Lessons Learned from the Global Scaling Up Handwashing with Soap Project 2013 Water and Health Conference Chapel Hill, North Carolina Jacqueline Devine Sr Social Marketing Specialist October 15, 2013

Slide 2 Session Objectives Share main lessons learned from Global Handwashing with Soap (HWWS) project Highlight areas of consideration for future programming

Slide 3 Roadmap Background –Project objectives –Implementation model Lessons learned Areas of consideration for future programming

Slide 4 Global Handwashing with Soap Project Intensive learning project funded by BMGF Peru, Vietnam, Senegal and Tanzania Targeting mainly caretakers of children < 5 years of age

Slide 5 Project Objectives 1.Learn what it takes to stimulate HWWS at large scale 2.Sustain activities after project ends 3.Measure impact on health

Slide 6 Main Project Components Enabling environment Behavior change program Impact evaluation Structured learning

Slide 7 Implementation Model Thinking at scale from design phase Technical assistance for development of materials, policy reform and capacity building provided by WSP Implementation through local governments, mass organizations, NGOs, firms or partner agencies

Slide 8 Some Lessons Learned

Slide 9 Men May Also Need to Part of the Behavior Change Journey Role Model Practices HW himself Protector Ensures that soap and water are available and used at critical times (follow-up role) Gatekeeper Allows access to his household to frontline workers Provides funds for soap for HW Source: Monitoring system, Senegal (WSP)

Slide 10

Slide 11 Programs Also Need to Include HWWS Stations HWWS stations provide: –Ease of access when, where needed –Environmental cue –Norm appeal Need to think beyond tippy-taps: –Mechanics of HWWS –User preferences –Size matters –Appearances

Slide 12 Design iteration of Happy Tap, Watershed Asia Design iteration of Mrembo, IFC/WSP Selling Sanitation

Slide 13 Stand-Alone Interventions May Not Be Sustainable Consider integrating and mainstreaming through: –Nutrition programs (e.g., cash transfers) –Ante-natal clinics –Sanitation –Corporate social responsibility But recognize this is further burdening health systems

Slide 14 Areas for Future Consideration

Slide 15 Getting the Right Behavior Change Framework Focus Target behavior Target population Opportunity Access/availabil ity Product attributes Social norms Ability Knowledge Social support Motivation Beliefs & attitudes Outcome expectations Threat Intention Implementation Intentions (conscious) Repetition in stable context Behavior relegated to cues (automatic)

Slide 16 Norming the Behavior Use subjective norms rather than descriptive Make the norm noticeable/visible Present the norm at the time desirable behavior is to occur Select communication channels that can allow for modeling Reinforce with policy

Slide 17 Prompting Critical for habit formation Consider environmental cues: –HWWS stations –Stickers/posters/print materials –Mobile applications Consider social cues: –Leverage household and community roles –Shift message from “Wash your hands” to “Remind someone to wash their hands”

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