Ecuador: Better Health through Messaging

Some communities in Ecuador face high incidences of water-borne illness because of contaminated water or poor hygiene and sanitation. It’s a multipronged problem calling for an interdisciplinary approach combining natural, medical and social sciences. Bret Shaw, a CALS professor of life sciences communication, last year helped implement a social science approach with funding from the UW–Madison Global Health Institute.

“I used a social marketing perspective, which utilizes psychological and communication tools, to try to help villagers make lasting behavior changes in how they interact with water and sanitation,” explains Shaw.

Shaw worked with two undergraduates, Lauren Feierstein and Brenna O’Halloran, to create health behavioral prompts—small signs in Spanish left in important areas where a reminder to wash hands is vital, such as in bathrooms, near sinks and on bottles of water. Since many people in the community have limited literacy, it was important for the prompts to use images and very few words.

While the concept can seem intuitive, years of research show that the most effective prompts focus on self-efficacy—showing individuals how easy a behavior is—and making sure that the people in the graphic are relatable to the target population. The images and words Shaw’s team used were as specific as possible, showing an individual washing his or her hands with just a simple phrase underneath.

“Understanding the perspectives on why someone wouldn’t do something such as boil their water or wash their hands was very important,” says Feierstein, who also worked with residents on making and distributing organic soap. “Knowing those barriers was crucial to addressing the issue from all angles.”

The project was an extension of a course called “Water for Life Sustainability and Health,” a partnership between the Madison-based Ceiba Foundation for Tropical Conservation and the Global Health Institute. The course is led by Catherine Woodward, a faculty associate with UW–Madison’s Institute for Biology Education and president of the Ceiba Foundation. Shaw was brought in to offer guidance about how social marketing strategies can encourage healthy behavior.

“I’m a biologist and most of the people we work with are biologists, so having a communications person on board was a critical part of getting the message out,” says Woodward. “And not just about the message and having people understand why it’s a good idea to conserve natural resources—but also to actually get them to change their behavior.”

Helping women help themselves

A little assistance can go a long way. That’s the lesson learned from multiple trips by CALS dairy experts to the state of Uttar Pradesh in northern India, one of the poorest parts of the world.

Many farmers there keep only a few cows or very small herds that, for the most part, produce enough milk for a family’s own use. Caring for livestock is work that falls almost exclusively to women.

By teaching the women better dairy practices—such as proper hygiene in milking and milk storage, providing adequate water, shelter and vaccinations for livestock, the basics of improvements in breeding—CALS experts and their partners in India are helping women dramatically increase their cows’ milk yields. Not only does that improve their families’ nutrition, it allows women to sell excess milk, adding to the family income.

Dairy science instructor Jerry Guenther has been to India three times over the past three years. “Most of the women are unable to read and write. But they are very attentive and very hungry for information,” says Guenther, who interacts with the women through an interpreter. “With every point you talk about, they are making notes and thinking about it. And they come up with very interesting questions.”

Since CALS teams began going over in 2009—besides Guenther, instructors have included Bob Kaiser and Ken Bolton—they have trained some 1,400 women.

But the team’s reach goes much wider. The women come from all over Uttar Pradesh—and when they return to their villages, they teach other women what they’ve learned. USAID, the program’s main funder, a few years ago reported that by adopting the new dairy practices, 32,000 women dairy farmers had seen a 25 percent increase in milk production, earning on average $11 more every month. The CALS team reports that since then the number of farmers helped has surpassed 50,000.

The initiative began as part of the Khorana Program run by agricultural economics professor Ken Shapiro and biochemistry professor Aseem Ansari, who was born and raised in India. It is conducted in partnership with the Babcock Institute for International Dairy Research and Development and the India-based Rajiv Gandhi Charitable Trust.

The dairy know-how provided by CALS fits into a bigger program of establishing women’s self-help groups throughout Uttar Pradesh. Guenther attended training sessions where women were taught how to pool their money to make loans to support each other’s growing dairy businesses or even cover each other’s emergency family health care needs.

Such a comprehensive approach is needed, says Ansari. “Women in this part of India are traditionally forbidden from making even the simplest decisions. While dairy work is assigned to women, for them to be truly empowered they need to be educated in the basics of how to interface with the world that lies beyond their front door—let alone the marketplace, banks and other financial institutions,” he says.

Women are seizing the opportunity to take part in that bigger world, Ansari says.

“Most of the rural, semi-literate women I met turned out to be incredibly bright and entrepreneurial,” says Ansari. “Once they figured out the system, they nimbly melded dairy management with the traditional constraints and then slowly pushed the constraints to gain new freedoms and develop long-term plans for their children and families.”