GUIDE FOR TRAINING OUTREACH

WORKERS
APPENDICES

APPENDICES

APPENDICES
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APPENDIX 1
Possible Tasks for Outreach
Workers Related to Improving
WASH Practices
The following tasks are related to improving WASH practices and may not
include broader responsibilities that the outreach workers in your program
have. Considering only their duties related to WASH, select those tasks
relevant for the outreach workers of your program. Use those tasks to
develop your program’s own job description or incorporate them into your
outreach workers’ existing job description.

 Facilitate assessments of the WASH situation in the community using

participatory exercises such as leading discussions of photos or
drawings, doing a WASH map, leading a walk focusing on hygiene, or
coordinating a community hygiene baseline survey.

 Advocate with community leaders and influential people to support

WASH improvements.

 Help establish, support, and participate in a community health

committee that focuses on or addresses WASH issues.

 Help establish, support, and participate in a community water

committee (which monitors and/or maintains and repairs the water
system, collects fees).

 Liaise with resource organizations: local health facilities, NGOs,

private companies, manufacturers and distributors of sanitation-
related technology, hand washing, and water treatment supplies.

 Conduct regular home visits/counseling on diarrhea prevention,

consisting of an assessment of current conditions and practices and
joint problem-solving to assist with improvements.

 Lead participatory group discussions on WASH issues.

 Put on demonstrations to teach WASH-related actions (e.g. proper

hand washing, how to construct a latrine, how to chlorinate water
correctly).
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 Organize events to promote improved WASH practices (health fairs,

contests, public demonstrations, etc.) and support school-based
WASH activities.

 Monitor or manage monitoring of WASH practices and conditions.

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APPENDIX 2
Tips on Demonstrations, Role
Plays, and Group Discussions
Conducting Promotional Activities in the
Community
In general, outreach workers will be working with three kinds of audiences:
individuals, families, and general or specific groups such as mothers’ clubs,
cooperatives, and school teachers. When conducting activities mainly for
creating awareness and sharing information about WASH issues, the
outreach worker will primarily be working with groups of people. The
activities below are generally appropriate for groups of more than 10
people. When the outreach worker is conducting activities with an
individual or family (to negotiate changes in behavior) s/he will be using IPC
and the discussion tools.

1. Tips for Conducting Successful Demonstrations

When you are planning a demonstration for an individual, family, or

group:

 Make sure you have assembled all the necessary materials and
equipment. Have these readily at hand. Audiences don’t like to wait
while you look for your props.

 Explain to the audience what you are about to do and why you’re
doing it, then give them time to move where they can see exactly what
you’re doing.

 It can help to have pictures for each step, or, if the audience is
literate, a written point-by-point description of the steps. You can also
tell the audience what you’re doing as you demonstrate.

 Once the demonstration is over, ask the audience to comment on what

they’ve seen (what was new, useful, important, feasible, or not?).
Generally you will have no trouble getting them to comment.

 If there’s time, you might want to repeat the demonstration with

audience participation, or have someone repeat it.
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 Ask the audience members what they might do differently as a result

of having seen the demonstration.

 Follow up with some negotiation (using the assessment tools and

counseling cards) to get the audience members to commit to new
behaviors and to talk about what would be easy or difficult for them.

2. Tips for Conducting Successful Role Plays

The following are tips for when you’re planning a role play using
members of your audience (or fellow outreach workers).

Be aware that in many cultures, people are reluctant to participate in

anything that makes them “stand out.” Other cultures use role plays
(skits) willingly. Know your audience beforehand.

 Make sure you’ve thought about what you’d like to achieve as a result
of the role play. Role plays are a technique that is best suited for
exploring skills (like the steps in a counseling session) and/or
attitudes (like feelings about the level of cleanliness of the village).
They are also good for showing what is “normal” in the community,
without embarrassing any particular individual.

 Prepare the players by giving them enough information about the

characters they will play. Give the players a couple of minutes to “get
in role.”

 Have them play their roles for a determined length of time. Five
minutes is a good length. Do not let the role play go on too long. If the
role play goes in the wrong direction, stop the action, regroup, and
start again.

 Tell the actors to step out of their roles and talk about what it was like
to play the parts. This will help them to talk about the role play as a
member of the audience and not the character they were playing.

 Discuss the role play with the audience members. How did it go? Was
it realistic?

 Talk about what they learned from watching the role play and what
they plan to do as a result of having seen the role play. Transition to
negotiation for a new behavior, if appropriate.

3. Tips For Managing a Group Meeting/Discussion

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Here are some tips for when you might have to run a meeting with a
large number of participants.

 When preparing, have a clear idea of what you want to accomplish. Is

the meeting primarily for discussion, or will you need to reach
agreement or a decision?

 Once everyone has assembled, explain some of the ground rules and
go over the agenda, making sure you emphasize the timing.

 Facilitate by paraphrasing (saying back to the speaker what you’ve

heard) and summarizing (stopping from time to time to capture the
important points that have been made) as the discussion moves
forward.

 Pay attention to body language and level of participation. Don’t let

people monopolize the floor.

 Encourage cross-participant dialogue and try to limit how much you

yourself talk.

 Use visual aids.

