Creating the Hygiene Culture: Impact of Dettol School Hygiene Program

COVID-19, the most severe public health crisis of our times, amplified our need for hygiene & sanitation. Governments, policy makers, health workers and civil society swiftly ramped up hygiene infrastructure and education in their drive for a disease-free world.

Following this trend Samhita & Collective Good Foundation partnered with Reckitt Benckiser to launched the Dettol School Hygiene Education Programme in the State of Andhra Pradesh in 2015 and extended the programme to Telangana by 2016 and to Tamil Nadu by 2018.

The programme builds knowledge, attitudes, practice and behaviour around hygiene in children by engaging children as collaborators, letting them drive the change. It builds their leadership and critical-thinking skills and enables them to solve hygiene problems in creative, sustainable ways, like solving the problem of access by setting up soap banks, ensuring hygiene through Child Parliaments and more.

In a boost to the programme, the curriculum was translated into several local languages, easing the path to adoption and engagement across South India. In another first, Collective Good Foundation introduced digital learning through government education portals. Andhra Pradesh was the first state to upload digital video episodes on their DISHA portals. These videos are accessible to all schools and teachers at the touch of a button and now reach 2.5 million students across 42,000 schools.

Click below to read the full report on how the Dettol School Hygiene Education Programme is developing a culture of hygiene in India’s children.

The key to COVID-19 prevention in slums

Slums across India have been disproportionately affected by the COVID-19 crisis. 42% of Mumbai’s population lives in slums and therefore they require carefully planned measures to ensure that preventative and primary care remain accessible.

The Bridgespan Group and WHO emphasise that community participation is the key to implement any COVID-19 preventive interventions in the slums.

This is as a model of care, designed while incorporating community participation is more likely to be accepted and effective in the long-term. To elaborate on the practicality of their recommendation, they describe activities where communities have been engaged and relay how this principle helped the programs in Mumbai slums.

WASH Platform | Wash Grand Challenge (2019)

The WASH Platform builds synergistic collaboration between multiple stakeholders from the Private Sector, Development Sector and the Government, to identify, implement and replicate high impact projects across the sanitation value chain, starting from the state of Maharashtra.

The platform is a joint initiative between Samhita Social Ventures and India Sanitation Coalition in partnership with The Government of Maharashtra, The Bill and Melinda Gates Foundation with UNICEF and CEPT University as knowledge partners.

Implementing sanitation Programme at RB

1. What CSR programs do you currently focus on in sanitation and the Swachh Bharat mission? How does this align with Reckitt Benckiser’s broader sustainability approach?

We have a broad responsibility towards Banega Swachh India (BSI). [RB’s ambitious program to address the sanitation and hygiene crisis in India] We work under 4 pillars. The first pillar is behaviour change communication, the second is mass reach, the third pillar is product access and fourth is infrastructure creation and maintenance. We give maximum weight to work around behaviour change communication because we find without BCC infrastructure created will remain only structures that will never be used. So our work is focused around the determinants of behaviour change. We are trying to understand through our work and processes why behaviours are such and what triggers non-behaviours into behaviours.“We give maximum weight to work around behaviour change communication because we find that without BCC infrastructure created…will never be used”

 2. Can you tell us about some activities that you have conducted in the area of behaviour change communication?

Under Banega Swachh India (BSI) we are developing school modules for very young children at the foundation stage which include early-learning goals like personal social and emotional development, knowledge and understanding, physical development. Typically what happens is that some hand washing programs are conducted for a session or two. They aren’t regular sessions, just awareness programs. We are trying introduce a program where there will be modules in place for school children, student work books, activity based learning kits and a school curriculum for the teachers amongst other things, so that there is a regularity in the messages that are disseminated.  We don’t only work on one aspect which is only hygiene or hand washing. We have elaborate modules that range from personal hygiene to hygiene at home, hygiene at school, hygiene during illness, hygiene in neighbourhoods etc. We are making strides at various levels and building a curriculum to implement good hygiene. In the coming months we will roll out a program with some very worthy partners that have been working with us since the launch of our BSI campaign, which is the Banega Swachh India campaign.

 Do you work with other communities as well?

We are starting with schools, but yes we do intend to work with natural leaders and community based leaders. We are also thinking about using a platform to create an enabling environment for the Banega Swachh India campaign to leads us towards the goal of the Swachh Bharat mission. We are currently in dialogue with certain organizations about this.

 3. Do you think that organizations are interpreting the Swachh Bharat campaign to mean “build toilets?” There are other aspects of WASH that are not receiving as much attention, why do you think this is so?

I feel that there are various partners so if someone is constructing toilets, it’s a very big part of the mission. To invest in creation of the infrastructure, a lot of capital is involved. But yes, we should leverage resources that everyone has – corporates, private foundations, international organisations, all have resources and it’s important to leverage these to shape the market.  One part is construction of toilets which is very important, but along with that, companies can come up with various things. Companies have brands and conduct campaigns and so we have experience in this area. We can do something to motivate people like bringing like-minded people together so that everyone contributes. It should not be a standalone thing – there needs to be a spirit of partnership on mutually agreed principles so that people work together and achieve the goal of making India open-defecation free.

