Department for Disease Control, London School of Hygiene & Tropical Medicine, London, England, United Kingdom.
Project CLEAR Ltd, Plot # 1297, Pieta Lane Masaki, Dar es Salaam, Tanzania.
Health Promot Int. 2023 Oct 1;38(5). doi: 10.1093/heapro/daad126.
Universal access to hygienic sanitation is a Sustainable Development Goal for international development. However, many countries are liable to miss this target by the deadline of 2030. As provision and subsidy are prohibitively expensive, promotion is the tactic commonly taken by governments and stakeholders in many countries, even though it is often not effective at generating significant changes in sanitation coverage. A recent 5-year programme used an international consortium made up of organizations' experts in consumer research, creative communication, programme management and event implementation, media monitoring and programme evaluation, to achieve significant increases in the coverage of improved sanitation facilities throughout Tanzania, using adaptive programming. A number of lessons, outlined here, can be drawn from this experience which are likely to be applicable to promotion efforts in other countries and contexts and which can hopefully help countries to reach their sanitation targets. These lessons include the use of motivation and targeted expertise rather than reliance on training, the use of the theory of change to guide development processes, targeting of high-level government support, collaboration with private sector actors, testing and refreshing of messaging, continuous monitoring of on-ground conditions, use of multiple modes of outreach and branding of all programme outputs.
普及卫生厕所是国际发展的可持续发展目标之一。然而,许多国家可能无法在 2030 年的最后期限前实现这一目标。由于提供和补贴的费用过高,促进成为许多国家政府和利益相关者通常采取的策略,尽管它通常无法有效地促使卫生设施的覆盖范围发生重大变化。最近一个为期 5 年的项目利用一个由消费者研究、创意传播、项目管理和活动实施、媒体监测和项目评估方面的组织专家组成的国际联盟,在坦桑尼亚各地实现了改良卫生设施覆盖范围的显著增加,采用了适应性规划。从这一经验中可以总结出一些经验教训,这些经验教训可能适用于其他国家和背景下的推广工作,并有望帮助各国实现其卫生目标。这些经验教训包括利用动机和针对性的专业知识而不是依赖培训,利用变革理论来指导发展过程,针对高级别的政府支持,与私营部门合作,测试和更新信息,持续监测实地情况,利用多种推广模式以及对所有项目产出进行品牌化。