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APPENDIX 3: Self-Assessment Form

Self-Assessment Form for Outreach Workers Counseling Families to Promote
Hygiene Improvement
Name of Worker: ___________________________ Name of Organization: ____________________________
Name of Community: ________________________ Year: ____________________________

Desired Practice Jan. Feb. Mar. Apr. May June July Aug. Sep. Oct. Nov. Dec.
I was friendly and polite.
I asked a lot of questions,
both for assessing and
planning.
I observed practices and
conditions to compare what I
saw with what people said.
I encouraged people to talk; I
was a good listener.
I used my visual aids and
other materials effectively.
I respected and tried to
incorporate people’s ideas.
At the end of counseling,
people clearly understand
what they will try to do.
Community members are able
to make the improvements we
discussed.
Follow-up Steps:

Instructions: The program or project should modify this form as needed (before the training). For example, the project could ask each
outreach worker to write “yes” or “no” for each practice at the end of each month. Or the outreach worker could be asked to use a
scoring system, for example, 1 = always, 2 = usually, 3 = sometimes. The purpose of the follow-up step boxes is to give space for the
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outreach worker to write a few words about what he or she will try to do to improve during the next month. The project may decide to
eliminate that section.
You, the outreach worker, should complete this form honestly. The purpose is not to evaluate, but rather to give you and your
supervisor feedback so you can improve the way in which you counsel community members on how to improve their WASH practices. If
all of your scores are perfect from the beginning, there is no room to improve!

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APPENDIX 4
Sample Questions & Evaluation
Templates
Questions and Templates for Evaluating the
Workshop
A Word about Evaluation: By Session and by Day

Trainers and program managers will want to gain a sense of how the
workshop is progressing on a daily or even on a session-by-session basis.
The feedback from the participants will help determine whether or not the
training is on the right track, if the level of the information being presented
is appropriate, and if the participants are indeed learning. Course
corrections are then possible.

If the trainer establishes a trusting atmosphere at the beginning of the

training and allows the participants to know that their feedback is welcome,
it should be easy to conduct evaluations in an open fashion by simply asking
questions. At the conclusion of each session a question such as, “Did we
meet the objectives for this session?” may suffice to establish a platform for
discussing whether or not the session was “successful” (useful, practical,
understandable, etc.).

At the end of the day, ask questions such as:

 What was the highlight of the day?

 What was the low point of the day?
 Were the logistical arrangements conducive for learning?
 How are you feeling about the amount of information? Too little? Too
much?
 How was the level of the technical information? Too hard? Too easy?
 Which training techniques did you find most exciting? Why?
 What would you do differently if you were the trainer?
 What suggestions do you have for the organizers?

It may take a while for the participants to become comfortable with this
type of discussion.

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If the participants would be more comfortable (and open) using a paper

evaluation form, keep it as simple as possible by using scales of 1 to 5 or by
having the participants make a check mark by their appraisal of the item.

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Example One

Evaluate the degree to which the logistical arrangements helped the

learning:

1 2 3 4 5
/____________/____________/___________/____________/

Did little to Contributed a lot to

encourage learning my learning

Example Two

Training techniques used in the workshop:

Very useful Somewhat useful Not useful

Demonstrations _________ ____________ ________

Group discussion _________ _____________ _________
Role plays _________ _____________ _________
Lecture _________ _____________ _________
Reading aloud _________ _____________ _________

The Final Evaluation

At the conclusion of the training, a final evaluation will give feedback on the
entire workshop to the trainer and the program manager. As with the daily
evaluations, the evaluation form should be as simple and straightforward as
possible and require as little writing as possible from the participants.
Again, a stand-alone oral evaluation can be conducted, but participants are
often reluctant to express any kind of “criticism” in public. Often, combining
an oral discussion with a written evaluation allows interesting and helpful
information to be obtained.

Sample Final Evaluation Template

1. Rate whether or not you think the workshop objectives were met.

(List workshop objectives with a 1 to 5 scale.)

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Describe the role of an outreach worker in the context of our

program.

1 2 3 4 5
/_____________/___________/____________/____________/
Not met Somewhat met Totally met

2. Rate how helpful the following training techniques were to you.

List the training techniques used during the workshop such as

lectures, demonstrations, etc. with a 1 to 5 scale.

1 2 3 4 5
/_____________/__________/____________/_____________/
Not helpful Somewhat helpful Very helpful

3. Rate the usefulness of the technical (WASH) information for your role
as a WASH outreach worker.

Same kind of scale.

4. Rate the logistical and administrative arrangements as to how

supportive they were for a learning environment.

Same kind of scale.

5. Rate the materials (handouts, drawings, etc.) as to how useful they

will be for your work in the community.

Same kind of scale.

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APPENDIX 5
Websites/Links
Hygiene Improvement Project
http://www.hip.watsan.net

IRC International Water and Sanitation Centre

http://www.irc.nl

Global Public-Private Partnership for Hand Washing with Soap

http://www.globalhand washing.org

Solar Water Disinfection

http://www.sodis.ch

WELL Resource Center

http://www.lboro.ac.uk/well/index.htm

Water Supply and Sanitation Collaborative Council

http://www.wsscc.org/interwater/

WHO/UNICEF Joint Monitoring Programme for Water and Sanitation

http://www.wssinfo.org/en/welcome.html

World Health Organization – Water Sanitation and Health

http://www.who.int/water_sanitation_health/hygiene/envsan/en

UNICEF Water, Sanitation and Hygiene

http://www.unicef.org/wes/index.html

Water, Engineering and Development Centre (WEDC)

http://wedc.lboro.ac.uk/

Useful Site for Finding Statistics (WHO)

http://www.who.int/quantifying_ehimpacts/national/en/

Global Handwashing Day

www.globalhand washingday.org

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WASH Visual Aids Library: All you need to run WASH activities: picture
sets, photos, posters, leaflets, games, songs, radio slots, videos. Comes with
instructions in English, French, and Spanish. Will be available at
www.humanitarianreform.org (click on “Water Sanitation Hygiene”)
Produced by the WASH Cluster Hygiene Promotion Project 2009 (c/o
UNICEF)

