z Participatory Action Oriented Training for Household Water and Sanitation An Implementation Manual National Target Program II for Water and Sanitation December 2009 NTPII PAOT Implementation Manual PREFACE This Implementation Manual has been developed to guide provinces who wish to use Participatory Action Oriented Training (PAOT) as an IEC and community development tool to improve water and sanitation and environment at the household level. The Implementation Manual has been developed from experiences in pilots under the National Target Program (NTPII) in Ninh Thuan and Dak Lak provinces as well as other applications of PAOT in Vietnam. Penelope Dutton, international consultant Ho Thi Tuyet Hong, Tien Giang WU, trainer Dinh Xuan Lam, national consultant, IEC specialist/trainer. i NTPII PAOT Implementation Manual TABLE OF CONTENTS I WHY CHOOSE PAOT? 1 1 What is PAOT? 1 2 Why Choose PAOT? 1 3 Core Principles of PAOT 1 II PAOT PROCESS 2 1 Step 1: Decide Who’s the Lead Agency 2 2 Step 2: Decide the Scale of PAOT 2 3 Step 3: Discuss with Local Authorities 2 4 Step 4: Prepare a detailed Plan and Budget 3 5 Step 5: Hire a Specialist PAOT Trainer 3 6 Step 6: Develop Household Checklists of Target Behaviours 4 7 Step 7: Select and Train Local Communicators 5 8 Step 8: Communicators organize Household Meetings 5 9 Step 9: Monitor the process 5 10 Step 10: Evaluate the Program and Improve 6 III ADDITIONAL INFORMATION 6 1 Questions and Answers on Tien Giang’s WIND Program 6 2 Implementation in Tien Giang 9 3 Additional Resources 10 ANNEXES Annex 1: Communicator Training Course Outline Annex 2: Communicator Course Guide Annex 3: Example Household Checklists Annex 4: PAOT Lessons Learned from Ninh Thuan and Dak Lak province Annex 5: Photos Annex 6: Surveys ii NTPII PAOT Implementation Manual ABBREVIATIONS DOH Department of Health IEC Information Education and Communication ILO International Labour Organisation NTPII National Target Program II (for Rural Water Supply and Sanitation) PAOT Participatory Action Oriented Training WIND Work Improvement and Neighbourhood Development iii NTPII PAOT Implementation Manual PAOT PROCESS I WHY CHOOSE PAOT? 1 What is PAOT? Participatory Action Oriented Training (PAOT) is an IEC method which promotes practical household improvements that families can do on their own. By identifying good local practices (good examples) and promoting these in the community through visual aids such as photographs, PAOT inspires households to carry out immediate improvements in their home environment. The basic idea of PAOT is that good local examples, such as an inexpensive, home-made handwashing device, or simply covering a well with available materials, are appropriate to the context, and more convincing to the local households. 2 Why Choose PAOT? PAOT is simple and practical. If training and implementation is well supported PAOT can have a positive influence on changing behaviour, sometimes this can happen quickly. PAOT also helps build up communities by strengthening relationships between households and developing confidence in communities to solve their own problems. The method has been proven in Vietnam – it is not a completely new approach, but because it is so simple and inexpensive PAOT does not get much attention. It was originally developed by International Labour Organization (ILO) as a useful methodology for occupational safety and health training. PAOT has improved operating conditions and safety for farmers, miners, industrial workers, and teachers in several provinces. PAOT has also been applied in other South East Asian countries to improve efficiency and safety in the work place, such as mines. In NTPII, PAOT is being applied to household water and sanitation improvements. The approach is piloted in Ninh Thuan Province (Luong Son and Hoa Son communes) and in Dak Lak Province (Ea D’rong and Yang Reh communes). In Ninh Thuan PAOT is being led by the provincial Department of Health with support from the Women’s Union, while in Dak Lak pCerwass is leading the process. 3 Core Principles of PAOT The core principles of PAOT are: • Build on local practices – choose available local solutions in the community (or a similar community) • Focus on positive achievements and build on the strengths of each household to improve its situation gradually • Link water and sanitation with improving health and living conditions for the whole family • Learn by doing – focus on the “doing” rather than the training and make step-wise improvements • Encourage people and communities to share their experiences – this can stimulate the self-reliance and the enthusiasm of the community and people will come up with 1 NTPII PAOT Implementation Manual PAOT PROCESS their own ideas and solutions • Promote people’s involvement – communities understand their conditions best and can solve their problems by themselves. This manual will show you the steps to follow to implement PAOT with a qualified trainer or facilitator. II PAOT PROCESS Implementing PAOT requires following some logical steps. This manual will help you follow the steps. 1 Step 1: Decide Who’s the Lead Agency Deciding who will be the lead agency for implementing PAOT is important as they will be responsible for taking PAOT from idea to reality. This is not just financial support but also spending time and effort to organize training, guide Communicators, and monitor implementation. Whoever takes the lead role must be committed to seeing the PAOT through, and be prepared to invest time and money and effort in the process to bring success. In some provinces the lead implementer has been the Centre for Preventive Medicine in the Department of Health, or pCerwass, or the Women’s Union. It is also important to identify other key stakeholders who can help and support PAOT. For example, the Women’s Union, through its own program of activities, plays an important role in promoting safe water and sanitation in households. Should they be included as part of the implementation? It is a good idea to talk to the Provincial Women’s Union and discuss how they might support PAOT. Commune People’s Committees are also key stakeholders in PAOT and they must be fully involved in the process from the very beginning. 