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close this bookSanitation Promotion (SIDA - SDC - WSSCC - WHO, 1998, 292 p.)
close this folderGaining political will and partnership
close this folderPrinciples and guidelines
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View the documentAdvocacy for sanitation - Sara Wood1 and Mayling Simpson-Hébert2
View the documentMobilizing the media for sanitation promotion - WHO, Geneva, Switzerland
View the documentMobilizing partners for sanitation promotion - Sara Wood1 and Mayling Simpson-Hébert2
View the documentPrivate-sector involvement in promoting sanitation - Sara Wood1
View the documentSocial marketing for sanitation programmes - Sunil Mehra1


A fundamental requirement for the promotion of sanitation is gaining the political commitment of key policy-makers and forging partnerships with various individuals and organizations in society. This part is designed to help you achieve both.

The ideas presented here are based upon good marketing practice. We have tried to adapt these good practices to the field of sanitation. This part is divided into Principles and guidelines and Case studies.

The first section, Principles and guidelines, explains the major concepts to be used in promotional activities. These include advocacy, mobilizing the media, and mobilizing partners (also called social mobilization). Ideas are offered on different ways the private sector can promote sanitation, and applying social marketing to sanitation.

The second section contains two case studies on how political will and partnerships were achieved.

Little has actually been done in the field of sanitation promotion to draw upon. Thus, the articles are a starting point upon which the sector should build, and, over time, create even better principles and guidelines for gaining political will and partnerships and provide more case studies.

Advocacy for sanitation - Sara Wood1 and Mayling Simpson-Hébert2

1 WHO Consultant, Geneva, Switzerland.
2 WHO, Geneva, Switzerland.

There are few mysteries about why we need to have environmental sanitation. Lack of sanitation makes people ill and kills. More than three million people die every year from diarrhoeal diseases alone (1). It is said to be easier and cheaper to treat every patient with a sanitation-related disease, but is it wiser? What dignity is there living in filth and having chronic epidemics causing great suffering and death if all of this is totally preventable? What is development if it is not helping human beings to live in health and cleanliness with dignity?

Lack of environmental sanitation probably causes more illnesses and death than any other single factor in the world today. Human excreta is probably the world's number one pollutant. We are not only spoiling our water supplies, contaminating our food, and killing our children, but many countries are suffering economic loss from embargoes on their exported foods and loss of tourism owing to cholera outbreaks.

Half of the world's population lacks basic sanitation and within a few years it will be more than half (2). Yet it does not have to be this way. One of the main reasons for lack of investments in sanitation is lack of political will. Investments in sanitation lag far behind investments in water supply, even though the two should go hand-in-hand. Sanitation departments are under-staffed and under-paid, their workers often having the lowest status in public service. All of this must change. This is what advocating for sanitation is all about.

Advocacy is one of the main tools used to mobilize politicians and other partners for a cause. “Advocacy is speaking up, drawing attention to an issue, winning the support of key constituencies in order to influence policies and spending, and bring about change. Successful advocates usually start by identifying the people they need to influence and planning the best ways to communicate with them. They do their homework on an issue and build a persuasive case. They organize networks and coalitions to create a groundswell of support that can influence key decision-makers. They work with the media to help communicate the message”(3).

The future of sanitation and the incidence of sanitation-related diseases rests more on the behaviour of politicians than on sanitary engineers. If we are to have good sanitation programmes and technologies to meet the varying geographical, climatic and socio-cultural conditions found in the world today, we must have national policies on sanitation and funding for research and development.

There are at least two messages we need to get across to politicians and other key partners. Lack of sanitation is responsible for most of the diseases and death in developing countries today. Sanitation together with hygiene education will break the cycles of these diseases. Different messages may be needed for the general public based upon prestige, comfort, convenience and privacy. Whether health should also be a message for the general public will depend upon the outcome of the market research required to target the general public.

This article outlines four basic steps that are essential for effective advocacy.

Steps to effective advocacy

The objective of advocacy is to raise awareness and convince others of the need to take action. To do advocacy well, one must follow a series of time-proven steps.

1. Target audience identification

Successful advocacy begins with the identification of groups that need to be influenced and working out the best way to communicate with each group. For example, different ways to communicate could include personal contact, asking others more influential than yourself to carry your message, through the media (newspapers, television or radio), or through traditional channels of communication such as churches, temples or mosques, festivals or street theatre. The methods are numerous. The key is to work out which methods will be the most effective in reaching your target group.

2. Developing an information base

An effective advocacy campaign requires information that demonstrates the extent of the problem and the effectiveness of the proposed solution. To do this you will need facts and figures. Emotional pleas which are not substantiated will be put aside. Facts and figures provide evidence of the problem and are more difficult to ignore or refute. They also attract the interest of the news media which then gets the attention of the general public. Public attention can influence politicians to act, because if they don't, they risk losing their popular support.

If possible, try to gather location-specific or country data which will show:

- the significance of the problem and its future trend;

- current spending on treating people with diseases related to poor sanitary conditions;

- current spending on sanitation;

- the benefits of sanitation for health, education or other issues;

- that spending on sanitation makes economic sense and is feasible in your country;

- the impact of not taking action (such as on health costs, quality of life, the economy, attendance of girls at school).

Box 1. Some examples of information to have on sanitation

· Percentage of people in the country (or city, town, district or province) without sanitary facilities.

· Percentage of people predicted to be without sanitation by the year 2020.

· An estimate of the number of people (in your country, city or district) who die from diseases related to poor sanitation.

· An estimate of the number of children who die per year (in country, city, or district) from diseases related to poor sanitation

· An estimate of the percentage of children 5-15 infested with intestinal worms.

· An estimate of the number of school days lost per year from diseases related to poor sanitation.

· An estimate of the number of girls who do not attend school owing to lack of sanitation facilities at school.

3. Building a persuasive case

You will be competing with many others for attention. Therefore, you need to present your information or message in such a way that it stands out from the crowd and is so memorable that your target group cannot ignore it. The following are some practical suggestions for increasing the effectiveness of your messages.

· Choose only a few key messages. Multiple messages are not remembered. By keeping to a few messages, your messages will not be competing with each other for attention. You will be able to repeat a few messages more often, making people more familiar with them, more quickly. Your aim is to have your messages become part of local discussion on the subject.

· Keep messages simple. Messages which are easy to understand are much more likely to be remembered than those that require thinking about. You may have only a few seconds of time to put your message across, so it is important that its meaning is clear and easy to understand. Think of your message as something that can fit on a T-shirt.

· Make your messages relevant to your target audience. Information that is linked to a subject area that your target audience is already interested in will be much more relevant, persuasive, and interesting to them. For example, most politicians are concerned about maximising the economic productivity of the country. Therefore, one way to make sanitation messages relevant to them is to present the economic impact of ignoring the problem of sanitation.

Examples of economic messages:

12 000 worker days were lost last year due to diarrhoeal diseases.

Last year's outbreak of cholera cost the country one billion dollars in lost tourist trade.

You can maximise the relevance and interest of your messages simply by looking for ways to frame your sanitation messages in terms of how it might affect a particular target audience's area of specific interest.
· Time the release of messages. Your messages can be more effective if you time the release of them to coincide with another event likely to attract attention. To help achieve this, it is a good idea to make a list of the dates when other events are taking place so you plan your advocacy around them. Other events might include health conferences. World Health Day, World Water Day, International Labour Day, release of new statistics and new documents or reports.

· Say something new. There is a lot of competition for attention. One way to grab attention is to tell your target audience something new. This is often not as hard as it sounds. Sanitation is a specialized field. What may be common knowledge to you is unlikely to be widely known by others. Another way to say something new is to present information from a new angle. For example, sanitation information can be presented to show its impact not just on health, but on education, on equality for women, on earning tourist dollars, on generating business opportunities, and on increasing worker productivity. This can be particularly effective if you link it to issues which are currently attracting a lot of attention.

· Use powerful language. Messages must be strongly worded to be noticed and memorable. They should be a responsible presentation of the facts, suggest the response, and still convey a sense of urgency.

· Say what should be done. Messages should always be presented in a way that makes the audience feel they can do something, otherwise a sense of being overwhelmed and powerlessness to help is created. This has a paralysing effect. Instead your message should indicate that with any little bit of help, progress can be made. Make people feel that their contribution, in whatever form, counts.


An increase in public spending of just one-half per cent will result in expansion of sanitation services to 50 000 more families.

If every citizen gave 2 cents a month for the rest of the year to the sanitation fund, every school in our community could have water supply and toilets.

· Aim for impact. Messages which put a human face to the problem can touch people more deeply. Provide real-life stories, not just ones that show the negative effects but also ones which give hope and show that people, even with very little, can achieve great things. Inspire people into action. Excite them with the possibility of what they can achieve.

