Participatory hygiene education : a people centred approach to behaviour change in hygiene : a description of the first three and a half years of the development and introduction of participatory hygiene education methods and tool in Zimbabwe

The Participatory Hygiene Education Project (PHE) (Zimbabwe) has been operating for three and a half years; one and a half years in the development of methods and tools in the field and two years in the promotion and dissemination of PHE. The project is about facilitating the change of approach in hygiene education from a didactic technical model to a participatory social one. The ultimate goal being that all extension staff will be using participatory methods in their learning sessions with community groups and a participatory approach and methods will be very influential in bringing about behaviour change in hygiene practices. The PHE project is finally to be measured in terms of behaviour change. PHE is based on the principle that people will begin to change their behaviour practices when they have been able to analyze all aspects of their situation and the available options. The project advocates what it calls people-centred methods resting on the use of visuals, mainly single line drawings of everyday events relating to hygiene, to initiate a process of analysis and discussion. These visuals and the method to facilitate a learning session using the visuals is called a tool. These tools have been the mainstay of the project, acting as a mechanism by which environmental health technicians were able to apply participatory methods; a means by which hygiene education could have an identity and a means around which a tangible programme of activities for hygiene education could be built. It should be emphasized that it was not the production of material that was central to the project, but rather the use of the tools and their influence in the community. At an institutional level the PHE project has raised the profile of hygiene education and made hygiene education a tangible entity for which specific plans and targets can be made. As result, the funding has increased and overall there is more specifically planned and prepared activities for hygiene education. Attitudes of staff at all levels has become increasingly positive towards the PHE approach, and its methods are being adopted by other projects. A major weakness of PHE is seen as being the lack of indicators for behaviour change that can be used as a sign post for extension staff as well as a way to measure change. In the future a regular and reliable follow-up support system for extension staff will need to be set up, making PHE a standard part of the basic training for Nurses and Environmental Health Technicians, including behaviour change indicators into the reporting system and putting community capacity process indicators into extension staff performance appraisals.