What is new about the UNICEF approach?
UNICEF recognizes the potential of children as agents of handwashing behavior change by coupling water and sanitation improvements in schools with hygiene education. The use of environmental health clubs, drama groups and student focus groups creates the conditions for children themselves to be agents of change in their schools, families and communities
Children have historically had few if any roles in school decision making, let alone in community-based programming in hygiene and sanitation. UNICEF works toward making schools healthier and more attractive to children, especially girls, through school-based water,
sanitation and hygiene programs. Guiding this approach is the knowledge that healthier children are more effective learners, and girls who spend less time fetching water have more time for school.
Helping to build separate and decent sanitation facilities in schools can reduce dropout rates, especially among girls.
The following UNICEF country programs illustrate the impact children are having on improving handwashing with soap behavior:
Nigeria. Efforts in Nigeria to change the classroom environment are childcentered, including forming children’s hygiene and child rights clubs, training teachers in life skills education, involving parents and encouraging village artisans to participate in hygiene and sanitation projects. One school initiated an Environmental Health Club, where students promote handwashing with soap in both the school and the community and advocate for secure household water supplies to continue hygienic behavior at home. With the help of a teacher, the 12 girls and 18 boys who make up the club operate and
maintain the facilities and keep track of the borehole’s usage. The club funds its activities by selling plastic buckets and clay pots fitted with taps. Two years after the project’s inception, handwashing among children increased by 95 percent. Teachers reported that students came to school clean and had fewer cases of ringworm and other skin diseases. In addition, school attendance grew steadily each year, from 320 pupils when the program was initiated to 538 in 2001.
Indonesia. A primary school project called “Dokter kecil,” or little doctors, develops school clubs, consisting of 30 students from grades four to six, that promote hygiene through community theater and other lively, interactive activities. The children put on school plays for their parents and other community members that convey lessons on the importance of washing hands with soap before preparing food or eating and after using the toilet. The students’ work of improving the health of their community goes beyond their theater productions. They also take charge of the village’s Jum’at Bersih (Clean Friday), a national movement, begun in 1994, that encourages hygiene promotion, particularly handwashing with soap, during meetings on Islam’s holy day. The little doctors are becoming leaders, learning to communicate
clearly and effectively, solve problems, negotiate and analyze. “People love drama, and parents especially love to see their children perform,” said one of the supervising teachers. “It is far more effective than telling people directly to change the way they do things.”
Malawi. An approach in Malawi honors the right of children to participate in a process of developing and instituting national standards for sanitation facilities and hygiene promotion in
primary schools. National review teams interviewed children on what they liked and disliked about their sanitation facilities and hygiene education programs. The children spoke candidly and perceptively of the changes needed, and their insights are being used to modify the technical designs and approach to health behavior change. The children proved keen advocates for better sanitation and child-friendly health education. Comic books based on their feedback have already been designed for grades five to eight. This approach and the insights derived are being seen more actively as having potential applications for programming improvements in nutrition, education, health and other areas.
UNICEF’s experience in promoting handwashing with soap in schools as part of a larger water, sanitation and hygiene effort shows how important it is to involve children themselves as active participants with real project responsibilities rather than as passive targets of health messages. Combining handwashing with soap promotion with hands-on school improvements also creates in the children a sense of ownership that makes new behaviors more likely to stick.