Chapter  F  provides an overview of different frameworks and approaches that aim to promote safe WASH behaviours. Some of them are ready-to-use; others need adapting to the given conditions. 

Some approaches are designed for specific target groups such as children, e.g. Fit for School F.10 or School Health Clubs F.1, or for specific target behaviours such as sanitation or handwashing with soap, e.g. Wash’Em F.22. A few of the approaches are more suited to implementation in rural communities, e.g. Community-Led Total Sanitation F.2 or Participatory Hygiene and Sanitation Transformation F.6, while others have been developed for institutions or the urban context, e.g. Social Marketing F.21. Some approaches may be easier to implement in acute emergency contexts; others are more suited to chronic situations. The selection of approaches will also be influenced by the level of public health risk and the availability of funding and resources. Most will need adaptation to the specific socio-ecological context.

In general, behaviour change approaches aim at promoting one or more safe or healthy behaviours within a specific target group. Ideally, the activities used are directly linked to the barriers, motivators and needs of the audience (B.3, B.4, B.5, B.6, B.7) and include interactive and engaging components (chapter  C  and chapter  E ). Most of the approaches have been developed from theoretical behaviour change models B.2 which stem from social and health psychology. 

It is important to know whether the selected approach is successful in changing behaviour and the related attitudes and norms. Monitoring M.2 and Evaluation M.3 can identify the results and impact and be used to modify the approach, improve activities and interventions and save resources in the longer term. Some of the approaches described integrate evaluation tools and strategies with their programme activities.

Process & Good Practice

• The following questions can guide the selection of a specific behaviour change approach. The list is not exhaustive but can stimulate further reflection and lead to an informed decision about which approach best fits the specific context.

• What are the national guidelines and recommendations? Before selecting a behaviour change approach, check the national guidelines to find out which procedures or approaches are already used and which approaches are mandatory. Many countries have national WASH policies; they may already define the targets, coordination mechanisms, monitoring and evaluation frameworks and standards to be used. Identify which Ministry or department is responsible for which sector and learn about their approaches or recommendations. 

• What resources are available for programme development? If material already exists and is validated for the specific context, consider using it. This can save resources, such as the time required for adaptation and money for producing new material. 

• When is it advisable to select an approach and prepare for implementation? Ideally, select an appropriate potential approach for your context during preparedness planning or when making longer-term plans. The selection can then be made according to the available resources, the staff can be trained and material developed in advance.

• Which approach should I use? This depends greatly on different contextual aspects. Rather than providing participants with an incoherent set of messages and activities drawn from different approaches, it is more effective to use a limited number of approaches systematically, so that the process and activities can be fully implemented. In an emergency, more than one approach may be needed to target different groups in the affected community.

• How will I know the intervention has made a difference? Evaluate the impact and get feedback from the community: adapt, improve and implement again.