Training Manual for SODIS Promotion. SANDEC Report No.13/06, 2006

© EAWAG/ SANDEC Regula Meierhofer
http://www.sodis.ch/files/TrainingManual_sm.pdf

References for more information on varying approaches to hygiene

in communities:

The PHAST Approach

http://www.who.int/water_sanitation_health/hygiene/envsan/phastep/en/
index.html

Community-Led Total Sanitation Approach

http://www.communityledtotalsanitation.org/page/clts-approach

Compendium of Hygiene and Sanitation Software

Water Supply and Sanitation Collaborative Council (wsscc.org), Draft 3.0,
February 2009.

WASH Standards in Schools in Low-Cost Settings

Edited by: John Adams, Jamie Bartram, Yves Chartier, Jackie Sims. World
Health Organization, Draft, January 6, 2009.
www.who.int/water_sanitation_health/hygiene/settings/
wash_standards_schools_per_review2.doc

Hygiene Promotion: A Practical Manual for Relief and Development

By Susan Ferron, Joy Morgan, and Mario O’ Reilly, Practical Action, 2007.
http://www.irc.nl/page/38052

Reference for WASH in Schools:

Towards Effective Programming for WASH in Schools: A Manual on

Scaling Up Programmes for Water Sanitation and Hygiene in Schools
IRC International Water and Sanitation Centre, 2007.
http://www.irc.nl/page/37479

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APPENDICES 6–8
Alternative Workshop Plans
To conduct all of the sessions in this Training Guide (covering all three
major WASH key practices—safe water, feces disposal, and hand washing)
requires a training of at least four days.
Appendices 6, 7, and 8 provide templates for a program manager who
wishes to sponsor a half-day session, a one-day session, or a three-day
session on WASH. The contents of the sessions have been selected from the
Training Guide, and some have been slightly modified to fit into the allotted
time.

It is important to understand that a half-day, one-day, or even a three-day

training does not provide the necessary time for community outreach
workers to acquire the skills and knowledge needed to proficiently promote
the range of key WASH practices, unless the outreach workers already have
a solid background in the WASH issues of the community. A three-day
training may be appropriate if the outreach workers are being trained in
one or two of the three main technical areas (safe water, safe feces
disposal, hand washing). The short versions should be used only for raising
WASH awareness or as a springboard for later programmatic action.

Organizations may need to assemble their own versions of a shorter

training. For example, an organization desiring to prepare its outreach
workers only in hand washing promotion would select only those sessions
relevant to this objective.

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APPENDIX 6:
The Half-Day Session
The half-day session is not long enough to train outreach workers; instead
its objective is to raise awareness about the importance of WASH for the
community.

The session is divided into two parts: part one orients the audience to local
WASH conditions and part two explores the contamination cycle. There are
learning objectives for each part of the session. The learning objectives
contribute to achieving the overall purpose: to raise awareness about how
important it is to address WASH issues in the community.

Before implementing these sessions, please read the introduction to this

guide. The sessions are interactive and participatory, so audience members
are best seated at tables. If this is not possible, some adaptation of the two
parts will be necessary. Each part suggests preparatory steps. This half-day
session is best suited for audiences that are literate, motivated, and have an
interest in the community’s welfare.

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Part One
An Introduction to Water,
Sanitation, and Hygiene (WASH)
at the Local Level
Session Objectives
By the end of part one, the audience members should be able to:

1. Describe briefly the importance of WASH for combating diarrheal

disease.

2. Relate some local statistics (or other relevant facts) on diarrheal

disease in the community.

3. Describe what the local WASH issues mean for the overall health
situation in the community.

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PART ONE AT A GLANCE:

Introduction to WASH
Activity Time Materials & Resource
A. Introduction: WASH 10 minutes - Flipchart, markers, tape
Snapshot
- Talking points prepared
Audience gets a quick overview ahead of time on
of the session and some flipchart about the
highlights from the talking points importance of diarrheal
so they understand the disease
importance of WASH.

B. Large Group Discussion 30 minutes - Flipchart, markers, tape

Audience discusses local - Guide questions on

conditions using the guide flipchart
questions.

C. Table Work 30 minutes - Table task on flipchart

paper
Groups at tables brainstorm
about the implications of what - Flipchart paper and
they’ve learned about local markers for the tables
WASH issues for overall local
health conditions.

D. Summary 10 minutes - Flipchart, markers, tape

Facilitator or audience members

summarize what they’ve learned
during part one of the session.

 80 minutes

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PREPARING TO TEACH
Part One: Introduction to WASH
Before you present this part of the half-day session:

1. Familiarize yourself with some national and especially local statistics

(if available). Some excellent sources: the Demographic and Health
Survey, the Outreach Worker’s Handbook of the WASH training
package, WHO websites, documents produced by the country’s
Ministry of Health, reports done by other organizations on WASH, and
your own organization’s files. Also see “Some Talking Points” below
for suggestions and examples of meaningful statistics to share with
the participants. For those desiring even more details, check the
various websites listed in the appendices of the training package.
Remember that the emphasis should be on local statistics.

2. From the menu of questions in the detailed trainer notes, select the
most relevant questions for your community and put them on flipchart
paper, one question per page. The discussion stimulated by the
questions and the responses should serve to paint a “picture” of the
local WASH situation and is based on the audience’s own observations
about what is happening in their community.