· Call for action. Include in your messages what action you would like to see taken. More often than not, your suggestions will be acted on. Community leaders often are busy and helping them with suggestions of appropriate actions enables them to act more quickly.

· Be creative. Doing things differently attracts attention. Study what others are doing in different sectors, in private business, and in other countries. Identify things that worked well and see if you can adapt them to your situation. Not everything effective will be appropriate. You have to consider the sensitivity of the issue and cultural and religious values in your country and make your decisions based on this understanding.

4. Continuous Action

Just as soft drink companies NEVER stop advertising, advocacy for sanitation should also never stop. Populations continue to grow and existing systems need to be maintained. The job is never done, but if advocacy stops, the funds to support sanitation may start to disappear along with public interest.

5. Build partnerships with influential supporters

Advocacy requires that the subject must seem important to important people. Movie stars and presidents of large corporations, for example, should be persuaded to become partners in an advocacy campaign. Some can become spokesmen and women for the cause. How to mobilize partners is explained in Mobilizing partners for sanitation.

6. Work with the media

The media is probably the most influential advocacy vehicle available. By putting the problem of sanitation before the people through television, newspapers, magazines and radio, politicians and decision-makers will take notice. Politicians are very sensitive to public opinion, they have to respond, explain the actions they intend to take, or risk losing popular support. The media, therefore, plays a key role in mobilizing public support and setting the political agenda. How to mobilize the media is explained in Mobilizing the media for sanitation.

BOX 2. Tips for effective advocacy

· Identify the persons and groups you need to influence in order to bring about change.

· Concentrate your efforts and start with those you know are sympathetic.

· Develop an information base of facts presenting the sanitation problem and the solutions.

· Choose only a few key messages.

· Make sure the messages are simple to understand.

· Increase the relevance of sanitation messages by expressing them in terms of their social, economic, and political impact.

· Time the release of your messages to coincide with other events that will attract additional attention.

· Make news by saying something “new”.

· Get support for change by using powerful messages which touch peoples' everyday lives.

· Provide evidence to prove your point.

· Suggest practical actions that leaders could take.

· Inspire people; don't present the case as beyond hope.

· Make people and institutions feel that their contributions can make a difference.

· Attract the attention of the media.

· Multiply your efforts by finding partners, building coalitions and recruiting influential supporters.

· Never stop trying, persistence pays off.

· Be opportunistic, and take advantage of situations which come up to promote sanitation.

· Be innovative and think of new ideas, but don't miss the opportunity to borrow the good ideas of others and adapt them to your own situation.

Box 3. 10 Tips for effective presentations

· Check out the physical set-up of the room before speaking. Note the room size, acoustics, microphone and audio-visual set-up.

· Focus your presentation on one or two main messages. Repeat these main messages in different ways again and again.

· Don't turn your presentation into a recitation of facts and data. Your main message could be lost if you bombard your audience with too much information.

· Practice, practice, practice! The more comfortable you are with the presentation, the more dynamic you will be. Practice giving your presentation before a colleague who can offer comments on how to improve your delivery.

· Make a good first impression. Memorize the first part of your presentation. Be confident.

· Make eye contact with your audience. Change your pace, tone, and hand gestures at key points to make an impact.

· Use powerful visual aids to emphasize main points. One well-planned photograph or chart can be worth a thousand words.

· Make sure overheads or slides can be quickly understood. Avoid complex graphs, small type and lots of words. As a rule of thumb, print no more than 50 words on any visual. Be sure everything can be clearly read from the back of the room.

· Your enthusiasm and concern about the issue will often be remembered more than the words you say.

· Keep to your time limit and allow time for questions. This is a critical opportunity to keep your audience engaged and excited about the topic.

Source: (3).

Monitoring and evaluating change as a result of advocacy

It is crucial to measure whether advocacy and other techniques are achieving change. Indicators of change should be developed for each target group. As an example, a list of indicators of increased political commitment from politicians may include:

- creating a national sanitation policy;
- creating a sanitation department with a responsible chief;
- well-maintained toilets in government buildings; and
- more government funds allocated to sanitation and hygiene education.

Source: (4).

Box 4. Other advocacy techniques

Job performance awards. In Indonesia in 1993 the political commitment of provincial governors was obtained by making the infant mortality rate a factor in assessing job performance. Governors were advised that there were several factors responsible for high infant mortality, a major one being diarrhoeal disease, best prevented by high latrine coverage and good hygiene behaviours. Many governors became more active in promoting sanitation. Awards were given to governors whose provinces have low infant morality rates (5).

Putting sanitation on the agenda of other sectors. In 1994, the Indonesian Department of Health launched the Clean Friday Movement to mobilize the support of religious leaders for sanitation and improved hygiene behaviours. While the movement was targeted at all government departments concerned with sanitation, NGOs, and political leaders, it was designed especially to call upon religious values in creating a clean environment. Religious leaders were asked to lead the movement from their Friday sermons. It was formally launched by the President of Indonesia.

Bringing politicians to successful sites. In 1994, the Department of Environmental Health of Zimbabwe brought political leaders to successful project sites to see progress and hear from communities how success was achieved. Zimbabwe had been conducting field trials of participatory methods and found them very successful. As a result Zimbabwe has decided to expand the approach nationally (6).

National high-level conferences. The Prime Minister of Bangladesh inaugurated a national conference in 1992 on Social Mobilization for Sanitation and Hygiene. Nationally televised, it greatly strengthened sanitation and hygiene promotion in the country. In 1994, the Prime Minister launched a National Sanitation Week to promote sanitation and hygiene nationwide. During the inaugural function, she called for a new Mid-decade Goal of 50 percent coverage by 1995, since the Mid-decade Goal of 35 percent sanitation coverage had been achieved in early 1994. The Minister of Finance immediately responded to the promotion of sanitation by allocating substantial funds to sanitation activities.

Inter-country workshops. In 1994, UNICEF held a four-day Sanitation Workshop for Eastern and Southern Africa in Zimbabwe, in which UNICEF staff and their government counterparts decided on what they could do personally and collectively to promote sanitation (7).

Inter-ministerial conferences. Sanitation advocates in Zimbabwe used the opportunity of a Regional Ministerial Conference in 1994 to produce a statement of intent from the ministers to go for full latrine coverage of the southern African region, with appropriate low-cost designs.

A condition for grants and loans. In 1993, a WHO consultant negotiated into an agreement for health centre equipment that the government build a latrine at each health centre prior to receiving the equipment. The agreement received the highest endorsement from the government, construction began immediately, and latrine coverage of health centres increased rapidly.


(1) WHO. Community water supply and sanitation: needs, challenges and health objectives. Report by the Director-General. Forty-eighth World Health Assembly, Provisional agenda item 32.1. Geneva, World Health Organization, 1995 (unpublished document A48/INF.DOC/2).

(2) WHO/UNICEF. Water supply and sanitation sector monitoring report: sector status as at 31 December 1994. Geneva, World Health Organization, 1996 (WHO/EOS/96.15).

(3) Owens B, Klandt K. TB advocacy: a practical guide 1998. Geneva, World Health Organization, 1998, (unpublished document WHO/TB/98.239).

(4) WHO. Promotion of sanitation. Report of the Sanitation Working Group to the Water Supply and Sanitation Collaborative Council. Geneva, World Health Organization, November 1995 (unpublished document WHO/EOS/95.24).

(5) Mathur S, UNICEF, Indonesia, personal interview.

(6) Mr Temba, Ministry of Environmental Health, Zimbabwe, personal interview.

(7) Sanitation: The missing link to sustainable development. Report from the Eastern and Southern African Region Workshop on Sanitation, Harare, Zimbabwe, UNICEF 1994.

Mobilizing the media for sanitation promotion - WHO, Geneva, Switzerland

The media can be one of the most effective advocacy vehicles available. The objective is to get the media interested in sanitation and motivate journalists and reporters to write about it in newspapers and talk about it on radio and television.

Help to mobilize the media can be found among people and organizations that have had previous experience, such as multi- and bilateral organizations, NGOs, and external support agencies or from organizations which specialize in this function, such as public relations companies. You can, however, achieve much yourself by being systematic in your approach and following the practical steps outlined below. Because the media are organized in different ways in different countries, for example, in some countries media outlets are state run, while in others they are in the hands of the private sector, or it can be a combination of both. It is necessary to take this into account and tailor your approach to the circumstances of the media in your own country.


Develop a plan for mobilizing the media

Before you approach the media, you need to develop a plan outlining what you want to achieve and the actions you will need to take to be successful. This is often called a Media Strategy (see pg. 34 for an example). You will find, once you have read this article, and Advocacy for sanitation and Mobilizing partners for sanitation, writing such a plan will be quite straightforward.

