1. 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

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

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

4. Slide 4 Global Handwashing with Soap Project Intensive learning project funded by BMGF 2006-2010 Peru, Vietnam, Senegal and Tanzania Targeting mainly caretakers of children < 5 years of age

5. 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

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

7. 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

8. Slide 8 Some Lessons Learned

9. 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)

10. Slide 10

11. 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

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

13. 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

14. Slide 14 Areas for Future Consideration

15. 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)

16. 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

17. 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”

18. To Learn More... http://www.wsp.org/hwws-toolkit/hwws-tk- home

19. www.worldbank.org/water blogs.worldbank.org/water www.wsp.org @wspworldbank HANDWASHING WITH SOAP TOOLKIT http://www.wsp.org/hwws-toolkit/hwws-tk- home