3. Put the table task on a flipchart: (“At your tables, given what you now
know about some of the local conditions, discuss/brainstorm with your
tablemates the implications of these conditions for the community.”) If
you would like the table groups to record their discussion points on a
flipchart, provide paper and markers. If the audience members are
seated theater style, have members talk to those around them.

4. It is important not to overwhelm the participants with too many

statistics or data points. Use statistics and data based on the
participants’ ability to deal with this kind of information. Remember
the overall purpose of this part of the session is to raise awareness.
Data and statistics can be presented in creative ways. For example, as
the facilitator, you can make a statement and have the audience
members guess at the correct response. “How many children do you
think die every year of diarrhea-related causes?” This creates
involvement right away.

5. If appropriate, use the following talking points to make some

introductory remarks about the importance of combating childhood
diarrheal disease.

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Some Talking Points for the

Introduction to WASH
Introduction to Diarrheal Disease and Children’s
Health
Diarrheal diseases take a tremendous toll on children and their families in
developing countries. “Diarrhea is one of the biggest killers of children
under five worldwide, accounting alone for 17% of deaths in this age-group”
(IYS Advocacy Kit, UN-Water 2008, Talking Points). Diarrhea kills children
when it causes them to lose so much water that their vital organs can no
longer function. This is called “dehydration,” which means losing water.

Diarrhea affects children’s nutritional status, how mothers spend their time,
how much time pupils are absent from school, and household expenses for
treatment, as well as the cost of lost work, wages, and productivity.

It is estimated that 80 percent of all cases of diarrhea can be attributed to

three major causes (WHO 2008*):

 Inadequate sanitation
 Poor hygiene
 Unclean water

There are numerous ways that the germs that cause diarrhea can enter a
person’s body:

 Fluids (through contaminated water)

 Fields (resulting from defecation outdoors)
 Flies (transmitting disease)
 Fingers (dirty hands to mouth)
 Food (infected by fluids, flies, or fingers and then ingested)

Certain hygiene practices have been proven to have the greatest potential
for preventing diarrhea. These so-called key practices are:

 Safe disposal of feces

 Correct hand washing
 Safe drinking water

Studies show that, when performed correctly and consistently, each of these
key practices can reduce diarrhea cases by 20 percent to 50 percent.
Correct hand washing in particular has also been shown to prevent many
cases of respiratory disease. Almost one-tenth of the global disease burden

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could be prevented by improving water supply, sanitation, hygiene, and
management of water resources (*Prüss-Üstün, A., Bos, R., Gore, F.,
Bartram, J. Safer water, better health: costs, benefits and sustainability of
interventions to protect and promote health. Geneva: World Health
Organization. 2008.)

TRAINING ACTIVITIES
Part One: Introduction to WASH
Raising Awareness about National and Local
Diarrheal Disease (10 minutes)
A. Welcome and Introduction to the Session (10 minutes)

1. Welcome the participants by introducing yourself. Thank them for

taking time out of their busy schedules to come hear about the
importance of water, sanitation, and hygiene issues for the
community.

2. Say that in this half-day session, they will get a brief overview of the
national and local situations with regard to diarrheal disease and
learn about the “contamination cycle.”

3. State that diarrheal disease (diarrhea) takes a terrible toll on children

and that many children die each year from diarrhea-related diseases.
By improving the way we properly dispose of our waste (feces), by
doing a better job of washing our hands, and by drinking potable
(clean and safe, uncontaminated) water, we can greatly reduce the
number of illness episodes and deaths due to diarrhea.

Trainer Note:
If appropriate for the audience, insert a few national and local
statistics here, if such data are available. See “Preparing to
Teach” above for a creative way to present statistics.
Examples of local statistics could be:


 % of children under 5 who had diarrhea in last 2 weeks
 Rank and % of diarrhea as a cause of childhood deaths

 % of households with safe sanitary solution (latrine, etc.)

 % of households with “access to water” and/or % that
treat their drinking water
 Any data relative to hand washing (% of households with

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soap)

B. Large Group Discussion: The Local WASH Situation (30 minutes

minimum)

1. Tell the participants they are going to discuss the local WASH
situation by looking at some questions.

2. Open the discussion by revealing the first question on the flipchart

and continue for as long as appropriate. Under each question, record
the highlights of the discussion, so that at the end of the time, you
have a more or less complete picture of the local WASH situation.
When each question is completed, post the flipcharts where the
audience can see them.

Diarrhea Questions:

 Is diarrhea common among children in your community?

 Are there more cases during certain times of the year?
 If so, when does the number of cases increase?
 Why do you think that the number of cases increases at certain
times of the year?
 Are you aware of children in your community who have died
from dehydration/ diarrhea? If so, tell us about it.

Water Questions:

 Where do most people get their water?

 How do they carry their water from the source?
 How do most people store their water at home?
 Do people treat the water in any way before drinking it? If so,
how?
 Are there times of the year when water is scarce?
 How many different ways do people treat their water? (bleach,
filters, boiling, sunlight, etc.)

Feces Disposal Questions:

 Where do most people go to relieve themselves?

 How do mothers dispose of their children’s feces?
 Do people relieve themselves near wells?
 How do most people manage animal feces near or in their
houses?

Hand Washing Questions:

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 How often do people wash their hands?

 When are people most likely to wash their hands?
 What do they use?
 Do most houses have soap?
 What do people do when soap is not available?
 What do people do when water is scarce?

