DFID teams up with local partners to improve hygiene standards

Project aims to provide hygiene products and training to one million rural households in five years

KARACHI: What started as a small venture a couple of years ago to raise awareness about the importance of hygiene and health products among the rural community, has now evolved into a grand idea to bring about positive change in the health and lifestyle of around one million people from the rural areas of Pakistan.



In 2016, a collaboration between the UK's Department for International for International Development (DFID) and Reckitt Benckiser (RB) set out to train three sehat apas [health sisters] from among the local residents of Dohri - a small village in rural Punjab - in the ways of maintaining health and hygiene standards. The women were provided hygiene products and trained in their use, besides ways to look for symptoms of common ailments such as diarrhoea, dengue and malnutrition, among others.

The volunteers embarked on a door-to-door campaign in their village, armed with baskets of health and hygiene products, teaching the villagers what they knew.

The novel idea started to bear fruit immediately and was soon expanded from the 600 households in Dohri to 28,000 households in 48 villages across the country. The results were instant as well as remarkable - in just a year, the number of deaths caused by diarrhoea had decreased from 53,000 to 30,000.

At a press conference at the British High Commission on Wednesday, RB's Global Head of External Communication and Government Affairs Patricia O'Hayer and DFID's Head of Business Engagement Laura Kelly announced plans to scale up Project HOPE to provide quality health and hygiene products to one million rural households over the next five years. For this, a new entity will be set up and would include investment from RB, DFID and four other local private sector companies - English Biscuit Manufacturers (EBM), Shield Corporation, Shan Foods and Santex. The collaboration would increase the number of products in the goods basket. The basket includes oral health, feminine and baby hygiene products, soaps, toilet cleaners, bug sprays and biscuits, among other items of daily use.

Addressing the media, O'Hayer said that the beauty of the project lay in its sustainable business model as HOPE works with the community members to affect change. The DFID and its partners reach out to the stakeholders in the community - the elders, clerics, and local government - and after taking them into confidence, empower the locals to bring about change.



"An investment in a woman is an investment in her family," said O'Hayer, adding that it had proved to be true in this case. "Almost 24% of the health sisters are primary earners in their households, making between Rs4,000 to Rs5,000 per month, and financially supporting their homes," she said.

The sisters also conduct follow-up question answer sessions in the community and help create a positive environment to create lasting behavioural changes. There has been a 5% improvement in hand washing four to five times a day from once or twice a day and 11% improvement in treating water before drinking, she said.

Kelly, with reference to Larry Fink's letter to CEOs that talked about doing business with purpose, said that HOPE had managed to define the practice. She added that private companies and civil society can work together for a win-win situation.

The journey

Speaking to The Express Tribune, O'Hayer shared her personal journey that led her to conceptualise the project. The starting point was the 'Save a Child' campaign where she came across a number of people dying from preventable diseases such as diarrhoea. She found it inconceivable that people still died from such diseases given the advancements in medicine. Thus, began a journey to bring about change.

In her efforts, she saw that while work was being done on the ground, the efforts only partially addressed the problem. Using the theoretical framework set up by the World Health Organisation, known as the seven-point plan that includes an element of treatment to reduce deaths among children caused by diarrhoea and a prevention element to make a long-term reduction in the cases of diarrhoea, she tried the model using a community-driven approach.

In the first phase of her research, O'Hayer set out to understand the reason why rural communities were reluctant to use hygiene products. While price was one factor, the focus group revealed other variables too. Using the example of Dettol soap, she said that women found the medicinal smell unsavoury and that they did not like the dryness that multiple uses of the soap left on their hands. Thus, O'Hayer set to redesign the product to those specifications and following that, persuading the company to produce it. This was not an easy task and the constant challenge she faced was to balance the interests of the company and the people.

She said that the company had to think of a way to promote the new product without harming the sales of other products, the profit of which helps fund the social initiatives. They also had to find cost-effective ways to get a product to its location. The resultant changes one sees are the example of doing business with purpose, of businesses working productively with the civil society.

RB gives its products to sehat apas at subsidised rates, which they sell on and earn a margin. This ensures that the companies remain in business, while bringing about an improvement in their consumers' living conditions.

Another challenge was to ensure that corporate competition did not undermine the work being done. Thus, they decided to divide the basket's categories among themselves. Also, the companies had to have a good portfolio and be willing to provide their products at competitive rates.

O' Hayer added that they were also very critical about the products being sold. She said that any community has only a limited disposable income to spend and to ensure that it was spent on the right products, they had, despite demand, refused to provide products such as cosmetics. 

Published in The Express Tribune, October 4^th, 2018.