Develop an information base

Good information is the basis of a successful relationship with the media. The media need facts from a credible source to use in their reports. One of the most important steps, before you even contact the media is to gather the data to make a case for sanitation. See “Developing an information base” in Advocacy for Sanitation. Do not underestimate the importance of having your facts well organized. The media will not take the time to research these things for themselves, and without facts they cannot make their reports or file their articles.

Choose only a few key messages

Many others are competing for the attention of the media. Your time may well be limited to a few seconds in front of a television camera, or a few minutes in a news conference. Therefore, it is necessary to select your messages carefully. Keeping to only one or two key points will enable you to repeat them more frequently which will help people remember them. Your key messages should communicate the one main point you want your audience to remember. More suggestions on how to develop effective messages are provide in Advocacy for sanitation under the heading “Building a persuasive case”.

Make sanitation news

Reporters and journalists are interested in “news”. This is what makes headlines and sells. You need to think of ways to present the problem of sanitation as news, make it interesting by releasing new information, or by putting it in the context of other issues which may be attracting media attention. For example, if education is receiving media attention, release facts and figures which show how sanitation improves child health and school attendance rates. Take advantage of media attention created by others by tailoring your own messages to be relevant to “the topic of the moment”. Remember that issues which are of local interest are more likely to be published so try to provide facts specific to your area and country.

Establish a media focal point

It is important to establish a point of responsibility for mobilizing the media. This can be one person or a group of persons in your organization, or a team created from a group of interested parties. Your focal point should reflect the local situation and the scale of your activities. Where possible, people that have worked successfully with the media in the past should be included.

Box 1. Focal point responsibilities

- developing a plan for mobilizing the media;
- implementing the plan (writing press releases, organizing news conferences);
- monitoring results;
- modifying the plan;
- organizing training for media spokespersons; and
- acting as a spokesperson.

Research the media

You need to familiarise yourself with the newspapers, magazines, television and radio outlets in your area and in your country and identify those which you think will be most interested in sanitation. Media personnel are more likely to pay attention to you and give you more time to present your case if you show you have done your homework and that you know something about the publications and programmes they work on. Developing a mutual respect for each others' work is an important aspect of building an effective media relationship.

Target the media

Once you have identified the media outlets you want to target, the next step is contacting them. First, you will need to find out the names of reporters or journalists specialising in health, environmental issues, government spending, or other issues which can be related to sanitation. Identifying a common area of interest is the first step towards establishing contact. You can make your contacts more successful by using the tips set out in Box 2.

Box 2. Tips for effective media contacts

· Do your homework.

Know the name of the person you want to speak to and know something about the publication or programme they work on.

· Plan ahead.

Think carefully about why you are calling, what you will say, and what you want to achieve from the contact.

· Practice.

· Be concise.

You only have one or two minutes to get your point across, and get the interest of the journalist.

· Be polite, professional and enthusiastic.

If they are not interested don't be discouraged. Ask what would be of interest to them.

· Contact the media well in advance of their print or broadcast deadline.

· Don't contact the media unless you have something to say that is of “news” value.

Preparing information for the media

Journalists work to tight deadlines. Therefore, information that is concise, clear and well presented is more likely to be used than material which requires extensive rewriting, researching, and confirmation. Specific guidance on how to prepare press releases and other key materials is provided later in the article, but the following general suggestions outlined in Box 3 should also be helpful.

Identify sanitation spokespersons

Reporters need to have access to people who will give interviews. They often need to interview people at short notice, so it is important to prepare well in advance to make sure the interview goes well and your point of view is put across effectively.

Select your spokespersons carefully. While some people make it look easy, don't be fooled. Their polished performance is usually a result of long hours of training, preparation and practice in front of friends, colleagues or the mirror at home. Most people are not naturals, and even if they are, they never neglect the golden rules of preparation and practice.

There are certain skills and techniques which can help people become more effective in interviews. It is advisable to organize this type of training for people selected as spokespersons, if they have not already had it. This is often called media training and courses are usually on a one-to-one basis. Participants are taught the basic techniques of effective interviewing and then practice these in simulated “live interviews” in front of a video camera. They can then see how they actually perform and where they need to improve. This type of training is most likely to be offered by public relations companies.

When spokespersons are first selected, they do not have to know about the subject, because preparing them and training them in effective interviewing techniques is part of the process of making a person an effective advocate.

Do not leave the result of an interview to chance. Carefully select your spokespersons (see Box 4), brief them well, and organize for training if it is needed.

Box 3. Tips for preparing information for the media

· Do prepare information specifically for use by the media. The media have specialised needs and you should tailor your information to meet these needs. This will always be better than pulling together more general information prepared for other purposes.

· Put yourself in the position of a journalist. Now prepare your information in a way that would help a journalist quickly put together a story to meet a tight deadline.

· Be concise. Rework your material by cutting and condensing it until there is no repetition or superfluous information. This saves a journalist time and makes your information more useable.

· Provide information in a summarised format, such as fact sheets, executive summaries of lengthy reports, and lists of commonly asked questions with answers.

· Make your point in an interesting way in the first few sentences to catch the attention of the media. This is sometimes called a “creative opening” and it means presenting your point in a different or unusual way to grab attention.

· Get straight to the point. Put the important information first and then provide any background detail necessary to support it. Don't do it the other way around.

· Use phrases that are easy to remember and make your point succinctly.

· Include direct quotes from influential people that express their belief and commitment to change.

· Provide sources for journalists to confirm statistics.

· Give your media contact a list of names and contact information of people available to give interviews.

Box 4. Tips for selecting spokespersons

Choose people who are:

- confident;

- influential;

- articulate;

- authoritative without being dictatorial;

- personable, that people can warm to easily and feel comfortable with;

- quick, organized thinkers, who can respond well to unexpected questions without taking much time to prepare;

- calm under pressure;

- enthusiastic about the subject; and

- already attracting media attention like film and sports stars, actors, academics or musicians.

Contacting the media1

1 Quoted from Owens B, Klandt K. TB Advocacy: a practical guide 1998. Geneva, World Health Organization 1998 (unpublished document WHO/TB/98.239). Chapter 3 pg 19-22, 26-29. The word sanitation has been substituted for the word TB.

Once you have done your preparation, you are ready to contact the media. Some of the main ways of contacting the media are outline below, with suggestions on how to do this effectively.

Press release

Journalists usually receive hundreds of press releases each day. For your release to get noticed, the headline and first paragraph must catch their attention. You should spend as much time getting the words just right in the headline and first paragraph as you do on preparing the rest of the release. (See Box 6 for a checklist on preparing effective news releases.)

Sending announcements or advisories

Advisories are used, along with phone calls, to alert journalists to a media event or news conference. An advisory should give all of the basic information on the purpose, date, time, location, and speakers at an event. A good advisory should also build some anticipation concerning the news which will be announced.

Placing feature stories

Feature stories are usually longer than news stories. They go into greater depth on how an issue affects people and may offer a number of different perspectives. In magazines, they can span several pages and be accompanied by pictures. On television, they can become hour-long programmes.

The best way to encourage a feature is to describe your idea in a two or three-page story proposal. You need to do a substantial amount of research yourself before handing the story over to the journalist to follow up. Your proposal should provide an outline of the story and list interesting people who could be interviewed. The newer, more unusual, significant or dramatic the story, the better. For example, a journalist will be more interested in an unreported outbreak of cholera, than a general story on diarrhoeal disease.

Writing for the media

Opinion piece

Most newspapers print opinion pieces called “opinion editorials” (op-eds) or guest columns. An op-ed is an expression of opinion rather than a factual statement of news. Although style varies according to different countries, an op-ed tends to be lively, provocative and sometimes controversial. It is a very effective way to register concern about sanitation to policy-makers and to inform communities about why they should care about controlling sanitation-related diseases.

Op-eds are usually around 1,000 words. It is best to call the newspaper first and request their guidelines for submitting an op-ed. If possible, speak to the appropriate editor to convince her or him of the importance of the issue.

Letter to the editor

Newspapers and magazines have a “letters page” which gives readers the opportunity to express their view or correct previously published information they feel to be inaccurate or misleading. Letters are widely read and provide a good opportunity to promote a cause and/or organization.

Letters should be short and concise. Those over 500 words are unlikely to be published. Short letters of no more than 100 words can be very effective. A letter should aim to make one main point and to end on a challenging note, with a call to action.

Make sure you refer to your organization. Letters can also be signed by a number of signatories, representing various organizations or interests, which may increase their impact. If it is responding to an article carried in a daily newspaper, it is important to fax or deliver it to the paper within a couple of days.

Planning media events

News conference

A news conference can be a very effective way to announce a news story to journalists. Speakers take the platform in a venue and make presentations after which journalists can ask questions. This is a tried and tested formula which, if you follow the rules (See Box 8), can make life easy for journalists and for yourself.

