Day Two Recap
Handwashing Behavior Change Think Tank
Here's a quick look at the sessions held:
There was some consensus that handwashing programs should use some kind of conceptual framework and have a well-thought-out theory of change (if we do x, then it will result in Y) to increase their chances of success. There are many frameworks out there (HIF, IBM, FOAM, etc.) and they can be intimidating and sometimes expensive to implement. The group realized every program has a "theory of change" whether it's explicit or not. Frameworks can simply help you articulate and explain your approach to handwashing behavior change. There is a need to make these frameworks more accessible to those implementers.
- Handwashing determinants (factors that lead to handwashing like the desire to protect children, the expectations of the community family, having soap and water, etc.)
We also said that the determinants may be different (or perhaps the same determinants, but their importance changes) for starting handwashing v. sustaining handwashing. Starting the behavior and maintaining it/creating a habit may need different approaches. For example, a community meeting to show the importance of handwashing may be important to get people started handwashing and make it a community pledge, but once the behavior is started durable handwashing stations may need to be available on the market so that handwashing can continue long term.
During this session we heard from a large-scale program that saw great increases in message recall, less increase on knowledge, and very little improvement on handwashing behavior over three years. There was a bigger impact on handwashing in communities that received both sanitation and handwashing messaging (not integrated), and no health effects. Again, reinforcing the fact that we still haven't seen many large-scale handwashing programs that have changed behavior over a long period of time.
- Handwashing and sanitation
UNICEF presented on their CATS programs (community sanitation). They did have success in changing handwashing behavior over a six month period, but CATS implementing partners rated handwashing behavior change to be the most challenging part of the sanitation and handwashing.
There are a number of opportunities to advocate for handwashing to governments, donors, NGOs, etc. this year, especially around the post-2015 processes (next set of Millenium Development Goals). The PPPHW is putting together a handwashing pack with key data, messages, and PowerPoints etc. We will share this with all our partners and networks for use when advocating for investment and attention to handwashing.
In the coming week, we'll be distilling all the results from the Think Tank and share with you all through a short report and then a webinar. In the meantime, please reply to this email with any questions or comments.
Thank you again for participating virtually!!!!
Katie Carroll and Hanna Woodburn
Global Public-Private Partnership for Handwashing (PPPHW)