Training Manual On Community Mobilization Health Promoters .
Amhara National Regional StateHealth BureauTraining ManualonHygiene and SanitationPromotion andCommunity MobilizationforVolunteer CommunityHealth Promoters(VCHP)Supported by:
TOTAL BEHAVIOR CHANGE IN HYGIENE & SANITATIONVCHP GUIDEAcknowledgementsTraining Manual on Hygiene and Sanitation Promotion and Community Mobilization forVolunteer Community Health Promoters (VCHP)/ Draft for Review2
TOTAL BEHAVIOR CHANGE IN HYGIENE & SANITATIONVCHP GUIDETABLE OF CONTENTSPreparation7Workshop Objectives7Workshop Organization8Materials9Unit One – Introduction10Activity 1.1 – Setting the Context10Activity 1.2 – Roots of Fecal Contamination11HandoutBreaking the Cycle of Fecal Contamination14Unit Two – Introduction to Water, Sanitation and Hygiene Key Practices15Activity 2.1 – Review Hand Washing Practices16Activity 2.2 – How Much Water Will it Take?17Activity 2.3 – Preparing Water Saving Devices18Activity 2.4 – Critical WASH Practices: Keeping Water SafeSafe-Looking Water22Activity 2.5 – Keeping Water Safe from Source to Mouth24Handout25The Water ChainActivity 2.6 – Safeguard Water for Drinking26Activity 2.7 – Making Water Safe for Drinking – Water Treatment27Activity 2.8 – How Do We Protect Our Well?34Activity 2.9 – Making Water Safer: Feces Management36Handout38Feces CalculationActivity 2.10 – Latrine Construction and Field Practice42Handout42The Sanitation and Hygiene LadderActivity 2.11 – Building a Hand Washing Device to Wash Hands at CriticalTimes Even When Water is Scarce48HandoutBuilding Hand Washing Devices to Save Water49HandoutHow-to Make a Tippy Tap51HandoutHow to Wash Your Hands53Unit Three – Tools and Techniques for Changing Hygiene and SanitationBehavior at the HOUSEHOLD Level55Activity 3.1 – Small Do-able Actions55Activity 3.2 – Changing Behavior through Small Do-able Actions58Training Manual on Hygiene and Sanitation Promotion and Community Mobilization forVolunteer Community Health Promoters (VCHP)/ Draft for Review3
TOTAL BEHAVIOR CHANGE IN HYGIENE & SANITATIONVCHP GUIDEActivity 3.3 – Tool: MIKIKIR Card59Handout -61MIKIKIR CardActivity 3.4 – Organizing a Good Discussion on WASH63Activity 3.5 – Using the GALIDRAA Steps to Discuss WASH64Activity 3.665VCHP Field Visit PracticeUnit Four – Tools and Techniques for Changing Hygiene and SanitationBehavior at the COMMUNITY Level68Activity 4.1 – Community Organization Tool: Sanitation Clean-up Campaign68Activity 4.2 – Community Organization Tool: The Village Pledge69Activity 4.3 – Establish Community Organizations71Activity 4.4 – Community Organization Tool: Community Conversation72Unit Five Getting Ready to Do YOUR Part in Achieving Total Behavior Change74Activity 5.1 - Opportunities and Obstacles74Activity 5.2 - Action Planning74Closing Exercise75Training Manual on Hygiene and Sanitation Promotion and Community Mobilization forVolunteer Community Health Promoters (VCHP)/ Draft for Review4
TOTAL BEHAVIOR CHANGE IN HYGIENE & SANITATIONVCHP GUIDETraining AgendaPreparing Volunteer Community Health Promotersfor Total Behavior Change in Hygiene & SanitationDAY 1 - Time8:30 – 9:30 a.m.9:30 – 9:50 a.m.9:50 – 10:20 a.m.10:20 – 10:35 a.m.10:35 – 10:55 a.m.10:55 – 11:15 a.m11:15-11:5511:55- 12:4512:45. – 1:45 p.m.1:45 – 2:05 p.m.2:05 – 2:35 p.m.2:35 – 2:50 p.m.2:50 – 3:10 p.m.3:10 – 4:10 p.m.4:10 – 4:30 p.m.4:30 – 5:10 p.m.5:10-5:40 p.m.DAY 2 / Time8:00 a.m. – 9:30 p.m.9:30-1:301:30-2:30 p.m.2:30-2:45 p.m.2:45- 3:15 p.m.3:15-4:00 p.m.4:00-4:15 p.m.4:15-5:15 p.m.5:15- 5:35 p.m.5:35 p.m.Activity #1.11.22.12.22.32.42.52.62.72.82.9optionalActivity #2.102.113.13.23.33.4DAY 3 / Time8:00-8:308:30 a.m. – 12:30 p.m.12:30-1:30 p.m.1:30-1:45 p.m.1:45 – 2:00 p.m.Activity #3.53.62:00-2:15 p.m.2:15 – 2:35 p.m.2:35-3:35 p.m.3:35-3:50 p.m.3:50-4:05 p.m.4:05 – 5:45 p.m.5:45-6:056:05 p.m.4.14.24.34.45.1Activity NameRegistrationIntroduction / Setting the ContextRoots of Fecal ContaminationBREAKIntroduction to Unit 2Review Hand Washing PracticesHow Much Water Will it Take?Preparing Water Saving DevicesLUNCHCritical WASH Practices: Keeping Water SafeKeeping Water Safe from Source to MouthSafeguard Water for DrinkingBREAKMaking Water Safer for Drinking – Water TreatmentHow to Protect our WellMaking Water Safer: Feces ManagementDVD “Awakening” if availableEND OF DAY ONEActivity NameLatrine ConstructionBuilding a hand washing device to wash hands at critical timeseven when water is scarceField