Be sure that your story warrants holding one, as news conferences can be quite expensive to organize and it can be disheartening if few people attend. In some cases, you may find you can achieve the same results by handling the story from your office. For this, you need to send your press release and briefing materials under embargo until the date of the launch to journalists, highlighting who is available for interview.

Press briefing

If journalists, who cover hundreds of stories and may know next to nothing about sanitation, are to produce informative accurate stories, they need to be properly briefed. Consider organizing an informal press briefing which also serves to build good relations with journalists.

For example, invite half a dozen selected journalists to attend a briefing at your offices in advance of a major event you are planning. Brief them on key developments and issues relating to sanitation and your organization's relevant work and policy. You may want to conduct this as a breakfast meeting and provide refreshments. It is a good idea to have clear briefing material, such as advocacy publications or fact sheets, to distribute.

If you attend an important national or international conference, you may wish to brief journalists in your community about important developments upon your return. Or, use an informal briefing to introduce a major new strategy or initiative in your organization.

Editorial meetings

In some countries, newspapers invite policy experts to give an “editorial briefing” at their offices. These provide an excellent opportunity to gain the editorial support of a newspaper which can be very influential in shaping political decisions.

Profile the kinds of editorials/columns that appear in the paper and the position they tend to take, particularly in relation to health care issues. Arrive armed with facts and figures that are relevant to the newspaper's audience. Make a persuasive argument to the editor that his/her readers should be concerned about lack of sanitation. Be ready to answer any questions the editor might have.

Photo opportunity

Television news and magazines need good pictures or visuals in order to report on a story. When you plan a media strategy, think about what images you need and how you will supply these.

You may want to pay for a photographer to take pictures and then distribute them to selected publications. You may also want to prepare a video news release (VNR) for broadcasters to use. Or, arrange a “photo opportunity” for photographers and television news people to take pictures themselves.

To announce the photo opportunity, send an advisory that gives the “Who, What, When and Where” of the event to media.

Box 5. Important international media

The following are a few of the most important media which have global influence. Sometimes your story will have regional or national but not international significance. But other times, it may be of international importance, and you should check to see if there are correspondents from these media located in your city you can contact.

- AP (Associated Press)
- Reuters
- AFP (Agence France Presse)
- International Herald Tribune
- New York Times
- The Washington Post
- The Economist
- FT (Financial Times)
- CNN (Cable News Network)
- BBC (British Broadcasting System)

Interviewing for the media

When an organization publicizes a story, it needs to have a number of spokespeople available to be interviewed. They need to be familiar with both their material and the basic rules of interviewing. It is very important to prepare. Find out about the show and if possible watch/listen to it. Find out who else is appearing with you.

Profile the audience and have in mind a typical viewer/listener. Ask whether the show is live or pre-recorded and if the audience will be calling in to ask questions. Anticipate the questions you may be asked and prepare a Question and Answer sheet. Practice. Practice. Practice.

Phone-in/discussion or talk show

Radio or television phone-ins, discussion and talk shows are a good way to put your point across live and unedited.

Talk show producers are always in search of new guests who can talk with authority on issues that concern their viewers and listeners. It is a good idea to research programmes and make contact suggesting yourself, your director or even a whole panel of speakers with different perspectives on the problems caused by lack of sanitation.

Contact phone-in programmes to establish when health issues are scheduled. Mobilize your supporters to phone in. When you call, strict first-come, first-served rotation applies, so hang on and you will be answered. Never read your contribution as it will sound stilted and people will stop listening. Aim to make two or three points succinctly and remember to mention your organization.

Access programmes

In some countries, broadcasters air what are known as access programmes. For example, in the UK, charities and NGOs can promote an issue or cause in a three-minute piece to camera known as a Public Service Announcement or Community Service Announcement, broadcast on regional television after the regional news. Contact your local TV station to see if they broadcast access programmes.

In some countries, TV and radio programmes are assigned a duty editor who logs calls from the public about specific programmes. Comments, passed on to the producer of the programme, are reportedly taken seriously. When a programme on sanitation is scheduled, mobilize your supporters to call and register their views.


When you have only a few seconds in front of a microphone or in a meeting, you need to use memorable phrases or soundbites that will stay with your audience long after you have left. The best soundbites get to the heart of the problem without lengthy qualified explanations. Broadcast producers can't resist them, and listeners and viewers remember them. The soundbite should capture and communicate the one key idea you want to leave with the audience, if they remember nothing else. Try to repeat the soundbite at least once during an interview with the media.

Box 6. Checklist for preparing an effective press release


· Make sure the headline and first paragraph are very interesting and newsworthy. The most important information should be in the first paragraph.

· Use the pyramid principle to order information, most important at the top, becoming more general for background.

· Aim to use a direct quote within the first three paragraphs of the press release. Use quotes to bring the issue to life and express strong opinions.

· Include the five Ws:

WHAT is happening?
WHEN is it happening?
WHERE is it happening?
WHO is saying it?
WHY is it important?

· Attach a fact sheet or background briefing material, rather than make the press release too long or cluttered.


· Use short sentences of 25 to 30 words.
· Use paragraphs containing only two or three sentences.
· Try to limit the release to one or two pages.
· Use a simple, punchy news style.
· Avoid jargon.
· Avoid lots of adjectives and adverbs.
· Use active rather than indirect verbs to tell the story with force and urgency.
· Proof-read the release carefully!


· Put the date and release details at the top of the page. State if it is EMBARGOED FOR RELEASE at the specific time and date, or is FOR IMMEDIATE RELEASE.

· At the end of the press release put END or -30 - or *** to indicate the final page of the release. Follow this with contact names and numbers for more information.

Box 7. Television interview tips

· Focus on getting one main message across in the interview. Come back to your main message again and again.

· Don't be afraid to turn around irrelevant questions and come back to your main point. Don't allow the interviewer to side-track you from your main message.

· Don't use jargon or highly technical medical language. Don't try to make too many complex points. Keep your answers simple.

· Be yourself. Rely on the strong points of your own character.

· Be enthusiastic about the subject. People will often remember the level of your passion for an issue more than what you specifically say.

· Look at the interviewer when talking with him or her. If there is an audience, look at them when appropriate.

· You don't have to know the answers to all questions.

· Don't allow yourself to become defensive or angry.

· Ask the producer what you should wear.

· Sit up straight and lean forward slightly.

Box 8. Checklist for an effective news conference


· A big, newsworthy story.
· New information relating to a big story being followed by the media.
· A statement on a controversial issue.
· Participation of high profile speakers or celebrities.
· Release of important new findings or research data.
· Launch of a major new initiative.
· Announcement of something of local importance.

Location and set-up

· A central well-known location, convenient for journalists, and appropriate to the event.
· Avoid large rooms which give the appearance that few people attended.
· Make sure the noise level of the room is low.
· Reserve space at the back of the room for television cameras, possibly on a raised platform.
· Reserve a quiet room for radio interviews following the news conference.
· Ensure light and sound systems are in working order.
· If possible, have fax, phone and e-mail capability available.
· Make sure there is a podium and a table long enough for all spokespeople to sit behind.
· Consider displaying large visuals, such as graphs, logos or charts.
· Prepare a “sign-in” sheet for journalists.
· Determine if you wish to serve coffee and tea, or light snacks, following the event.


· Hold the event in morning or early afternoon of a work day so reporters can meet deadlines.

· Check that you are not competing with other important news events on the same day.

· Start the event on time - avoid keeping journalists waiting.

· If you distribute material prior to a news event, use an embargo to prevent journalists from publishing before the event.

· Wait until the event to release information to create an element of suspense.

Possible materials

· Press release.
· List of news conference participants.
· Executive summary of report.
· Case studies and stories.
· Fact sheets.
· Biography and photos of speakers, and copies of speeches.
· Pictures (colour transparencies/black and white photographs).
· B-roll (broadcast quality video background footage).
· Consider putting all of the printed materials together into one “press kit.”

Inviting journalists

· Keep an up-to-date mailing list or database of journalists.

· Make sure you know who the health and social affairs correspondents are.

· Monitor which journalists are reporting on health.

· Focus on getting the most influential media to attend.

· Remember to invite international and foreign media.

· Get your event in journalists' diaries seven to 10 days before the event.

· Always make a follow-up call to check that the right journalist has received the information.

· Build interest and anticipation for the event without giving out the story.

· Consider providing general, background briefings to important journalists prior to the event, without disclosing to them your main news story.

· Consider offering “exclusive” angles on the story to key media.

