To achieve an effective and sustainable introduction of skills-based hygiene education, a program should follow these ten steps.
| Step1: Inventory existing situation |
Before new methodologies are developed, an inventory of the existing situation must be made.
- Review the contents of the curriculum
- Identify the content that is relevant to education on hygiene
- Review and describe the content of the relevant subjects that are taught
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| Step 2: Select priorities for change |
| Select the knowledge, attitudes, and skills to address. Generally the most relevant issues to be addressed are methods of human excreta disposal, including anal cleansing and possible disposal of anal cleansing materials; hand washing, especially with soap, ash or clay; and choice of drinking water source. For older students the list might be extended to include food handling and personal hygiene (with a special component for the girl students on menstrual hygiene). The locally prevailing health issues and the priority concerns of local people, and the baseline data collected, will determine any specific additional practices to be detailed. Those practices can be easily identified in consultation with teachers, children, and parents, recognizing that many children have never used a toilet, urinal, or hand washing facility before entering school. |
| Step 3: Define goals and objectives |
| Define specific goals, objectives, and desired changes in hygiene conditions…. And stick to them. |
| Step 4: Learn from others and from the past |
| Learn from the experiences in the past and from others. Review the existing hygiene education materials and select what is still relevant. Re-use the good parts: doing so allows teachers to use materials they are already familiar with and thus saves resources. In addition, try to find good examples of other materials that can be adapted to the local situation. There are many good quality materials that demonstrate their effectiveness through research and evaluation. Some good examples of teaching materials and methodologies can be found in Resources (link with block 5). |
| Step 5: Develop new materials if necessary |
| Check to see whether the combination of old and new materials meets the criteria set for skills-based hygiene education. If not (which is most likely), identify the gaps and develop new age-appropriate, skills-based materials to fill those gaps. |
| Step 6: Establish complete methodology |
| Compile the complete methodology. A hygiene promotion methodology goes beyond teaching materials. It also includes the design of support structures such as hygiene committees, school health clubs, and teaching methods such as Nali Kali and the Child-to-Child approach. In most settings a phased approach might be preferable, allowing children to foster good hygiene behaviors, knowledge, and skills from the start while improvements for sanitation and water are being made. |
| Step 7: Provide capacity building and training |
| Provide ongoing training for teachers and support teams from schools, ministries, and communities. Provide support for implementation and collaborative strategies such as partnerships with young people. |
| Step 8: Implement field testing |
Field test the materials in schools in different settings in close cooperation with teachers, parents, children, and the community. Field testing should take place
- In at least six schools, in all grades, to allow for a representative sample
- Through at least one full school year, to allow sufficient time to observe application in all seasons, each of which has specific hygienic demands (e.g. dry and rainy season)
- After setting a base-line on hygiene behavior.
During and after testing the impact of hygiene education should be monitored and evaluated.
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| Step 9: Conduct overall assessment |
| After the field-testing period, an overall assessment should be done that goes beyond the hygiene and health impact to focus on issues such as project management and facilities and implementation support. This assessment should involve all stakeholders. |
| Step 10: Go to scale |
| The skills-based hygiene education can go to scale |
