Participatory Health & Hygiene Education

PHHE is a process that aims to promote conditions and practices that help to prevent water and sanitation related diseases. The PHHE approach seeks to facilitate a change in health and hygiene education approaches from a didactic technical model to a participatory social model. The didactic teaching approach used fear of illness and death to convince families to change behaviours, while this approach worked for some people, the overall effect did not last and very quickly people went back to their old ways. PHHE helps people to develop the outlook, the competence, the self confidence and commitment that will ensure a sustainable and responsible community effort towards th
eir overall development including the control and management of communicable diseases. 

Change agents in development particularly extension workers, field officers, and managers, often come across communities that have fears, suspicion, doubts, lack of self-assurance, traditional beliefs, values and practices that run counter to the proposed change. In such communities behavioral change is unlikely to take place unless a sufficiently sensitive and facilitative approach is used. A participatory approach is usually effective under such circumstances as it will assist to uncover, examine and address any social constrains, leading to sustainable behavior change.  PHHE is about changing hygiene behavior and has its starting point, the home. It is therefore family focused with the mother being at the centre of activities in the home. Since it is a process rather than an event PHHE is used for awareness creation to motivate people to adopt new hygienic patterns of behavior. Therefore PHHE seeks to:

• Create a non-threatening atmosphere in which people can feel free to ask questions and to challenge each other and outsiders on health, hygiene and other developmental issues.
• Transform all learning sessions into sharing situations in which every one can participate equally, learning from each other.
• Share and analyze information for collective action.
• Facilitate improved community hygiene behavior and practices.
• Prevent and control communicable diseases    

FCTZ PHHE programs

PHHE is the third component of FCTZ’s Water, Sanitation and Hygiene program. It precedes all WASH activities as it is used to create demand for other WASH activities. FCTZ’s approach to PHHE starts with the training of extension staff especially Environmental Health Technicians (EHT) and Field Officers in participatory methodologies especially the use of PHHE tool kits. 

PHHE in School 

PHHE in schools involves the training of school health teachers at schools in the area where the project will be implemented. Two teachers one male one female are trained per school and are issued with PHHE tool kits that will be used during PHHE. Hygiene awareness is done through the school health clubs concept. School Health clubs are formed on a voluntary basis were children are invited to join or form a health club. School health clubs will then meet for sessions on a weekly basis where a particular topic is discussed. Peers are also trained by health teachers to share hygiene information with other children under supervision. 

PHHE in the Community 

Community Based Facilitators identified from community volunteers preferably village health workers will also be trained in PHHE so that they can implement the approach in the community. These are selected in each ward to represent a village or a group of villages. A whole village can form a health club or several clubs can be formed in a village.

The health club concept is also used in the community where community health clubs are also formed on a voluntary basis. Health club members attend sessions on a weekly basis on an agreed day for at least 2 hours where they go through a selected topic. Each member of a community health club is issued with a health club membership card that will be used as a record of the sessions they attend. The community based facilitator will sign against a topic that would have been covered on the health club membership card until all topics are covered and a member will graduate. 

Ideal home competitions are held at village and ward level to encourage members to improve their homes and winners are given prices.  These are based on what a ward would have greed on as the basic requirements for an ideal home.