|Hygiene Evaluation Procedures - Approaches and Methods for Assessing Water - and Sanitation-Related Hygiene Practices (International Nutrition Foundation for Developing Countries - INFDC, 1997, 124 pages)|
|2. Planning a hygiene evaluation study|
In order to assess hygiene practices and to understand why they occur in the way they do, you will need to gather diverse types of information. Some of these may already exist in your project files and/or other written documents, while others will need to be collected during your hygiene evaluation study.
The Physical Environment
Climate, soil type, and availability of water may all influence hygiene practices. For example, people are not likely to use water for washing or bathing frequently if there is very little water available near them and if they have to walk long distances to fetch water for everyday use. Similarly, pastoralist communities who live in very arid regions and move periodically from one area to another are not likely to be concerned about building sanitary facilities.
Different sources may be available for you to use to research this information. There may be written records with detailed descriptions of the area, perhaps with historical perspectives. Ministries of Agriculture, Forestry, and/or Natural Resources may have records you can consult: usually, their annual reports provide some maps and photographs.
However, one of the best ways to collect relevant information on the physical environment is to go out and see, smell, touch, and feel the place of interest for yourself. Visits to existing water sources in and outside villages and familiarity with different parts of villages, districts, and regions around you are necessary if you want to learn about the physical conditions and features of your project site. Try to visit the study site when you start planning, so that you can plan your activities with the particular place in mind. You learn more by visiting villages yourself (and preferably staying in them for more than a day at a time), than by learning about them secondhand. Repeat visits at different times of the year are often necessary to appreciate seasonal variations in climate, water availability, accessibility of villages, agricultural workload of the inhabitants, and so on. Repeat visits also give you the chance to build up friendships with the inhabitants, so you can learn more from them as well as from your own observations.
Before meeting people in your study site, try to find out as much as possible about them. You (and your study team) need to ask yourselves the questions in Box 2.
Once you have answered these questions, you will be able to describe the population and the community. Be clear though, to whom you are referring when you use these terms. A few definitions may be useful:
Population. A defined group of people. The population of a country refers to all people in the country; the population of a village refers to all people in the village.
BOX 2: Preparing for the Study
· How much do I know about the people served by my project?
Study Population This refers to all people you include in the study or evaluation. It is up to you to define them. The study population may be a sample of the total population of a given area.
Village. This term may refer to an administrative area and a geographic area (a group of houses close together), or it may be used only to refer to the administrative area including outlying land. When we talk about villages, however, we usually refer to a number of houses positioned closely together, which share some public facilities - a meeting place or common land, a well, a place of worship such as a mosque, temple, church, or schoolhouse.
Community. A community is a group of people with a shared identity and common interests. People may share a common interest because of their residence, or because of ethnic, language, religious, or other ties.
Family. This term is used to indicate that a group of people are related to each other by blood or by marriage. Not all members of a family will constitute a household, and not all householders may be related or part of a family.
Household. A household is conventionally defined as a group of people who share a single cooking pot. It can include nuclear families (husband, wife, and children only), extended families (additional family members, often grandparents as well), households with more than one wife, and households where not all members are related. In general, households include people usually related, who live under one roof, and share certain economic resources.
Note that all of these terms need to be defined. The term community, for example, seldom refers to a homogeneous group of people. A village community is usually made up of subgroups such as elders, leaders, men, women, and children, and poor and wealthy family groups who may belong to different clans or ethnic groups. The village community may be made up of people who belong to the same language or ethnic group but do not necessarily share the same views or beliefs. People from two different ethnic or language groups in the same area, even in the same village, may be regarded as-and much more importantly, they may regard themselves as-belonging to one community sometimes, and two communities on other occasions.
You cannot assume that these groups share the same views or have the same interests. You need to be sensitive to any conflicting interests within your study population. Men and women may represent significantly different interests. There may be differences even within these two gender groups. Some may be traditional while others are modernist. Some may be conformists while others are rebels.
In urban areas, people may consider themselves to be part of one or more interest groups, types of community that do not necessarily share the same ethnic, linguistic, cultural, or religious affiliations, but have similarly felt or expressed needs and concerns. If you use the term community, make sure you understand what it stands for, and define it carefully.
You need to collect and interpret information that is gender-specific. In other words, you should be able to come up with information that is specific to men, information that is specific to women, and information that is common to both men and women. Many hygiene-related activities have gender-specific roles and values associated with them. You need to ask women about their activities. Do not rely on men telling you what women do, or why they do it. Similarly, do not rely on women to de scribe men's activities.
For example, women and young children are often solely responsible for fetching water, and men's accounts of accessibility and use of water may be very different from women's. Women are also the first health and hygiene educators in the home. Sanitation and hygiene-related habits are inculcated at a very early age when toilet training and personal cleanliness are strongly influenced by the mother's teaching and practice.
Gender-specific roles may influence the adoption of sanitation facilities. In many cultures, the construction of pit latrines is seen as a man's job while the task of cleaning them is be a woman's. In rural western Kenya, women-headed households may face difficulties with latrine construction and repair, because it is not acceptable for a woman to dig a pit latrine or to repair a latrine with a leaking roof.
Hygiene Practices and Health
In order to identify practices that pose health hazards, you will need to find out which water and sanitation-related diseases are prevalent in the project site. This can be done by consulting the local dispensary, clinic, or hospital personnel, and their records. There may also be other institutions including your own project, which may have conducted health surveys or compiled records.
More importantly, you will need to find out what local people do about health-related problems. There may be documentary sources of information on existing health practices, including traditional practices, but there may still be more for you to find out. Understanding what the local population perceive to be good practices and bad ones (those that promote health and those that do not) and why, is an important contribution that your evaluation can make towards the design of an effective health or hygiene promotion intervention. You may be able to provide information on which good hygiene practices to encourage and which bad or harmful ones to try to discourage in acceptable ways.
Your study plan should include some detail of whether the different types of information will be qualitative, quantitative, or a combination of both. The units of analysis used and the sampling strategies applied will depend on the type of information gathered in terms of the qualitative-quantitative mix. As mentioned in the introduction, the emphasis of this handbook is on the depth or richness of information on hygiene practices that can be gathered through qualitative methods, and that can help project personnel better understand the cultural and social context in which they work. Whether or not the study is designed to include quantitative data also will depend on the resources available. The two approaches can be adopted side by side to address questions of breadth and depth at the same time. A qualitative study ideally always precedes the quantitative investigation, especially for baseline evaluation purposes. However, qualitative research can also be preceded by a quantitative survey, which might identify certain issues to be followed up, using qualitative methods, for clarification and further detail.