C. Table Work (30 minutes)

1. In your own words, talk again about the importance of combating

diarrheal disease (diarrhea) both nationally and locally. Use the
information from the above discussion to illustrate your points.

2. Assign the task to the tables. Have them begin to think about some of
the conditions, issues, and problems that exist locally with regard to
access to potable water, correct hand washing, and proper disposal of
human waste. Have them record some of the implications on a
flipchart.

 Trainer Note:
If participants are seated “theater style,” have audience
members work in groups of three or four with those seated
around them.

D. Summary (10 minutes) .

1. Summarize or ask for volunteers to summarize some of the key points,

especially with regard to local WASH conditions. Include some of the
points below, if not mentioned.

Summary points:

 Globally, diarrhea causes over a million and a half deaths in

children per year.
 Nationally, diarrhea causes _____ (fill in number) deaths per
year.
 Locally, diarrhea causes _____ (fill in number) illnesses per year.
 Based on the discussion, some important WASH issues for our
community are….

2. Offer a quick stand up break. Transition to the next session by saying

that following a short break, they will have the chance to look at the
contamination cycle.

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Part Two
The Importance of Drinking Safe
Water: The Contamination Cycle

Session Objectives
By the end of this session, the audience members will be able to:

1. Describe the contamination cycle.

2. Describe the connection between contamination and diarrhea.

3. Classify practices related to diarrhea as positive, negative, or neutral.

4. Optional: review some common local practices contributing to water

contamination.

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PART TWO AT A GLANCE:

Contamination Cycle
Activity Time Materials
A. Introduction to the Session 5 minutes - Flipcharts, markers,
tape
Facilitator makes the link - If appropriate,
between part one and this part of objectives on flipchart
the session. Reviews what the
audience members should learn.

B. Climate Setters 10 minutes - 2 plastic bottles with

+ 10 clean water and a large
Audience members engage in minutes measure of salt
two exercises that help them to - 1 plastic bottle or glass
see that even “clear” water with water; one long
might be contaminated. hair (or other long thin
object like a blade of
grass or piece of
thread)
- Feces sample

C. Large Group Activity 30 minutes - Unlabeled poster of

the contamination cycle
Audience classifies practices as - 3 flipchart pages
positive, negative, or uncertain. marked with positive,
Discussion along the way. negative, uncertain
faces; illustrations
- Illustrations from
Collection of Resource
Materials

D. Show and Tell 20 minutes - Labeled poster of the

contamination cycle
Facilitator uses the routes of - If local data are
contamination poster with labels available, put on poster
to explain how germs travel and
consequences. Discussion of
local situation with reference to
part one.

E. Summary 10 minutes - Handouts with

supplemental

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Facilitator summarizes and information
points out supplementary
information.

 85 minutes
PREPARING TO TEACH HALF-DAY
SESSION PART TWO:
Contamination Cycle
Before you present this part of the half-day session:

1. Gather all materials (four clean plastic bottles filled with potable
water, salt, one bottle or glass with water in it, and one long very thin
object such as a human hair, piece of thread, or blade of grass. In two
of the four bottles, dissolve lots of salt so that the water is still clear
but very salty to the taste).

2. Have three posters (on flipchart paper) ready with the following titles:
Diarrhea, No Diarrhea, and Uncertain. On the “diarrhea poster” draw
a sad face, for the “no diarrhea” poster draw a happy face, and for the
“uncertain poster” use a face with a horizontal line for the mouth.
Tape these up in the room so that they aren’t visible to the
participants.

3. Prepare the illustrations to show to the participants. They can be

found in the Collection of Resource Materials.

4. Prepare two posters for the routes of contamination: one with labels
and one without.

6. Prepare a flipchart page with key points to summarize at the

conclusion of the session.

7. Using the Outreach Worker’s Handbook, photocopy additional

information on the contamination cycle for distribution to the
participants, should anyone desire to have more detailed information
about the contamination cycle.

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DETAILED TRAINER NOTES:

Contamination Cycle
A. Introduction to Part Two (5 minutes)

1. Welcome the audience members back from the break.

2. Continue by saying that in part one, they looked at some of the local
WASH conditions and what they implied for the community. Say that
in this part of the session, they are going to take a closer look at the
contamination cycle: how germs travel and the relationship between
contaminated water and diarrhea.

3. Say that by the end of this session, they should be able to describe the
contamination cycle and the connection between the contamination of
water and diarrhea. Remind audience members that the purpose is
not for them to become “scientists” or technical experts, but to raise
their awareness of WASH conditions in the community so that they
might eventually move to act to address those conditions so their
children are healthier. Suggest they might want to start with their
own families.

B. Climate Setter (10 minutes)

Salty Water—Clear but Unpleasant

1. Show the audience the two bottles of water, one with dissolved salt in
it. Ask them to look closely and see if they can tell any difference
between the two. Take a couple of responses.

2. Ask for two volunteers to come forward. Show the two bottles again
one at a time (salty and not) to the audience members and ask them to
raise their hands if they think the water in both bottles is “safe” to
drink. Ask why.

3. Now ask the volunteers to drink. Have the audience members watch
their faces.

4. Reinforce the point that although water may appear clean, clear, and
safe, it can contain things that you can’t see that can make people ill.

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Trainer Note:

 You might want to introduce the local term “small bugs” or its
equivalent if the word “germ” is not understood. In some
areas, the words “dirt” or “dirtiness” work.

Clear but Contaminated

1. Tell the audience members that they are going to continue to look at
water and possible ways it can become contaminated but might not
look harmful.