Preparing speakers

· Select appropriate speakers.
· Select strong speakers who are charismatic, articulate and authoritative.
· Brief speakers carefully on the main message of the event.
· Prepare speakers in advance on how to answer difficult questions.
· Try to hold a meeting to brief all speakers before the event.
· Ideally, each speaker should present for only three of four minutes.
· Have each speaker make different points.
· Make sure that each makes one or two important points.
· Keep speeches short and simple aimed at a general audience and avoid technical jargon.
· Select a moderator who will manage questions from the floor after the presentation.
· Encourage lots of questions. Keep answers short.


· Within a few hours of the conclusion of the news conference, fax or deliver information to important journalists who were unable to attend.

· Make sure the switchboard of your organization is advised on where to direct follow-up calls from journalists.

· Gather news clippings of the coverage which results from the news conference and distribute this to important coalition partners and policy makers. A good source is the Internet.

Improving your performance

One of the most important things you can do to build your relationship and the continuity of contact with the media is to improve the way you work with them. By becoming better at what you do and understanding more about what the media can and can't do, you will build a greater mutual respect for each other. To improve the way you work, you need to evaluate your activities carefully. You need to work out what went well and why and what didn't go well and how you can overcome these problems. Investing time in evaluating activities and modifying your them accordingly will pay big dividends in your future relationships with the media.

Box 9. Example Media Strategy

This has been simplified to illustrate the sort of information which might be included in a media strategy. This is an example only, it is not exhaustive nor is it a template for what to include because you will need to create your own plan which reflects the local situation and your own priorities.


1. Put sanitation on the front page of two daily newspapers three times this year.

2. Have our sanitation spokespersons interviewed on radio once a month throughout this year

3. Have our sanitation spokesperson interviewed on television once this year.

Media targets


International Herald Tribune

National Newspapers




Local relevant magazines

Radio Stations:

BBC World Service

Voice of America

Local relevant radio stations



National public and private TV channels

Action plan




(write name
in this column)

1. Collection of key facts, statistics and research findings on sanitation.


2. Organization and preparation for Nov. Sanitation Conference


3. Preparation of media material including key messages, fact sheets, report summaries etc.


4. Development of sanitation logo and slogan, e.g. Sanitation. A right of every citizen.


5. Media training for sanitation spokespersons

May (1 week course)

6. Mobilization of partners and organization of joint activities to coincide with November National Sanitation Conference


e.g.-school childrens' artwork competitions

-street rally of supporters

-fun run with other events in support of sanitation

-ceremony to present a petition to politicians

-site visits

7. Press briefing


8. Press release(s) announcing


- National Sanitation Conference

- Joint activities to raise the profile of sanitation

9. Invite journalists to News Conference on last day of Sanitation Conference

10 days before Sanitation Conference

10. National Sanitation Conference

12-15 Nov

11. Joint Activities

12-15 Nov

12. Press release(s) to announce actions resulting from Conference.


Each of these activities will need a detailed plan of its own.

Monitoring and evaluation

· News clipping service to collect all articles published on sanitation
· Record of number and duration of radio and television interviews
· Record of actions taken by policy and decision-makers to advance sanitation.


Total: x dollars

Mobilizing partners for sanitation promotion - Sara Wood1 and Mayling Simpson-Hébert2

1 WHO Consultant, Geneva, Switzerland.
2 WHO, Geneva, Switzerland.

Your efforts to focus attention on sanitation can be multiplied by identifying other organizations and individuals to work in partnership with you. It is easy to ignore the voice of one organization, but much more difficult to ignore the voices of many thousand or perhaps millions of people. By involving others you will also have access to a much larger pool of ideas and resources for your activities. This means you can do more, and active partnerships attract higher levels of attention from both politicians and the media. Other organizations and groups work with different groups in society, for example, medical associations work with the medical community, business associations work with corporations and industry, local NGOs work with the community. By involving a variety of partners you can mobilize support from a broad cross section of society representing a wide diversity of interests.

Identifying partners

Mobilizing partners starts with identifying potential partners, then meeting with them and presenting a convincing case of why they should become involved. Some suggestions on how to make a presentation more effective are provided in Box 3 in Advocacy for sanitation. Advocacy is the key tool to use to convince groups to become partners. See “Building a persuasive case” in Advocacy for sanitation. Once you have the interest and commitment of a potential partner, you will need to work together to develop a programme of joint activities and establish how you can work together effectively.

Ideal partners are those that share a common interest, have previous experience in gaining support and initiating change, are influential in their own right, and already attract media attention.

The boxes which follow offers ideas for potential partners for sanitation promotion, tips for building successful partnerships, ideas for joint activities, principles for successful coalitions, tips for writing letters to government officials and three country examples.

Box 1. Potential partners for sanitation promotion


Government officials at national, district, municipal and local levels

· Prime Minister

· Ministers of relevant departments

· Mayors

· Councillors

· District and local government officials

External support agencies

· Multilateral organizations e.g. UNDP, WHO, UNICEF, UNCHS (United Nation's Centre for Human Settlements)

· Bilateral organizations e.g. Sida, DANIDA, SDC, USAID

International and national NGOs

· Foundations, e.g. Carter Institute

· Health organizations

· Women's organizations

· Development organizations

· Human rights organizations

· Children's organizations e.g. scouts and girl guides

· Water and sanitation development organizations

· Research organizations

Local nongovernmental organizations

· Community development groups

· women's groups,

· children's groups

· income generation committees

· village health committees

· cooperatives

· religious, social and traditional leaders

The private sector

· Multinational companies

· National and local businesses

The media

· Journalists interested in health, women's issues, development, government spending, environmental issues etc.

· editors

The medical community

· public and private sector health workers

· medical associations

· universities

· training institutions

The general public

· men
· women
· children


· powerful
· highly visible
· respected
· authoritative
· opinion leaders

· expertise

· outside the country political process

· relatively independent

· highly visible

· well respected

· difficult to ignore

· opinion leaders

· expertise

· independent from the political process

· action orientated

· flexible

· respected

· local knowledge

· local influence and respect

· influential
· independent
· opinion leaders
· respected
· international links
· expertise

· independent
· act quickly
· respected
· credible

· respected
· credible
· influential
· shared interests

· directly effected by inaction

· if united, the public is difficult to ignore

· if united, can influence policy

What they can do

· support sanitation policy development

· increase budget allocation for sanitation

· speak out and draw attention to sanitation

· lobby others

· influence others

· document and publicise results

· influence policy and decision-makers

· lobby government

· provide funding

· provide funding

· local knowledge and experience

· lobby others

· document and report results

· raise community awareness and support for sanitation

· influence the community

· participate in planning for change

· lobby local level government officials

· speak out and draw attention to sanitation

· initiate community-level action

· interest local media

· coordinate activities

· provide funding

· lobby for change

· provide specialist expertise, e.g. marketing, communications, technical, financial management etc.

· document and publicise results

· speak out and draw attention to sanitation

· grab national and international attention

· can be a vehicle for advocacy

· can make sanitation “news”

· influence politicians and decision-makers

· reach virtually every person in society

· create a sensation, or a controversy

· lobby for change

· influence politicians and decision-makers

· provide expertise

· demonstrate good practices

· document and publicise results

· undertake research and pilot projects

· participate in planning for change

· lobby politicians by writing letters, signing petitions

· hold mass demonstrations to show discontent

· attract media attention

Suggestions on how to mobilize

· use advocacy to draw attention to sanitation

· invite media attention

· work with partners on joint strategies to target this group

· use advocacy, but tailor the messages to the interests of this group

· organize meetings to bring different groups together

· sign joint declarations calling for action

· establish a coordinating committee

· develop joint activities

· identify those that share a common interest in sanitation

· use advocacy, but tailor the messages to be meaningful to the interests of this group

· initiate a dialogue

· set up a coordination mechanism

· agree a joint plan of action

· invite them to meetings and forums

· form a joint pressure group

· identify those that share a common interest in sanitation

· use advocacy, but tailor the messages to be meaningful to the interests of this group

· initiate a dialogue

· set up a coordination mechanism

· agree a joint plan of action

· invite hem to meetings and forums

· form a joint pressure group

· identify organizations that share an interest in advancing sanitation

· do personalized advocacy

· establish a coordination mechanism

· keep them informed

· develop joint activities

· develop a “good” information base of facts, figures and statistics

· identify the journalists with a special interest in sanitation and keep them informed

· provide journalist with newsworthy, timely information

· establish a media relations focal point in your organization

· organize important and influential people to act as spokespersons

· make an annual plan of events designed to attract media attention

· identify organizations with shared interests

· do personalized advocacy

· set up a coordinating mechanism

· keep the information flowing in both directions

· develop joint activities

· identify actions they can undertake

· seek their ideas

· advocacy through mass media

· organize community groups

· school and university activities

· awareness building at community festive gatherings

· request support from traditional and religious leaders

Box 2. Tips for building successful partnerships

· Look for groups that share a common interest.

· Do your homework. Find out about potential partners, and know something about their organization, what its goal are, how it is structured, who the key people are, and most importantly what they do.

