Volunteering for WASH

Behaviour Improvements
Ivo Guterres, Environmental Health Department Head
Ministry of Health, Timor-Leste
5 July 2011
 Background
Timor Leste: Socio Political Context

1999 Referendum on Independence from Indonesia

70 percent of economic infrastructure
destroyed and displacement of population

2002 Declaration of sovereign nation state

2006 Civil conflict

Population in 2010 1,149,000 (50% of the population is under 18

yrs)
Expected Population in 2015 1,293,000

Human Development Index 162nd (HDI Report 2009) 2nd Lowest in Asia
 Background Cont.
Timor Leste: Rural WASH Context
Water Supply Coverage
MDG Target
Sanitation Coverage
MDG Target
Diarrheal Disease
National Priority 1 for 2010
Increased Government
Commitment
55% - (Studies have indicated a range between 10
70% are functioning)
75% by 2015
40%
55% by 2015
15% of children under 5 had diarrhea in 2 weeks
prior to DHS 2009 survey
Second highest cause of mortality in children
under five
Roads and Water / Sanitation
USD 2.5 million in 2009 to USD 12.8 million in
2010 for water supply
Establishment of Sanitation Department at MoI
 Extending Effective WASH Promotion
into the Community
1. SISCa (Integrated Community Health Services)
- From, with, and to the community
1. Family Health Promoters
2. Taking a behaviour change approach to promote
improvements in key WASH practices :
Handwashing with soap at critical times
Safe management of water from source to mouth
(consumption)
Safe disposal of adult and child faeces
Support active participation of women in WASH
decision making
SISCa
Table 1 Community
SISCa
Registration
Table 2 - Nutrition
Table 3 Maternal
and Child Health
Personal counseling and
promotion regarding:
-Handwashing with soap
-Personal Hygiene
-Household sanitation
and hygiene
-KUBASA

Table 4 Monthly Health Promotion

Environmental Health Topics / Activities, including:
-Handwashing
demonstrations and games
Table 5 General exploring routes of
Consultations transmission
-Building handwashing
stations from locally
Table 6 Health resourced materials
Promotion
 Family Health Promoters - PSFs

Community nominated volunteers

Mobilize communities to participate in SISCa
Assist the implementation of SISCa
Conduct house-to-house environmental health
monitoring (KUBASA) and negotiation of behaviours
Challenges
Large amount of support and supervision
Ongoing capacity development
On the training job
Good relationship with the community to be effective
Case Study: Role Modeling in Communities

PSFs received additional support

from USAID WASH programme in
target areas

PSFs were trained in interpersonal

communication for behaviour
change
Identifying barriers to change
Working with community
members to resolve problems

PSFs role model target behaviours

at the community level

Support provided by the the USAID

WASH programme has equipped
PSFs with technical skills as well as
motivation to engage community
members around WASH behaviours
Case Study: Soap social marketing and hygiene promotion

PSFs received additional support

from a Japanese NGO in target areas

Trained PSFs to make and market

soap

PSFs sell soap at SISCa and when

promoting hygiene door-to-door
Increased access to soap
Incentive for PSFs

Ongoing support from NGO provides

supportive supervision to improve
PSF skills and organize activities
CREATIVE HANDWASHING FACILITIES
 Hygiene Behaviour Improvements
Lessons Learned
Family Health Promoters
Volunteers can be effective at
negotiating WASH behaviour
change
Supportive Supervision
Ongoing capacity building
Partners can support district
health services
Male and female PSFs are
essential to effectively reach the
entire population
 Hygiene Behaviour Improvements
Lessons Learned
Behaviour Change Approach
Increased knowledge around
WASH is not sufficient.
Improved skills in
interpersonal communication
is essential to identify
specific barriers and to help
community members explore
ways for resolving
Monitoring systems for
behaviour change need to be
improved
OBRIGADO!

THANK YOU!