Hetherington Erin, Eggers Matthijs, Wamoyi Joyce, Hatfield Jennifer, Manyama Mange, Kutz Susan, Bastien Sheri
Cumming School of Medicine, University of Calgary, TRW 3rd Floor, 3330 Hospital Dr. NW, Calgary, AB, T2N 4N1, Canada.
Maastricht University, School for Public Health and Primary Care (Caphri), P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
BMC Public Health. 2017 Feb 7;17(1):172. doi: 10.1186/s12889-017-4100-7.
Diarrheal disease is a major cause of mortality and morbidity in low and middle income countries with children being disproportionately affected. Project SHINE (Sanitation & Hygiene INnovation in Education) is a grassroots participatory science education and social entrepreneurship model to engage youth and the wider community in the development of sustainable strategies to improve sanitation and hygiene.
Based in rural and remote Tanzania, this pilot study engaged pastoralist high-school students and communities in the development and evaluation of culturally and contextually relevant strategies to improve sanitation and hygiene. Using a train-the-trainer approach, key activities included teacher workshops, school-based lessons, extra-curricular activities, community events and a One Health sanitation science fair which showcased projects related to water, sanitation and hygiene in relation to human and animal health. The process and outcome of the study were evaluated through qualitative interviews and focus group discussions with diverse project participants, as well as pre- and post- questionnaires completed by students on knowledge, attitudes and practices concerning sanitation and hygiene.
The questionnaire results at baseline and follow-up showed statistically significant improvements on key measures including a decrease in unhygienic behaviors, an increase in the perceived importance of handwashing and intention to use the toilet, and increased communication in the social network about the importance of clean water and improved sanitation and hygiene practices, however there were no significant changes in sanitation related knowledge. Qualitative data highlighted strong leadership emerging from youth and enthusiasm from teachers and students concerning the overall approach in the project, including the use of participatory methods. There was a high degree of community engagement with hundreds of community members participating in school-based events. Sanitation science fair projects addressed a range of pastoralist questions and concerns regarding the relationship between water, sanitation and hygiene. Several projects, such as making soap from local materials, demonstrate potential as a sustainable strategy to improve health and livelihoods in the long-term.
The Project SHINE model shows promise as an innovative capacity building approach and as an engagement and empowerment strategy for youth and communities to develop locally sustainable strategies to improve sanitation and hygiene.
腹泻病是低收入和中等收入国家死亡和发病的主要原因，儿童受影响的比例尤其高。SHINE项目（教育中的卫生与卫生设施创新）是一种基层参与式科学教育和社会创业模式，旨在让青年和更广泛的社区参与制定改善卫生与卫生设施的可持续战略。
这项试点研究位于坦桑尼亚农村和偏远地区，让牧民高中生和社区参与制定和评估与文化和背景相关的改善卫生与卫生设施的战略。采用培训培训师的方法，关键活动包括教师研讨会、校本课程、课外活动、社区活动以及一个“同一健康”卫生科学博览会，该博览会展示了与人类和动物健康相关的水、卫生与卫生设施项目。通过与不同项目参与者进行定性访谈和焦点小组讨论，以及学生填写的关于卫生与卫生设施知识、态度和行为的前后调查问卷，对研究过程和结果进行了评估。
基线和随访时的问卷结果显示，在关键指标上有统计学意义的改善，包括不卫生行为减少、对手部清洁重要性的认知和使用厕所意愿增加，以及社交网络中关于清洁水重要性以及改善卫生与卫生设施行为的交流增加，但与卫生相关的知识没有显著变化。定性数据突出了青年展现出的强大领导力以及教师和学生对项目整体方法（包括参与式方法的使用）的热情。社区参与度很高，数百名社区成员参加了校本活动。卫生科学博览会项目解决了牧民关于水、卫生与卫生设施之间关系的一系列问题和担忧。一些项目，如用当地材料制作肥皂，显示出作为长期改善健康和生计的可持续战略的潜力。
SHINE项目模式有望成为一种创新的能力建设方法，以及青年和社区制定当地可持续战略以改善卫生与卫生设施的参与和赋权战略。
