National hygiene promotion strategy for a healthier Bangladesh

In 2012 the National Hygiene Promotion Strategy (NHPS) for Water Supply and Sanitation in Bangladesh was launched, and it has been an integral part of the Sector Development Plan (SDP), 2011-25 for water and sanitation sector in Bangladesh. This strategy incorporates five behavioral domains including sanitation, hygiene, water hygiene, personal hygiene, food hygiene and environmental hygiene promotion. Hygiene is crucial in preventing disease. In WASH services, hygiene is integrated into everything what is done and forms part of a three-pronged approach alongside water and sanitation.
The objective of the national hygiene promotion strategy is to promote sustainable use of improved water supply and sanitation infrastructures and to create an enabling environment ensuring comprehensive hygiene promotion and practices to reduce water and sanitation related diseases. Hygiene promotion includes strategies that encourage or facilitate a process whereby people assess, make considered choices, demand, effect, and sustain hygienic and healthy behaviors.
This encompasses personal, domestic, and environmental hygiene practices and any action or initiative taken to erect barriers to diseases.
Besides, the promotion of better hygiene, alone, or in combination with better water supply and/or sanitation, can have a major impact on reducing disease prevalence and public and private health costs.
The Hygiene Promotion Strategy for Water Supply and Sanitation in Bangladesh has been developed on the basis of a Hygiene Improvement Framework. The three components of the framework are: access to hardware, hygiene promotion, and enabling environment. An integrated program with all three components is the ideal for hygiene promotion.
Implementation of the National Hygiene Promotion Strategy for Water Supply and Sanitation will require systematic approach, tools and guidelines. Not necessarily that the system is required as a precondition of the implementation process to start, rather that should be gradually developed and incorporated into the present system of operation in each service providing agency. For putting those in place, the following key steps and actions are recommended hygiene strategy:
1.Preparing a Guideline for Implementation and Coordination of the hygiene promotion programmes;
2. Arranging periodic training and orientation programs for the departmental staff and agencies on the public health and hygiene issues;
3. Developing client-service provider’s accountability relationships;
4. Undertaking comprehensive monitoring system over the hygiene promotion interventions.
Monitoring is to be carried out at two levels:
1. Progress monitoring to measure the achievement of targets set for different phases and
2. Impact monitoring to evaluate behavior change as a result of interventions
No doubt, the policy that has been taken is really timely and worthy of praise but the most important concern is to implement the policies made by Bangladesh Government into action to promote the better health condition especially low advantage community. Government of Bangladesh and other stakeholders working in the Water, Sanitation and Hygiene Sector have long felt the need of a National Hygiene Promotion Strategy for Bangladesh to have agreed strategic effort to improve public health situation. In this regard, germane GoB stakeholders, few agencies, and NGO’s is working together to fulfill the targeted goals. In wider sense, the responsible stakeholders in Bangladesh are- LGD, LGIs, DPHE, WASA, NGOs etc.
The private sector is already active in hygiene promotion as a mechanism for expansion of their market by promotional activities for personal hygiene related products (soaps, sanitary pads, ORS, water storage tanks, pipes, hand washing buckets, toilet papers etc). Effective Public Private Partnership (PPP) will be a win-win situation for both public and private sector. The public sector will gain from expertise and resources under respective corporate social responsibility (CSR) initiatives with the private sector for promotional activities, while private sector will gain from expansion of their market. Proper incentive packages should be in place for private sector to encourage them in hygiene promotion activities. The development partners also play an important role in supporting safe water supply and sanitation services through projects or programs. They can also play a key role in extending support to implement Hygiene Promotion Strategy and prompting hygiene behavior as an integral part of WSS projects.
NGOs play an important role in helping certain population groups, or filling gaps in government services. The main task of NGO’s are to harmonize the policy and strategy, coordinate with LGIs and implement the policies in field level working with community.
It is found in several reports that, lack of good sanitation and hand washing infrastructure in schools and hospital facilities hampers improvement of hand washing and sanitation behaviors in these institutional settings. Besides, Menstrual hygiene management at home and in schools and beliefs that menstruation limits regular activities can impact on girls’ school attendance and education attainment. From this backdrop, Sajida Foundation started a project in Bangladesh in 2012 that has been designed to address, promote and ensuring use of safe water, sanitation(inclusive toilet for all) and hygiene among working children, school children  as well as pavement dwellers in Dhaka city. The Project aims to work with the exclusive community like working children, and pavement dwellers with the objective of improving the health status through increased accessibility to safe drinking water, sanitation and hygiene promotion. This project is funded by Water Aid Bangladesh.
It is true that, assessment of hygiene practices in accurate way is not an easy job due to a number of practical reasons. For instance, measuring hygiene practices is difficult in larger scale. Mostly we depend on self-reported information as observing one’s personal hygiene practices are expensive and intrusive for people. Academicians and researcher are working to make a feasible, scientific and more effective mechanism of assessment of hygiene practices of a community.
Last but not least, the National Hygiene Promotion Strategy (NHPS) is a living document. It will be consciously reviewed and updated from time to time. The Sector Development Plan (SDP), 2011-25 prepared by the Local Government Division is to guide the water supply and sanitation sector. The SDP will be applicable for a period of 15 years, which started from FY 2010-11, divided into a short term period (2011-15), medium term (2016-20) and long term (2021-25). The national hygiene promotion strategy shall also follow the same timeframe. However, the success of NHPS requires intensive monitoring to ensure the policies into action.