W27 Recording changes in understanding

SanitationHygieneWater and sanitation

After a time of sharing the messages learned from this Guide with people in the community, it is good to assess their impact. We need to know whether sharing new information has resulted in people changing their practices. We need to know if people are washing their hands after touching faeces and before handling food. We need to know if they are using latrines.

Practical change about where people get water, and how many latrines, tippy taps and dish racks there are, is fairly easy to record. However, personal information about people’s beliefs, practices and understanding is much harder to find out.

This diagram, which we looked at in W3, describes all the different ways in which microbes from faeces get into our mouths and cause illness. Explain the diagram and help people discuss each of the seven possible routes of infection. For example, flies can land on faeces left in a field and then land on a plate of food that someone eats. Find out if people have learned about ways to break these routes of infection. Mark these on a copy of the diagram. These discussions will show how people’s understanding has changed.


  • What sort of information do we need to gather to measure any change or improvement?
  • Who is best able to gather this information?
  • What change or indicators of change are we wanting to see in people? How can we measure these?
  • How could records from the health clinic provide useful information to measure improvements in health?
  • How will this information be stored for the future? How can the findings be shared and used most effectively?
  • Who needs to have this information?
  • How can the findings be shared for the good of the community?