In the Amhara Region of Ethiopia, the Learning by Doing Initiative (LBDI), a joint project between the Government of Ethiopia, the Amhara Regional Health Bureau, USAID’s Hygiene Improvement Project (HIP), and the Water and Sanitation Program, started at large scale and then expanded, growing from an initial 93,000 households in four districts to include 5.8 million people in 94 districts. LBDI resulted in 2.8 million more people stopping the practice of open defecation.
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