See you at World Water Week 2019

We’re looking forward to participating in World Water Week again this year. Will you be there? Let’s connect!

CAWST at World Water Week

Let’s connect in Stockholm!

CAWST will be in Stockholm from Saturday, August 24 to Friday August 30 for World Water Week activities and the SuSanA (Sustainable Sanitation Alliance) meetings.

Will you be there? Get in touch, let us know what you’re up to. We will be connecting with colleagues to share knowledge and learn from each other’s work in WASH.

The CAWST team traveling to Stockholm will include:

Shauna Curry & and Eva Manzano - CAWST at World Water Week 2019

 

What we’ll be doing

Drinks on a blue table, Canadian maple leaf overlay and event details

Why capacity development?

(We’re glad you asked!) Because it’s how you get knowledge to the people who will make use of it, and achieve behaviour change.

Are you into capacity development and sanitation? CAWST co-leads the SuSanA Capacity Development Working Group 1, via Laura Kohler, BA, MSc, PhD. We’d be delighted to see you join the group!

Find out how CAWST can help you start, scale up, or strengthen your WASH programs through capacity development .

 

Why Household Water Treatment and Safe Storage (HWTS)?

HWTS focuses on simple, yet effective solutions to improve water quality and reduce the risk of diarrheal disease.

The ability of a networked system to provide full-service, sustainable service to a community or city may be limited by cost, land requirements or lack of government capacity. Non-networked WASH solutions:

  • Are affordable and easily adapted to local contexts
  • Provide services to marginalized, vulnerable or hard-to-reach communities in remote areas
  • Protect human health and the environment, in contexts where networked systems are not feasible
  • Can be constructed, operated, maintained, and financed by community members, when combined with knowledge and skill training.

 

Dive deeper into HWTS

Learn more about the exciting advances in this area that are happening in Latin America. Check out our HWTS Knowledge Base at hwts.info/tandas.


About Shauna and Eva

Shauna Curry is the CEO at CAWST. She joined the team as a Global WASH Advisor in 2004, became head of our global training and consulting services in 2005, and assumed the CEO seat in 2011. She has led the development and expansion of CAWST’s service delivery from two countries to its current network of 1,490 implementing clients in 87 countries. Shauna has worked in 14 low- and middle-income countries, has experience in environmental engineering, and holds a Bachelor of Science in Agriculture and Bio-resource Engineering from the University of Saskatchewan. She is passionate about decentralized water, sanitation and hygiene, and the role of capacity building in reaching everyone with safe water and basic sanitation.

Eva Manzano, BEng, MA is a Senior Global WASH Advisor at CAWST. She joined our team as an intern in July 2010 as the translation coordinator. In 2011, she became a Technical Advisor and since then, she has provided training and consulting services to clients in Latin America and Southeast Asia. Eva holds a Bachelor’s Degree in Chemical Engineering with a specialization in Environmental Engineering, and a Master’s Degree in Development and Humanitarian Aid. Eva leads CAWST’s efforts to expand Household Water Treatment and Safe Storage (HWTS) in Latin America. Notably, Eva co-organized and co-facilitated the first-ever Latin America Regional Workshop: Advancing the Water Safety Agenda alongside the WHO/UNICEF HWTS Network, the Government of Colombia, the Panamerican Health Organization (PAHO) and UNICEF. Subsequently, she has co-hosted a number of Learning Exchanges in the region, converging efforts of training and implementing organizations, local service providers, government ministries and departments at various levels, and technology solutions providers. Eva is fluent in English and Spanish. Say “Hola” to Eva and ask her about the encouraging progress reaching remote regions in Latin America with safe water through non-networked solutions at emanzano@cawst.org.

 

 

CAWST 2019 AGM

Join us to celebrate our achievements of the past year at our Annual General Meeting (AGM) on Tuesday, September 24, 2019.

