Publication: Peru : A Handwashing Behavior Change Journey
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2010-08
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2012-08-13
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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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“World Bank. 2010. Peru : A Handwashing Behavior Change Journey. Water and Sanitation Program : Learning Note. © World Bank. http://hdl.handle.net/10986/11692 License: CC BY 3.0 IGO.”
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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 Introducing FOAM(World Bank, Washington, DC, 2010-08)The FOAM (Focus on Opportunity, Ability, and Motivation) is a framework designed to help in the development, monitoring, and evaluation of handwashing behavior change programs. FOAM was developed for use in resource-poor settings, but it can also be adapted for other socioeconomic environments. This working paper is intended for use by program managers implementing handwashing behavior change initiatives, as well as multilateral and bilateral agencies, academic institutions, and government and nongovernmental organizations (NGOs) working in water and sanitation.Publication Tanzania : A Handwashing Behavior Change Journey(Washington, DC, 2011-10)In Tanzania, nearly 30,000 people die annually due to diarrheal diseases and an estimated 12.6 percent of children suffer from diarrheal diseases. There is a widespread and deep-rooted belief that diarrhea is part of growing up and cannot be prevented. Working with the government and with non-governmental organizations, the Water and Sanitation Program (WSP) sought to increase rates of handwashing with soap among women and children, especially at critical junctures. This learning note documents the development of the project, with a focus on how it was designed, implemented, and monitored. Challenges and lessons learned are highlighted to assist program managers in designing and managing evidence-based handwashing with soap and other hygiene promotion programs.
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Research carried out from October 18 to November 5, 2010, followed a 2007 baseline EE assessment. The same instrument was used in both assessments, with some modifications and additions made in 2010 based on program experience and learning. An international consultant carried out the assessment.Publication Scaling Up Handwashing Behavior : Findings from the Impact Evaluation Baseline Survey in Peru(Washington, DC, 2010-08)In response to the preventable threats posed by poor sanitation and hygiene, the Water and Sanitation Program (WSP) launched two large-scale projects, global scaling up handwashing and global scaling up rural sanitation, to improve the health and welfare outcomes for millions of poor people. Local and national governments are implementing these projects with technical support from WSP. Global scaling up handwashing aims to test whether handwashing with soap behavior can be generated and sustained among the poor and vulnerable using innovative promotional approaches. The primary objectives are to reduce the risk of diarrhea in young children and increase household productivity by stimulating and sustaining the behavior of handwashing with soap at critical times. Overall, the project aims to generate and sustain handwashing with soap practices among 5.4 million people living in Peru, Senegal, Tanzania, and Vietnam, the four countries where the project has been implemented to date. This technical paper presents the findings of the WSP impact evaluation (IE) baseline survey in Peru and is one in a series of papers presenting IE findings from surveys conducted in each project country.Publication Integrating Hygiene Promotion Into World Bank Projects : Experiences from Colombia and Peru(World Bank, Washington, DC, 2011-05)This report has been created to provide practical tools, tips, and methodologies for project leaders to integrate hygiene components into their projects. 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For example, the Global Public-Private Partnership for hand-washing with soap helps countries close the gap as they strive to meet the millennium development goals. The tools and guidelines referenced in this document do not offer a strict formula, however, and should be revised and adapted to the needs of each project. The door remains open for continuous learning and improvement.Publication Disease Control Priorities in Developing Countries, Second Edition(Washington, DC: World Bank and Oxford University Press, 2006)The purpose of this book is to provide information about what works -- specifically, the cost-effectiveness of health interventions in a variety of settings. Such information should influence the redesign of programs and the reallocation of resources, thereby helping to achieve the ultimate goal of reducing morbidity and mortality. 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