Increased access to proper water and sanitation facilities is a key step in improving Indonesians’ health status, economic well being, and environment.  However, improved facilities are not enough. Communities are often unaware of the importance of good hygiene and what practices can help them to maintain good health and their water sanitation facilities.

IRD’s approach is to ensure that improvements in facilities are accompanied by health and hygiene education.  IRD works with local government health and education officials to train health workers, community volunteers, teachers, and children in techniques to promote good health and hygiene practices in their communities. IRD’s programs for communities and schools are designed to demonstrate the benefits of the new behaviors to be adopted and provide audience appropriate opportunities to practice them.  The activities focus on maximizing the benefits and minimizing the barriers for positive health and hygiene behaviors among the target audiences. The infrastructure improvements made in the villages and schools are key to providing positive opportunities to practice new behaviors as well as minimize barriers to their adoption.

In Aceh, IRD trained 16 midwives, 20 village health workers, 74 community volunteers, 50 teachers, and 119 student peer educators with funding from UNICEF and the Latter Day Saints Charities. Together, they trained 10,692 villagers and 1,541 students from 40 villages on good health and hygiene practices.  In Yogyakarta, 183 teachers and 3,292 peer educators were trained with funding from UNICEF.  IRD trained 104 trainers, more than 1,200 teachers, 150 community facilitators, and 782 children as peer educators with funding from the US Department of Agriculture.

Forming the Core Group and Health Committee

IRD uses the UNICEF-recommended Participatory Hygiene and Sanitation Transformation (PHAST) methodology to train key health workers who can help support behavior change in the community.  Training materials and messages are also closely coordinated with provincial and district level health officials. Puskesmas midwives, village midwives, members of the Core Groups’ water sanitation and health committees, and Paysandú cadres (health volunteers) are all trained as trainers.  They will then train community members in good health and hygiene practices. Promotion will also occur through such activities as “Gotong Royong,” community gatherings, Friday sermons, women’s discussion groups, and cultural and artistic performances.

Starting Good Practices Early

The sooner children can learn proper hygiene practices, the better their chance for healthier living; poor hygiene practices can be very difficult to change later in life.  Healthier children also spend more time in school giving them greater opportunity to learn.

 IRD works with teachers, students, and school leadership to make sure that proper health and hygiene practices are taught and reinforced in children’s daily school activities.  The primary topics addressed are: hand washing, latrine use, drinking safe water, waste disposal, sanitary food preparation and personal hygiene such as nail cutting, tooth brushing, bathing, and changing clothes regularly.  The teachings also incorporate such things as diet and exercise, maintaining a sanitary environment, and being a good community member.

Working with all local relevant education and health stakeholders, IRD develops a health education curriculum that draws from internationally accepted heath education standards.  The curriculum is highly participatory, concept-based, and provides ample practice opportunities.  IRD trains a core group of teachers who serve as trainers for their colleagues and communities.  Additionally, IRD trains teachers to monitor and evaluate achievements and challenges as well as provides follow up training as necessary throughout the project period. 

IRD also works with teachers and students to train peer educators.   These children learn about good health and hygiene practices and how to encourage those practices among their fellow students.  Such activities as school-wide health campaigns, health quizzes and games are used to promote this information sharing among peers.   IRD also works with teachers and students to promote health and hygiene education through various extra-curriculum activities such as a children’s theater performance, poster contests, hygiene festivals, and regular “Gotong Royong” activities.