2 Step 2: Decide the Scale of PAOT Where will PAOT be implemented and why? Will it be two pilot communes to begin with, with a plan to extend to some or all communes in the province in the future? How will you prioritise where PAOT should be started? Will PAOT be implemented in poor remote communes or communes that are easy to get to for the implementing agency to visit? A decision is needed on the scale of PAOT and where it will be implemented first as this will affect the amount of budget and human resources that are needed. As a general rule it is better to start small, and learn the process than to try and do too many areas at once as it is difficult to support and encourage too many communes at one time. 3 Step 3: Discuss with Local Authorities It is important to discuss the plan with District and Commune authorities so they understand the purpose of PAOT and how they might be able to support you with implementation. These discussions should take place very early in the planning stage. Their local knowledge might help you with your planning and understanding of the local issues and needs, as these may be different between communes. Local authorities are critical in unifying the 2 NTPII PAOT Implementation Manual PAOT PROCESS implementation plan, choosing commune staff and communicators. The Commune People’s Committee is a key partner in making PAOT happen in the community so it is essential to make the time and effort to visit the area in advance and explain how PAOT works. The relationship with local authorities should be an ongoing one, throughout the entire implementation and monitoring. 4 Step 4: Prepare a detailed Plan and Budget Now it is time to put your plan on paper and estimate the costs. Your plan should include a timeframe of activities, as well as all the items that need to be budgeted for. It is better to include a generous budget than to cut back costs and not be able to carry out the level of work and support required. Typical costs will include: • PAOT staff time from the key implementing agency (for meetings, planning, preparing a budget, supervising, reporting) • Travel for PAOT staff to visit the communes • Specialist PAOT trainer/facilitator (time, travel costs, accommodation and living) • Equipment (eg. digital camera) • Training of staff at district, commune and communicators about the skill to deploy the PAOT activities in the community (venue fee, training materials, refreshments, trainee allowances) • Compiling and producing PAOT Materials (printing of checklists, reporting formats, handbook) • Allowances for Communicators and group meetings (household meeting allowances) • Support costs (small gifts or rewards for role model households, incentives for Communicators etc). • Supervision of how communicators carry out the activities in the community (staff time costs, travel) • Evaluation (workshop or meeting costs similar to training). 5 Step 5: Hire a Specialist PAOT Trainer Not everyone can be a PAOT trainer. Master Trainers need to have been trained and developed skills in promoting self-help initiatives of local people. They should have first hand experience of implementing PAOT elsewhere so they can guide you in the process, not just be the “Trainer”. Their teaching style needs to be highly participatory and respectful of community ideas. Find a good trainer by talking to others who have implemented PAOT. A good starting point is to contact the following people or organizations: • Tien Giang Women’s Union, Ms Ho Tuyet Hong • Ninh Thuan Department of Health, Dr Khanh • Dak Lak pCerwass, Mr Pham Phu Bon • Soc Trang Women’s Union, Ms Trinh • UNICEF • National Women’s Union, Hanoi 3 NTPII PAOT Implementation Manual PAOT PROCESS 6 Step 6: Develop Household Checklists of Target Behaviours Compiling and producing materials for PAOT is a critical step. You will need expert support to identify and photograph local low cost, practical examples of water and sanitation solutions. To do this you will need to have some desirable behaviours in mind and discuss these with local stakeholders such as the Commune People’s Committee, Health Centre, Women’s Union, or Farmers Union. They can help you locate some good examples in the commune, and can confirm what are appropriate target behaviours. For example, if there is no piped water scheme in the community and none is planned then connecting to the piped water scheme should not be a target behaviour. It is important to choose practical low cost solutions as examples. When the community carefully observes and admires good solutions from other people who are in similar conditions, they can easily see what to do. Simple solutions also motivate people to take immediate action. Over time they can improve the solution according to their needs and ability. Photographs play a vital role in PAOT. The entire training course depends very much on photographs showing good examples clearly, so the Trainer is the best person to take the photographs. They can fully understand the value of an improvement, therefore they can identify which details are necessary to include in each photograph and the collection of photos. Use a digital camera to photograph local examples. Before taking a photo, be sure that you know its exact “message”. Photos in PAOT provide participants with a practical view to solve problems; therefore during the training workshop, trainers must be sure that the message of the picture is clear. Don’t take photos with too many details in them but focus on the main object or example. When you take photos, ask for permission from people and explain your purposes. Local people are usually very interested and willing to cooperate. Select the most appropriate photographs for the use in the household checklist. The other photos can still be used in the