Since 2006, the Viet Nam Ministry of Health and the Viet Nam Women’s Union, with support from the World Bank’s Water and Sanitation Program (WSP), have been carrying out an evidence-based, comprehensive behaviour change communications programme to promote handwashing with soap (HWWS) among women aged 15-49 and schoolchildren aged 6-10 throughout Viet Nam. The ultimate objective is to reduce the incidence of diarrhoeal diseases in children under the age of five.

The programme has reached more than 1.8 million people in the first phase, with a target of 30 million in phase II. Viet Nam is one of four countries (along with Tanzania, Senegal and Peru) involved in a large global Scaling Up HWWS Behaviour Change project by WSP. This tests whether innovative behaviour change approaches can generate widespread and sustained changes in handwashing with soap habits in target populations. To date, the programme has developed two communications campaigns, one aimed at caretakers of children under the age of five and the other targeting rural and semi-urban schoolchildren in Viet Nam.

Complimentary campaigns

In developing the communications campaigns, a framework was created to analyse formative research findings; campaign concepts were designed for pre-testing and adjustment; and there was a monitoring system designed based on the communications campaign objectives. This process resulted in complimentary campaigns: one for caretakers that taps into the aspirations of mothers to ensure the health and development of their children; and a children’s programme that promotes handwashing with soap through games, contests and a cartoon series shown on children’s channels. The campaigns integrate national mass media, community-based interpersonal communications activities, high-impact community marketing events and public relations and advocacy aimed at national policy makers.

Soap “expensive” but smells sweet

After extensive research, the group published the following findings from the research with caretakers:

• 92% of caretakers reported washing hands at critical junctures - but only with water;
• 60% of caretakers who washed their hands did not feel that soap was important or necessary;
• Caretakers were most concerned with ensuring that their children meet developmental milestones so that they are able to keep up with their peers;
• Smell is the most salient product associated with soap;
• Many caretakers reported that “soap was too expensive,” yet most households had at least one type of soap;
• Television is the best way to reach caretakers, but Women’s Union members and heath workers are the most trusted sources of information.

The FOAM framework

At the time that the formative research study was completed in Vietnam, there was no framework for a handwashing with soap programme. WSP developed a framework titled FOAM to help guide programme staff in the four focus countries in designing and monitoring their handwashing communications programmes. This framework was applied in the context of Viet Nam to analyse factors that can facilitate or hinder HWWS behaviour.

These include:

• Focus: who is the target audience and what is the behaviour we want them to adopt?
• Opportunity: is the target audience able to carry out the behaviour?
• Ability: is the target audience capable of carrying out the behaviour?
• Motivation: does the target audience want to carry out the behaviour?

An end line impact evaluation is planned for the end of 2010, but there has already been significant demand from other donor and government programmes for integration of handwashing with soap messages into their water and sanitation programs using the materials developed by the Handwashing Initiative.

* Note: This summary is taken from a paper presented by Nga Kim Nguyen at the January 2010 South Asia Hygiene Practitioners’ Workshop in Dhaka, Bangladesh. Ms. Nguyen’s presentation also includes practical recommendations for programme managers of behaviour change programmes and includes examples of the communications materials developed for the Viet Nam Handwashing Initiative. The presentation and others from the Workshop are being compiled in a joint publication from WSSCC, WaterAid, BRAC and IRC, the co-convenors.

For more information, contact the Secretariat.

Tags: east asia & pacific, gender, hygiene promotion, information and communication, on-site sanitation, school sanitation