Publication: Tanzania : A Handwashing Behavior Change Journey
Loading...
Date
2011-10
ISSN
Published
2011-10
Author(s)
Editor(s)
Abstract
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.
Link to Data Set
Citation
“World Bank. 2011. Tanzania : A Handwashing Behavior Change Journey. Water and Sanitation Program : Learning Note. © World Bank. http://hdl.handle.net/10986/11683 License: CC BY 3.0 IGO.”
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
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 Senegal : A Handwashing Behavior Change Journey(Washington, DC, 2010-09)In 2003, the Public-Private Partnership for Handwashing with Soap (PPPHW) was created in Senegal with technical assistance from the Water and Sanitation Program (WSP). Housed initially within the Office Nationale de L'Assainissement, the government unit overseeing sanitation within the Ministry of Health, the PPPHW's main objective was to catalyze and coordinate multi-sectoral involvement in the promotion of handwashing with soap. This learning note serves to document the behavior change component of the project in Senegal, including key strategies, results, challenges, and lessons learned.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.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 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.
Users also downloaded
Showing related downloaded files
Publication Guide to the Debt Management Performance Assessment Tool(Washington, DC, 2008-02-05)The purpose of this document is to provide guidance and supplemental information to assist with country assessments of debt management performance, using the Debt Management Performance Assessment (DeMPA) tool. The DeMPA is a methodology used for assessing public debt management performance through a comprehensive set of 15 performance indicators spanning the full range of government Debt Management (DeM) functions. It is based on the principles set out in the International Monetary Fund (IMF) and World Bank guidelines for public debt management, initially published in 2001 and updated in 2003. It is modeled after the Public Expenditure and Financial Accountability (PEFA) framework for performance measurement of public financial management. The DeMPA has been designed to be a user-friendly tool to undertake an assessment of the strengths and weaknesses in government DeM practices. This guide provides additional background and supporting information so that a no specialist in the area of debt management may undertake a country assessment effectively. The guide can be used by assessors in preparing for and undertaking an assessment. It is particularly useful for understanding the rationale for the inclusion of the indicators, the scoring methodology, and the list of supporting documents or evidence required, and the questions that could be asked for the assessment.Publication Crime and Violence in Central America : A Development Challenge - Main Report(World Bank, 2011-01-01)Crime and violence are now a key development issue for Central American countries. In three nations El Salvador, Guatemala, and Honduras crime rates are among the top five in Latin America. This report argues that successful strategies require actions along multiple fronts, combining prevention and criminal justice reform, together with regional approaches in the areas of drug trafficking and firearms. It also argues that interventions should be evidence based, starting with a clear understanding of the risk factors involved and ending with a careful evaluation of how any planned action might affect future options. In addition, the design of national crime reduction plans and the establishment of national cross-sectoral crime commissions are important steps to coordinate the actions of different government branches, ease cross-sectoral collaboration and prioritize resource allocation. Of equal importance is the fact that national plans offer a vehicle for the involvement of civil society organizations, in which much of the expertise in violence prevention and rehabilitation resides. Prevention efforts need to be complemented by effective law enforcement. The required reforms are no longer primarily legislative in nature because all six countries have advanced toward more transparent adversarial criminal procedures. The second-generation reforms should instead help deliver on the promises of previous reforms by: (i) strengthening key institutions and improving the quality and timeliness of the services they provide to citizens; (ii) improving efficiency and effectiveness while respecting due process and human rights; (iii) ensuring accountability and addressing corruption; (iv) increasing inter-agency collaboration; and (v) improving access to justice, especially for poor and disenfranchised groups. Specific interventions reviewed in the report include: information systems and performance indicators as a prerequisite to improve inter-institutional coordination and information sharing mechanisms; an internal overhaul of court administration and case management to create rapid reaction, one-stop shops; the strengthening of entities that provide legal counseling to the poor and to women; and the promotion of alternative dispute-resolution