Publication: Scaling Up Handwashing Behavior : Findings from the Impact Evaluation Baseline Survey in Senegal
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2011-06
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2011-06
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In December 2006, 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. The goal of the Global Scaling up Handwashing Project (HWWS) is to reduce the risk of diarrhea and therefore increase household productivity by stimulating and sustaining the behavior of handwashing with soap at critical times for 5.4 million people in Peru, Senegal, Tanzania, and Vietnam. The project aims to test whether this handwashing behavior can be improved among the poor and vulnerable using innovative promotional approaches. In addition, it will undertake a structured learning and dissemination process to develop the evidence, practical knowledge, and tools needed to effectively replicate and scale up future handwashing programs.
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“Orsola-Vidal, Alexandra; Yusuf, Ahmad. 2011. Scaling Up Handwashing Behavior : Findings from the Impact Evaluation Baseline Survey in Senegal. Water and sanitation program technical paper. © http://hdl.handle.net/10986/17290 License: CC BY 3.0 IGO.”
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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 Scaling Up Handwashing Behavior : Findings from the Impact Evaluation Baseline Survey in Vietnam(World Bank, Washington, DC, 2010-11)The goal of global scaling up handwashing is to reduce the risk of diarrhea and therefore increase household productivity by stimulating and sustaining the behavior of handwashing with soap at critical times in the lives of 5.4 million people in Peru, Senegal, Tanzania, and Vietnam, where the project has been implemented to date. The structure of this report proceeds as follows: In chapter one author provide an overview of the global scaling up handwashing and global scaling up rural sanitation projects, as well as background on the handwashing project in Vietnam. Chapter two details the methodology that underlies the impact evaluation, and provides details on the sampling design, sample selection, and field work protocols. The baseline findings for general household characteristics, handwashing behavior, child health, and child growth are presented in depth in chapter three. In chapter four authors conclude with a summary of the next steps of the impact evaluation study.Publication Scaling Up Handwashing and Rural Sanitation : Findings from a Baseline Survey in Tanzania(World Bank, Washington, DC, 2012-09)Since 2007, the Water and Sanitation Program (WSP) has provided technical assistance to local and national governments implementing large rural sanitation and handwashing promotion programs in various countries. In Tanzania, handwashing with soap and sanitation programs were phased into 10 rural districts in the second half of 2009. This report presents summary descriptive statistics for key demographic, socioeconomic, hygiene, health, and child development variables based on a survey of approximately 1,500 households. It offers a glimpse at the general status of sanitation and hygiene practices in some of the program's target areas before the beginning of implementation activities. In the targeted areas in rural Tanzania, the typical household is headed by a male and comprises five members. Most houses are single detached dwellings with mud or brick walls and clay floors. Households typically use kerosene for lighting and wood for cooking, and about half of households own a few animals and a bicycle. Handwashing behavior is known to be difficult to assess. In this study, we relied on two sources: self-reported handwashing at critical times and, as a proxy measure, spot-check observations of whether the household had a designated place for handwashing with both soap and water. An additional measure assessed the cleanliness of the caretaker's hands through direct observation again to serve as a proxy indicator of handwashing with soap behavior. The survey revealed that there was limited baseline knowledge of the critical handwashing times among the target households prior to the program, indicating room to improve handwashing behavior. Likewise, the survey indicated limited access to improved water sources, a scarcity of pit latrines with slabs, and a non-negligible percentage of open defecation practice in the studied households. Underlying challenges also included unsafe facilities for small children and poor practices related to disposal of child feces. The data presented in this technical report provides a snapshot of the conditions of the target population prior to the start of the sanitation and handwashing programs. An impact evaluation of the programs, which will rely exclusively on post-intervention data, will be carried out during 2012; a full report will be published in 2013. The study hopes to enable a close examination of the links between poor sanitation, handwashing behavior, and health, and provide evidence for future projects in rural Tanzania.Publication Promoting Handwashing Behavior in Peru : The Effect of Large-Scale Mass-Media and Community Level Interventions(World Bank, Washington, DC, 2012-11)This paper analyzes a randomized experiment that uses novel strategies to promote handwashing with soap at critical times in Peru. It evaluates a large-scale intervention that includes a mass media provincial campaign and a district-level community component. The analysis finds that the mass media intervention alone had no significant effect on exposure to the handwashing promotion campaign messages, and therefore no effect on handwashing knowledge or handwashing behavior. In contrast, the community-level intervention, a more comprehensive intervention that included several community and school activities in addition to the communications campaign, was successful in reaching the target audience with handwashing promotion messages and in improving the knowledge of the treated population on appropriate handwashing behavior. Those improvements translated into higher self-reported and observed handwashing with soap at critical junctures. However, no significant improvements in the health of children under the age of five were observed. The results are consistent with earlier literature, which indicates that substantively changing behavior to improve health is a complex task requiring intensive and more personalized interventions.Publication Scaling Up Rural Sanitation : Findings from the Impact Evaluation Baseline Survey in Indonesia(World Bank, Washington, DC, 2010-11)The overall purpose of the Impact Evaluation is to provide decision makers with a body of rigorous evidence on the effects of the hand washing and sanitation projects at scale on a set of relevant outcomes. It also aims to generate robust evidence on a cross-country basis, understanding how effects vary according to each country's programmatic and geographic contexts, and generate knowledge of relevant impacts such as child cognitive development, child growth (anthropometric) measures, anemia, acute lower respiratory disease, and productivity of mother's time, among many others. The studies will provide a better understanding of at-scale sanitation and hygiene interventions. The improved evidence will support development of large-scale policies and programs, and will inform donors and policy makers on the effectiveness and potential of the Global Scaling Up projects as massive interventions to meet global needs.
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