Visit: Building Latrines and Handwashing StationsLUNCHDebrief from Field VisitSmall Do-able ActionsChanging Behavior Through Small Do-able ActionsBREAKTool: MIKIKIR CardOrganizing a Good Discussion on WASHEND OF DAY TWOActivity NameUsing GALIDRAA to Organize a Good Discussion on WASHPrepare for Field Visit / VCHP Field Visit PracticeLUNCHDebrief from Field VisitGeneral Discussion on Role of Community MobilizationApproaches for TBCCommunity Organization Tool: Sanitation Clean-up CampaignCommunity Organization Tool: The Village PledgeEstablish Community OrganizationsCommunity Organization Tool: Community ConversationBREAKApplying this to Your WorkClosing SessionClose of TrainingTraining Manual on Hygiene and Sanitation Promotion and Community Mobilization forVolunteer Community Health Promoters (VCHP)/ Draft for Review5
TOTAL BEHAVIOR CHANGE IN HYGIENE & SANITATIONVCHP GUIDETraining Manual on Hygiene and Sanitation Promotion and Community Mobilization forVolunteer Community Health Promoters (VCHP)/ Draft for Review6
TOTAL BEHAVIOR CHANGE IN HYGIENE & SANITATIONVCHP GUIDE1. Preparation Select volunteers with kebele administrator, manager and other kebele resource people Prepare to train volunteersa. Prepare the necessary materialsb. Prepare venuec. Review training guided. Prepare formats, exercise materials as directed in the Training Manual Agree on convenient season and date for training Arrange for two field visits – select sites, visit and prepare; arrange transportation ifneeded2. Workshop ObjectivesAt the end of the workshop, participants will be able to: Recognize and describe roots of faecal contamination Explain the importance of SAFE EXCRETA DISPOSAL, SAFE WATER ANDHAND WASHING in breaking the cycle of Faecal contamination Conduct HOME VISITS to negotiate improved hygiene and sanitation practices. Identify (together with householders) ‘small do-able actions’, feasible and effectivebehaviors based on THEIR current context Use the MIKIKIR job aide for negotiating improved practice Describe how the MIKIKIR approach facilitates a focus on behaviors Identify major barriers and motivators to the 3 key practices from the householders’point of view Build a tippy-tap, water saving device for hand washing that can serve ad demonstrationsite for other community members Construct and improve traditional latrine from local materials that meet minimumstandards Identify the tasks of a VCHP Support HEWs to discuss and raise issues of Hygiene and sanitation and other healthissues in the communities Collect information on number of latrines constructed, hand washing stands, home visitscompost pits etc. Develop ACTION PLANS for the next THREE months to conduct communityconversations, Coffee for Health, and sanitation campaigns in the communities.Training Manual on Hygiene and Sanitation Promotion and Community Mobilization forVolunteer Community Health Promoters (VCHP)/ Draft for Review7
TOTAL BEHAVIOR CHANGE IN HYGIENE & SANITATIONVCHP GUIDE3. Workshop OrganizationThis training activity is divided into five units: Unit One: Introduction to the Cycle of Fecal Contamination and the importance of safeexcreta disposal, safe water and hand washing in breaking the cycle of fecalcontamination.Unit Two: An examination of the Three Key Behaviors of Hygiene and Sanitation TotalBehavior ChangeHand washing with Soap or Soap SubstituteSafe Water Handling and TreatmentFeces ManagementExploring the Role of the Volunteer Community Health Promoter in breaking the cycleof fecal contamination and achieving TOTAL BEHAVIOR CHANGE IN HYGIENEAND SANITATION HW Unit Three: Tools and techniques for changing hygiene and sanitation behavior at theHOUSEHOLD LEVELIdentifying Small Doable Actions to move people toward total behaviorchangeNegotiating Improved Practices using the MIKIKIR and GALIDRAAHow to wash hands correctlyHow to build a hand washing stationHow to build a household latrine Unit Four: Tools and techniques for changing hygiene and sanitation behavior at theCOMMUNITY LEVELCoffee for Health meetingsCommunity ConversationsSanitation Clean-up CampaignsCommunity Declarations Unit Five: Roles and Responsibilities of the VCHWHow do you start?What is your six month plan?Who will you work with?What help/support do you need?Training Manual on Hygiene and Sanitation Promotion and Community Mobilization forVolunteer Community Health Promoters (VCHP)/ Draft for Review8