2. Ask one participant to give you a hair (or use some other long and thin
object, like a blade of grass or piece of thread). Place the sample of
the feces where everyone can see it. Hold one end of the hair in each
hand and run it through the feces. Dip the hair into the glass of water
and then remove the hair.

3. Ask for a volunteer to drink the water—only to see their reaction. DO

NOT ALLOW ANYONE TO CONSUME THIS WATER.

4. Conduct a discussion of the group’s reaction and stress that although

the water looks clear, it is, in fact, contaminated.

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C. Large Group Activity Classifying Practices/Actions (30 minutes)

1. Show the “contamination cycle” (Collection of Resource Materials or

Outreach Worker’s Handbook p. 41) poster to the group without the
labels. Ask the audience what they think the poster is trying to tell
them. Take a couple of answers, but do not belabor this exercise.

2. Tell the audience members that you are going to show them pictures.
Say that some of the pictures depict positive actions against diarrhea;
some are negative, which could put people at risk of getting diarrhea;
and some actions they might be uncertain about. Tell them that as you
show the pictures, they should go stand under the poster that they
think best indicates how they feel about the picture.

Trainer Note:
Once everyone is under a poster, ask one person from the group
to explain why s/he chose that poster. It is important to realize
that although a picture may be considered “positive,”
“negative,” or “uncertain,” there can be scenarios in which a
practice might fit into another category. For example the picture

 of the kettle with boiling water is usually categorized as

“positive” because boiling water kills germs. However, boiled
water can easily become contaminated again (so a participant
could choose to stand under the “uncertain”/ “straight mouth
face” sign). It is not necessary for all participants to agree. What
is important is that everyone understands which practices in
each picture can protect a person against diarrhea or increase
the risk of getting diarrhea.

3. Repeat with as many of the pictures as time allows. Move quickly

while encouraging discussion.

D. Demonstration with the Labeled Poster (20 minutes)

1. Show the labeled poster to the participants so that everyone can

see it and review the key ideas:

 The cycle starts with people defecating in the open.

 The feces spread out on the ground and contaminate food crops,
people, and animals.
 Feces on the ground attract flies, and flies contaminated with
feces land on food that people eat.
 Feces on the ground may be spread by rain or other water.
 People who do not wash their hands after using the toilet spread
germs.

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 Feces in the soil contaminate our water supply and then we
drink contaminated water.
2. Then lead a discussion about local sources of water. If local data
were available in part one, display those charts.

 Where do most families get their water?

 Could there be contamination even if the water appears “clear
and clean?”
 What might be some of the community sources of
contamination?
 What are their observations about the number of children with
diarrhea?

3. Ask the group if they think children’s feces or adult feces have more
germs or contamination that cause diarrhea. After responses, explain
that children’s feces have more and are therefore more dangerous.

E. Summarizing and Reading More about Diarrhea (10 minutes)

1. Ask an audience member(s) to summarize what s/he has learned

during this part of the session. Supplement his/her points with those
below.

Summary Points:

 The cycle starts with people defecating in the open.

 The feces spread out on the ground and contaminate food crops,
people, and animals.
 Feces on the ground attract flies, and flies contaminated with
feces land on food, which people eat.
 Feces on the ground may be spread by rain or other water.
 People who do not wash their hands after using the toilet spread
germs.
 Feces in the soil contaminate our water supply and then we
drink contaminated water.

2. Thank the audience members for attending. Ask if there are any final
questions.

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Trainer Note:
If this session and its two parts are given as part of the one-

 day session described in Appendix 6, make the linkage to the

afternoon by stating that after lunch, the audience members
will have the chance to explore the four effective ways of
making water safe to drink and get a demonstration of correct
hand washing.

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APPENDIX 7:
A Sample One-Day Session
This appendix outlines a one-day session for:

1. Raising awareness about the importance of WASH for the community.

2. Exploring the contamination cycle.

3. Exploring the four methods for making water safe to drink.

4. Demonstrating good hand washing techniques.

Trainer Note:
The session adds “safe drinking water” (part three) and “hand
washing” (part four) to the half-day session outlined in
Appendix 6, parts one and two. When conducting this one-day
session, do parts one and two from the half session in the
morning and parts three and four in the afternoon.

 The purpose of this one-day session is to create awareness as

well as impart some basic WASH knowledge. As with the
session described in Appendix 6, part one, the audience
members should be literate. Seating at tables is preferred to
encourage discussion and participation.
This session includes an overview of the four treatment
methods to make water safe to drink. If one or more of these
methods is not appropriate for your setting, please omit it.

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APPENDIX 7: One-Day Session

Part Three
Four Methods for Making Water
Safe to Drink

Session Objectives
By the end of part three, the audience members should be able to:

1. Describe in general the four methods for making water safe to drink.

2. Relate some of the advantages and disadvantages of each method.

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SESSION THREE AT A GLANCE:

Water Treatment Methods
Activity Time Materials & Resource
A. Introduction 10 minutes
- Flipchart, markers,
Audience gets a quick review of tape
parts one and two from the - Summary flipcharts
morning and the objectives for from the morning
the afternoon.

B. Climate Setter 10 minutes - Flipchart, markers,

tape
The audience members
brainstorm about the ways in
which they think water can be
made safe to drink.

C. Large Group Discussion 30 minutes - Appropriate visual

and Lecture aids for each method

Facilitator reviews the results of

the climate setter, and the
audience members get a quick
overview of the four methods.

