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05 December 2018

Recruiting and Training of Hygiene Promotion Facilitators

Author/Compiled by
Luisa Muenter (cewas)
Executive Summary

In humanitarian crises, hygiene promotion campaigns are conducted by different types of facilitators, who need to be recruited and trained by the humanitarian actors. Firstly, hygiene programme coordinators must be trained to liaise with local WASH committees, participate in the development of hygiene promotion campaigns, manage hygiene teams and oversee their training. Secondly, hygiene promoters are required to manage the day-to-day activities of hygiene promotion campaigns. Lastly, members of the displaced population must be trained as community mobilisers to carry out the day-to-day activities of the program. When recruiting and training facilitators, their skills, characteristics, literacy levels, gender and roles within the affected population must be considered. It is recommended that trainings initially focus on building the basic and essential skills and then evolve towards strengthening capacities for participative methods and community mobilisation. This factsheet provides guidance on the needs for facilitators in humanitarian contexts, the roles and skills of different types of facilitators, recommended training focus, required materials and considerations regarding didactic versus participatory methods.

Advantages
Proper training and recruiting can improve effective hygiene promotion campaigns.
Training of facilitators can provide livelihoods of the affected population and reduce the vulnerability of these members of the population.
Training community mobilisers from the community can support building their capacity to take accountability for their own hygiene improvement through planning and monitoring and secure the sustainability of the intervention in camps.
Disadvantages
Training and recruiting can be costly and time consuming.
 Training for hygiene promotion may take away resources for other essential services.
Coordination with public health promoters and other WASH sectors for training may be difficult to organise.
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Introduction 
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Hygiene promotion campaigns are usually carried out by hygiene promotion facilitators such as hygiene program coordinators, hygiene promotors and community mobilisers. While the different types of facilitators all have specific roles and skills (see below), they should share abilities and characteristics conducive to working within cultural norms, shared beliefs and practices of the affected refugee or Internally Displaced People (IDPs) that may differ from their own (THE SPHERE PROJECT 2011). 

Adequate training of hygiene promotion facilitators is vital for ensuring the necessary knowledge, skills and capacities to deliver successful hygiene promotion campaigns in these settings. Facilitators must be knowledgeable in the present traditional beliefs of the refugees and IDPs and must be able to assess health problems related to water, sanitation and hygiene (WASH). Furthermore, they need to be equipped with communication skills as well as with the capacities to effectively deliver hygiene promotion messages (GWC 2009a). 

In acute emergency stages, time pressure and limited capacities often lead humanitarian actors to deploy volunteers from existing organisations or secondments of humanitarian agencies and to postpone adequate recruitment and training of dedicated, local staff to the post-acute phase (ODHIAMBO AND REED 2013). However, it is recommended to form WASH committees (made up of representatives of the different types of hygiene promotion facilitators as well as of the various user groups (see invalid link factsheet) from the beginning, in order to integrate initiatives and to lay the foundation for a more long-term maintenance of hygiene promotion practices and services (GWC 2009b).

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Roles and Skills of Different Types of Facilitators
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There are three different types of hygiene promotion facilitators with specific roles and skills: 

Hygiene Programme Coordinators

  • Role: Hygiene programme coordinators are a part of the WASH team and are managed by WASH programme managers. They have the responsibility to coordinate activities with humanitarian actors that provide water and sanitation services as well as to manage the network of hygiene promoters and mobilisers. The coordinators ensure compliance with WASH standards, arrange trainings of the facilitation team and contribute to the overall design of the hygiene promotion campaign (GWC 2009b). 
  • Skills: The individuals should bring in-depth knowledge in public health, experience in working in humanitarian crises and good knowledge of and experience in working with humanitarian actors at play in the region (GWC 2009b). 
  • Required numbers: One hygiene coordinator is required for each hygiene promotion campaign in each camp or collective centre. 
  • Recommended compensation: The hygiene promotion coordinator is an experienced professional, compensated with a full professional wage (GWC 2009b). 

