Through its Global Scaling Up Handwashing project, WSP supported government partners to apply innovative behavior change approaches to improve handwashing with soap behavior at-scale among women and young children in Peru, Senegal, Tanzania, and Vietnam. The project had four components: changing handwashing behavior at-scale; creating an enabling environment to ensure the sustainability of the interventions; monitoring and learning; and evaluating impact. The modules within this toolkit capture the experiences and lessons learned from the project, which was implemented by local and national governments with technical support from WSP.

The modules have a common organizational structure. Each module has a Key Terms section, where you can find definitions for concepts used throughout the toolkit. The section Keep in Mind contains key tips learned during the course of this project. In addition, you will find tools and resources, such as a page for each of the four countries, which shares documents, videos, and other materials used during implementation.

Key TermsKeep in Mind

enabling products



performance monitoring


  • Special (and often new) skills are needed.
    Efforts to change behavior require skills that are less common in sectors such as water and sanitation, which have typically focused on improving infrastructure.
  • Institutional arrangements are often unclear.
    Because handwashing with soap efforts cross institutional and sectoral boundaries, they often have multiple homes with little clarity in terms of roles and responsibilities for policy formulation, financing, implementation, and monitoring.
  • Global Scaling Up Handwashing: Annual Progress Report
    From July 1, 2009 to June 30, 2010,  WSP's Global Scaling Up Handwashing Project reached more than 2.1 million people (68% of end of project target, or EOP) through interpersonal communication, and more than 615,000 people through direct consumer contact events (91% of EOP).  In addition, mass media channels carried behavior change messages to more than 20 million people from July through December 2009 and nearly 18 million people from January through June 2010. Overall, the  project’s target numbers for people reached through integrated communication channels were achieved or are on track in each of the project countries.
  • Brochure: Global Scaling Up Handwashing Project
    Handwashing with soap is one of the most cost-effective ways to prevent diarrhea. However, worldwide handwashing with soap rates are low. This introduction to WSP’s Global Scaling Up Handwashing Project provides a brief overview, including learning goals, programmatic approaches, and targets.
  • Global Learning Strategy
    Findings on what works, and what doesn’t, in scaling up and sustaining handwashing programs can be short lived unless a structured process for generating, sharing, capturing, and disseminating knowledge is established. Included are recommendations based on a learning strategy developed by WSP’s Global Scaling Up Handwashing Project.
  • Brochure: Multi-Country Impact Evaluation Study
    The impact evaluation (IE) study is an integral component of WSP’s Global Scaling Up Handwashing. The cross-country IE, implemented using randomized controlled designs, aims to support thoughtful and analytical learning and generate robust evidence on the effects of handwashing with soap on relevant health and welfare outcomes. This introduction summarizes the approach and shares best practices that can be adopted to design IEs for future multi-country interventions.
  • Practical Guidance for Measuring Handwashing Behavior
    Accurately measuring handwashing behavior is a critical step in understanding and improving overall health. However, the lack of a universally applicable method for measuring handwashing behavior makes gathering reliable data a challenge. This Working Paper addresses that gap and offers researchers and public health professionals practical guidance on how to accurately measure handwashing behaviors in a variety of settings.
  • Progress Report July 1, 2009 – December 31, 2009
    This reporting period marks the beginning of the final year of implementation of WSP’s Global Scaling Up Handwashing Project. Globally, the project expects to meet or exceed expected end-of-project (EOP) targets for behavior change communication interventions and strengthening enabling environments.