CAWST will host our Annual General Meeting (AGM) on Tuesday, September 24, 2019. We hope you will join us to celebrate our achievements of the past year, and to shape our future.

Date: Tuesday, September 24, 2019
Time: 5.00pm – 7.30pm (MST)
Location: B12 – 6020 2 St SE, Calgary, AB T2H 2L8

The meeting will include the following: Appointment of the Chair and Secretary of the Meeting * Report from the Chair * Appointment of Directors * Approval of the CAWST 2018 Audited Financial Statements * Appointment of Auditors for CAWST 2019 * Adjourn

CAWST Booth Host at CWL National Convention

Are you keen to share knowledge about water and sanitation with the public? We are hosting a booth at the Catholic Women’s League Convention in August and we need your help.

The Position: CAWST Booth Host at Catholic Women’s League National Convention

Purpose of the Role:

CAWST has been invited to the Catholic Women’s League National Convention in Calgary. As a volunteer for this event, you will work alongside a CAWST staff member to host a CAWST booth and information on CAWST, especially how we address water and sanitation challenges globally.

Duties and Responsibilities:

  • Share knowledge on CAWST and CAWST Wavemakers
  • Engage people in discussion on water and sanitation
  • Respond to questions on CAWST
  • Sell water bottles as part of Gift of Water
  • Track and log volunteer hours with the CAWST volunteer coordinator

 

Skills and Qualifications:

  • Familiar with CAWST, able to give a brief intro on water and sanitation
  • Friendly personality
  • Passion to help CAWST spread the word about water & sanitation
  • Organized and reliable

We will provide orientation, key messages and all supplies.

Timing: August 18 – 21, 2019 at the Hyatt Regency Hotel, 700 Centre Street SE, Calgary

  • Set Up Sunday, August 18 at 12 pm
  • Monday, August 19 7:30 am – 11 am, 11 am – 2:00 pm, 2 pm – 5 pm
  • Tuesday, August 20 7:30 am – 11 am, 11 am – 2:00 pm, 2 pm – 5 pm
  • Wednesday, August 21 7:30 am – 11 am, 11 am – 1:30 pm
  • Take Down Wednesday, August 21 at 1:30 pm

Department and Supervision: Public Engagement and Donor Initiatives


Application:

If you are already a CAWST volunteer, please email Tori D’Avella at volunteers@cawst.org to express your interest and preferred shift time.

If you are new to CAWST, please complete the volunteer sign up form and we will get you started.

Additional comments:

All CAWST volunteers are invited to participate in a 4-day training workshop of their choice after completion of 40 volunteer hours. CAWST welcomes volunteers searching for work experience, and is happy to provide letters of reference to interested volunteers.

Classroom Workshop Facilitator (Various Positions)

Are you passionate about engaging youth on global issues? We are now recruiting for new Wavemakers volunteers to deliver classroom workshops in the Calgary area for grade K-12 students under our Youth Wavemakers Program.

Classroom Workshop Facilitator (Various Positions)

Youth Wavemakers program is CAWST’s local programming that works to engage, educate and empower Canadian educators and youth to help increase awareness of and catalyze action on local and global water issues. The Wavemakers program delivers classroom workshops grade K-12 and we are currently seeking dedicated volunteers to deliver classroom workshops in the Calgary area.

Duties and Responsibilities:

  • Attend an orientation session to become familiar with CAWST and our classroom workshop presentations. Shadow Wavemakers staff on your first workshop.
  • Deliver classroom workshops in the Calgary area to grades K-12. You will not be required to deliver to all ages and all areas of the City, please state your interests and availability.
  • Pick up and drop off presentation materials before and after presentations.
  • Support Wavemakers public engagement and promotion, including attending booths at Teachers’ Conventions.

Orientation and Training:

  • Attend a training session at the CAWST office. Date and time to be determined.
  • Training will also be provided in classrooms until you are comfortable presenting alone.

