**6. Results**

#### **6.1 Mobilization of community**

#### *6.1.1 Mberengwa District, Zimbabwe*

The completion rate of the CHC training was exceptionally high in Mberengwa with full attendance of all 20 sessions by 6335 (77%) of CHC members. With sufficient time to repeat many of the session for a second time, all members had the opportunity to complete the training if they had missed the original session due to other commitments. The CHC training was well-timed by the NGO to coincide with the dry season (March – December 2012) to coincide with the 8 months of the year when there is little demand from farming to distract members from the training. All CHCs did more than 20 sessions properly, providing only one topic only per session of at least 2 hours of participatory activities. All the mobilization targets were not only achieved but surpassed during the first year, with follow-up by Project Officers, who arranged model home competitions. All CHC held their Graduation ceremonies properly with CHC members receiving certificates with due recognition. Those who did not finish in Year 1 had a second chance to complete their training and graduate in Year 2, while the water and sanitation component of the project was being done. However, as the number of members was limited to 50 per CHC, we could not judge the popularity of a CHC by the number of members

**45**

*Comparative Assessment of Hygiene Behaviour Change and Cost-Effectiveness of Community…*

in the normal size of CHCs as is routinely expected in Zimbabwe, where CHC can reach over 100 people. Instead we ascertain the level of popularity by the fact that there was universal coverage with over 1407 households (17%) having two members in the CHC. Therefore, the CHC model in Mberengwa was clearly very popular.

The completion rate of the training in Rwanda was not as high as had been hoped with only 41% of CHC members attending all 20 sessions in 5 months. However, this appeared to be, not because they did not *want* to attend sessions, but because they did not want to get wet in the torrential rain! In addition, the training was held during the season that farmers were at their busiest in the fields, planting and weeding crops. Not as many members completed as was expected because the training was shortened by a full month and they had no opportunity for repeating any sessions. Crucially there was no time for Graduation Ceremonies and no "Model Home competitions" were held as had been planned. However, monitoring records show that in the post research intervention, all CHCs continued to meet and over 6 sessions were done per CHC after the official end of the cRCT [30]. This demonstrates the demand for CHC activities. As attendance continued without external support, we would take this as an indication of a high level of sustainability. In Rusizi District, despite the constraints encountered by the community, the large size of the CHC in terms of memberships with an average of 80 members per CHC which exceeded the expected target of 70 members per CHC demonstrates popularity of the CHC. At the end of the cRCT intervention (i.e. after the first year), the spread of the intervention had only reached 58%. However, by the end of 3 years, the spread of CHC households had increased to 80% with CHC members ranging

Our monitoring data shows that the uptake of the CHC model in Rusizi, although it was slow initially, did eventually meet all targets. Therefore, we would consider the CHC project to be a popular intervention in Rusizi District, and that what appears to have been community resistance was mainly due to external constraints imposed by the research and implementing team. Once Ministry of Health had clearly endorsed the intervention, the village leaders whole heartedly led the CHC with much interesting anecdotal evidence of community-led initiatives.

The household observation included 7477 households in the end line survey (**Figure 2**) in Mberengwa District, with a clear pattern of community effort being

Of the 21 indicators, 12 were found in over 90% of CHC households, and three indicators were found in over 80% of households after 8 months. To measure the effect of the CHC it is important to note which indicators have made the most change. The most impressive change from baseline to the post intervention 8 months later, was in the use of hand washing facilities in the home which increased by 85.4% (from 6.4 to 91.8%), the use of ladles to draw water from a bucket increased by 65% (18–83%), bathing rooms increased by 51% (16–67%), the use of pot racks to dry plates increased by 51% (46–97%), the use of refuse pits to ensure fly control increased by 39% (58–97%), decorated kitchens increased by 30% (66–95%), Blair Ventilated Improved Latrine (BVIP) for a household increased by 27% (from

*DOI: http://dx.doi.org/10.5772/intechopen.89995*

*6.1.2 Rusizi District, Rwanda*

from 40 to 100% in 50 villages.

**6.2 Hygiene behaviour change**

*6.2.1 Mberengwa District, Zimbabwe*

evident in all indicators (p > 0.001).

in the normal size of CHCs as is routinely expected in Zimbabwe, where CHC can reach over 100 people. Instead we ascertain the level of popularity by the fact that there was universal coverage with over 1407 households (17%) having two members in the CHC. Therefore, the CHC model in Mberengwa was clearly very popular.
