Rapid Behaviour assessment and ranking of PRI members, Natural and faith based leaders And Dipstick assessment of ASHA, Anganwadi workers Bihar and Uttar Pradesh 1 Febr16 Table of Contents Executive Summary Key Recommendations 1. Background 1.1 Programme: A brief description on intervention, geography, school settings 1.2 Objectives of the study 2. Methodology 2.1 Sample size calculation 3. Data collection and tools 3.1 Training of teams 3.2 Ensuring data quality 4. Socio Demographic Profile Go to Table of Contents 2 Executive Summary The aim of the study is to assess the behaviour and knowledge of the PRI members and ASHA Angadawadi workers on issues such as open defecation and hand washing practices and also their awareness about the Swach Bharat Program of the Indian Government. For the purpose of the Study, a survey was carried out in 4 Districts of UP and Bihar in which respondents from over 201 villages were interviewed. Amongst the ASHA and Angadwadi workers, almost all have received some sort of formal education and also hygiene training and all of them are house makers. On the other side, primary occupation of most of the PRI members is farming with very less in business and self- employment. When asked about the time given by these workers and leaders in interacting and solving issues of the fellow villagers, over 57% in Bihar and 52% in UP said to devote somewhere between 1 to 2 hours every day. In the survey conducted, lack of proper facilities was founded to be the major reason behind open defecation with more than 75% of the respondents in both states saying so. Among other major reasons were lack of government effort and awareness among the villagers. Also more than 50% of mothers interviewed throw the feces of their children in open in both states while only around 30% use household toilets for disposing it. Also on hand washing practices, most of the respondents were found aware of the critical moments of hand washing, with 86% and 92% of them doing so after defecation in Bihar and UP respectively and 56% and 43% ding so before having food in Bihar and UP respectively. After assessing the behaviour of the respondents, the study also tries to rank individuals on the basis of their knowledge about open defecation and Swach Bharat Programme, motivation, social commitment and self-efficacy, the factors which are found most significant in analysing individual attitude towards becoming a change agent. For carrying out the Ranking, logistic regression with the above said variables was used. Go to Table of Contents 3 Key Recommendation Based on the findings in the study following action points will be considered: i. Community mobilisation should be of highest priority for implementing open defecation initiatives in these 200 villages. As it was observed that lack of access to proper facilities 75% of the respondents reported of choosing open defecation in respective States. ii. ASHA, Anganwadi Workers need to work on behaviour change around disposal of child’s faeces as 50% of mothers interviewed out of 2000 mothers reported disposing in open faeces iii. It was also noted that 78% of ASHA, Anganwadi workers are aware of the Sanitation activities as well as they are trained by the govt departments. Hence their contribution to the community mobilisation would be very important. iv. Change agents ranking highlights that the Pradhans, Religious leaders are key change agents as per the criteria set for selecting them. v. Use of change agents especially in behaviour change and community initiation of construction and use of toilets would be critical and the study reveals over 57% in Bihar and 52% in UP said to devote somewhere between 1 to 2 hours every day. vi. The caregivers should be engaged with mothers and their relatives to emphasize on hand washing, access to safe water and sanitation facilities. vii. The workshop to be organized for state and district level officials, block representatives, PRI members, media and civil society representatives who are working on sanitation and health issues. 1. Background The Project under Banega Swachh India aims at bringing behaviour change among villagers making about 200 villages open defecation free during the project period. To augment behaviour change the project will use PRI members, religious leaders, natural leaders and caregivers to influence and motivate the villagers for ODF villages. The project is planned in 100 villages of Uttar Pradesh in the districts of Varanasi (50 villages), Kannuaj (25 villages) and Etawah (25 villages) and 100 villages in the Bhagalpur district of Bihar. In these 200 villages efforts are being made to create demand for household toilets, facilitate resource mobilization for construction of toilets. Go to Table of Contents 4 The project will also consider participation from state and district level officials of the relevant different departments, block representatives, PRI members, media and civil society representatives who are working on sanitation and health issues. The project also aims at working with mothers especially those having under five children to engage them in sanitation and hygiene practices. Also hygiene practices in child care has been focused through introduction of baby book, an innovative concept to recall messages around the hygiene practices that are required during the entire neo-natal and peri-natal period of the newborn. Role of change agents in creating an enabling environment, demonstrating evidence and community persuasion, triggering sense of identity and pride among villagers, create a positive environment for rewards and recognition and strive towards ODF village. 1.1 Programme: A brief description on intervention, geography A brief description of intervention: The intervention is aimed at community mobilisation across different age groups in a village and creates demand for sanitation and hygiene practices, access to sanitary facilities at household level. The intervention is taking up capacity building of change agents and use of technology to persuade behaviour change among villagers. The caregivers are expected to engage with mothers and their relatives to emphasize on hand washing, access to safe water, and access to sanitation facilities. As a part of enabling environment liaison with government departments, other stakeholders envisaged in the project. Also part of the project activities such as wall paintings, sanitation chaupals, publishing health charters planned at village level. For mass media activities radio and TV episodes targeting behaviour change, prashna preher sessions targeting myths and misconceptions and newspaper articles targeting experience sharing has been planned. Geography: According to the latest Guidelines on ODF in villages by Govt. of India, it is essential that the activities being carried out under Swachh Bharat Abhiyan are targeting villages which can achieve ODF through a rigorous behaviour change and shaping of enabling environment. Pehel initiative in 200 villages is aimed at creating behaviour change agents who will create a sustainable enabling environment so that the villagers change their behaviour towards hygiene Go to Table of Contents 5 practices including open defecation. Considering the geographical variation in the States of Bihar and UP, the selection criteria has been formulated for identifying villages which would be part of the Pehel initiative. The core principle of the criteria is to initiate activities in villages where the last mile approach is achievable and ensures ODF in a limited period of time. Later on the learnings of these villages would fast track the achievement in other category of villages. State Average member Household size Current Duplication of resources per household per village availability of HH with other partners toilets Bihar 4-5 members More than 100 More than 15% No Uttar Pradesh 4-5 members More than 150 More than 15% No The list of villages selected based on the above norms is annexed at the end of the report. 1.2 Objectives of the study The following are the objectives of the study: 1. To carry out rapid behaviour assessment of sampled PRI members, Natural and Faith based leaders on leadership, motivation and drive to lead the change in sanitation programs. 2. To rank these respondents and use these ranking to build capacities. 3. To carry out dip stick KABP among sampled ASHA and Anganwadi workers in 200 villages. 2. Methodology 2.1 Sample size calculation Purposive samples were taken from the existing ASHA and Anganwadi Workers to select respondents for interview. Similarly the PRI members, natural leaders were selected from the pool of them available in the village during the survey through purposive sampling technique. Go to Table of Contents 6 Summary of category of participants attached as annexure at the end of the report. 3. Survey Design Pehel project envisages to select change agents based on the past involvement in community development activities. For this Dure Technologies has developed a ranking criteria using regression analysis of their traits and skills. This analysis is being done by using following: ● Free listing of natural, faith based and PRI members is done in a village by surveyor and Pehel staffs jointly. Snow balling and FGD are done to identify a sample of above for interview by the surveyor. Photographs and signature of the respondents have been taken as part of documentation. ● The interview contains questions which simulate an environment of their future or past involvement in Sanitation activities