mechanisms and the implementation of community policing programs.Publication World Development Report 2011(World Bank, 2011)The 2011 World development report looks across disciplines and experiences drawn from around the world to offer some ideas and practical recommendations on how to move beyond conflict and fragility and secure development. The key messages are important for all countries-low, middle, and high income-as well as for regional and global institutions: first, institutional legitimacy is the key to stability. When state institutions do not adequately protect citizens, guard against corruption, or provide access to justice; when markets do not provide job opportunities; or when communities have lost social cohesion-the likelihood of violent conflict increases. Second, investing in citizen security, justice, and jobs is essential to reducing violence. But there are major structural gaps in our collective capabilities to support these areas. Third, confronting this challenge effectively means that institutions need to change. International agencies and partners from other countries must adapt procedures so they can respond with agility and speed, a longer-term perspective, and greater staying power. Fourth, need to adopt a layered approach. Some problems can be addressed at the country level, but others need to be addressed at a regional level, such as developing markets that integrate insecure areas and pooling resources for building capacity Fifth, in adopting these approaches, need to be aware that the global landscape is changing. Regional institutions and middle income countries are playing a larger role. This means should pay more attention to south-south and south-north exchanges, and to the recent transition experiences of middle income countries.Publication The Mexican Social Protection System in Health(World Bank, Washington DC, 2013-01)With a population of 113 million and a per-capita Gross Domestic Product, or GDP of US$10,064 (current U.S. dollars), Mexico is one of the largest and highest-income countries in Latin America and the Caribbean (LAC). The country has benefited from sustained economic growth during the last decade, which was temporarily interrupted by the financial and economic crisis. Real GDP is projected to grow 3.8 percent and 3.6 percent in 2012 and 2013, respectively (International Monetary Fund, or IMF 2012). Despite this growth, poverty in the country remains high; with half of the population living below the national poverty line. The country is also highly heterogeneous, with large socioeconomic differences across states and across urban and rural areas. In 2010, while the extreme poverty ratio in the Federal District and the states of Colima and Nuevo Leon was below 3 percent, in Chiapas, Guerrero, and Oaxaca it was 25 percent or higher. These large regional differences are also found in other indicators of well-being, such as years of schooling, housing conditions, and access to social services. This case study assesses key features and achievements of the Social Protection System in Health (Sistema de Proteccion Social en Salud) in Mexico, and particularly of its main pillar, Popular Health Insurance (Seguro Popular, PHI). It analyzes the contribution of this policy to the establishment and implementation of universal health coverage in Mexico. In 2003, with the reform of the General Health Law, the PHI was institutionalized as a subsidized health insurance scheme open to the population not covered by the social security schemes. Today, the PHI covers all of its intended affiliates, about 52 million peoplePublication Classroom Assessment to Support Foundational Literacy(Washington, DC: World Bank, 2025-03-21)This document focuses primarily on how classroom assessment activities can measure students’ literacy skills as they progress along a learning trajectory towards reading fluently and with comprehension by the end of primary school grades. The document addresses considerations regarding the design and implementation of early grade reading classroom assessment, provides examples of assessment activities from a variety of countries and contexts, and discusses the importance of incorporating classroom assessment practices into teacher training and professional development opportunities for teachers. The structure of the document is as follows. The first section presents definitions and addresses basic questions on classroom assessment. Section 2 covers the intersection between assessment and early grade reading by discussing how learning assessment can measure early grade reading skills following the reading learning trajectory. Section 3 compares some of the most common early grade literacy assessment tools with respect to the early grade reading skills and developmental phases. Section 4 of the document addresses teacher training considerations in developing, scoring, and using early grade reading assessment. Additional issues in assessing reading skills in the classroom and using assessment results to improve teaching and learning are reviewed in section 5. Throughout the document, country cases are presented to demonstrate how assessment activities can be implemented in the classroom in different contexts.