· Be persistent. Building successful relationships with others takes careful planning, time and patience.

· Develop open and effective lines of communication so that everyone can be kept informed and up to date on activities.

· Share information, resources, ideas and expertise.

· Recognise that while there is common ground, there will also be areas of fundamental difference. Plan how you will deal with these situations.

· Be diplomatic.

· Consult your partners and ask their advice on relevant issues.

· Work in a participatory way and involve partners in planning and decision-making. This will increase their sense of ownership and responsibility for activities.

· Use a consensus approach to work with partners.

· Be enthusiastic.

· Show partners what they can do to make a difference. This is motivates action.

· Celebrate your joint successes.

· Evaluate your activities together and see how you can improve them in the future.

· Follow up and feedback results.

· Formally thank your partners for their efforts.

Box 3. Ideas for joint activities

· Letter writing campaigns to newspapers and government officials.
· Fund raising initiatives.
· Demonstrations/marches/fun runs etc.
· Events, sanitation days, clean up days etc.
· Advocacy workshops.
· News conferences.
· Joint statements calling for action.
· Sanitation awards.
· Internet websites.

Box 4. Principles for successful coalitions

· Choose unifying issues.
· Understand and respect institutional self-interest.
· Agree to disagree.
· Recognize that contributions from member organizations will vary.
· Structure decision-making carefully based on level of contribution.
· Clarify decision-making procedures.
· Help organizations to achieve their self-interest.
· Distribute credit fairly.

Adapted from: (1).

Box 5. Tips for writing letters to government officials

· Keep your letter concise and focus on a single issue.

· Make your argument in a well-reasoned way and support it with relevant data, statistics and powerful real-life stories.

· Be clear about what you want to happen.

· Ask for a specific action, a change in policy, an increase in funding, an appointment to present your case.

· Be positive and conciliatory in your first communication; avoid harsh criticism.

· Request information about the officials ability to respond; it may be that you need to be referred to somebody else.

· Request a direct response and follow up the letter with a telephone call.

Adapted from: (2).

Box 6. Mobilizing intersectoral partners in Nepal

Nepal has made impressive progress over the last five years in mobilizing partners for sanitation. They did it by:

· Creating awareness among politicians, planners, administrators, and media personnel, through meetings and brief orientation sessions, of the importance of sanitation and their responsibility for ensuring its integration into all development programmes.

· Raising awareness about the importance of different aspects of sanitation among the members of intra- and intersectoral coordination committees.

· Establishing a focal point for sanitation promotion in an appropriate government agency.

· Assigning the focal point clearly defined responsibility and authority as well as accountability.

· Organizing periodic meetings of water and sanitation coordination committees at all levels.

· Involving NGOs in the sanitation programme at every level.

· Involving as many women as possible in the sanitation programmes at every level.

· Including appropriate sanitation components in the curricula of schools, colleges, and training institutions of all development programmes.

· Emphasizing the integration of sanitation into all development programmes.

· Considering legislation on various sanitation issues.

Contributed by Dinesh C. Pyakural, Director General, Department of Water Supply and Sewerage, Ministry of Housing and Physical Planning, Nepal.

Box 7. Joining hands with churches for sanitation promotion in Angola

An effective partnership is taking place in two Angolan cities of Lobito and Benguela, with a total population of about one million. In 1997, 11 000 new latrines were built using the dome-shaped SanPlat, up from a little over 4000 the year before. The key to this sudden increase lies in the partnerships forged between the sanitation project and local churches, other NGOs and local leaders. Of all of these groups, the churches have played the most pivotal role. In 1998 they plan to build 40 000 more latrines.

The project actually began in 1990, but war and administrative problems caused the latrine building activities to gradually drop to zero by 1993. Subsidies for the slabs were increased to stimulate demand, but there was no enthusiasm and the ploy failed.

In 1995 the project decided to begin working with traditional leaders, something which had been impossible earlier because of the political situation in the country. At a meeting during that year, the traditional leaders suggested that the project approach the churches for assistance. “That is what we do when we have a problem,” they said.

The project called for a meeting with church leaders. This was something very new for government, as relations between the Marxist regime and the churches had been very tense. More than 30 church leaders attended the meeting where the situation was presented. The project asked for help and explained their difficulties. They made the point that the project and the churches actually had a common mission: to help people in need.

The project leaders talked about hygiene, diseases and death, about Christian values such as “love your neighbour” and being a “good Samaritan”, about Christians being the Light and the Salt, about Faith and Works. They distributed papers they had prepared that presented sanitation from a Christian perspective.

The churches are now involved in three things. First, they run two casting yards for making latrine slabs (out of a total of five), they do all of the community mobilization for sanitation and they do hygiene education for the project. Three messages with explanations are now advocated:

- Always use the latrine
- Wash your hands
- Be cautious with baby's faeces.

Why it worked

· The technology was simple, understandable, attractive and adaptable to felt needs. You can only mobilize a community for something they like.

· Only the slab was subsidized. The remainder of the materials and labour could be organized with no cash input. Most families are very poor and would have no cash to contribute.

· A partnership was forged among the project, traditional leaders, many churches and a few NGOs, all of whom had high credibility among the population. The project did not tell any of their partners how to mobilize the people or do the hygiene education. It was done their traditional way and it worked.

Contributed by Bjorn Brandberg, SBI Consulting, Eveni-Mbabane, Swaziland.

Box 8. Advocacy, social mobilization and communication for sanitation in Bangladesh

Bangladesh achieved major increases in drinking-water coverage in the 1980's but parallel improvements in the health of the country's population were not seen. Although safe water coverage had reached 80 per cent by the late 1980s, sanitation coverage remained a mere 8 per cent. This was because safe latrines, despite having been promoted in Bangladesh for nearly 30 years, remained unpopular with most of the population. A main factor was the high cost of the waterseal latrine being promoted. Also, latrines had been promoted on the basis of the health and germ theory, when in fact the attractions they would hold for the population related to privacy for women and prestige.

The programme. In 1990, with support from UNICEF, Bangladesh's Department of Public Health and Engineering started a social movement for change programme to encourage better hygiene practices and the buying of basic latrines. The programme focused on “users as customers”, “commercial producers as suppliers” and “an affordable product” (3), and from 1993 to 1995 took the form of a massive demand-creation effort - to the tune of US$ 3.7 million.

This involved advocacy to organize information into argument, which was then communicated through various interpersonal and media channels in order to gain political and social leadership acceptance, and to prepare communities for the programme. More specifically, advocacy:

- mobilized senior government staff, members of parliament, the media, NGOs and the community;

- persuaded politicians and senior government decision-makers that sanitation is a top priority in the drive against diarrhoea (which accounts for 300 000 child deaths each year in Bangladesh); and

- promoted the idea of “pathogen overload”, showing how every sector in society is vulnerable to waterborne disease.(4)

Social mobilization was next used to bring together intersectoral social “allies” to raise awareness of and demand for the programme, and to help ensure effective delivery of resources and services. These allies included:

- the leadership of a village-based organization, “Ansars”, with four million members, which trained its officers in sanitation;

- Islamic clergy who permitted a UNICEF communications officer to address 1.5 million people at a religious gathering and to distribute half a million leaflets on sanitation;

- the Prime Minister, who agreed to launch the programme logo at a national rally;

- organizers of a National Sanitation Week which was designed to promote the goal of a sanitary latrine for each household by the year 2000.

Wide-ranging programme communication efforts also contributed to this drive towards sanitation improvement. Such communication involves identifying, segmenting and targeting specific groups/audiences with particular strategies, messages or training programmes. In this case, the strategy included courtyard meetings which were used to explain the benefits of the programme to 25-30 families at a time. Concurrently, sanitation promotional materials, rather than simply repeating health messages, highlighted the privacy, convenience and prestige of latrines; in other words, they identified preferences and cultural values and ensured that the targeted messages reflected these.

Figure 1. The key elements of the strategy for sanitation in Bangladesh

Source: (5).

Importantly, a range of more affordable latrines were promoted. A more modest waterseal latrine was designed, less than half the price of the original and commercially produced by suppliers. A do-it-yourself latrine, which can be produced at little or no cost to the family, and with a life of about five years, was also approved.

The results of these activities have been impressive, as shown by a 1994 survey of 10 000 randomly selected families. Compared to 1985:

- use of sanitary latrines has increased from 4 to 35 per cent;
- use of tubewell water for drinking reached 92 per cent (up from 80 per cent);

- handwashing with soap or ash after defecating was up from 5 to 27 per cent.


(1) Organizing for Social Change. Washington, DC, Seven Locks Press, 1991.

(2) Owens B, Klandt K. TB Advocacy: a practical guide 1998. Geneva, World Health Organization, 1998. (unpublished document WHO/TB/98.239).

