Harnessing young people's skills to improve hygiene in Cambodian healthcare

5 min read
Medical students from Battambang Regional Technical School for Medical Care pose for a picture at their exchange visit to a health centre.
Image: WaterAid/You Sokmeng

In Cambodia, the creativity and energy of young people has been key in our campaigns to improve hygiene behaviours among healthcare professionals. In the first of our blog series about Healthy Start – our global campaign to improve newborn and child health and nutrition – Campaign Officer Hoky He and former Youth Engagement Campaign Intern Dara Chea from WaterAid Cambodia describe three years of youth-led campaigning.

Health professionals are at the frontline of delivering essential care to people when they are at their most vulnerable. But lack of the basics of clean water, decent sanitation and hygiene (WASH) facilities in Cambodian healthcare facilities is a huge challenge to workers’ abilities to perform their roles and provide the quality of care patients have the right to expect. When healthcare workers are unable to keep their hands, equipment and hospitals clean, the lives of mothers and babies are put at serious risk from deadly infections.

Healthy Start is our global campaign to improve the health of newborn babies and children through clean water, decent sanitation and good hygiene. Such a huge goal requires a lot of people full of energy, passion, determination and interest in joining our global movement.

Helping young people to be part of the hygiene in healthcare solution

Crucial to making sure healthcare centres are hygienic is embedding understanding of good hand hygiene among everyone working in them. Although this is a routine part of healthcare training, we had seen that, in practice, hygiene habits often slip. Changing behaviours and habits can be difficult.

Where better to look for energy and enthusiasm to tackle this challenge than the next generation? We decided to work with youth groups to create a movement that would drive behaviour change and improve hand hygiene practices among healthcare workers in Cambodia.

When we began developing our Healthy Start campaign, we reflected on our notion of ‘inspire the next generation of WASH leaders and professionals,’ and the words of Nelson Mandela:

Sometimes it falls upon a generation to be great. You can be that great generation. Let your greatness blossom.

2017: giving birth to a grassroots campaign for better hygiene and child health

We launched the first campaign in February 2017, selecting three youth groups who would work on specific areas of interest and devise creative campaigns to tackle them. We chose three youth groups – AYLA (ASEAN-Youths Leader Association), Beautiful Birth and Balloon – to join. As we had hoped, the groups created small grassroot movements that encouraged healthcare professionals and medical students to improve healthcare facilities for mothers and newborns.

They reached this striking achievement by using new campaign approaches, working together to get the messages out to thousands of people. Their methods gave a fascinating insight into the improvement of WASH in healthcare facilities in Cambodia.

The groups’ creative campaign ideas included a documentary filmed at a healthcare centre, a shadow show performance and an exchange visit to a health centre for nurses and midwives, followed by several campaign events in Phnom Penh city and Battambong province. In three months, the groups reached approximately 300 trainee doctors, nurses and midwives at four medical universities in Phnom Penh and Battambang, and 2,000 viewers online.

2018: growing the campaign to reach more healthcare workers

Building on successes and experiences from the previous year’s campaign, we decided that Cambodia’s 2018 Healthy Start campaign would target medical students as key hygiene messengers in National Hand Hygiene Day. With the theme ‘It’s in your hands – prevent sepsis in healthcare,’ we would promote hand hygiene practices among healthcare professionals and medical students.

We engaged three new inspiring youth groups from targeted medical schools in Phnom Penh and in Kampot province in the campaign. One fantastic initiative among this cohort was to create a multimedia campaign including original songs, short silent films and hand hygiene live performances, which were launched during National Hand Hygiene Day, 5 May, at the Ministry of Health, reaching more than 200 health professionals and medical students from Phnom Penh and other provinces.

Additionally, they reached around 1,000 trainee health professionals in Phnom Penh, Kampong Cham and Kampot through awareness-raising workshops and campaign products.

UHS Sabay group performing the hand hygiene song on National Hand Hygiene Day at the Ministry of Health
UHS Sabay group performing the hand hygiene song on National Hand Hygiene Day at the Ministry of Health
Image: WaterAid/Hoky He

Can we see signs of long-term hygiene behaviour changes?

In Cambodia, our work with young people and communities is the story we most often tell. Healthy Start could not be such a fruitful campaign without youth engagement in helping healthcare providers to reinforce the importance of improving the health and nutrition of newborn babies and children, by integrating health plans with investment in clean water, decent sanitation and good hygiene.

The most inspiring and important driver of our Healthy Start campaigns' success was the involvement of so many young people, from many different walks of life, right across the country. It was these young people who gave up so much of their time to be active in their communities, make phone calls, create buzz on social media platforms, knock on doors and have conversations about why WASH matters so much in giving everyone the healthy start to life that they deserve.

The young people’s energy and creativity have been crucial to our campaign. One group summed up their passion to drive change:

To create an environment for medical students to gain knowledge and understanding about the important link between clean, hygienic water and baby delivery. To gather the ideas and voices from social media to advocate with the government for support to enhance access to clean and hygienic water.

Watch our film about the first two years of the campaign:

The way forward for working with young people on hygiene campaigns

The University of Health Science in Phnom Penh is leading the third and final cohort of youth groups for the Healthy Start campaign, again focused on hand hygiene. With 2020 the World Health Organization’s Year of the Nurse and Midwife, the campaign will specifically target nursing and midwifery students from the University’s Technical School for Medical Care. The official launch of the campaign was on 26 February. We will report back on their progress!

Hoky He is Campaign Officer and Dara Chea was Youth Engagement Campaign Intern at WaterAid Cambodia.