4. What are the main issues that you think need intervention in sanitation and how does RB approach these issues?

What’s important here is to work as a consortium rather than alone, because organizations have different skill sets and different strengths, so if everyone comes together there’s a good chance things will happen. To take the example of Samhita and how you bring in multiple stakeholders for an issue – if we do that then we will know what TCS is doing, how someone else is contributing etc.  No organization or company can do this alone, we need to fit in with the overall vision of Swachh Bharat. We are currently exploring the best ways to do this.

5. At the Chicago Booth event, you mentioned an innovative approach that RB is implementing, can you tell us a little bit more about that?

Our work is of 2 kinds. One is hardcore execution on the field through intervention partners. We work on bringing partners together and we also bring some global people together so that the best can be achieved. Our second approach is working on something which is more on the policy level. Here we’re looking at how all this work can be integrated into the larger framework of sanitation.

6. What do see as the major obstacles or challenges to having a Swachh Bharat? What challenges has RB faced?

Let’s call it learnings, not challenges. We see opportunities for where we can do better, not just the challenges. I think we need to have more partnerships and more aligned thinking. It’s very important to have design thinking. We are continuously working on that – improving our design thinking.

7. What do you see as the key development issues in India? What is the role that companies can play?

You see, health, hygiene, sanitation they all go hand in hand. There are various things that need our urgent attention.  You must know that India has committed to the MDGs. The MDGs talk about the latest figures for under 5 mortality and morbidity arising out of diarrhoea. That’s one of the things which is very important. A lot of theories state that this is an unexplored space where companies can come forward to contribute. There are only a few foundations working in this area.

I also see that very simple things like hand-washing can reduce diarrhoea and pneumonia mortality and morbidity rates using very simple tools.

There are 3 aspects on which define your CSR strategy – one is the company’s mission the other is sustainability goal of the company and the third is seeing if there is a match between the two. I would also like to say that without partnerships no one can achieve anything. This is the time to work together to achieve Swatch Bharat Mission and make India Open Defecation Free.

The need for sustainable sanitation solutions

The Prime Minister’s call for a Swachh Bharat Abhiyan in 2014 has reactivated the demand to provide better health and hygiene to communities. The mission became one of the first big priorities of CSR, after the law came into force, with several companies, foundations and individuals pledging their support to the cause of sanitation. While providing infrastructure and other resources is critical, it is also equally important to practice a holistic approach to implementing such programs.

 Sanitation, or WASH (Water, Sanitation and Hygiene) issues are divided into two broad categories of supply and demand. Supply side issues include building toilets, drainage systems and the availability of water and electricity. Issues that affect demand are to do with caste, location, environment, security, social prejudices, religious beliefs etc.

The government continues to restrict support to supply issues without adequately addressing demand barriers. It has capped the spending on Information, Education and Communication (IEC), to 15% of the budget signalling that it is secondary to creating infrastructure.

India is suffering from a serious sanitation crisis: we have the largest number of people practising open-defecation in the world. The situation is so bad that open defecation is more common in India than in poorer countries like Bangladesh, Pakistan, Kenya and Rwanda. To achieve the primary objective of Swachh Bharat and end open-defecation in India, it is critical that both aspects of WASH are addressed. In this context, it would be helpful to understand some of the ground level challenges, gaps and the scope for companies to provide sustainable and scalable support to the sanitation ecosystem.

Construction: The need for well-built toilets

Most companies have pledged to build toilets, which is desperately needed to combat the practice of open-defecation. India needs sanitation infrastructure for the more than 600 million people who do not have access to a toilet.

Construction is a cost-intensive activity and yet could be a half-baked solution if issues related to availability of water, electricity, land, manpower and appropriate toilet designs are not addressed upfront.

Companies need to rise to this challenge and focus on building good quality toilets. The one-size-fits-all approach cannot work because of vast differences between urban and rural spaces and variances in community practices and beliefs across geographies. Badly constructed toilets will also further discourage use.

What is needed is a concerted effort to build toilets that people will be encouraged to use, that keep in mind specific community needs, and also ear-mark resources for maintenance. There is also scope for funders to look at the renovation of existing toilets that have fallen into disrepair, reducing the need for cost-intensive construction projects.

To successfully tackle the problem of open-defecation we need to approach the issue holistically and encourage behaviour change rather than measuring our success by the number of toilets being built.

Critical WASH components that need support: maintenance, waste management and capacity building

A critical factor that is failing to receive adequate operational support is the maintenance of toilets. Hundreds of toilets lie unused due to the lack of proper maintenance systems – the total maintenance allocation for schools under the Sarv Shiksha Abhiyan (SSA), including cleanliness, consumables, and small repairs is a paltry Rs. 5000 a year. Providing a reasonable percentage of the budget to ensure proper maintenance – at least for some period of time after installation – can be a critical input for WASH programs.

Attention also needs to be paid to supplementary components like waste management, drainage systems, waste-water treatment, fecal sludge management and capacity building.

