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At what point can one determine behavior change in sanitation and how can it be sustained over time? Are there any evaluation systems or tools that are available for use?

Determining behaviour change depends on having a performance monitoring or evaluation system set up to measure behaviour. This can be done in one of two ways. Measuring behaviour at two points - before and after an intervention (evaluation) or measuring behaviour continuously at several time points (monitoring). However, you don't always need to measure behaviour, you can measure the determinants of behaviour, if you are confident that those determinants are predictive of behaviour change. Can I recommend that you download and read SaniFOAM which is a framework for sanitation behaviour change that was developed collaboratively by a number of different agencies working in the sector. In terms of how do we sustain behaviour over the years - this is an issue with all behaviours. We can't guarantee sustained behaviour change. Many people may relapse (for example back to open defecation, or back to an unimproved latrine) before taking the steps to change behaviour once again. Maintenance of behaviours need different cues to action to changing behaviours. There are some models of behaviour change which specifically address these issues such as the Stages of Change model, or the Precaution adoption process. Beth Scott and Mimi Jenkins have developed a model on decision making for sanitation which draws on some of this stage thinking. Try reading this article.

Answer thanks to:

Yolande Coombes

Yolande Coombes has more than 20 years experience in public health, behavior change and evaluation. She gained her PhD in Public Health from the University of London. She has held academic positions at the London School of Hygiene and Tropical Medicine, and College of Medicine in Malawi. As a consultant she has worked on topics on a number of communicable and non-communicable diseases. She has worked for both Population Services International and Marie Stopes International providing technical social marketing, behavior change, franchising and M&E support. In 2007 she took up a position as a specialist consultant in sanitation marketing and hygiene with WSP and became a staff member in 2010 responsible for leading WSP’s sanitation and hygiene work in Africa, including task managing the AfricaSan 3 conference in 2011.


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