TOTAL BEHAVIOR CHANGE IN HYGIENE & SANITATIONVCHP GUIDE4. MATERIALS NEEDED FOR HOLDING THE WORKSHOP(According to the number of participants invited, with a maximum of 30 recommended)MATERIALSFlip ChartMarkers (Four different colors, if possible)Package of Index CardsReam of A4 PaperSanitation-related photosJar of Tumeric SpiceBowlBars of SoapEmpty water bottlesHollow pens or strawsNailsBottle of Clean WaterBottle of Salted WaterPalm piece from hand brushDisposable CupAnimal or Human FecesPostersRoll of masking tapeIllustration Book: “How do We Protect Our Well?”BallMIKIKIR Job Aid for Negotiating Improved PracticesMIKIKIR CardsGuidelines for VisitIllustration: “How do We Chlorinate Our Water?”Bottle of Water Guard / Wuha AgarJericansBuckets of water, each with a lid and a spoutDisposable cups or glasses, brought to the meeting by the participantsIllustration: “How do We Boil Our Water?”Illustration: “SODIS method”Transparent 2-liter bottles with lidsPitcher of WaterAide-Memoire: “SODIS Water Purification Method”Coffee/TeaSample of Village PledgeColorful Balls of Yarn for Closing 01303015166301515306303013Training Manual on Hygiene and Sanitation Promotion and Community Mobilization forVolunteer Community Health Promoters (VCHP)/ Draft for Review9
TOTAL BEHAVIOR CHANGE IN HYGIENE & SANITATIONVCHP GUIDE1UNIT ONE - INTRODUCTIONUNIT ONE OBJECTIVESAt the end of this unit, participants will be able toRecognize and describe the roots of fecal contaminationIdentify the relationship between open defecation and water contaminationACTIVITY 1.1INTRODUCTION/SETTING THE CONTEXTPREPARATIONThis session will help participants visualize the role of the Volunteer Community HealthPromoters and the link between WASH and healthy living in their communities.Participants will observe, discuss and analyze the roots of fecal contamination and its effecton the health and identify barriers that can improve the well being of all community membersWrite on the flipchart: Water, sanitation and hygiene improvements can improve everyone’shealth.MATERIALSFlipchartTIME20 minutesPROCEDUREAskparticipants: What is the most important cause of death among children under five inEthiopia? Answer: DiarrheaRefer to the statement on the flipchartAskparticipants to discuss the truth about the written statementPossible answers: Adequate quantities of safe water can reduce diarrhea by one fifth and also reduceschistosomiasis by three quarters. Improved water supply also reduces the time andenergy spent on collection of water, particularly for women and girls. Safe latrines can reduce diarrhea by one third and also reduces intestinal worminfections and malnutrition. Latrines give women and girls privacy and increase theirdignity. Improved hygiene, particularly hand washing at critical times can reduce diarrhea byone third and reduce malnutrition. Face washing reduces trachomaTraining Manual on Hygiene and Sanitation Promotion and Community Mobilization forVolunteer Community Health Promoters (VCHP)/ Draft for Review10
TOTAL BEHAVIOR CHANGE IN HYGIENE & SANITATIONTell Participants:ACTIVITY 1.2VCHP GUIDEPeople who drink safe water, and use clean latrines and practice handwashing at critical times will save money because they will not need tospend money to treat the diseases. They will also be able to work orstudy on the days that they would have been sick.ROOTS OF FECAL CONTAMINATIONPREPARATIONMATERIALSPicture of man and open defecation5 Index Cards8 pieces of A4 paper cut in halfFlipchartTIME30 minutesPROCEDUREFacilitator: Before the session begins, write on the flipchart paper the following words:1. Feet, 2. Flies; 3 Fingers (hand); 4. Fields, 5. Fluids (water supply)Tellparticipants that we will discuss the behavior\s of open defecation.Showparticipants Picture of ODAskWhat happens when someone defecates in the open?Where do the feces go?What happens when it rains?Training Manual on Hygiene and Sanitation Promotion and Community Mobilization forVolunteer Community Health Promoters (VCHP)/ Draft for Review11