training to provide examples of other solutions. All the training materials, checklists and Communicator guidebooks must be ready in time for the training. At the beginning stage, a survey should be undertaken to find out the baseline situation, before PAOT is implemented. Such a survey will help you compare the changing process and document the achievements over time. A baseline survey should relate to the behaviours and practices that you want PAOT to change, and it should be simple and easy to carry out and understand the data. Baseline information can be collected on the number of households with toilets, with piped water connections, with covered wells and so on. You can also collect information from households on their attitudes and knowledge which could help you to implement PAOT such as what they know about credit services, and which mass organizations they are members of. After implementation, the same survey can be carried out and the results compared. The results can be a powerful tool to prove to leaders the influence of PAOT, or to learn more about what can be improved in the PAOT process. Appendix 6 contains some more information about Baseline and Evaluation Surveys. 4 NTPII PAOT Implementation Manual PAOT PROCESS 7 Step 7: Select and Train Local Communicators Well before the training, the type of Communicator needed should be discussed with the Commune representatives. The best Communicators are those that have a personal interest in improving the water and sanitation situation in their community, and are active in their community. Often they are role models for good environmental behaviour. It is important that they are credible to the community. Communicators should understand their role before the training. When they understand their role, communicators will better appreciate the need to focus on training content, and pay attention to what they will need to do on their own after the training. Local communicators/role models are trained by an experienced PAOT trainer in the concepts of PAOT and how to motivate households. At the beginning of the course they are introduced to the action checklist. The training includes observation visits to households, and practice at running household meetings as part of the training. Staff at district, commune and village level are also trained in the communicator training (but it is necessary to have the support from experts and trainers). 8 Step 8: Communicators organize Household Meetings After training, Communicators initiate meetings with households. During the meeting, the Communicator explains the household checklist, and facilitates the group to share experiences, and identify their priorities for improvement. Households develop an action plan for their own situation and goals, which includes an estimate of the time when each improvement will be achieved. They each get a household checklist and use this as a reminder for action and to follow their progress towards their own goals. After the meetings, motivators should visit the households to: advise households how to improve; record the changes of households; and report to higher level authorities monthly or quarterly depending on their agreed reporting schedules. Households who were good at improving their living conditions should also be motivators as they have the experience and enthusiasm for the role. Initially they can organize meetings with their families and neighbours, (with the support of more experienced motivators). Experience from Ninh Thuan and Daklak shows that: in order to support motivators to carry out quality activities in their community and support them to have enough enthusiasm from the beginning, financial support is needed for motivators to conduct meetings and household visits immediately after training. Provincial and district members from the implementing organizations should allocate time to visit the community at least every 3-6 months to meet and assist motivators. If there is no financial support to PAOT or provincial/district staff support, PAOT activities in the community will quickly come to a halt. 9 Step 9: Monitor the process It is important to monitor both the PAOT process (how it is implemented) and the improvements made. Monitoring should include supporting and supervising activities in communes, and villages, and ensuring data is collected continuously during implementation. Data should be collected on the number of households making improvements, number and type of improvements of households, and the timeframe for making improvements. A survey should be taken a second time to get results on the effectiveness of the program and to prepare for the evaluation workshop (see step 10). The survey can include quantitative information such as the number of improvements made, but should also include qualitative information (through interviews with households) to find out the positive and negative 5 NTPII PAOT Implementation Manual PAOT PROCESS aspects of the PAOT program. 10 Step 10: Evaluate the Program and Improve Process monitoring (finding out what is going well and what is not working, and why) will help identify areas that need to be improved, for example refresher training of Communicators may be needed. A full review of the PAOT implementation should be made and the results presented at an Evaluation Workshop. This workshop is the important time to make plans to improve implementation and multiply the PAOT method. III ADDITIONAL INFORMATION 1 Questions and Answers on Tien Giang’s WIND Program Before PAOT was piloted in Ninh Thuan and Dak Lak provinces, representatives from these provinces visited Tien Giang province, where PAOT has been used to improve household living conditions through the WIND (Work Improvement in Neighbourhoods) program. The purpose of PAOT was to “improve the labour condition, equipment and environmental sanitation” of households. The following questions and answers maybe helpful for those considering introducing a PAOT program, even if the objectives are