Issue 106 | July 3, 2013 | Focus on Behavior Change
This issue contains 2013 studies and resources on behavior change in water, sanitation, and hygiene programs. Included are a USAID-sponsored event and webinar on behavior change and an interview featuring WASHplus Deputy Director Julia Rosenbaum about small doable actions as a behavior change approach. Other resources include toolkits from the SHARE project and the World Bank’s Water and Sanitation Program as well as reports and case studies from Bangladesh, Vietnam, and Zimbabwe. 
EVENTS/INTERVIEWS
- Behavior Change in WASH Programs, June 27, 2013. (Video)
One in a series of “Strate-Chats” that USAID is hosting to coincide with the launch of its new Water and Development Strategy, this event focuses on behavior change methodologies and case studies. Presenters include Chris Holmes and Merri Weinger of USAID, Ron Cleemer of World Vision, and Orlando Hernandez from WASHplus. - Breaking the Cycle: Small Doable Actions in WASH to Improve Child Health, 2013. J Rosenbaum, WASHplus. (Video)
WASHplus’s Julia Rosenbaum discusses the power of small doable actions as a behavior change approach when it is applied to water supply, sanitation, and hygiene (WASH) programs.
TOOLKITS
- Behavior Change. The World Bank Water and Sanitation Program, 2013. (Toolkit)
This behavior change module introduces the theory of change and key components of the approach WSP used in the Global Scaling Up Handwashing project. The module includes four presentations: behavior change overview, FOAM Framework, enabling products, and monitoring. - Choose Soap. SHARE Project. (Toolkit)
The SHARE resource was created to promote hand washing with soap in households in low income settings and draws on ideas and best practices from different fields, including hygiene and health promotion, behavioral sciences, and marketing. This kit is designed to be used to promote hand washing with soap: at key times; within a realistic budget and time frame; and for an organization working at village level across multiple villages.
JOURNAL ARTICLES
- Behaviour Change for Better Health: Nutrition, Hygiene and Sustainability. BMC Public Health, Mar 2013. R Newson. (Full text)
Unilever organized a symposium entitled “Behaviour Change for Better Health: Nutrition, Hygiene, and Sustainability.” The intention was to discuss how consumers can be motivated to live a more healthy and sustainable lifestyle in today’s environment. This article summarizes the main conclusions of the presentations given at the symposium. - Creating a Culture of Health: Hygiene Behaviour Change in Community Health Clubs through Knowledge and Positive Peer Pressure. Journal of Water, Sanitation and Hygiene for Development, 3(2) 2013. J Waterkeyn. (Abstract)
Understanding the mechanisms that trigger behavior change to overcome risky hygiene is critical to improving family health. Research in an integrated health promotion program in 382 Community Health Clubs (CHCs) in three districts of Zimbabwe showed clearly the value members attached to gaining “knowledge,” which was their strongest motivation for joining CHCs. - Hygiene Intervention Reduces Contamination of Weaning Food in Bangladesh.Trop Med Intl Health, Mar 2013. M Islam. (Abstract)
A hygiene intervention following the Hazard Analysis Critical Control Point approach reduced weaning food contamination significantly. Awareness building among mothers about weaning food hygiene could be an important intervention for preventing weaning food-related diarrhea in Bangladesh. - Predicting Water Consumption Habits for Seven Arsenic-Safe Water Options in Bangladesh. BMC Public Health, May 2013. J Inauen. (Full text)
This general model for the habitual use of arsenic-safe water options may prove useful to predict other water consumption habits. Behavior-change interventions are derived from the model to promote the habitual use of arsenic-safe water options. - Teaching Handwashing with Soap for Schoolchildren in a Multi-Ethnic Population in Northern Rural Vietnam. Global Health Action, Apr 2013. L Xuan.(Full text, pdf)
This study demonstrated that it is feasible to engage teachers and implement active teaching methods for behavior change of hand washing with soap in a group of multi-ethnic primary schoolchildren without the need for major investments in water and hygiene infrastructures. However, in those areas there was limited transfer of practice from school promotion to home. Investment is needed to ensure continuous access to soap at schools. - Water Diaries: Generate Intra-Household Water Use Data—Generate Water Use Behaviour Change. Journal of Water, Sanitation and Hygiene for Development, 3(1) 2013. K Harriden. (Abstract)
This paper describes the Water Diary, a method to generate intra-household water use data, as a tool to promote water use behavior change by sensitizing users to their water behaviors and practices.
