Childhood bedtime folktales narrated by grannies, story-lines inherent to street-based puppets and magic shows invariably remain etched in children’s memory and, thus, trigger certain behaviours in the ensuing years. Engagement with multiple extra co-curricular activities (ECAs), and art and craft experiences in school, at home or out of school settings not only foster creativity in young minds, but are also known to reinforce positive behaviour changes. Handwashing, as a starting point for healthy practices among children, falls in this category.

Multiple studies focus on the dramatics, plays, and expressive arts, and how they serve as a dynamic platform for children to express emotions and thoughts. Multiple art forms are also known to have positive association with academic, psycho-social, and behaviour outcomes, and provide therapeutic advantages for children and adolescents.

Different Creative Take

Unless appropriate knowledge and skills are imparted, children and adolescents lack a primary understanding of the process of germ transfer. In many countries, educational resources describe this transfer, and enable the child to understand how proper handwashing can prevent it. Such resources include pictorial books, drama scripts, animated cartoons, songs, outdoor sports, and online games, which are largely informed by an appropriate change conceptual model.

Ensuring promotion of good hand hygiene is a significant strategy to reduce the burden of several diseases. Although it is unclear what brings about a desired change in behaviour; controlled studies bring forth ample evidence demonstrating positive outcomes through the use of ECAs such as, drama/theatre, musicals, puppet shows and animated films.

Findings suggest that hand hygiene interventions need to utilise a strategic combination of behaviour change techniques (BCTs), which include an interactive component of ECA that ensures: (i) young targets understand the behaviour and consequences of hand hygiene; (ii) hardware is accessible and affordable, and; (iii) much needed community support is provided. It is proven that specifically designed resources can significantly improve handwashing practices and understanding, and, therefore, can lead to marked reduction in transmission of diseases.

Strong Linkages, Young Minds

Research establishes that some children, who grow under adverse or challenging circumstances, may not always have outlets to express or cope with emotions. Scientists opine that through the strategic use of art forms, interactive ECAs and games, communities can put forth appropriate platforms in providing coping skills. The former bear a positive impact on a child’s social and emotional development. They can potentially be put to use as a unique platform for self-expression. Therefore, there are opportunities to creatively weave in life-saving positive health messages, such as hand hygiene, in these forms.

According to a leading social scientist (Goldstein; 2017), any activity in arts is likely to have an important bearing on cognitive, social, and emotional functions. Yet another research states that specialists in respective fields, for example developmental psychologists and artists, can co-create rich and diverse partnerships with which to invest in and further investigate children’s developmental issues in the real world.

Designing theatre, drama, games and other art-related interventions in early childhood education help in imp-roving developmental outcomes. Inculcating ‘positive life skills messages’, such as handwashing, with the support of arts and ECAs, almost always demonstrate tangible behaviour-change results.

Looking Ahead

In the context of the ongoing pandemic, children - invariably always - need social and emotional support, now more than ever. The pandemic brought about various changes in everyone’s daily lives, even their livelihoods, wherein children’s risk was amongst the highest - as their regular lives were affected adversely in many ways. Not only were young kids facing digital fatigue due to lockdowns affecting regular schooling, they were being restricted from socialising with peers. Pandemic-related restrictions have now eased and children have started going back to schools. But they are only slowly catching up with regular day-to-day routine. However, their safety from the virus remains an issue with ever-popping regular, and possibly dangerous, variants. Therefore, the threat still looms large, and it includes invasion by other pathogens.? It is critical that hygiene messages are reinforced on a routine basis, and people’s access to soap and clean water is ensured.

In pursuance of the development agenda, and by keeping a strategic focus on hand hygiene among children and adolescents, key private sector organisations have started innovative work under several CSR programmes. A case in point is an initiative designed by Reckitt. Under its plan, the conceptual design of Dettol Hygiene Park is visualised as a designated space for children, ena-bling them to engage in sporting and play activities. Such a created space shall foster experiences through hygiene-themed games.

The hygiene park is conceptualised for children from different age groups. The underlying theme of the park revolves around hygiene at home; hygiene at school; hygiene during illnesses; hygiene in neighbourhood, and; personal hygiene. The DHP teams are geared to think about, and implement, games that reinforce and reiterate key hygiene and prevention messages with a healthy dose of fun and playfulness.

Research shows that sustained engagement with creative and physical activity leads to academic progress, social competencies and self-regulation skills. When such ECAs are combined with hygiene messages, they go a long way in imbibing handwashing behaviours, i.e. timely washing of hands in the correct form.

In order to design future interventions and put resources to eff-ective use, more focused research is required to identify the individual components used in hand hygiene interventions, and assess their contribution to intended behaviour change. Previous ECA interventions, wherein health-rel-ated behaviour development/change messages are woven-in, have reported positive outcomes. But, obviously, more needs to be done by the stakeholders in the near future.

Deepak Gupta Senior Consulting Advisor with UN System