Hygiene Promotion: A practical manual for relief and development 2nd edition

ISBN 978-185339-641-0

Suzanne Ferron, Joy Morgan and Marion O'Reilly



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WHILE SEVERAL TEXTS on refugee health care explicitly state that health promotion in emergency settings is important, they do not detail how it could be done. The conditions facing those affected by crises and those working with them warrant the development of more specific guidelines, taking into account the variable nature of emergencies and current issues in the provision of emergency relief. This manual attempts to fill a gap in the current literature on health and hygiene education in relief and rehabilitation settings but is also applicable to development settings. The manual is written mainly for fieldworkers on projects or programmes aiming to reduce the incidence of water- and sanitation- related diseases. It may also be useful to programme managers or ministry officials struggling to integrate water, sanitation and hygiene education/community management into their projects, and for health care workers attempting to address the high incidence of diarrhoeal diseases in either development or emergency programmes. The manual draws together the experiences of hygiene promotion fieldworkers in humanitarian settings over the last 15 years, experiences from development programmes and the insights of current hygiene promotion theory. The approaches that we have described are flexible enough to be used in a variety of settings. The illustrations and materials have been designed and pre-tested for use in the Great Lakes region of Africa, but could be adapted and used almost anywhere. Working in collaboration with people and allowing them to take more control in the design, implementation and management of water and sanitation systems is central to the aims of hygiene promotion and this concept is also central to this manual. Such action for change cannot be achieved by using didactic approaches to education that do not encourage the development of problem-solving skills. This manual stresses the need for education that fosters capacity building by not relying on the simple provision of information alone. It is often assumed that there is little scope for participatory learning outside the development field, but we have tried to look beyond this limited perspective. Wherever there are people there will be opportunities to build on their knowledge and skills through a more interactive type of learning. When we talk about people in communes or settlements, or refugees in camps, it is not to highlight the distinction between them, but rather to explore the learning potential common to both. We hope that the flexibility of approach will maximize the opportunities for promoting hygiene in such challenging environments.

About the authors

Suzanne Ferron works as a freelance consultant and has background in public health and health promotion. She has worked as a health advisor with Oxfam for several years and now specialises in training.

Joy Morgan has worked in the water, sanitation and hygiene sector since 1982 in the UK, Africa and Asia. Her most recent assignments have been on large development programmes; with UNICEF/ Government of Bangladesh and with CARE with Government of Ethiopia. Joy is currently working as a freelance consultant.

Marion O'Reilly is a Health Team Coordinator in Oxfam's Humanitarian Department. She has many years' experience working in both emergency and development contexts and has a postgraduate degree in Helath Promotion. She manages a team of advisers and field workers who support health promotion activities as part of Oxfam's emergency response programmes.

Table of contents


1 Assessment and analysis: Where are we now? 
Collecting information 
Rapid assessment 
Baseline information requirements 
Tools or methods of data collection 
Participatory data collection
Using the information 

2 Planning: Where are we going? 
Planning framework 
Action plans 

3 Implementation: How do we get there? 
Selection of fieldworkers 
Training of fieldworkers 
Management of fieldworkers 
Meetings and negotiations 
Information collection and analysis 
Campaigns, education and social marketing 
Operation and maintenance of water supply and sanitation facilities 
Other practical actions  

4 Monitoring and evaluation: How shall we know when we have got there? 
Defining monitoring and evaluation 
Why monitor and evaluate? 
Who will monitor and evaluate? 
What to monitor and evaluate 
When to monitor and evaluate? 
Participatory monitoring and evaluation 
How to do monitoring 
Carrying out evaluations 
How can we do it better next time? 


…contains useful new material, notably the up to date information…a resource rather than a recipe book…with clear and simple explanations given throughout. 
London School of Hygiene and Tropical Medicine

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