Behavior Change Communication (BCC) Strategy to Improve Sanitation and Hygiene Practices Among New Arrivals: Case Study in Dadaab Refugee Camp

Background

The Dadaab Refugee Camp in northeastern Kenya is one of the largest in the world, hosting hundreds of thousands of refugees, many of whom are fleeing conflict, drought, and poverty in neighboring countries. New arrivals face numerous challenges, including lack of familiarity with basic sanitation and hygiene practices, limited access to clean water and proper sanitation facilities, and exposure to crowded, unsanitary conditions.

The camp's diverse population, which includes people from Somalia, South Sudan, Ethiopia, and other regions, presents unique challenges in terms of language, cultural practices, and social norms. With the arrival of new refugees, often from areas with poor infrastructure and limited education on sanitation, there is an urgent need to improve sanitation and hygiene to reduce the spread of diseases such as cholera, dysentery, and respiratory infections.

This Behavior Change Communication (BCC) strategy aims to empower new arrivals to adopt improved sanitation and hygiene behaviors through interactive, culturally sensitive methods that align with their daily realities.

Goal

The main goal of this BCC strategy is to reduce the incidence of waterborne and sanitation-related diseases by improving hygiene practices and ensuring the proper use of sanitation facilities among new arrivals in the Dadaab Refugee Camp.

Key Challenges

1. Cultural and Social Diversity: Refugees come from diverse backgrounds with different sanitation norms, some of which may conflict with established practices.
2. Limited Access to Facilities: Overcrowded facilities and insufficient infrastructure pose challenges to promoting consistent hygiene practices.
3. Low Literacy Levels: Many refugees have limited literacy, making text-heavy communication methods less effective.
4. Language Barriers: A multitude of languages are spoken, requiring multilingual approaches.
5. Water Scarcity: The camp’s semi-arid environment limits access to water, affecting hygiene behaviors like handwashing.
6. Health Risks: Overcrowded living conditions, open defecation, and improper waste disposal contribute to the high prevalence of diseases.

Detailed BCC Strategy

1. Audience Segmentation

• Primary Audience: New arrivals, with a focus on women (primary caregivers) and children (vulnerable to diseases), who are the primary influencers of household hygiene practices.
• Secondary Audience: Camp officials, community health workers (CHWs), and established refugee populations, who can serve as peer influencers and role models in promoting healthy hygiene behaviors.

2. Communication Objectives

• Objective 1: Increase knowledge of proper handwashing techniques and frequency among new arrivals.
• Objective 2: Ensure that all new arrivals understand the importance of using latrines and stopping open defecation.
• Objective 3: Promote safe water handling and storage practices to prevent water contamination.
• Objective 4: Foster community-driven sanitation management to ensure the sustainability of hygiene practices.

3. Behavior Change Focus Areas

1. Handwashing:
2. Latrine Use:
3. Safe Water Storage:
4. Community-Led Waste Management:

Interactive Components

4. Communication Channels and Interactive Approaches

1. Participatory Learning and Action (PLA) Workshops
2. PHAST (Participatory Hygiene and Sanitation Transformation) Sessions
3. Community Dialogues
4. Interactive Demonstrations

5. Visual and Audio Learning Tools

• Illustrated Posters: Simple, clear, and culturally relevant posters will be placed in high-traffic areas, including latrines and water points. These posters will depict handwashing steps, latrine use, and safe water storage visually.
• Audio Messages: Since many refugees may not be literate, audio broadcasts in multiple languages (Somali, Oromo, Swahili) through local loudspeakers will share key hygiene messages. These broadcasts will also include testimonials from refugee leaders who have adopted better sanitation practices.
• Interactive Radio Programs: Local radio stations will air hygiene and sanitation programs with live call-in segments. Refugees can ask questions and share feedback, and health experts will provide solutions live on-air.

Monitoring and Evaluation (M&E)

1. Baseline and Endline KAP Surveys

• Baseline Survey: Conduct Knowledge, Attitude, and Practice (KAP) surveys upon arrival to assess the refugees’ initial understanding and behaviors related to hygiene and sanitation.
• Endline Survey: Conduct the same survey after six months to measure changes in behavior, knowledge, and attitude, comparing it with the baseline data.

2. Behavior Observation and Feedback Mechanisms

• Direct Observation: Refugee camp staff and CHWs will observe handwashing practices at water points, monitor latrine usage, and assess the cleanliness of water storage containers.
• Focus Group Discussions (FGDs): Refugees will be invited to participate in focus groups to give qualitative feedback on the effectiveness of the BCC strategy.
• Feedback Tools: Use suggestion boxes and community-led feedback sessions to gather input from refugees on how the campaign can be improved.

Expected Results

• Increased Handwashing: The percentage of refugees practicing handwashing with soap before meals and after defecation is expected to increase from 20% to 70%.
• Improved Latrine Use: Latrine use among new arrivals is expected to increase by 60%, significantly reducing open defecation.
• Reduced Disease Incidence: The incidence of waterborne diseases such as cholera and diarrhea is expected to decrease by at least 40% due to improved hygiene practices.
• Enhanced Community Ownership: Through participatory methods like PHAST and CLTS, refugee communities will take greater ownership of their sanitation and hygiene practices, fostering sustainable behavior change.

Conclusion

The BCC Strategy for Dadaab Refugee Camp integrates interactive and participatory methods to drive behavior change in sanitation and hygiene practices. By actively involving new arrivals in the learning process through workshops, demonstrations, and dialogues, the strategy ensures that refugees not only understand the importance of good hygiene but also take ownership of the solutions. This approach is vital in a complex, multicultural setting like Dadaab, where sustainable change depends on the community's engagement and commitment.

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