D. Table Task 30 minutes - One-page descriptions

of each method
Tables are assigned a method - Flipchart paper for
and are asked to discuss the recording table work
advantages and disadvantages of
each method.

5. Table Reports and 40 minutes

Discussion (10 per
table)
Each table reports on its
findings. Discussion about
methods for the community.

6. Summary 5 minutes - Flipcharts and visual

aids

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 125 minutes

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PREPARING TO TEACH
Part Three: Water Treatment
Before you present this part of the one-day session:

1. Hang the flipcharts from the morning’s work so the audience

members can see them clearly.

2. Use visual aids from the Collection of Resource Materials to illustrate

the lecture points during the large group discussion. These visual aids
might be table size or large posters. They should illustrate the steps
for each of the water treatment methods.

3. If time permits, gather some of the materials used for the various
treatment methods: large plastic bottles for SODIS, approved bleach
packets, or commercially available filters.

DETAILED TRAINER NOTES

Part Three: Water Treatment
A. Welcome and Introduction to the Session (10 minutes)

1. Welcome the participants back to the session.

2. Review the morning’s work by saying they learned something about

the local WASH conditions and what they mean for the health of their
children, and explored the contamination cycle. Spend some time
reviewing and validating their earlier work.

3. Say that this afternoon they are going to look at the four ways to
make water safe for drinking and also how to properly wash their
hands. They should be thinking about how to apply what they have
learned to their families and eventually what they might do in the
community.

B. Climate Setter (10 minutes)

1. Brainstorm with the audience members about ways to make water

safe to drink. Make no evaluative comments. Record their answers as
they call them out. Encourage them to keep going if the brainstorming
appears to lag.

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C. Large Group Discussion and Lecture (30 minutes)

1. Using the information from the brainstorming session during the

climate setter, review the four methods of treating water to make it
safe to drink. Be sure to use any visual aids (objects or posters) to
make the lecture as interactive as possible. Make sure any questions
are answered.

D. Table Task (30 minutes)

1. Divide up the treatment methods among the audience members. Ask

each group to think about as many advantages and disadvantages of
their method as they can, and write them on flipchart paper that has
been divided into two columns. For example, an advantage of SODIS
is that it’s relatively inexpensive. A disadvantage is that it’s
impractical in rainy climates (see the Considerations for Deciding
Appropriate Water Treatment Methods, p. 9, in the Outreach Worker’s
Handbook).

E. Table Reports and Discussion (10 minutes per table x four tables)

1. Have each group report. Discuss the advantages and disadvantages in

the large group. Make sure you address all their concerns. Discuss
which methods, based on what they’ve been reviewing, might be
practical for their community.

F. Summary (5 minutes)

1. Have one of the participants do a quick summary of the work, if time

permits.

2. Transition to the next session by saying that following a short break,

they will have the chance to look at good hand washing practices.

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Appendix 7: One-Day Session

Part Four
Good Hand Washing Practices

Session Objective
By the end of this session, part four, the audience members will be able to:

1. Describe optimal hand washing practices (when and how to properly

wash their hands).

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SESSION FOUR AT A GLANCE:

Hand Washing
Activity Time Materials
A. Introduction 5 minutes - Flipcharts, markers,
tape
Facilitator makes the link - If appropriate,
between part three and this part objective on flipchart
of the session.

B. Climate Setters 10 minutes - Basin of water, soap,

towel
Audience members talk about - Flipchart, markers,
how they presently wash their tape
hands. Play the estimating game.

C. Large Group Activities 15 minutes - - Picture of dirty hands

and picture of clean
Facilitator gets the audience hands
members to think about clean - Two volunteers
and dirty hands.

D. Large Group Discussion 15 minutes - Flipchart, markers,

tape
Facilitator and audience - Poster of critical
members discuss the critical moments for washing
times for washing hands. hands

E. Demonstration 10 minutes - Tub of mud

- Basin of water, soap,
A volunteer shows correct hand and towel
washing procedures. - Extra water, soap, and
towel for
demonstration
F. Summary 15 minutes - Flipchart, markers,
tape
Facilitator and audience discuss
possibilities for demonstrations
in the community and summarize
part four.

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 70 minutes

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PREPARING TO TEACH
Part Four: Hand Washing
Before you present this part of the session:

1. Gather all the required items: soap, basin, water, towels. Have a tub
of mud covered so the audience members can’t see what’s inside.

2. Have copies of the hand washing poster available, either small copies
for each table or a large poster for the front of the room.

3. Two drawings: 1) a person with demonstrably dirty hands; 2) a person

with “clean” hands.

4. Research some of the ways that people in the community clean their
hands (wipe them off, in the stream, using tap water, etc.).

DETAILED TRAINER NOTES

Part Four: Hand Washing
A. Introduction to Part Four (5 minutes)

1. Welcome the audience members back from the break.

2. Make the link between part three (methods for treating water) to this
part of the session (washing hands). Say that once water is treated
and clean, there is another way to reduce the incidence of diarrheal
disease: properly washing hands. State that in this part, they will
learn when and how to effectively wash their hands.

B. Climate Setter (10 minutes)

1. Go around the room and ask the participants how they presently clean
their hands: at home, in the fields, during a trip, etc. Acknowledge
that it’s often hard to wash hands depending on where we find
ourselves and how much we are in a hurry.

C. Large Group Activities (15 minutes)

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1. Tell the audience members that you are going to walk around the
room with two pictures. You are going to ask them a question, and
they are to point to the picture that best represents their answer.

