World Health Organization data shows that 1.7 million deaths a year are attributable to unsafe water, sanitation and hygiene. 54.2 million disability-adjusted life years (DALY) are caused by unsafe water, sanitation and hygiene – each DALY represents the loss of one year of equivalent full health. Interventions to improve water, sanitation, and hygiene practices have been shown to reduce sickness from diarrhea by between one-quarter and one-third.
Communities can examine existing hygiene behaviors, practices, traditions and understand how transmission of disease takes place and how it can be prevented at a household level. Girls who are unable to access clean safe water, separate toilets and handwashing facilities at the school are much more likely to drop out.
Participatory methods recognize that the learner can also offer something to the effort of community development. This approach encourages the participation of individuals in a group process no matter what age, sex, social class or educational background. It works on the premise that all partners are equal. Participatory Hygiene And Sanitation Transformation (PHAST) is one such approach that does not pivot on the premise that knowledge is transferred from well-informed teacher to an eagerly receiving learner.
In 1992 the World Health Organisation (WHO)/United Nations Development Planning (UNDP)/World Bank Water and Sanitation group joined forces to develop and produce better methods for hygiene education by adopting Self-esteem, Associative Strengths, Resourcefulness, Action Planning and Responsibility (SARAR) methods to address issues directed to sanitation and hygiene behaviour.
A collaborative process to develop and test the Self-esteem, Associative Strengths, Resourcefulness, Action Planning and Responsibility (SARAR) method for hygiene education was launched in1993. It marked the birth of the PHAST initiatives which subsequently brought together and adopted a number of SARAR activities. The PHAST approach helps people feel more confident about them and enables them to take action and make improvement in the communities.
The previous community water programmes on Water Supply, Sanitation and Hygiene Education (WASHE) emphasis was placed on water programmes. However, UNICEF/WHO Consultative meeting on key hygienic behaviors influencing the reduction of diarrhea diseases identified the need to focus on sanitation in relation to addressing hygiene issues.
Participatory Hygiene and Sanitation Transformation (PHAST) training support water, hygiene and sanitation projects by increasing hygiene awareness within communities. It seeks to help communities improve in their hygiene practices to prevent diarrhoeal diseases. It encourages community management of water and sanitation facilities.
It does this by demonstrating the relationship between sanitation and health status, increasing the self-esteem of community members and empowering the community to plan environmental health improvements and to own and operate water and sanitation facilities.