TOTAL BEHAVIOR CHANGE IN HYGIENE & SANITATIONVCHP GUIDEPossible answers All excreta is dangerous and needs to be isolated from the environment, including that ofchildren and infants. When someone defecates into the open, we are all at risk of eating the feces. Open Defecation is easily spread to contaminate food and water, making it easy to ingest.This in turn causes diarrhea.PlaceShowOD picture above the 5 words written on the flipchartflip chart with the 5 words written on themOpen defecation is most commonly spread by these “F”s:FeetDivideFliesFingers(Hand)FieldFluid (Watersupply)participants into groups of 5Hand outDiscussinfants?]5 pieces of cut A4 paper and marker per groupAre people disposing of all excreta safely?” [Farmers in fields? Children andWhat could make it easier for community members to stop open defecation?What could prevent the spread of feces into our food and water supply?Write One response per piece of paperAfter the groups have finished their discussions, use the picture of OPENDEFECATION andAsk one group to select and place one prevention behavior written on the paper, under theOPEN DEFECATION pictureTell other groups to place a different response under the OPEN DEFECATION picturePossible Prevention Behaviors:Proper latrine construction and useProper hand washProper water treatment and storageCompound sanitation and proper waste managementWashing ray foods and fruitsProper washing and storage of food utensilsHand washing before preparing and eating foodDebrief: The first defense against open defecation is proper latrine use by every member ofthe family, hand washing and proper water storage and treatment.Training Manual on Hygiene and Sanitation Promotion and Community Mobilization forVolunteer Community Health Promoters (VCHP)/ Draft for Review12
TOTAL BEHAVIOR CHANGE IN HYGIENE & SANITATIONVCHP GUIDE A safe latrine separates the excreta and people if it has a cover or some other kind of sealto prevent flies and people from coming into contact with the excreta. Latrines have the added advantage of providing privacy when they havesuperstructures (walls and a door or curtain). Women and girls in particular reallyappreciate the privacy that latrines provide. Knowing women have their privacymakes the whole family proud. After using the latrine the person can wash their hands so another barrier is to washhands after using the latrine. Excreta can be made safe by burial in the ground. Even a cover or shallow coveringof soil over the top of the excreta will prevent flies from walking and feeding off theexcreta. Where no other type of excreta disposal system is available, burial is a cleanand convenient way of disposal. For example, a person working in the fields canbury his/her excreta with a hoe. This is sometimes called the ‘cat method’. Care needs to be taken to make sure that all excreta, including the excreta of babiesand children, is disposed of in a latrine or is buried. Infants’ feces actually containmore contaminants than even adult feces. Care must be taken to keep the latrine clean and strong.Training Manual on Hygiene and Sanitation Promotion and Community Mobilization forVolunteer Community Health Promoters (VCHP)/ Draft for Review13
TOTAL BEHAVIOR CHANGE IN HYGIENE & SANITATIONVCHP GUIDEBREAKING THE CYCLE OF FECAL CONTAMINATION/KEEPING FECES OUT OF THE ENVIRONMENTTraining Manual on Hygiene and Sanitation Promotion and Community Mobilization forVolunteer Community Health Promoters (VCHP)/ Draft for Review14
TOTAL BEHAVIOR CHANGE IN HYGIENE & SANITATION2VCHP GUIDEUNIT TWO – Introduction to Water Sanitation & Hygiene Key PracticesUNIT TWO OBJECTIVESAt the end of unit two, participants will be able to:Explain the links between WASH and healthy living.Describe critical hand washing practicesIdentify, discuss and demonstrate critical WASH practices that can help improveour health and community healthExplain the links between WASH and healthDescribe critical hand washing practicesReview exercise on hand washingPractice making a tippy tap water saving deviceIdentify various options for making hand washing stations out of local materialsDiscussed ways to keep water safe.Observed and practiced using tools and techniques for changing hygiene andsanitation behavior at the HOUSEHOLD LEVELPracticed skills to build a hand washing stationPracticed steps to build a household latrinePREPARATIONRead preparations for each activity thoroughly. Extensive preparation isneeded for some. This unit also ends with a field visit to build a latrine,which requires preparation. Guidance is provided in the ActivityPreparation section.Introduction to Unit:Ask Participants:What could you do, in your role as VCHP, to help make it easier forpeople to dispose of feces safely?Possible Responses:Help community start safe excreta disposal practices to make a hugedifference in people’s health and well-being. Reducing