Time Requirement:

  • Minimum one day per month.
  • Workshops are generally during school hours, on weekdays.
  • We tend to have more workshops booked later in the school year.

Skills and Qualifications:

  • Experience in leading activities for youth
  • Comfortable talking to youth of all ages
  • Must be available during school times to deliver presentations
  • Responsible for transportation to and from workshops
  • Knowledge of CAWST’s mission and vision preferred

Department and Supervision: Public Engagement & Donor Initiatives, under Wavemakers Program Manager

Location: Various schools in the Calgary area

Application:

If you are already a CAWST volunteer, and you wish to apply for this volunteer position, please contact the Volunteer Program Coordinator, Tori D’Avella, at volunteers@cawst.org. If you are new to CAWST, please complete the volunteer sign up form.

Additional comments:

All CAWST volunteers are invited to participate in a 4-day training workshop of their choice after completion of 40 volunteer hours. CAWST welcomes volunteers searching for work experience, and is happy to provide letters of reference to interested volunteers

Yemen

Case Study Context

Country: Yemen
Context: Rural villages
Organisation: Solidarités International, CARE, and UNICEF
Point Person: Luca Zaliani, WASH Programme Manager, Solidarités International
Duration of Training: Half a day (covering 2 methods only)
Number of People Trained: 12 including hygiene promoters, WASH officers and WASH engineers
Duration of Data Collection: 2 days (about 3 hours in each village)
Number of Locations: 2

What appealed to you about the Wash’Em tools and made your organisation want to try them?

We made the decision as a mission, together with our HQ in France. We chose just to try two of the tools to start with. I chose the handwashing video because I wanted to show my team that it is important not just to ask questions about handwashing behaviour, but to also try and see directly what is the actual behaviour without influencing them. I also chose risk perception because I am interested in how people perceive their risk of disease. The other appealing thing about these two tools was that they seemed quite easy to understand for my team and for me to train them on. But I am very interested in the other three; we just thought we would do this as a start given the time we have and the profile of the team.

Having tried the Wash’Em tools, what is different about them compared to the standard processes you used for WASH assessments in crises?

The tools try to understand in more depth what works better, what will be more effective, and have greater impact. They provide qualitative data about real behaviours.

Give an example of one particularly interesting insight you gained from using the Wash’Em tools or something you wouldn’t otherwise have known.

My team realised that informed consent is an important step to get trust and not only to get the participant’s consent. An important aspect before starting the assessment is the presentation of the approach to communities. This enables the creation of a relationship with beneficiaries. It is part of the training, and can take more time than the assessment in itself.
 

“My team realised that informed consent is an important step to get trust and not only to get the participant’s consent.”

 

How does your organisation intend to use the findings?

We are withdrawing from the area in two weeks. I will hand over the findings to the WASH Coordinator and he will coordinate with other NGOs who will intervene in the area so that the activities can be implemented.

Nigeria

Case Study Context

Country: Nigeria
Context: Internally displaced people in camps in Maiduguri
Organisation: ACF
Point Person: Pir Bakhsh – ACF Nigeria Regional Coordinator WASH
Duration of Training: 2 days
Number of People Trained: 27 members of ACF WASH team including WASH managers, WASH officers and WASH assistants
Duration of Data Collection: 1/2 day
Number of Locations: 1 (4 teams)

What appealed to you about the Wash’Em tools and made your organisation want to try them?

Wash’Em allows you to get a real-time picture of handwashing practices and provides a user-friendly approach to improving the status of handwashing within displacement camps.

Having tried the Wash’Em tools, what is different about them compared to the standard processes you used for WASH assessments in crises?

Wash’Em does not just provide the figures about how many people are or are not washing their hands. It also identifies and dig out information about values, beliefs and the historical context of the community, generating many interesting stories.
 

“Wash’Em does not just provide the figures about how many people are or are not washing their hands. It also identifies and digs out information about values, beliefs and the historical context of the community, generating many interesting stories.”

