Working Paper 15. Promoting Sanitation and Hygiene to rural households in SNNPR, Ethiopia: Experiences of Health Extension Workers and Community Health Promoters

Abstract

This is the report of the research study carried out in 2009 on experiences of health extension workers (HEWs) and community health promoters (CHPs) in the Southern region of Ethiopia (SNNPR), in two districts (‘woreda’) - Halaba Special Woreda and Mirab Abaya Woreda - in relation to promotion of sanitation and hygiene in rural communities. The study confirms that health extension workers (HEWs) and community health promoters (CHPs) in the Southern Region (SNNPR) of Ethiopia are going about their work of informing households on improved sanitation and hygiene practices and are succeeding in persuading many households to change their behaviour. The system of health extension is working and making a contribution to improvement of life in rural communities. Key informants in the communities value the work of the HEWs and CHPs. This does not mean that attaining improvements in sanitation and hygiene practice is simple and straightforward. Commentators, in Ethiopia and internationally, recognise that bringing about behaviour change in relation to sanitation and hygiene is not a ‘one-off’ activity - promotional agents need to provide follow up, with repeated visits to households, until the desired behaviour changes. The experience of the HEWs and CHPs in SNNPR constitutes an instructive example of the achievements and challenges of promotion, in rural communities, of sanitation and hygiene as part of the Ministry of Health’s Health Extension Programme-HEP