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Creating demand for sanitation and hygiene through Community Health Clubs: A cost-effective intervention in two districts in Zimbabwe

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  • Waterkeyn, Juliet
  • Cairncross, Sandy

Abstract

Unless strategies are found to galvanise rural communities and create a demand for sanitation, we cannot achieve the United Nations Millennium Development Goal of halving the 2.4 billion people without sanitation by the year 2015. This study describes an innovative methodology used in Zimbabwe--Community Health Clubs--which significantly changed hygiene behaviour and built rural demand for sanitation. In 1 year in Makoni District, 1244 health promotion sessions were held by 14 trainers, costing an average of US$0.21 per beneficiary and involving 11,450 club members (68,700 beneficiaries). In Tsholotsho District, 2105 members participated in 182 sessions held by three trainers which cost US$ 0.55 for each of the 12,630 beneficiaries. Within 2 years, 2400 latrines had been built in Makoni, and in Tsholotsho latrine coverage rose to 43% contrasted to 2% in the control area, with 1200 latrines being built in 18 months. Although Zimbabwe has historically relied on subsidies to stimulate sanitation, this intervention shows how total sanitation could be achievable. The remaining 57% of club members without latrines in Tsholotsho all practised faecal burial, a method previously unknown to them. Club members' hygiene was significantly different (p

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  • Waterkeyn, Juliet & Cairncross, Sandy, 2005. "Creating demand for sanitation and hygiene through Community Health Clubs: A cost-effective intervention in two districts in Zimbabwe," Social Science & Medicine, Elsevier, vol. 61(9), pages 1958-1970, November.
    • Handle: RePEc:eee:socmed:v:61:y:2005:i:9:p:1958-1970
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    1. Arnold,Benjamin Ford & Briceno,Bertha & Colford Jr.,John M. & Gertler,Paul J. & Patil, Sumeet R. & Salvatore,Alicia Link, 2013. "A randomized, controlled study of a rural sanitation behavior change program in Madhya Pradesh, India," Policy Research Working Paper Series 6702, The World Bank.
    2. Hugh Sharma Waddington & Sandy Cairncross, 2021. "PROTOCOL: Water, sanitation and hygiene for reducing childhood mortality in low‐ and middle‐income countries," Campbell Systematic Reviews, John Wiley & Sons, vol. 17(1), March.
    3. YuJung Julia Lee & Tiffany Radcliff, 2021. "Community interactions and sanitation use by the urban poor: Survey evidence from India’s slums," Urban Studies, Urban Studies Journal Limited, vol. 58(4), pages 715-732, March.
    4. Marion W. Jenkins and Steven Sugden, 2006. "Rethinking Sanitation: Lessons and Innovation for Sustainability and Success in the New Millennium," Human Development Occasional Papers (1992-2007) HDOCPA-2006-27, Human Development Report Office (HDRO), United Nations Development Programme (UNDP).
    5. Curtis Hanson & Emily Allen & Margie Fullmer & Rachel O’Brien & Kirk Dearden & Joshua Garn & Cut Novianti Rachmi & Jeffrey Glenn & Joshua West & Benjamin Crookston & Parley Hall, 2020. "A National Communication Campaign in Indonesia Is Associated with Improved WASH-Related Knowledge and Behaviors in Indonesian Mothers," IJERPH, MDPI, vol. 17(10), pages 1-10, May.
    6. Rejaul K. Bakshi & Debdulal Mallick & Mehmet A. Ulubaşoğlu, 2019. "Social capital as a coping mechanism for seasonal deprivation: the case of the Monga in Bangladesh," Empirical Economics, Springer, vol. 57(1), pages 239-262, July.
    7. McGranahan, Gordon, 2015. "Realizing the Right to Sanitation in Deprived Urban Communities: Meeting the Challenges of Collective Action, Coproduction, Affordability, and Housing Tenure," World Development, Elsevier, vol. 68(C), pages 242-253.
    8. McMichael, Celia & Robinson, Priscilla, 2016. "Drivers of sustained hygiene behaviour change: A case study from mid-western Nepal," Social Science & Medicine, Elsevier, vol. 163(C), pages 28-36.
    9. Caroline Hunt, 2006. "Sanitation and Human Development," Human Development Occasional Papers (1992-2007) HDOCPA-2006-26, Human Development Report Office (HDRO), United Nations Development Programme (UNDP).
    10. Whittington, Dale & Jeuland, Marc & Barker, Kate & Yuen, Yvonne, 2012. "Setting Priorities, Targeting Subsidies among Water, Sanitation, and Preventive Health Interventions in Developing Countries," World Development, Elsevier, vol. 40(8), pages 1546-1568.
    11. Zuin, Valentina & Delaire, Caroline & Peletz, Rachel & Cock-Esteb, Alicea & Khush, Ranjiv & Albert, Jeff, 2019. "Policy Diffusion in the Rural Sanitation Sector: Lessons from Community-Led Total Sanitation (CLTS)," World Development, Elsevier, vol. 124(C), pages 1-1.
    12. Bardosh, Kevin & Inthavong, Phouth & Xayaheuang, Sivilai & Okello, Anna L., 2014. "Controlling parasites, understanding practices: The biosocial complexity of a One Health intervention for neglected zoonotic helminths in northern Lao PDR," Social Science & Medicine, Elsevier, vol. 120(C), pages 215-223.
    13. Coffey, Diane & Spears, Dean & Vyas, Sangita, 2017. "Switching to sanitation: Understanding latrine adoption in a representative panel of rural Indian households," Social Science & Medicine, Elsevier, vol. 188(C), pages 41-50.
    14. Jonathan Jared Ignacio & Roy Alvin Malenab & Carla Mae Pausta & Arnel Beltran & Lawrence Belo & Renan Ma. Tanhueco & Marlon Era & Ramon Christian Eusebio & Michael Angelo Promentilla & Aileen Orbecido, 2018. "Perceptions and Attitudes Toward Eco-Toilet Systems in Rural Areas: A Case Study in the Philippines," Sustainability, MDPI, vol. 10(2), pages 1-20, February.
    15. Rheinländer, Thilde & Samuelsen, Helle & Dalsgaard, Anders & Konradsen, Flemming, 2010. "Hygiene and sanitation among ethnic minorities in Northern Vietnam: Does government promotion match community priorities?," Social Science & Medicine, Elsevier, vol. 71(5), pages 994-1001, September.
    16. Cairncross, Sandy & Shordt, Kathleen & Zacharia, Suma & Govindan, Beena Kumari, 2005. "What causes sustainable changes in hygiene behaviour? A cross-sectional study from Kerala, India," Social Science & Medicine, Elsevier, vol. 61(10), pages 2212-2220, November.
    17. Hatcher, Abigail M & McBride, Ruari-Santiago & Rebombo, Dumisani & Munshi, Shehnaz & Khumalo, Mzwakhe & Christofides, Nicola, 2020. "Process evaluation of a community mobilization intervention for preventing men’s partner violence use in peri-urban South Africa," Evaluation and Program Planning, Elsevier, vol. 78(C).
    18. Emmy De Buck & Hans Van Remoortel & Karin Hannes & Thashlin Govender & Selvan Naidoo & Bert Avau & Axel Vande Veegaete & Alfred Musekiwa & Vittoria Lutje & Margaret Cargo & Hans‐Joachim Mosler & Phili, 2017. "Approaches to promote handwashing and sanitation behaviour change in low‐ and middle‐income countries: a mixed method systematic review," Campbell Systematic Reviews, John Wiley & Sons, vol. 13(1), pages 1-447.

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