diarrhea amongchildren and reduce death from diarrhea as it is the main cause of deathin children under 5.Safe excreta disposal, hand washing and safe and secure water will breakthe cycle of fecal contamination all VCHP play a critical role in theircommunities to help community members practice these behaviors thatwill improve their health and well being.VCHW will be involved in:Demonstration Latrines, Hand washing Stations, and other Hygiene-related productsDemonstrate how local skills and materials can be used to construct an approvedtraditional latrineIntroduce hand washing station made from local materialsIntroduce local detergents such as ash (amed or indod).Training Manual on Hygiene and Sanitation Promotion and Community Mobilization forVolunteer Community Health Promoters (VCHP)/ Draft for Review15
TOTAL BEHAVIOR CHANGE IN HYGIENE & SANITATIONVCHP GUIDECommunity mobilization and household visits are essential for TOTAL BEHAVIORCHANGE. The Regional Behavior Change Strategy identifies the critical role ofCOMMUNITY MOBILIZATION AND HOME VISITS in achieving the ambitious goalsof hygiene and Sanitation Improvement.Each workshop participant is here because you have a particular role in achieving the goal, andeach of you has a specific role within the behavior change strategy, primarily around communityand household visits.SayNow we will focus on Hand WashingACTIVITY 2.1REVIEW HAND WASHING PRACTICESOBJECTIVEBy the end of this activity, participants should be able to describe how “invisible feces” easily passes and spreads explain importance of hand washing at critical moments like afterdefecation, before and after food preparation in order to preventcontaminationMATERIALSTurmeric Spice and bowlTIME20 minutesPROCEDUREFacilitator dips hands into a bowl filled with Ethiopian turmeric spice powder.Shake hands with some participants, refilling your hands with the turmeric asnecessary.Participants shake hands with each other too.Touch other surfaces in the classroom, leaving a trail of turmeric.AskBased on the turmeric, how fast does contamination occur?Possible answers highlight t
TOTAL BEHAVIOR CHANGE IN HYGIENE & SANITATION VCHP GUIDE Training Manual on Hygiene and Sanitation Promotion and Community Mobilization for Volunteer Community Health Promoters (VCHP)/ Draft for Review 4 Activity 3.3 – Tool: MIKIKIR Card 59
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TRAINING MANUAL. Robust and Sustainable Resource Mobilization: . by Sarah Ford and the guide was developed by Meghan Armistead, who also piloted the first training. John Donahue was also directional from the inception of the . successful in resource mobilization, and to think
community mobilization that used home visitors to provide health education to mothers and established Community Action Groups. These groups followed a prescriptive process known as the Community Action Cycle to identify and address their own community's maternal and newborn health issues. As a community-based project
organizational management and development involves establishing and strengthening organizations for the resource mobilization process.it involves identifying the organization's vision,mission,and goals,and putting in place internal systems and processes that enable the resource mobilization efforts,such as: identifying the roles of board and
mobilization training. Using multi-echelon training techniques, coupled with a mix of live, virtual, and constructive training, commanders efficiently achieve pre-mobilization training requirements within the limited time and resources available. Training will be planned, prepared, executed, and assessed (IAW) Army/ASDF doctrine. (Annex A) e.
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Resource mobilization can be defined as a management process of identifying people who share the values of your organization and take steps to manage this relationship (IDRC, 2010). Resource mobilization is often wrongly considered as fundraising. In fact, fundraising is a component of the resourc
ANSI A300 Part 9: A nce 28 2012. Reality Bites Puget Sound Energy, 1998 – 2007 34,000 tree-caused outages Trees were primary cause of unplanned service interruptions 95% due to tree failure From Arboriculture & Urban Forestry July 2011. 37(4): 147 - 151 . Key Points What is ANSI A300 (Part 9)? How does it relate to IVM? How does it apply to utilities? ANSI Standard A300 Tree Risk Assessment .