2. Take the two pictures and stand in front of one of the audience
members. Ask participants which person they would like to fix their
meals.

Trainer Note:


Some other questions:
 Which person would you like to weed your garden?
 Which person would you like to take care of you when
you’re sick?
 Which person would you like to change your baby’s
diaper?
 Which person would you like to change your bicycle tire?

3. Say that for many activities, we like people with clean hands. For
some activities it doesn’t matter. During this part of the session, we’re
going to learn about when and how to properly wash our hands.

4. Then ask for two volunteers to come to the front of the room. Whisper
to one volunteer that she is going to pretend to meet the other
volunteer and shake his hand. Before she offers her hand she’s going
to cough into it.

5. Have them play out the “introduction.”

6. Ask the group how they think the person feels about being offered a
“dirty” hand. If necessary, introduce the concept of “germs.” Stress
that hands can look clean and still be “dirty.” Recall the part of the
session where the water looked clean but was contaminated. With
hands, they may look/appear clean, but may not be. It’s always better
to be safe.

D. Large Group Discussion (15 minutes)

1. The facilitator then leads a discussion with audience members about

the times when they think it’s critical to have clean hands. Once the
discussion is over, show the poster with the times for washing hands
BEFORE an activity (such as preparing food) and when it’s critical to
wash AFTER an activity (e.g. changing the baby’s diaper).

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2. Ask the audience members if they can think of other times, either
before or after. Remind them that some people wash their hands
before they pray.

E. Demonstration (10 minutes)

1. Ask for another volunteer to come forward. Uncover the basin of mud
and ask the person to put his/her hands into the mud.

2. Ask the person how that feels and smells.

3. Get a reaction from the audience members about the “dirty hands” by
asking a question like, “How does it feel when our hands are like
this?”

4. Ask the audience members to stand where they can see the volunteer.
Ask one audience member to time the hand washer (do this as an
aside). Ask the person with the dirty hands to wash them in the basin.
Ask the other audience members to make a mental note of how the
volunteer washes his/her hands.

5. When the volunteer is done, have an audience member describe the

actions of the volunteer as s/he washed hands. Ask the timer how long
the person took to wash his/her hands.

6. Ask the audience members if they would do anything differently.

7. If necessary, do a demonstration of how to properly wash hands

including air drying or with a clean towel. (In many situations it is
nearly impossible to rely on finding a clean towel. If this is the case in
your situation, please use air drying as the only option).

F. Summary (15 minutes)

1. Summarize or ask one of the audience members to summarize the

major content from part four. Ask the audience members what they
might do when they leave. Might they change the way their family
members wash their hands? Are there possibilities for conducting
hand washing demonstrations in school? In individual homes? At a
meeting?

2. Thank the participants for their attention during the day. Ask if there
are any final questions. Wish them good luck and tell them you are
available for future activities, should they have an interest.

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APPENDIX 8:
A Sample Three-Day Workshop for
Outreach Workers
Trainer Note:
This part of Appendix 8 outlines the sessions that might
constitute a three-day workshop for community outreach
workers. It is offered for the program manager who is thinking
about incorporating community outreach workers (regardless of
their sector) into WASH activities and is based completely on the
information contained in the Guide for Training Outreach


Workers, the Outreach Worker’s Handbook, and the Collection of
Resource Materials. Given the local situation, the program
manager will need to make some choices about which water
treatment sessions to put into the workshop. Furthermore,
this agenda has deliberately omitted some of the
sessions in the full training package to save time. The
program manager should adapt this agenda as necessary,
adding or substituting other sessions to meet the needs of the
particular program.
All modules and sessions mentioned below are those modules
and sessions from the full Training Guide.

Day One Morning

 Module 1, Session1: Orientation to the Training (90 minutes)
 Module 1, Session 2: An Introduction to WASH (50 minutes)
 Module 1, Session 3: The Role of the Outreach Worker (45 minutes)
 Module 1, Session 4: Key Practices for Preventing Diarrhea(55
minutes)

Total: Approximately 4 hours, not counting break

Day One Afternoon

 Module 1, Session 5: The Contamination Cycle (95 minutes)
 Module 2, Sessions 2–5 as appropriate (no more than 180 minutes;
the program manager should only include training on water treatment
methods that are locally appropriate and pick out only those sessions)
 Module 2, Session 6: Transporting, Storing, and Retrieving water (50
minutes)

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Total: no more than 5 hours and 30 minutes (but will be significantly less
if a program only focuses on certain water treatment methods and omits
the sessions on the others), not counting break

Day Two Morning

 Module 2, Session 7: Helping Families Choose (100 minutes)
 Module 2, Session 8: Water Synthesis (65 minutes)
 Module 3, Session 1: How to Wash Our Hands (35 minutes)
 Module 3, Session 2: When To Wash Our Hands (85 minutes)

Total: approximately 5 hours, not counting break

Day Two Afternoon

 Module 3, Session 3: How Much Water Does It Take? (60 Minutes)
 Module 3, Session 5: Hand Washing Synthesis (65 Minutes)
 Module 4, Session 2: Proper Feces Disposal (100 minutes)

Total: approximately 4 hours, not counting break

Day Three Morning

 Module 5, Session 1: Interpersonal Communication (70 minutes)
 Module 5, Session 2: Using Discussion Tools (110 minutes)
 Module 5, Session 3: Opportunities/Techniques for Hygiene Promotion
(95 minutes)

Total: approximately 5 hours, not counting break

Day Three Afternoon

 Module 6, Session 1: Action Planning (70 minutes)

Total: less than 2 hours

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