Children under
five typically have three-five episodes of diarrhea
and a similar number of respiratory infections a year.
Nine million episodes of disease could be prevented
each year by washing hands with soap.
Ghanaians use soap, and they buy a lot of it. However,
the soap is almost all used for cleaning clothes,
washing dishes and bathing. In a baseline study, 75
percent of mothers claimed to wash hands with soap
after toilet use, but structured observation showed
that only 3 percent did so, while 32 percent washed
their hands with water only. Mothers who did wash
hands with soap generally did so because it felt good
to remove dirty matter from hands, it was refreshing,
it was a way of caring for children and it could
enhance their social status.
The Ghana Public-Private Partnership to Promote
Handwashing with soap crafted a high-impact
communication strategy with the slogan “For Truly
Clean Hands, Always Wash with Soap.” The intensive
phase of the program’s communication activities was
carried out in the period 2004-06. During this phase,
the program used three routes to bring the handwashing
with soap message to the target audiences – mothers
and caregivers of children under five years and
children in basic school, ages 6-15 years, across the
whole country. The routes included mass media, direct
consumer contact and a district-level program through
schools, health centers and communities. The
communication strategy also included a public
relations and advocacy component that targeted policy
makers and opinion leaders and promoted the provision
of handwashing infrastructure in schools and public
latrines.
The Communication
Strategy
Achievements Mass media: The program employed
state-of-the-art marketing strategies. The guiding
concept for this phase of work was “Your hands are
only truly clean if washed with soap.” Two radio and
two TV adverts suggested that there was “‘something’
on your hands,” suggesting an unknown menace, an
unseen contamination that only soap could remove. The
two radio adverts and a TV advert targeted mothers and
caregivers, while the other TV advert targeted
children. The radio and television adverts were
supported by posters and billboards sited in all 110
district and 10 regional capitals of the country, and
the distribution of promotional items like badges,
T-shirts, branded poly bags and soap. The radio and TV
adverts ran for six months, with particularly intense
activity in the first three months
of the campaign.
Direct to consumer contact: Under the Direct Consumer
Contact (DCC) Programme, an event management firm
visited two districts per region in six regions and
conducted 128 high-impact events in schools to reach
103,313 school children, 2,930 teachers, 926 food
vendors and 132 events in health centers and
communities for 11,500 mothers. DCC is used as an
interpersonal communication strategy that provides
information on handwashing with soap in an innovative
and interactive, face-toface manner. This direct
contact allows consumers to ask questions and converse
about handwashing with soap, which facilitates
behavior change.
PR
campaign: A public relations program targeted at
opinion leaders and strategic targets delivered
continued press and media coverage in support of the
aims of the handwashing program. A number of radio and
television discussion programs and interviews were
held throughout the country on national media and
district-specific FM radio stations. An advocacy
brochure that outlined the strategy for the initiative
was also produced and distributed to strategic targets
and partners. An evaluation reported that, after six
months of the campaign, rates for handwashing with
soap for mothers were over 80 percent. Exposure to all
campaign materials was also high, with almost everyone
aware of and able to sing the campaign theme song, and
with more than 80 percent of children and adults
reporting more handwashing with soap since the
campaign.
The Ghana handwashing program for the first time made
contamination visible to the ordinary Ghanaian and was
able to communicate a hygiene message in an innovative
manner along the lines of commercial marketing.
Lessons
A major lesson from the Ghana program was that when
partners from different backgrounds and sectors are
not accustomed to working together, establishing
common grounds and trust takes time and effort.
Another important take-home lesson was that the public
and private sector can work together for the public
good when there is transparency, the strengths of
reach are recognized and each member is treated as an
equal in the partnership. |
