In mid-2014 WaterAid and the International WaterCentre (IWC) undertook a situational analysis of hygiene behaviours in East Sepik, Papua New Guinea. The analysis found that infant faeces are rarely managed safely in East Sepik. Improper handling and disposal of infant faeces pose serious health risks for children and their carers. It may increase the risk of diarrhoeal diseases – the leading cause of malnutrition and second leading cause of death amongst children under five in Papua New Guinea and globally.

To better understand these behaviours, WaterAid, IWC,  Divine Word University (DWU) along with  local partners, Integrated Rural Development Initiative (IRDI) and South Seas Evangelical Church (SSEC) led research to understand infant faces management practices among mothers and caregivers of children under five years’ old in four villages across the East Sepik region. The study found that households without toilets typically bury their child’s faeces, or place it with their general rubbish for disposal. Nappies are disposed of in household toilets or into the sea, rivers and creeks. The findings show that infant faeces is rarely managed safely as it is often seen not to pose a health risk.

To help communities improve their practices, WaterAid developed the Infant Faeces Management Behaviour Change Campaign Toolkit with IWC, IRDI and the Department of Health. The toolkit materials were designed in collaboration with local community members.

The campaign was trialled in June 2017 in one East Sepik community. Mothers and fathers from the community were selected as ‘change agents’, and provided training. Their role as change agents was to engage their fellow community members and deliver information about proper practices for safe infant faeces management. The campaign ran for four weeks, and in the week following the end of the campaign, community focus groups were undertaken to discuss the campaign, how effective people found it and how it had changed their behaviours.

Following the campaign, community feedback suggested that many households had stopped problematic behaviours, such as dumping infant faeces in the river, and instead had built toilets and were disposing of faeces there. Importantly we also noticed the project had contributed to shifting cultural beliefs about men’s and women’s roles, encouraging some men to take up more duties related to childcare. In focus group discussions, fathers clearly expressed the need to contribute more to child hygiene. One man said, “I feel ashamed that, it didn't happen before. I as a man say, she’s a woman let her do the job - now I’m ashamed that I should also help.” Another noted that, “…it is a right practice that both man and woman have to share responsibilities. We can no longer say, oh that is a women’s job and I’m a man. That should not happen…I as a man should also share in the responsibilities to work together.”

Beyond the life of the CS WASH Fund project, the next step will be to roll out the campaign in more communities in partnership with government and CSOs, to see if similar changes can be replicated.