Hygiene Promotors 

  • Role: The principle responsibility of hygiene promoters is to manage the day-to-day hygiene promotion activities and to work with a group of community mobilisers in a specific location or sector within the refugee or IDP population (GWC 2009b). 
  • Skills: Skills in health care, health promotion, community development, education or extension work are desired. Hygiene promoters require strong people skills and the ability to relate to the affected population (GWC 2009b). 
  • Required numbers: The Sphere Project minimum standards recommend one hygiene promoter for every 1000 affected people (THE SPHERE PROJECT 2011) whereas the UNHCR Emergency Hygiene Standards recommend two promoters for every 1000 affected people (UNHCR 2015). 
  • Recommended compensation: Hygiene promoters are generally employed on a full-time professional basis and are generally awarded a contract appropriate for their level of responsibility and in accordance with national legislations (GWC 2009b).

Community Mobilisers

  • Role: The primary role of community mobilisers is to carry out the day-to-day hygiene promotion activities within a defined section or area of the refugee or IDP population. Community mobilisers can be instrumental in doing outreach and household visits, which provide an interactive manner of assessing practices and hygiene levels in the households (THE SPHERE PROJECT 2011).
  • Skills: Community mobilisers are generally recruited from within the affected populations as they will have a better understanding of the local challenges and will be more easily accepted and respected by the population (ODHIAMBO AND REED 2013). Only if necessary – for instance when the urgency of the humanitarian response requires it - should people from outside the affected population (for example Red Cross volunteers) be selected as community mobilisers. Suitable candidates should represent both genders and different community roles and should have experience in community health, education or development (such as teachers, health care workers, traditional birth attendants and community leaders) (HARVEY et al 2002). Precautions should be taken not to remove important staff and volunteers from other essential activities of the humanitarian response to hygiene promotion (GWC 2009b). High levels of literacy are helpful but not vital if communication skills are strong and individuals can rely on their colleagues for reporting and monitoring (ODHIAMBO AND REED 2013). As the skills of the community mobilisers increase, the promoters can increasingly hand over their task to the mobilisers, thus strengthening the local population thereby mobilising their community (GWC 2009e). To provide effective household visit assessments, community mobilisers require specific training in facilitating these assessments (THE SPHERE PROJECT 2011). 
  • Required numbers: At least two community mobilisers per 1000 affected people or two per hygiene promoter are recommended (GWC 2009b). If there is an outbreak of a water-borne or WASH-related disease, the number may need to be increased (UNHCR 2015).
  • Recommended compensation: Community mobilisers may be employed as daily workers, through a contract or on a voluntary basis in accordance with national legislation (THE SPHERE PROJECT 2011).The advantages of paying community mobilisers include (adapted from GWC 2009b): a) paid mobilisers can focus full time on the hygiene promotion and can thus respond immediately to emerging concerns (e.g. hygiene related epidemics); b) it is easier to plan and manage paid workers as they have contractual obligations and incentives to perform through receiving a wage; c) wages can avoid overburdening a specific group within the refugee population with the responsibility of hygiene promotion (THE SPHERE PROJECT 2011); d) by providing a livelihood to community mobilisers from the affected population they and their families` capacity is strengthened which in turn reduces their overall vulnerability; e) it is simpler to manage money payments rather than time-consuming and complex in-kind incentives which are sometimes used to recruit and retain community mobilisers. The disadvantage of paying community mobilisers include: a) the individual may start to be regarded as working for the implementing humanitarian agency which can weaken their ties with the affected population they are part of; b) affected populations may be less inclined to participate if they know community mobilisers receive payment; c) if some humanitarian actor pays community mobilisers, it may create problems for other actors or agencies who carry out similar work on a voluntary basis; d) paying community mobilisers may be expensive and divert payment from other essential services; e) it can be difficult to maintain sustainability after the emergency phase.

 NRC 2015 Women leading all-female shelter team in Kabul. Source: NRC (2014).