 

Give an example of one particularly interesting insight you gained from using the Wash’Em tools or something you wouldn’t otherwise have known.

During the data collection, IDPs shared that they do have access to WhatsApp and this was very surprising for me. It turns out that WhatsApp is used for all sorts of purposes, like managing money and navigating the local economy.

How does your organisation intend to use the findings?

The Wash’Em findings will be used to develop a hygiene promotion strategy (centered on handwashing promotion) for the ACF Nigeria mission. We used the findings to develop a set of handwashing activities which we are incorporating into ongoing and new WASH grants for Borno and for the Yobe state in Nigeria.

CAWST in the News: Launching Multi-Million Dollar Match

CAWST was featured in the news for our announcement of a multi-million dollar investment by David O’Brien and Geoffrey Cumming that will match all new donations, one-to-one.

Pictured, left to right: Gail O’Brien, David O’Brien, Shauna Curry, Anna Cumming, and Geoffrey Cumming.
obrien-cumming-match-campaign-cawst
All donations up to $12-million will be matched, thanks to generous donations from David O’Brien and Geoffrey Cumming.

Following our announcement of the generous commitment by renowned businessmen and philanthropists David O’Brien and Geoffrey Cumming to CAWST, our story was featured in several news outlets.

660 News Calgary

Shauna Curry, CAWST’s CEO, was interviewed by 660 News Calgary. Tune into 660 News to listen (all day on June 6), or check out the article online.

Calgary Herald

The Calgary Herald interviewed David O’Brien, Geoffrey Cumming, and Hailey Carnegie. They spoke about their involvement in CAWST’s mission and our hope for increasing collaborative impact throughout the world. Read the article to learn more.

CBC News Calgary

David O’Brien, CAWST Board Chair and donor, was interviewed by CBC Calgary, featured on the Eyeopener and in an article. 

CBC Radio-Canada

Emilie Sanmartin, CAWST Public Engagement Lead, was interviewed by CBC Radio-Canada for Le Café radio show. Listen to the segment here (in French, at 7 h 46). 

CTV News Calgary

CTV News Calgary interviewed Shauna Curry, CAWST CEO. You can read the article here.

Consulting Canada

Consulting Canada, the Canadian branch of consultancy.org, an online platform for the global advisory and consulting industry, posted this article.


We are excited to launch the O’Brien-Cumming Match, and very thankful for the support we have received thus far. If you’re interested in joining us to tackle the critical global need for safe drinking water and safely-managed sanitation, please donate. 

 

Calgary-based global water charity receives multi-million dollar boost from two Canadian businessmen and philanthropists

CAWST, Centre for Affordable Water and Sanitation Technology, announced today two significant gifts from David O’Brien and Geoffrey Cumming that will see all new donations matched, up to $12 million.

MEDIA RELEASE

FOR IMMEDIATE RELEASE

 

 

 

CALGARY, June 6, 2019 – CAWST, Centre for Affordable Water and Sanitation Technology, announced today two significant gifts from David O’Brien and Geoffrey Cumming that will see all new donations matched, up to $12 million. The two successful Canadian businessmen and philanthropists have each chosen to invest in accelerating the impact of this Calgary-based international clean water charity.

“CAWST is addressing one of humanity’s biggest issues. I had the privilege of seeing the enormous leverage of this small, but mighty charity over the past 14 years. In 2017, I visited East Africa and witnessed how CAWST’s model is so effective and scalable,” said O’Brien, CAWST chairman and major donor. “This match campaign will change lives.”

CAWST is a Canadian charity and not-for-profit engineering consultancy that provides practical training to organizations in developing countries on household water and sanitation solutions. One-third of the world’s population—that’s 2.1 billion people—are trapped in a cycle of poverty because they lack access to safe, readily available water at home[1]. To tackle this issue, CAWST works to scale up the number of local water, sanitation and hygiene professionals in developing countries and improves their knowledge and skills.

