Hygiene promotion: lessons from Save the Children’s Bangladesh programme

Save the Children’s School Health and Nutrition (SHN) program (2002-2008) in Nasirnagar, Bangladesh, provided water, sanitation, and hygiene facilities in 127 schools, reaching over 33,500 children. In 2006, the SHN programme integrated PHASE (Personal Health and Sanitation Education program) into its approach. PHASE, a hand-washing program targeting school-aged children, was developed and funded by research-based pharmaceutical company GlaxoSmithKline. The programmes also helped to improve access to and use of household water and sanitation facilities.

School wall murals showing good health and hygiene practices. Photo: Save the Children

Despite its achievements, the SHN program encountered a number of challenges [1,2]:

• 13 percent of households continue to practice open defecation due to lack of funds for a latrine, lack of space for construction, or lack of knowledge;
• hand-washing habits were more difficult to change at the household-level than at the school-level;
• 57 percent of households still do not properly dispose of their waste, due to a lack of facilities away from households and the belief that children’s faeces is less harmful than that of adults;
• handwashing facilities were sometimes vandalised and replacement parts and repairs are costly and rely on external support;
• as there was not always enough time to provide school health and hygiene promotion lessons, Save the Children recommends adding a weekly health class to the national curriculum;
• the success of health and hygiene promotion depended largely on the participation of school management committees; and
• mothers’ gatherings and courtyard meetings needed to be held at convenient times in women’s daily schedules—usually between breakfast and lunch, and have the support of husbands and family members.

[1] Save the Children (2009). Improving water and sanitation in schools and communities : successes and lessons learned from Nasirnagar, Bangladesh. 6 p. Download here

[2] Save the Children (2009). Changing hygiene behavior in schools and communities : successes and lessons learned from Nasirnagar, Bangladesh. 5 p. Download here

Contact: Save the Children, Ikhtiar Uddin, ikhtiar@savechildren.org or Natalie Roschnik, nroschnik@savechildren.org

Web sites: Save the Children ; Schools & Health ; WASH in Schools