A simple monitoring methods involves Integrated Health Post (Posyandu) cadres in recording behavioral change in ESP activity areas
Jakarta. An effort to decrease the incidence of diarrhea in children under three years of age through the Environmental Services Program (ESP) has resulted in activities focusing on healthy and hygienic behavioral changes. In order to most accurately determine the number of incidences of diarrhea at the household level the “Ten Minute Monitoring” approach is being applied. This method was selected because it is simple and can be done by community members.
As the method’s name implies, interviews of housewives are done quickly, taking no more than ten minutes at a time. These monitoring activities are done every six months in various ESP working areas, and are accomplished by asking questions relating to five basic healthy and hygienic living behaviors, including concerning the incidence of diarrhea in small children, hand washing with soap habit, waste management, processing of potable water and toilet habits. The results of these interviews are analyzed to determine the impact of ESP behavioral change campaigns on the reduction of incidences of diarrhea.
The last two monitoring rounds were done in February 2007 and November 2007. Previously, ESP, in cooperation with other USAID programs of HSP (Health Services Program) and SWS (Aman Tirta or Safe Water System) had done a baseline survey in December 2006 to get a picture of diarrhea incidence situation before the launch of ESP campaign.
The results of the monitoring rounds done in February and November 2007 indicate that the number of incidences of diarrhea has begun to decrease at an average of 28 percent; with an 18.3 percent decrease recorded during the initial monitoring sweep, and a 17.9 percent decrease occurring in the second round. The 28 percent decrease was determined through comparison of new data to the baseline data. These survey results are based on all data collected and combined from the various survey locations.
If viewed from the percentages alone, the decrease in the incidence of diarrhea recorded in the first and second monitoring phases seems relatively small, but within the context of the monitoring periods themselves, the decrease was significant enough. The initial data collection phase was done in the dry season, while the second phase took place in the rainy season in which diarrhea is much more common. Yet, the figure for the rainy season was lower than that for the dry season. This indicates that the ESP activities have had an impact on changing behavior in the community toward better hygiene and healthier living habits, which then contributed to a decrease in the number of diarrhea incidences.
In general, the monitoring results indicate that ESP intervention activities on household level have influenced positive hygiene and health changes in the community.
A similar result was recorded in the Ten Minute Monitoring results for the washing hands with soap campaign. Initial monitoring indicated that 63.3 percent of respondents washed their hands with soap after meals and 62.6 percent did so after cleaning up their children after defecating or urinating. The second monitoring phase found an increase to 78.9 percent for hand washing after child toilet assistance, and 77.1 percent for hand washing after going to the toilet. The number of respondents washing their hands with soap after meals also rose to 70.5 percent.
Further results are expected to be seen in relation to reduced incidence of diarrhea and improved hygiene and health practices in the third phase of Ten Minute Monitoring started at the end of April 2008. As many as 75 integrated health post (posyandu) cadres in 14 municipalities and regencies working with ESP are currently interviewing around 1,035 housewives to determine the extent of further developments in the figures for diarrhea incidences and healthier living habits. The housewives being interviewed are the same women previously interviewed in the first two monitoring surveys.
Besides the mathematical figures collected, the Ten Minute Monitoring survey also collects information useful to local health centers, health agencies and schools, the three main formulators of community health improvement programs. ”Through the Ten Minute Monitoring survey, we have the opportunity to reinforce important health and hygiene messages, in particular the washing of hands with soap,” said Wahyuni, cadre from the health post in Gading Subdistrict, Surabaya.
Alifah Lestari, ESP Jakarta