REPORTS/BLOGS
- Achievements of BRAC Water, Sanitation and Hygiene Programme Towards Millennium Development Goals and Beyond, 2013. BRAC. (Full text)
Evidence reveals that a significant reduction in the prevalence of water-related disease has taken place but challenges remain to sustain hygiene practices. This study emphasizes that women still play a significant role in water collection and cleaning of tubewell platforms and household latrines. Increased involvement of other family members in household activities would open up the opportunity for women to be involved in productive activities. - A Brief Overview of Sanitation App Developments, 2013. M Prat. (Full text, pdf)
Applications that have been developed for the sanitation sector so far can be classified in four main categories: self-reporting of maintenance needs; mapping of infrastructure and needs; monitoring of sanitation programs; and education for behavioral change. Apps have the potential to support significant improvements in the monitoring and planning of sanitation projects, programs, and policies. This note gives an overview of the types of apps (mainly prototypes) that have been developed so far in the sanitation sector and identifies the need for further development. - Facilitator’s Reference Guide for Frontline Activators on Interpersonal Communication, 2013. The World Bank Water and Sanitation Program. (Full text, pdf)
This guide is designed to help facilitators train Frontline Activators (FLA) on interpersonal communication skills to enable them to promote hand washing with soap in their communities. It also serves as a detailed reference guide. - Hygiene Promotion: How Effective Is It? How Much Does It Cost? 2013. IRC WASHCost. (Full text)
The benefits of hygiene promotion are generally not prioritized and the costs of hygiene promotion are poorly understood and therefore not adequately budgeted into programming. In this study WASHCost examined hygiene promotion and associated costs in Ghana, Mozambique, and Burkina Faso, looking at interventions that targeted latrine use and fecal containment, hand washing with soap, and the protection of drinking water. - Insights from a Food Hygiene Intervention Study in Nepal, 2013. O Gautam.(Blog)
This study was designed to implement a simple, feasible, and replicable food hygiene intervention and assess the effect of this intervention on mothers’ food hygiene practices as well as the impact of the interventions on the level of microbiological contamination in food and diarrheal disease burden. The study also explores how food hygiene interventions can be integrated into nutrition, health, and WASH policy and programs in Nepal. - Nudging to Use: Achieving Safe Water Behaviors in Kenya and Bangladesh, 2013. J Luoto. (Full text, pdf)
This paper presents results from two complementary field experiments conducted in rural western Kenya and the urban slums of Dhaka, Bangladesh. In both settings, participating households received free trials with a variety of point of use products as well as repeated educational messages about the importance of safe drinking water and its link with diarrheal illness. - Practical Guidance for Measuring Handwashing Behavior: 2013 Update, 2013. P Ram. (Full text, pdf)
In low- and middle-income settings, accurate measures of hand washing behavior are critical to understanding households’ health environment. But it can be challenging to measure hand washing. This document discusses a set of hand washing indicators and recommendations prepared to support the Water and Sanitation Program’s Global Scaling Up Handwashing project carried out in four countries. - A Tool for Conducting Population, Health and Environment Behavior Monitoring Surveys, 2013. E Torrell. (Full text, pdf)
The Population, Health, and Environment (PHE) Behavior Monitoring Survey tool is designed to help PHE practitioners develop and implement situational and behavior monitoring surveys. It recognizes that PHE intervention designs must be tailored to the specific needs of the place where they are implemented. Understanding the context of the place will help identify possible entry points where PHE activities might have the potential to improve the quality of life.
Each WASHplus Weekly highlights topics such as Urban WASH, Indoor Air Pollution, Innovation, Household Water Treatment and Storage, Hand Washing, Integration, and more. If you would like to feature your organization’s materials in upcoming issues, please send them to Dan Campbell, WASHplus knowledge resources specialist, at dacampbell@fhi360.org.
Sanitation Updates 