Women leading all-female shelter team in Kabul. Source: NRC (2014). 

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Training Focus Areas and Materials
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Training of hygiene promotion facilitators should adopt a step-wise (modular) approach and should gradually move from building essential skills and knowledge required for hygiene promotion towards further modular trainings focused on upgrading skills. An example of a modular form of training is the Global WASH Cluster training, in which module 1 focuses on essential things to know, module 2 focuses on useful skills to know, module 3 focuses on situation or agency specific approaches, and module 4 focuses on coordination (GWC 2009a). The following training focus areas are recommended (adapted from OBHOIAM AND REED 2013; REED 2014):
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Training on Didactic versus Participatory Methods
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Under certain circumstances, didactic (instructional, traditional teaching style) approaches are best to use, while in many other situations participatory methods are more appropriate (JOHN HOPKINS UNIVERSITY AND IRFC 2008). There are also situations in which a combination of both might be most suitable. For this reason, hygiene promotion facilitators should be trained in both areas. Training in participatory methods is particularly important where facilitators are used to a traditional, didactic style of teaching rather than a more participatory form of communication (REED 2014). Training facilitators in using participatory methods and materials that are culturally appropriate provides the affected population with opportunities to take accountability for their own hygiene improvement through planning and monitoring. 

Training Course for Hygiene Promotion Teams in Damascus, Syria. Source: SARC (2016)

Training Course for Hygiene Promotion Teams in Damascus, Syria. Source: SARC (2016).

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Applicability
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The guidance provided in this factsheet is intended primarily for planned Camps or collective centres but also applies to Prolonged Encampments or Rural Settings. In collective centres, forming and training sub-committees for hygiene are especially important but complex and expensive as the existing level of hygiene is often extremely inadequate (IOM, NRC AND UNHCR 2010). For self-settled camps in Rural Settings, villages workers in the rural areas can be trained using guidance in this factsheet to provide ongoing motivation and support for improving hygiene practices. However, when local people are providing this service, it must be considered that they have limited time to devote to this as their poverty levels often oblige them to devote significant time to securing their own livelihoods.

Library References

Hygiene Promotion. Training for Hygiene Promoters.

This 96-page package provides material for training sessions for hygiene promoters. Module 1 covers the essentials to know. Model 2 useful to know information, Module 3 the situation or agency-specific information, and Module 4 covers sessions for hygiene coordinators. The package includes handouts, theory and content for teaching and factsheets that can be used by hygiene promoters in their campaigns.

GWC (2009): Hygiene Promotion. Training for Hygiene Promoters.. Geneva: Global WASH Cluster URL [Accessed: 14.11.2016]

Hygiene Promotion in Emergencies

This Global Wash cluster manual provides training materials and handouts for facilitators to train hygiene prompters. It contains advice on hygiene promotion related non-food items selection and delivery. The WASH related non-food items briefing paper addresses maximizing benefits of the distribution of hygiene items, selection of hygiene items, guidance on distribution and tips for improving distribution of items, as well as suggestions for improved coordination.

GWC (2009): Hygiene Promotion in Emergencies. A Briefing Paper. New York: Global WASH Cluster URL [Accessed: 08.11.2016]

Water, Sanitation, and Hygiene in Emergencies

The International Red Cross’s Health Guide Book provides a chapter providing guidance to improving water, sanitation, hygiene and vector control in emergency settings. It provides information on assessing needs in different phases, identifying the vulnerable group, and determine diseases to target. It provides guidance on disease transmission, community involvement in disease prevention with detail on the requirement in early emergencies phases.

JOHN HOPKINS UNIVERSITY IFRC (2008): Water, Sanitation, and Hygiene in Emergencies. Baltimore: John Hopkins University URL [Accessed: 14.11.2016]

Hygiene Promotion in Emergencies

Communities affected by a disaster often lack basic water and sanitation facilities. They are likely to be traumatized and vulnerable to disease. This technical note explains why hygiene promotion is important in emergencies and describes how to carry it out.