Companies also fail to strategize their exit from communities. Very few CSR efforts have exit plans that build in takeover by the community, which is essential to ensure longer-term sustainability of the initiative and durability of the intended outcomes. Another way of ensuring the sustainability of programs is through collaborative interventions, which provide a wider donor base for communities to draw upon. It is necessary for companies to support the sanitation ecosystem in a way that programs can be sustained after their exit.

Changing behaviour

Behaviour change communication is critical to ensure the usage of toilets. Messages need to be professionally developed and context-specific to account for the widely different reasons for open-defecation in urban and rural spaces. For example, rural areas are governed by socio-cultural practices, whereas the issue in urban areas is related to space, time and maintenance.

For FMCG companies, behaviour change campaigns also present an opportunity to strategically address the imperatives around WASH through cause-marketing campaigns, rather than be seen as pure CSR initiatives.

The need for sustainable solutions

The CSR mandate has motivated companies to participate in the Swachh Bharat campaign but in order to meet the goals of the campaign, CSR efforts need to be channelled towards interventions that are sustainable in the long-term.

Samhita strongly believes that in order to effectively address the problem of open-defecation companies need to fund end-to-end solutions that support the sanitation ecosystem. Programs should include the construction and maintenance of toilets, behavioral change communication, monitoring impact and sustainability. The program life-cycle should be designed such that all aspects of WASH are adequately covered.

We are not, however, suggesting that companies take on the entire responsibility at an individual level; companies could pool funds or create/join coalitions with other key stakeholders like Foundations, research bodies, social organizations to support specific interventions and drive collective impact.

2019 may be the year when India has a 100 million more toilets but unless the government, companies and other key stakeholders adopt a more holistic approach to sanitation, those toilets will lie abandoned and unused while people use the fields they find so pleasureable and convenient.

– Mr. Vaidyanathan Krishnamurthy

Reckitt Benckiser | How to leverage core competencies to create impact

Urbanisation and climate change have led to an increase in the need for improved water, sanitation, and hygiene (WASH).  While companies across India try to address the critical gaps in WASH through their CSR, RB decided to take a shared value approach and unlock advantages for both business and society. 

The Reckitt Benckiser Story

Children spend a significant portion of their day at school where WASH services (including access to drinking water, sanitation and hygiene) can impact student learning, health and dignity particularly for girls. Most water and sanitation related diseases can only be prevented by improving a number of hygiene infrastructure and behaviours.

With a view to harness the potential of India’s next generation to become sanitation change leaders, RB and Samhita designed an intervention which recognizes the role of children as key drivers of change and arms them with the right tools to drive change as well as collaborated with the government to scale the impact.

How did we impact 1 lakh students

Samhita designed a program with a focus on driving behavior change through community ownership and advocacy at the level of government and the school administration, in addition to imparting education on hygiene practices among children. Our approach to multiply the impact was two fold:

This project has adopted the proven route of community engagement to reach thousands of lives. The Behavioural Change Communication (BCC) plan covers not only hand washing but also the importance of personal and environmental hygiene practices. Wall paintings, celebration of important international and national events related to WASH were observed in large scale in the states. In addition, students and teachers engaged several community leaders and school management committees in their locations to spread awareness on best practices in the communities.



Why the health of sanitation workers needs to be our society’s concern?

“In a world without sanitation workers, business and daily life would come to a halt”.

It may seem too extreme to state but is nevertheless true. Without sanitation workers, the functioning of our ecosystem will halt as supply chains of products and services are adversely affected.

Samhita believes that it is essential to ensure preventive health care for our sanitation workers to not only ensure the smooth functioning of our society but also enable them to live a life of dignity. Our WASH platform and, more recently, our IPA platform aims to put money where our mouth is.

To know more about our approach, read this article written by Priya Naik, Ragini Menon and Tushar Carhavlo for CNBC-TV18.

The key to COVID-19 prevention in slums

Slums across India have been disproportionately affected by the COVID-19 crisis. 42% of Mumbai’s population lives in slums and therefore they require carefully planned measures to ensure that preventative and primary care remain accessible.

The Bridgespan Group and WHO emphasise that community participation is the key to implement any COVID-19 preventive interventions in the slums.

This is as a model of care, designed while incorporating community participation is more likely to be accepted and effective in the long-term. To elaborate on the practicality of their recommendation, they describe activities where communities have been engaged and relay how this principle helped the programs in Mumbai slums.

Are healthcare facilities accessible to India’s tribals?

“India no longer has the luxury of continuing to wait and watch as millions of its tribal peoples suffer and die from preventable causes.”

There is a much higher incidence of maternal and under-five mortality, stuntedness, tuberculosis, and cardiovascular diseases among India’s 104 million tribals compared with the larger population.

Piramal Swasthya and The Bridgespan Group map out the reasons for the lack of reduction of health challenges in tribal areas based on their field studies.

They outline factors such as barriers in access to healthcare and information, insufficient number of public health facilities, and lack of data.

They stress that for scalable and population-wide impact to be achieved, especially to meet India’s national aspirations of Sustainable Development goals of health and well being- a focused and collaborative approach between all stakeholders of society is the only way forward.