Installation of water supply systems and sanitation facilities are not enough to improve people’s health – good hygiene practices are essential to serve that purpose. BRAC WASH adopted a number of practical approaches to promote hygiene messages that are based on socioeconomic and hydrogeological conditions, culture and existing practices. Cluster meetings conducted by field staff raise awareness on the use of safe water, hygienic latrines and good hygiene practices through the use of various communication tools. Imams (Muslim leaders) of mosques are trained to promote hygiene activities to reach out to people through religion. Local folk media and popular theatre teams are used to deliver crucial messages from the WASH programme to communities by incorporating hygiene issues in their drama scripts.
Cluster meetings are held separately for men, women, adolescent boys and girls, and children to spread hygiene education at all levels. These meetings are conducted by designated field staff, and key messages on good hygiene behaviour are shared. To make sure that all the households in a given village receive the information conveyed, the meetings are organised in small groups and the participation of members from each invited household is ensured.
Moreover, as each of these groups play different roles in the society, reaching out to them separately helps behavioural change messages to be communicated in more effective ways. Messages are tailored to what each group is most interested in, eg, appealing to mothers by informing them of the benefits of good hygiene on their children’s health. Likewise, as children can be very effective carriers of messages to their families, it is crucial to have separate sessions to create awareness among them.
Training of imams
As the majority of the Bangladeshi population is Muslim, reaching out to the rural population through religion is an effective means of spreading hygiene messages. Mosques have a significant influence on the religious rural population. Thus, khutba (sermon) guidebooks have been developed based on verses from the Quran and Hadith that refer to cleanliness and hygiene. More than 18,000 imams, who are key religious and opinion leaders in rural Bangladesh, have been trained on hygiene promotion, and are delivering these messages during the Friday prayers.
Menstrual hygiene management
Menstrual hygiene is a topic surrounded by taboos and superstitions, and a matter which is often avoided in rural Bangladesh. Practices such as using rags instead of sanitary napkins still take place, and superstitious beliefs, such as eating less during menstruation, still exist. The programme has taken several steps to improve these issues. BRAC’s health volunteers sell sanitary napkins door to door. BRAC’s sanitary napkin production centre (one of its social enterprises) has been supplying affordable, biodegradable napkins since 1999, to meet the public health needs of poor women and girls in rural areas.
In BRAC’s WASH programme areas, school teachers hold regular sessions on menstrual hygiene, which were initially conducted by the programme staff. The programme assistants discuss menstrual hygiene issues when they hold cluster meetings for women and adolescent girls. They also educate women and girls on issues like eating healthy and iron-rich food during their periods. Women who cannot afford to buy sanitary napkins, and still have to use rags, are taught to wash the rags thoroughly with soap and dry them under sunlight. Through these meetings, women and adolescent girls not only learn, but also speak up about menstrual hygiene issues, something that was nearly unthinkable just a few years ago.
Mobilising health volunteers, local folk media and popular theatre teams
Among BRAC’s health volunteers, more than 14,000 have been trained to deliver crucial WASH messages. In addition, local folk media and popular theatre teams are used to deliver these messages to communities by incorporating hygiene issues in their drama scripts, which have been found to be effective among rural populations.
Tea stall sessions
Since 2014, regular hygiene promotion sessions are taking place in tea stalls to reach those men who are not being reached through the cluster meetings. Experience shows that these men are either not interested in participating in cluster meetings or are unable to attend due to their working hours. Tea stalls have been proven to be effective spaces to reach out to them as most men frequent these shops after work. It is essential to ensure men’s participation to meet the programme objectives since they are, in many instances, the decision makers of the household expenditures and often provide a significant part of the household income.