“CAWST is notable for its can-do, entrepreneurial, spirit of innovation attitude. The high purpose of its mission and the professionalism of its people is what drew me to this organization,” said Cumming. “CAWST is tackling a critical global need and this unique international charity and professional engineering entity is making significant progress addressing clean water and sanitation in developing countries.”

Both O’Brien and Cumming are no strangers to philanthropic giving. Mr. O’Brien was named an Officer of the Order of Canada, recognizing him as a respected corporate leader and philanthropist, predominantly focusing on post-secondary education. In addition to CAWST, his notable list of charitable contributions include the O’Brien Institute for Public Health at the University of Calgary, Sick Kids, Centre for Addiction and Mental Health, McGill University and Concordia University, among others. Mr. Cumming’s transformational $100-million gift to the University of Calgary was one of the largest philanthropic gifts in Canadian history. In honour of the donation, which the Government of Alberta matched, the school of medicine at the University of Calgary carries the name, Cumming School of Medicine. Mr. Cumming also, among other initiatives, created and funds the annual global Ryman Prize, which is frequently referred to as the Nobel Prize relating to aging.

The O’Brien-Cumming Match kicks off immediately. The $12 million donation is split evenly between Mr. O’Brien and Mr. Cumming, with each party contributing up to $6 million. To learn more about CAWST and the match campaign, Canadians are encouraged to visit cawst.org.

About CAWST

Founded in 2001, CAWST is a Canadian charity and licensed not-for-profit professional engineering consultancy working to address the global need for safe drinking water, sanitation and hygiene in developing countries. CAWST reaches people in need by working with the thousands of existing, in-country organizations to start or improve their water and sanitation projects. To learn more about CAWST and its transformational work, visit cawst.org.

– 30 –

Media contact

Hailey Carnegie
Public Relations Lead
CAWST, Centre for Affordable Water and Sanitation Technology
hcarnegie@cawst.org
1.403.243.3285 ext. 258

Find the CAWST logo here.


References

[1]  Progress on drinking water, sanitation and hygiene: 2017 update and SDG baselines. Geneva: World Health Organization. (WHO) and the United Nations Children’s Fund (UNICEF), 2017. Licence: CC BY-NC-SA 3.0 IGO. who.int/water_sanitation_health/publications/jmp-2017/en/

 

National Nurses Week: Meet Rebecca Morante

In honour of National Nurses Week, we’d like to introduce you to an inspiring nurse on staff, Rebecca Morante. As a Global Learning Advisor, Becky navigates the space between WASH and health, focused on the causes of outbreaks, illnesses and infections, so we can most effectively prevent disease and promote health.

Happy Nurses Week!

In light of this week being National Nurses Week, we’d like to introduce one of our new team members at CAWST, Rebecca Morante.

This year’s theme is Nurses: A Voice to Lead – Health for All which is a fitting intro for Rebecca Morante, a Registered Nurse with an MSc in Health Education who sees her role as developing local leaders to improve WASH and health for those in need. Becky’s career as a nurse has evolved from emergency humanitarian relief to capacity development, recognizing, “The greatest changes will come from recognizing the potential within local people, helping them realize their potential and finding ways to develop leadership.” Educated in Calgary at Mount Royal University, Becky has worked in Australia, Cambodia, Lao PDR, Mexico, Myanmar, Nepal, New Zealand, and Peru.

Becky Morante, Registered Nurse, meeting with her staff in Lao PDR

As former Nursing Director of Northern Lao’s first full-service pediatric hospital, Becky brings a firsthand understanding of the links between maternal and child health, WASH and behaviour change. Joining CAWST as a Global Learning Advisor, Becky will navigate the space between WASH and health. Her experience designing training for health professionals is an exciting complement to the team’s instructional design expertise. In her words:

“If we can get to the sources of outbreaks, illnesses and infections, we can prevent disease and promote health. And in many cases, it all starts with water.”