(3) Ikin D. A sanitation success story - the effect of demand creation in Bangladesh. Waterlines, July-September 1996, 30: 1-3.

(4) McIntyre P. Communication case studies for the water supply and sanitation sector. Water Supply and Sanitation Collaborative Council/IRC, The Hague, The Netherlands, 1993.

(5) McKee N. Social mobilization and social marketing in developing communities, lessons for communicators. Penang, Southbound, 1992.

Private-sector involvement in promoting sanitation - Sara Wood1

1 WHO Consultant, Geneva, Switzerland.

The rapidly developing trend of private-sector involvement in manufacturing and distribution of sanitation hardware bodes well for the sector. Private enterprise often brings with it competitive pricing and better service than that offered through public provision. In addition, the private sector's increasing interest in utility partnerships will bring new sources of finance and expertise to sanitation. These trends, which contribute significantly to sustainability in the sector, are being fostered worldwide.

This article looks at another opportunity for engaging the private sector in promoting sanitation. It shows how private industry, through its use of promotion programmes in the workplace, can be instrumental in motivating people to improve their sanitation and hygiene practices.

Is there evidence that private-sector promotion can work?

Only anecdotal evidence exists of the success of private-sector promotion of sanitation (see Box 1), but the success of this approach in other health-related initiatives has been well-documented. For example, the private sector supports healthier, more active life-styles by sponsoring sporting events, providing physical exercise facilities at workplaces, and manufacturing food products with less fat, fewer calories and greater amounts of fibre. Advertisements for healthy manufactured food products advocate that their purchase will lead to a better, healthier quality of life.

Sanitation needs innovative approaches and the private sector's participation in promoting sanitation presents an opportunity that should be seized.

What opportunities are there for the private sector to promote sanitation?

Various opportunities exist for the private sector to get involved in promoting sanitation, depending on the relevant company's type of business. Examples of private-sector promotion follow.

Company-based hygiene improvement programmes

Success in the food and beverage industry is directly linked to high food safety and hygiene standards. These companies have a vested interest in promoting improved hygiene behaviours and improving sanitation facilities in the workplace. They are likely to be very responsive to increasing their effectiveness in these areas because of the direct impact on their business objectives. Some multinational companies already support sanitation programmes in several countries, but this opportunity could be developed with a specially targeted programme.

Box 1. Private sector promotion of sanitation in Indonesia

In April 1997, Unilever, a multinational manufacturing company and Lintas an international advertising agency, combined forces to develop a television advertisement for a World Bank-supported hygiene and sanitation education programme. The Hygiene and Sanitation Education Programme is part of a wider Water Supply and Sanitation Project for Low-income Communities (WSSLIC).

WSSLIC is a project targeting poor communities without adequate water and sanitation facilities in six provinces of eastern Indonesia. In total the project is expected to reach over two million people in 1400 villages. The project is coordinated by the National Development Planning Board which brings together contributions from government ministries, nongovernmental organizations and private enterprise.

The objectives of the project are to:

- provide safe, adequate and easily accessible water supply and sanitation services;
- support hygiene and health education aimed at improving hygiene practices; and
- alleviate poverty.

Budget limitations for the hygiene and sanitation education component of the project, and the need to develop of a public service television advertisement, led to and alliance between the Regional Water and Sanitation Group for East Asia and Pacific (RWSGEAP) and the advertising agency Lintas. This collaboration resulted in the production and free airing of a television advertisement. The television advertisement targeted children with the message that they should wash their hands after defecation. The advertisement featured animated characters and special sound effects.

After the initial free playing of the advertisement on the national television network, Unilever funded the reproduction of the advertisement and the cost of advertising it on Indonesia's five private television channels. The logos of the contributing organizations appeared at the end of the advertisement.

The success of this collaboration has led project personnel at the World Bank to look for other private sector companies to involve in other aspects of WSSLIC.

Source: personal correspondence, Ratna I. Josodipoero, Regional Water and Sanitation Group for East Asia and Pacific (RWSGEAP),World Bank, Jakarta, email

Tourism is another industry that could benefit directly if sanitation is improved in the countries it promotes. Its support in promoting initiatives to improve sanitary conditions, by providing financial assistance for such public campaigns as national sanitation day, for example, could be explored further.

Example-setting by the private sector

Private-sector employers have the opportunity to set a good example and act as important influences for wide-scale acceptance of more effective methods of excreta disposal and the adoption of hygiene behaviours necessary for improved health.

This is especially pertinent to employers that provide housing for workers. These companies could take this opportunity to set an example for appropriate excreta disposal facilities, demonstrate alternative technologies, and introduce hygiene behaviour-change campaigns to encourage workers to adopt new practices.

Private-sector social responsibility

Private-sector employers have a social responsibility to their workers which they can exercise by introducing health-promoting activities in the workplace. This has been done with AIDS, where trucking companies have launched educational campaigns to encourage their drivers to use condoms. The companies in question have recognized that their workers, who travel extensively throughout the country, could pose a risk to themselves and the areas they visit. By supporting safe sex messages, companies are fulfilling their responsibility to their workers and the public.

The private sector should be encouraged to adopt such a role and to fulfil its responsibility as a corporate citizen by protecting and advancing the health of its employees. The benefits of increased employee loyalty, consumer preference, and a favourable public image are the likely outcomes of such employer-supported activities.

What are the advantages of the private sector undertaking a promotional role?

Public influence. The private sector, as individual companies and as a whole, can reach a vast number of workers daily and therefore has an unparalleled opportunity to influence positively the beliefs and opinions of these people towards sanitation. Furthermore, the high profile and respect that many private-sector organizations have in the community make them a powerful advocacy force.

Communication expertise. The private sector is also well-versed in the use of marketing and communication strategies, which they use to reach the public and influence their behaviour. These strategies could be employed to promote health by adopting new or improved behaviours.

Improved economic performance. Improved employee health as a result of private-sector promotion will lead to greater economic productivity. Cost savings on health services owing to lower rates of the diseases normally associated with poor sanitation will also have a positive economic impact. These results will not be achieved in the short term. Their achievement will result from a consistent long-term commitment to health and economic improvement.

New funding sources. Private-sector participation in promoting sanitation is a new opportunity to increase available funds for improving sanitation coverage. Government financial resources are shrinking and this situation is unlikely to improve in the short term. New avenues for funding are required and the private sector is an important and relatively under-utilized source.

How can the private sector be encouraged to get involved in promoting sanitation?

The private sector will promote sanitation if it is convinced that in doing so it will be advancing its own interests. Thus, the challenge for a sanitation programme manager lies in developing a strategy to convince prospective private-sector companies of the benefits of investing in sanitation promotional activities. The advantages have to be clearly demonstrated to show how they will positively affect the goals and objectives of the company from which support is being sought. Suggestions on a systematic approach that might be used are provided for your guidance. They are based on lessons learned in obtaining sponsorship funding in a commercial environment, but are relevant to this situation as it is the process that is important.

Steps in generating private-sector participation in sanitation promotion

· Identify prospective private-sector companies.
· Develop a proposal.
· Raise awareness.
· Demonstrate benefits of involvement.
· Develop the funding/sponsorship opportunity.
· Integrate with other activities in the development sector.
· Monitor and evaluate.

Social marketing for sanitation programmes - Sunil Mehra1

1 Senior Associate, Malaria Consortium, London School of Hygiene and Tropical Medicine.

Sanitation programmes face numerous challenges in their efforts to change sanitation practices and sustain improvements in sanitation behaviour. To address these, they must enhance the user's contribution in defining needs and how to meet them. The social marketing approach, with knowledge of consumer preferences at its core, is a promising means of addressing issues concerning the demand for sanitation products, provision of sanitation services, and changing sanitation behaviours. It could be used, for instance, to promote use of products such as improved water systems, and latrines, and household behaviours such as proper use and maintenance of latrines, handwashing, and covered storage of water, and proper waste disposal.

This article provides an overview of the social marketing concept so that sanitation planners, and programme managers can decide if they would like to apply it to their own activities.

What is social marketing?

Social marketing is a systematic strategy in which acceptable concepts, behaviours, or products, and how to promote, distribute and price them for the market, are defined (1). More specifically it applies commercial marketing techniques to social programmes in order to improve their effectiveness. It involves building up an understanding of the target group(s) (usually through research) to determine the most effective way to meet the group's needs as expressed by its members. The “Four Ps” which form the basis of commercial marketing - product, price, place and promotion - are used in social marketing campaigns.

Product in social marketing may be a physical product, such as a latrine, or a change in behaviour, such as handwashing after defaecation.

Price in social marketing may be a physical exchange of value, such as a commercial transaction, but it can also refer to the price involved in changing a behaviour. For example, there is a price in terms of time, if time is needed to carry additional water for handwashing rather than for other activities.

