A review of health and hygiene promotion as part of sanitation delivery programmes to informal settlements in the City of Cape Town

Abstract

Good sanitation includes appropriate health and hygiene promotion. This implies that proper health and hygiene promotion would have the desired effect as part of sanitation service delivery. However, lessons learnt worldwide show that in the promotion of health and hygiene, it is not enough simply to provide facilities, because if people do not use the available facilities properly, conditions do not improve or the system breaks down. The 1986 Ottawa Charter of the World Health Organisation suggests that effective health and hygiene promotion requires the following key elements: • the empowerment of local communities to take responsibility for promoting sanitation and environmental health • collaborative partnerships of role-players across departments • supportive policy environments. Against this background. the focus of this study is the extent to which health and hygiene promotion forms part of sanitation delivery programmes to informal settlements in the City of Cape Town. The investigation was confined to a comparative review of approaches to health and hygiene promotion in four case study sites (Khayelitsha, Joe Slovo, Kayamandi and Imizamu Yetho) in the context of the following criteria: • Community and household capacity to take responsibility for community-based health and hygiene promotion • Role-players and collaborative partnerships across departments • Implementation of health and hygiene promotion and alignment with national policy. Analysis of the case studies highlights the ineffectiveness of once-off awareness campaigns and the need for a more comprehensive approach to health and hygiene promotion in line with the Ottawa Charter. The push towards universal coverage of basic sanitation services will not bring the intended health benefits of delivery if, for instance, the provision of toilets is not complemented by appropriate health and hygiene promotion programmes.