The Global Scaling Up Handwashing Project is learning how to apply innovative promotional approaches to behavior change to generate widespread and sustained improvements in handwashing with soap at scale. The project’s development objective is to stimulate and sustain recommended handwashing behavior in 5.4 million people in four countries in four years, resulting in a decrease in diarrheal disease in young children and an increase in productivity in households with young children.
Core project components include:
- Expanding Reach and Exposure through Innovative Programming
- Strengthening the Enabling Environment
- Results Based Monitoring and Evaluation
- Impact Evaluation
- Learning What Works and Expanding the Knowledge Base
The programming component includes the design, delivery, supervision, and monitoring of a behavior change communication program at scale. Communication approaches include interpersonal, direct consumer, and mass media strategies designed to motivate and empower women and children to adopt and sustain handwashing with soap practice. Formative research was conducted to identify the salient factors to address by the program.
The Global Scaling Up Handwashing Project is learning how to strengthen the institutional and programmatic conditions, or Enabling Environment (EE), that is critical to scaling and sustaining a hygiene practice such as handwashing. EE factors include:
1. Policy, strategy, and direction
2. Institutional arrangements
3. Program methodology
4. Implementation capacity
6. Availability of products and tools
8. Cost-effective implementation
9. Monitoring and Evaluation
Measurement of EE condition includes baseline assessments and a planning and monitoring tool to track behavior change over time. This tool is used to create a ‘spider diagram,’which in turn can help bring partners together to identify problem areas and chart progress.
To support evidence-based learning and the effective management of results, the Global Scaling Up Handwashing Project has a strong monitoring and evaluation component. Global and country objectives are aligned through a series of Results Frameworks. In addition, a Global Management Information System will capture data on the key global indicators and provide the headquarters team, country teams and stakeholders with performance information on a regular basis. In this way, local governments and the project team can track how each country is performing, what is being learned, and any additional efforts that may be needed to achieve outcome and impact.
The Global Scaling Up Handwashing Project is conducting a comprehensive impact evaluation study to document the wide range of health, development, social, and economic outcomes that are believed to be influenced by fetal contamination.
For example, there is important but only preliminary evidence that childhood diarrhea is an inhibitor of children's long-term physical and even cognitive development. If true, the child development benefits of reduced diarrhea may overshadow its already enormous health and mortality consequences and this study promises to yield scientifically valid evidence.
The impact evaluation will be run as a set of coordinated, community-randomized, controlled trials of Handwashing projects in Peru, Senegal, Tanzania, and Vietnam. In addition to collecting a broad range of indictators to allow an intensive study of handwashing with soap’s economic, developmental, and social welfare impacts, the project costs and the value of these diverse benefits will be closely examined. Knowledge products will be developed to reach and inform government officials, stakeholders, and civil society, while research papers presenting the findings will be submitted to peer-reviewed journals.
The Global Scaling Up Handwashing Project is designed to learn about implementation and achieving results at scale with a focus on sustainability and replicability. Through the ongoing research being conducted and field experience, we are finding out more about the contributing factors to washing hands with soap.
The project learning strategy documents the key questions guiding the teams’ learning and details the process for generating, sharing, capturing, and disseminating knowledge about what works. This information will benefit current stakeholders as well as future stakeholders who want to promote and implement effective, sustainable, large scale sanitation programs.