Place in social marketing means the distribution channels used to make the product, service, or concept available to the target group. If a physical product or service is being marketed, the place may mean the actual point of purchase or access. It if is a concept, the place would refer to the media through which the target group learns about that concept (2).

Promotion covers the broad range of channels through which the campaign messages are directed to the target group. Channels for promotion include mass media (television, radio, magazines and newspapers), and traditional methods such as plays, folk singers, and interpersonal communication.

To be successful, social marketing requires that the intended target groups, and groups that influence them, participate in formulating and testing products, programme strategies, activities, and specific messages and materials (1).

What does social marketing involve?

The key steps involved in adopting a marketing approach can be summarized as follows:

Problem identification. This needs to be defined in broad terms. Initially, the problem is defined in general terms only. This is because as more becomes known through research, the focus of the activity may shift.

Research. This is needed to identify the target group and its characteristics. Social marketing involves a number of different research stages and different research techniques may be used. For sanitation programmes, basic questions would include:

· How many households/neighbourhoods have adequate sanitation facilities or systems?
· What do people perceive as “good” and “bad” sanitation?
· Are the needs of women and men different?
· How much do people pay and how much would they be willing to pay for latrines?
· What are the perceptions of men and women about latrines, and are they different?
· What type of system do they prefer?
· What important characteristics do they prefer?

Research methods could include focus group discussions, in-depth interviews, observations of lifestyles and large-scale surveys.

Objective setting. This means development of measurable and time-bound objectives.

Target group segmentation. The data gathered during the research step is used to divide the target group into subsets with common characteristics.

Marketing plan development. The data gathered during the research is used to develop a plan detailing the activities that will be undertaken on each of the “Four Ps”, i.e. which products or behaviours will be communicated to the target group, what will be the pricing structure (if relevant), how the product, service, or concept will be made available to the target group, and, finally, how it will be promoted. Decisions will be based on the consumer preferences as identified through research.

Test marketing. Products, pricing, distribution strategies and promotional messages are tested among representatives of the selected target group(s) and modified and retested until they generate the desired result.

Launch. The social marketing campaign moves out of the test phase into the marketplace.

Monitoring and evaluation. This provides the information which can be used to modify any of the aspects of the campaign to make it more effective.

The steps in social marketing are not necessarily discrete stages with each needing to be completed before the next begins. Instead, several steps can be undertaken at the same time; for example, research results may be used simultaneously to develop programme objectives and to identify target groups.

How could sanitation programmes benefit from a social marketing approach?

Lessons (3) from past sanitation programmes and projects have shown that:

· Water and sanitation projects have often not taken adequate account of individual and community behaviour that affects people's use of the facilities provided. Expected health benefits were therefore not realized, despite the safe water provided to thousands of communities worldwide.

· Goals of sanitation projects have tended to focus on the number of latrines constructed or the number of people provided with access to latrines, and failed to consider promotion of the many behaviours - handwashing, safe excreta disposal, good personal and household hygiene, safe food handling, the avoidance of unsafe water sources, and protection of pumps and wells - that largely determine whether new facilities bring health benefits.

Sanitation programmes have been more concerned with the “supply” of sanitation products, and materials rather than with assessing the needs and preferences of intended beneficiaries. Yet responding to these needs and preferences could contribute to the design of appropriate and acceptable solutions to sanitation problems and help make improvements in sanitation sustainable. “Demand-led” sanitation places emphasis on what people want and how they can contribute to these efforts. Demand creation is also part of commercialized marketing, and may also have a role in sanitation programmes, provided the product in question is actually something consumers want and/or need.

To be successful, social programmes must meet the needs of the target group in a way that they prefer; this is often called consumer-orientation, an important facet of social marketing. Consumer orientation has been shown to be successful in a number of social programmes dealing with family planning, nutrition, immunization, oral rehydration, smoking, cancer detection, use of seat belts and prevention of heart disease and AIDS. It is a particularly valuable approach for solving problems that are related to behaviour, rather than technology (3).

Some recent accomplishments in social marketing include (4):

· The 30 per cent decline in infant mortality in Egypt due to promotion and marketing of oral rehydration salts.

· Improved use of contraception in Bangladesh. Around 44 per cent of men in Bangladesh talked to their wives about family planning within 12 months of a campaign launch and contraceptive prevalence increased by 10 per cent.

· Improved child nutrition in Indonesia. In this country, 85 per cent of women now feed their child a mixed food with green leaves, which has led to improved nutritional status of 40 per cent of Indonesia's children under two years of age.

· A decrease of almost 50 per cent in deaths due to diarrhoea in Honduras following a programme to educate mothers about the use of oral rehydration salts.

Applying social marketing in sanitation programmes

It is usually necessary for sanitation programmes to include those with proven experience in applying social marketing to development activities. And since social marketing activities involve a variety of different skills, it is likely that expertise from a number of different specialist areas will be needed. The following table provides some suggestions on where you may find expert help and the kind of expertise that might be offered.

Table 1. Sources of expert assistance on social marketing

Source of expert assistance

Type of expertise available

Private marketing companies experienced in social marketing agencies

· Practical experience in applying social marketing
· Project management
· Knowledge of specialized agencies such as research companies and advertising

Advertising agencies

· Developing communication messages including television, radio and press advertising
· Selecting the most effective way to reach the target group through mass media, traditional methods, interpersonal channels or a combination of these
· Buying media time and space, e.g. television advertising, newspaper space, etc.

Local media personnel from radio, television, newspapers or magazines

· Broadly, the same expertise as for advertising agencies but specialized to the particular medium they represent

Research institutions, organizations and private research companies

· Research (different organizations often specialize in one specific type of research, therefore, a number of research organizations may be involved if a variety of research techniques are used)


· Academic advice on marketing and social marketing
· Research skills and experience

Government departments or agencies

· Practical experience in applying social marketing in different situations
· Project management
· Various specialists, e.g. anthropologists, researchers, social scientists, marketers
· Advice on how to select appropriately experienced external specialists

Social development organizations

· Similar expertise to that available from government departments

Initial problems in applying a social marketing approach are likely to be poor understanding of the concept among the institutions and organizations responsible, and difficulties in bringing together experts and personnel from engineering, promotion, marketing, and health education. Social marketing experiences in other programmes show that one of the ways of overcoming these problems is to involve and inform all concerned from the start of the process (5).

Social marketing worksheet

The following worksheet is provided to help you understand the steps involved in adopting a social marketing approach in your programme. It may help you to identify whether use of social marketing would be appropriate, whether you would need to seek expert help, and what information you lack.

Try and fill in the last column of the worksheet below for your programme or project. Information on the target group(s)' preferences is required to define each of the “Four Ps” for social marketing to be successful.

Table 2. Worksheet 1: Applying the “Four Ps” to your sanitation programme

“Four Ps” of social marketing

Examples for sanitation

For your programme or project

Decide on what the product is, its form, format, presentation, in terms of packaging and characteristics

Products (tangible outputs): latrines
Practice or behaviour:
Using and cleaning latrines, washing hands after using the latrine
Clean environment, good sanitation for health/hygienic excreta management

Decide on what the consumer would be willing to pay, both regarding direct and indirect costs and perceptions of benefits: make the product worth getting

Cost of products (with or without subsidies)
Opportunity cost:
Time lost from other activities, missed opportunities, transport, loss in production or income
Psychological or physical:
Stress in changing behaviour, effort involved in maintaining latrine or obtaining additional water

Where will the product be available for the consumers, including where it will be displayed or demonstrated

Delivery of product:
Health centres, clinics, pharmacies, households, clubs, local businesses, schools

How the consumers will know the product exists, its benefits, costs, and where and how to get it

Delivery of message:
Television, radio, newspapers, posters, billboards, banners, folk singers or dramatists, public rallies, interpersonal/counselling

Source: Adapted from (2).

To find out more

This article provides an introduction to social marketing. Readers are encouraged to refer to the references overleaf for more information.


(1) Attawell K, ed. “Partnerships for change” and communication - guidelines for malaria control. Division of Control of Tropical Diseases, World Health Organization (1211 Geneva 27, Switzerland) and Malaria Consortium (London School of Hygiene & Tropical Medicine, Keppel Street, London WCIE 7HT, UK).

(2) McKee N. Social mobilization and social marketing in developing communities, lessons for communicators. South Bound, Penang, 1992.

(3) WASH. Lessons learned in water, sanitation and health: thirteen years of experiences in developing countries. WASH, Arlington, VA, 1993.

(4) Griffiths M. Social marketing: a key to successful public health programs. Paper presented at the Social Marketing for Public Health Conference, 5-7 March 1991.

(5) WASH. Social marketing and water supply and sanitation: an integrated approach, Arlington, VA, May 1988 (WASH Field Report No. 221).