ODHIAMBO, F. REED, B. (2013): Hygiene Promotion in Emergencies. (= Technical Notes on Drinking-Water, Sanitation and Hygiene in Emergencies , 10 ). Geneva: World Health Organization (WHO) URL [Accessed: 27.08.2013]

Training Course for Hygiene Promotion Teams

The Syrian Arab Red Cross provides hygiene promotion training for rural Damascus as an eight-day course. One held in June 2015 trained 29 volunteers from various SARC sub-branches. The project by the SARC is carried out in conjunction with UNICEF.

SARC 2016 (2016): Training Course for Hygiene Promotion Teams. Damascus: Syrian Arab Red Cross URL [Accessed: 22.11.2016]
Further Readings

Hygiene Promotion. Training for Hygiene Promoters.

This 96-page package provides material for training sessions for hygiene promoters. Module 1 covers the essentials to know. Model 2 useful to know information, Module 3 the situation or agency-specific information, and Module 4 covers sessions for hygiene coordinators. The package includes handouts, theory and content for teaching and factsheets that can be used by hygiene promoters in their campaigns.

GWC (2009): Hygiene Promotion. Training for Hygiene Promoters.. Geneva: Global WASH Cluster URL [Accessed: 14.11.2016]

Introduction to Hygiene Promotion: Tools and Approaches

This is a manual with training material and handouts for facilitators to prepare training for hygiene promotion at different levels. The manual provides hygiene promotion training materials including tools and approaches for training including human resources planning, recruitment, and management, WASH generic job description for hygiene Promotion staff and volunteers, and a list of essential hygiene promotion equipment for communication.

GWC (2009): Introduction to Hygiene Promotion: Tools and Approaches. Geneva: Global WASH Cluster URL [Accessed: 08.11.2016]

Landscape of WASH-relevant Training for Humanitarian Emergencies

This research paper provides the results of a landscaping exercise of available WASH relevant training for humanitarian emergencies. The paper presents 42 courses are presented relevant to humanitarian emergencies in WASH, five of which are specifically for hygiene promotion.

DOREA, C. (2015): Landscape of WASH-relevant Training for Humanitarian Emergencies. In: PLOS Natural Diseasters: Volume 1 URL [Accessed: 08.11.2016]
Case Studies

Training Course for Hygiene Promotion Teams

The Syrian Arab Red Cross provides hygiene promotion training for rural Damascus as an eight-day course. One held in June 2015 trained 29 volunteers from various SARC sub-branches. The project by the SARC is carried out in conjunction with UNICEF.

SARC 2016 (2016): Training Course for Hygiene Promotion Teams. Damascus: Syrian Arab Red Cross URL [Accessed: 22.11.2016]

Hygiene Promotion in Emergencies

The Sphere Project and India RedR provide a training module hygiene promotion in emergencies targets health and hygiene promoters and engineers who are already working in the community in humanitarian relief. The module is a four-day course and offered participants with the opportunity to grow their skills and knowledge to allow them to raise hygiene awareness and enable communities to take action through participation. The module covers water and sanitation issues effect on the heath, operations and maintenance of sanitation facilities through community management, targeting and addressing key risk practices to reduce morbidity and mortality in an emergency, PHAST, SARA, and other hygiene promotion tools, methods, and approaches, and community strategies for behaviour change.

THE SPHERE PROJECT REDR (2013): Hygiene Promotion in Emergencies. London: REDR URL [Accessed: 18.11.2016]
Training Material

Introduction to Hygiene Promotion: Tools and Approaches

This is a manual with training material and handouts for facilitators to prepare training for hygiene promotion at different levels. The manual provides hygiene promotion training materials including tools and approaches for training including human resources planning, recruitment, and management, WASH generic job description for hygiene Promotion staff and volunteers, and a list of essential hygiene promotion equipment for communication.

GWC (2009): Introduction to Hygiene Promotion: Tools and Approaches. Geneva: Global WASH Cluster URL [Accessed: 08.11.2016]

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