different. Question: How can we request cooperation between agencies to apply PAOT? What does the Women’s Union do to get DOH’s cooperation in applying PAOT? Answer: The WIND program in Tien Giang was initiated by the Women’s Union and Farmers’ Union. The Women’s Union coordinated with the Famers’ Union to develop this program based on their networks (such as province -> districts -> communes). Tien Giang chose My Tho as the pilot city. When developing this program, the Women’s Union and Farmers’ Union worked with the People’s Committee, and reported to local authorities to get the necessary support for the program. Question: How can we apply a PAOT program in a household if only the wife OR the husband agrees to it, not both spouses? What should we do if households oppose PAOT? Answer: In order to evaluate a family and know the real situation, we must consider the house carefully from the inside to the garden. However, many residents do not understand the program, therefore, they sometimes do not cooperate with us. In this case, we choose other families because this program is based on voluntary participation and gender equality. Question: How can we choose the best IEC method for different objectives eg. water and sanitation? What is the criteria to choose the program’s objectives? Answer: 6 [...]... Materials for learners: follow up improvement checklists (1p/each household) : 210ps (180ps for households, 30ps communicators) Handbooks for communicators (1p/communicator): 30p Picture (1p/communicator): 30p 12 NTPII PAOT Implementation Manual - PAOT PROCESS Making plan form at hamlet level (1p/hamlet):12ps 13 NTPII PAOT Implementation Manual Annex 2: Communicator Training Course Guide and Materials 1.1 ACTION. .. materials of PAOT Subject 1: USING AND PROTECTING THE CLEAN WATER SOURCES METHOD Presentation VISUAL AIDS CONTENT SOLLUTIONS FOR WATER AND SANITATION There are 4 technical subjects: 1 USING AND PROTECTING THE CLEAN WATER SOURCES 2 3 4 -Pictures are shown based on documents order -Raising questions projector GARBAGE COLLECTION AND WASTE TREATMENT SCHEME MANAGEMENT SHARING AND COOPERATING TO COMMUNITY IN... Content Time Preparation ACTIVITY Activity 1 10 mins Activity 2 20 mins - Understand deeply the 4 technical subjects of Water and Sanitation - Sharing solutions of water and sanitation - Methods of explaining and guiding a subject - Group discussion 4 hours 1hour for each subject - White board pen, A0 paper, A4 paper, projector, hand out, scissors, sticky-tape, paper clips - Pictures of recommended solutions... responsibility, they consider sanitation promotion as one of their main duties, and they are proud of their work to create a clean, clear environment Local authorities’ support: local authorities’ staffs at commune and village level are interested very much in activities of sanitation environment scale They consider water and sanitation in households as a criteria to vote as a cultural family; sanitation at public... Class analyses and finds out picture’s strength and easy-doing things - Choose randomly a colored piece from the picture containing a lot of yellow paper and ask “Why do you think this is the cheapest solution?” - Class analyses and finds out picture’s strength and cheapest solutions - Choose randomly a colored piece from the picture containing a * Remind learners to choose independently 31 NTPII PAOT Implementation. .. questions” for information making further 17 NTPII PAOT Implementation Manual * Presenting * Giving question: What is the good point you can find? * Suggesting learners to focus on the topic “Cover the water tank” * Presenting * Giving question: What is the good point you can find? * Suggesting learners to focus on the topic “Protect water meter” 18 NTPII PAOT Implementation Manual Water Treatment at Household. .. as an additional means of communication Changing behaviour checklists and communicators’ supervision are key to the success of PAOT 3 Additional Resources Copies of PAOT manuals used for a Work Improvement in Neighbourhood program: http://www.win-asia.org/Content/PAOT.htm Other training manuals are available on WIN website: www.win-asia.org Contacts: Center for Occupational Health and Environment Can... the training place Household used for visiting and doing checklist should be appropriate and include things involved in the checklist Group discussion content: • Based on household visit results, each group finds out 3 strong points and 3 points that need improvement • Rank the priority of improvement and write on coloured paper Each group appoints a person to present their discussion and stick their... city, therefore, we don’t have any special experience on this issue However, because we mainly use pictures and visual aids these help all residents to easily understand and participate in the program even if they cannot read Question: What is the approach of the WIND program? How does the process work? How many volunteers are there in each commune? How many households are managed by a volunteer? Answer:... can be addressed immediately and which ones may be solved later (around 1 or 3 months) When some households register to join the program, volunteers arrange time to randomly visit and evaluate those households Question: How do we find out which solutions are suitable for our area For example, is hanging a mosquito net a suitable checklist item? Is this still a positive improvement if there are so many . z Participatory Action Oriented Training for Household Water and Sanitation An Implementation Manual National Target Program II for Water and Sanitation December 2009 NTPII PAOT Implementation. water and sanitation and environment at the household level. The Implementation Manual has been developed from experiences in pilots under the National Target Program (NTPII) in Ninh Thuan and. you want PAOT to change, and it should be simple and easy to carry out and understand the data. Baseline information can be collected on the number of households with toilets, with piped water