Behavioural change key to tackling diarrhoea

A regional meet in Paro is looking into ways to alter hygiene attitudes

Health: Diarrhoea continues to be a top 10 disease in Bhutan as a result of poor sanitation practices and, in particular, the poor state of toilets and associated facilities.

This was pointed out at a regional meet being held in Paro, where representatives from seven countries are exploring ways to change hygiene behaviour.

Department of public health executive engineer, Sonam Gyaltshen, said that, despite high water and sanitation coverage, the incidence of illness due to water, sanitation and hygiene related diseases is still high in Bhutan.

Bhutan currently has basic sanitation coverage of 95 percent, improved sanitation coverage of 60 percent and 97 percent access to safe drinking water.

Sonam Gyaltshen said that, till 2009, only the pit latrine had been promoted in rural areas by health workers, as there was a lack of technology options available for improved latrines.

“There is urgent need to focus much more attention on hygiene behaviour change, if any meaningful progress is going to be made in gaining a health impact from investments in water supply and sanitation,” he said. “The mere installation of toilets does not by itself solve the problem, because a much broader and more holistic intervention that seeks to block all of the faecal-oral disease transmission routes is required.”

He added that, while many behaviour change communications interventions have been developed, there was room for improvement.  The meeting is expected to improve these interventions by allowing for ideas and experiences to be exchanged, for participants to look at different strategies, innovations, roles of relevant agencies, and the different motivators and barriers for rural men and women.

“Sanitation and water provision is one that directly contributes towards Gross National Happiness,” he said.

The SNV programme coordinator, Gabrielle Halcrow, said that Bhutan is moving from an awareness and knowledge giving stage to having the research that explains what will motivate people to change their behaviour.

The SNV provided technical assistance to the public health department to develop a rural sanitation and hygiene programme under a five-year framework in 2008.  Between 2010-13, the programme was expanded from four gewogs to two districts.

Following its success, a new agreement between the health ministry and SNV was made to take the programme nationwide as part of the present Plan.

IRC International Water and Sanitation Centre expert Erick Baetings said that a study was currently in progress that would attempt to correlate changes in behavior, and the costs invested by the government to bring about this change in Samtse dzongkhag.  The study will be conducted for the next two years.

The results of this study will provide information to the government on what practices are worth replicating in other dzongkhags.

IRC has been working with SNV since 2009, particularly in supporting programmes in Bhutan and Nepal.

The department of youth and sports (DYS) deputy chief program officer, Deki Tshomo, said that, for the department, the strategy was to bring about behaviour change by educating children.

She said that it was comparatively harder to change an adult’s behaviours and that educating children was easier. “Through the children we want to make a difference, positive change in society.”

DYS is one of the implementing agencies.

The four-day meet ends on March 12.

By Gyalsten K Dorji

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