Publication: Enabling Environment Assessment and Baseline for Scaling Up Handwashing Programs : Vietnam
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2008-04
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2008-04
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To follow up country work supported by the Public-Private Partnership for Handwashing (PPPHW), the World Bank Water and Sanitation Program (WSP) received funding from the Bill & Melinda Gates Foundation to support projects to scale up the promotion of handwashing with soap (HWWS) in Peru, Senegal, Tanzania, and Vietnam. The major project objectives of the Handwashing Initiative are: a) inculcate the HWWS habit among millions of mothers and children in these countries, b) use a strong monitoring and evaluation (M&E) component to enhance the conceptualizing and management of such programs, and c) establish sustainable programs that will continue and expand after this four-year grant ends. Enabling environment assessments are being carried out in all four countries to assess current conditions for scalability and sustainability and to make recommendations for improving conditions that are not supportive. This report summarizes the study in Vietnam. All four county studies are following a similar methodology, developed by WSP, to examine nine dimensions of scalability/sustainability through individual and group in-depth interviews and an electronic survey in which respondents are asked to score various statements.
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“Cogswell, Lynne; Anh Thu, Le Thi. 2008. Enabling Environment Assessment and Baseline for Scaling Up Handwashing Programs : Vietnam. Water and Sanitation Program;. © http://hdl.handle.net/10986/17371 License: CC BY 3.0 IGO.”
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Publication Enabling Environment Assessment and Baseline for Scaling Up Handwashing Programs : Peru(World Bank, Washington, DC, 2008-04)To follow up country work supported by the Public-Private Partnership for Handwashing, the World Bank Water and Sanitation Program (WSP) received funding from the Bill and Melinda Gates Foundation to support projects to scale up the promotion of handwashing with soap (HWWS) in Peru, Senegal, Tanzania, and Vietnam. The major project objectives of the handwashing Initiative are: (i) inculcate the HWWS habit among millions of mothers and children in these countries; (ii) use a strong monitoring and evaluation (M&E) component to enhance the conceptualizing and management of such programs; and (iii) establish sustainable programs that will continue and expand after this four-year grant ends. Evaluation of actual impact on knowledge, attitudes, and practice regarding HWWS shows some positive and some inconclusive findings. However, the study team feels that much excellent groundwork for the expanded program in Peru has been solidly laid by efforts to date and that, in combination with strong political will from the national government and a certain level of guaranteed funding, the outlook for effective expansion is very good. The Peruvian program implemented activities at the national level and developed partnerships and activities in 14 of Peru's 24 regions. Preliminary monitoring and evaluation showed mixed but promising improvements in knowledge, attitudes, and practices, particularly in handwashing before eating and preparing food. Fostering partnerships at the national, regional, and local levels has been a key project strategy. Although this has been difficult and demanding at times, it has also been a major reason for progress. Both interpersonal communication (in schools and communities) and mass media (mostly print and radio) made important contributions to changing knowledge, attitudes, and practices.Publication Handwashing Behavior Change at Scale : Evidence from a Randomized Evaluation in Vietnam(World Bank, Washington, DC, 2012-09)Handwashing with soap, which has been shown to reduce diarrhea in young children by as much as 48 percent, is frequently mentioned as one of the most effective and inexpensive ways to save children's lives. Yet rates of handwashing remain very low throughout the world. Handwashing with soap campaigns are de rigueur in developing countries, but little is known about their effectiveness. Few have been rigorously evaluated, and none on a large-scale. This paper evaluates a large-scale handwashing campaign in three provinces of Vietnam in 2010. Exposure to the campaign resulted in a slight increase in the availability of handwashing materials in the household, and caregivers in the treatment group were more likely to report washing hands at some of the times emphasized by the campaign. However, observed handwashing with soap at these times is low, and there isn't any difference between the treatment and control groups. As a result, no impact on health or productivity is found. These results suggest that even under seemingly optimal conditions, where knowledge and access to soap and water are not main constraints, behavior change campaigns that take place on a large scale face tradeoffs in terms of intensity and effectiveness.Publication Global Scaling Up Handwashing Project : Results, Impacts, and Learning from Vietnam(World Bank, Washington, DC, 2012-09)The Vietnam Handwashing Initiative (HWI) began in January 2006 with the goal of reducing morbidity and mortality from diarrheal diseases in children less than five years of age. In December 2006, Vietnam became one of four countries in the Water and Sanitation Program's (WSP) Global Scaling Up Handwashing Project. The objective of the project was to learn how to stimulate improved hand washing behaviors at large scale, sustain the activities after the project ended, and measure the impact on behavioral, health, and welfare outcomes. This learning note presents the achievements, learning, and reflections that resulted from implementing a large-scale hand washing program in Vietnam and provides recommendations for future hygiene promotion initiatives. During the four-year implementation (2006-2010), the program achieved all four of its key objectives. However, a randomized control trial (RCT) impact evaluation found no significant changes in hand washing behavior and no impact on health in children under two. Although much has been learned about how to implement a nation-wide communication program in Vietnam, behavior change at scale has proven challenging.Publication Vietnam : A Handwashing Behavior Change Journey for the Caretakers’ Program(Washington, DC, 2011-12)The Vietnam Handwashing Initiative (HWI) was launched in January 2006 by the Ministry of Health (MoH) with funds from the Danish Embassy in Vietnam and technical assistance from the Water and Sanitation Program (WSP). This learning note documents the development process of the caretakers' program with a focus on how it was designed, implemented, and monitored. Lessons learned and challenges are also highlighted to assist program managers in designing and managing evidence-based handwashing with soap or other hygiene promotion programs. A separate publication will focus on the process of developing the children's handwashing program.Publication Peru : A Handwashing Behavior Change Journey(Washington, DC, 2010-08)In 2003, a national multi-sectorial Handwashing Initiative (HWI) was created in Peru to increase handwashing with soap among mothers and children. The early years of the HWI focused on laying groundwork, including a formative research study in 2004; the creation of a consultative committee by the Ministry of Health (MoH); and a national decree formalizing the HWI. The Water and Sanitation program (WSP) has coordinated the HWI since its inception. This learning note profiles the behavior change component of the second phase with a focus on how it was designed, implemented, and monitored. Challenges and lessons learned are included to assist program managers as they make decisions to develop and manage a handwashing promotion initiative. Peru provides an interesting case study because the intervention itself is interwoven with efforts to strengthen capacity, policies, partnerships, and other aspects of the enabling environment required to sustain handwashing with soap programs. Though detangling these various program components is a challenge, this note on the behavior change journey attempts to do so.
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