Lessons Learned from the Global Scaling Up Handwashing with Soap Project

Lessons Learned from the Global Scaling Up

Handwashing with Soap Project

2013 Water and Health ConferenceChapel Hill, North Carolina

Jacqueline Devine Sr Social Marketing Specialist October 15, 2013

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Session Objectives

• Share main lessons learned from Global Handwashing with Soap (HWWS) project

• Highlight areas of consideration for future programming

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Roadmap

• Background

– Project objectives– Implementation model

• Lessons learned

• Areas of consideration for future programming

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Global Handwashing with Soap Project

• Intensive learning project funded by BMGF

• 2006-2010

• Peru, Vietnam, Senegal and Tanzania

• Targeting mainly caretakers of children < 5 years of age

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Project Objectives

1. Learn what it takes to stimulate HWWS at large scale

2. Sustain activities after project ends

3. Measure impact on health

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Main Project Components

Enabling environment

Behavior change

program

Impact evaluation

Structured learning

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Implementation Model

• Thinking at scale from design phase

• Technical assistance for development of materials, policy reform and capacity building provided by WSP

• Implementation through local governments, mass organizations, NGOs, firms or partner agencies

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Some Lessons Learned

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Men May Also Need to Part of the Behavior Change Journey

Role Model• Practices HW himself

Protector• Ensures that soap and water

are available and used at critical times (follow-up role)

Gatekeeper• Allows access to his

household to frontline workers• Provides funds for soap for

HW

Source: Monitoring system, Senegal (WSP)

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Programs Also Need to Include HWWS Stations

• HWWS stations provide:– Ease of access when, where needed– Environmental cue– Norm appeal

• Need to think beyond tippy-taps:– Mechanics of HWWS– User preferences– Size matters– Appearances

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Design iteration of Happy Tap, Watershed Asia

Design iteration of Mrembo, IFC/WSP Selling Sanitation

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Stand-Alone Interventions May Not Be Sustainable

• Consider integrating and mainstreaming through:– Nutrition programs

(e.g., cash transfers)– Ante-natal clinics– Sanitation– Corporate social responsibility

• But recognize this is further burdening health systems

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Areas for Future Consideration

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Getting the Right Behavior Change Framework

Focus

Target behavior

Target population

Opportunity

Access/availability

Product attributes

Social norms

Ability

Knowledge

Social support

Motivation

Beliefs & attitudes

Outcome expectations

Threat

Intention

Implementation Intentions(conscious)

Repetition in stable context

Behavior relegated

to cues(automatic)

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Norming the Behavior

• Use subjective norms rather than descriptive

• Make the norm noticeable/visible

• Present the norm at the time desirable behavior is to occur

• Select communication channels that can allow for modeling

• Reinforce with policy

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Prompting

• Critical for habit formation

• Consider environmental cues:– HWWS stations– Stickers/posters/print materials– Mobile applications

• Consider social cues:– Leverage household and community roles– Shift message from “Wash your hands”

to “Remind someone to wash their hands”

To Learn More . . . http://www.wsp.org/hwws-toolkit/hwws-tk-home

www.worldbank.org/water

blogs.worldbank.org/water

www.wsp.org

@wspworldbank

HANDWASHING WITH SOAP TOOLKIThttp://www.wsp.org/hwws-toolkit/hwws-tk-home