This week and all weeks, we appreciate all the nurses, healthcare and WASH professionals working on this complex challenge towards a world where people have the opportunity to succeed because their water and sanitation needs have been met.

Learn more about the health impacts of WASH and its links to reproductive health, women & children in our infographic. Check it out at cawst.org/WASHandMNCH


Tori D’Avella, BA, MSOD is a Public Engagement Officer on the Public Engagement & Donor Initiatives team. Her background is working in indigenous community development in partnership with institutions and natural resource companies. Tori is a brilliant communicator and loves plants, cooking, and most outdoor activities. 

Summer Festival Crew Member (multiple positions available with various shifts)

CAWST is looking for individuals interested in setting up, hosting, and taking down our spring and summer festival booth and activities, to raise awareness and understanding of the challenges and solutions to access to safe water and sanitation.

The Position: Summer Festival Crew Member

 Purpose of the Role:

To help set up, host, and take down our fun and engaging CAWST booth at:

Please note: shifts for each festival are available. You will not be expected to be at the booth the entire time listed above.

Duties and Responsibilities:

  • Attend a training at the CAWST office (July 10, 5:30 – 6:30 pm)
  • Set up an engaging activity (such as the Poo Toss game, make your own filter, or a photo booth) that informs and engages people on the challenges and solutions of water and sanitation crisis
  • Talk with the festival attendees about CAWST’s model of development and how CAWST is addressing the water and sanitation crisis
  • Share ways to get involved with CAWST and information on Wavemakers and encourage sign ups for our newsletter or membership
  • Share content for live Tweeting during the events
  • Take down the display
  • Track and log volunteer hours with the CAWST volunteer coordinator

Orientation and Training:

  • An hour-long orientation is required. Scheduled for July 10, 5:30 – 6:30 pm at the CAWST Office.

Skills and Qualifications:

  • Familiar with CAWST
  • Friendly personality and keen to work with all ages
  • Passion to help CAWST spread the word about water & sanitation
  • Organized and reliable

Department and Supervision: Public Engagement and Donor Initiatives


Application:

If you are already a CAWST volunteer, and you wish to apply for this volunteer position, you can contact the Volunteer Program Coordinator, Tori D’Avella, at volunteers@cawst.org. If you are new to CAWST, please complete the volunteer sign up form and we will email you to confirm.

In your email, please tell us which festivals you are interested in volunteering at.

 

Additional comments:

All CAWST volunteers are invited to participate in a 4-day training workshop of their choice after completion of 40 volunteer hours. CAWST welcomes volunteers searching for work experience, and is happy to provide letters of reference to interested volunteers. 

Ethiopia

Case Study Context

Country: Ethiopia
Context: Internally displaced people in the SNNPRS region
Organisation: People in Need
Point Person: Girmay Hadgu, WASH Engineering and Infrastructure Advisor, People in Need
Duration of Training: 2 days
Number of People Trained: 4 members of its WASH team including hygiene promoters and WASH Engineers
Duration of Data Collection: 3 days
Number of Locations: 1

What appealed to you about the Wash’Em tools and made your organisation want to try them?

People in Need decided to try the Wash’Em tools because sometimes the assessment tool we were typically using doesn’t work perfectly, so we wanted to test and then adapt to our hygiene promotion standard across the mission.

 

Having tried the Wash’Em tools, what is different about them compared to the standard processes you used for WASH assessments in crises?

In the usual assessment period, we just focus on the known facts and methods, i.e., asking technical questions, which by nature can be difficult to easily understand. However, in this tool we learned that we should also give attention to people’s internal feelings. The Wash’ Em tools investigate not only whether people are lacking proper handwashing facilities, they also prompt us to explore the internal reasons or motives why people are not practicing handwashing. It digs more into the barriers to handwashing and then triangulates this with personal histories, Touchpoints, Risk Perception and Motives. I liked that there are images with the tools and these are used to support and trigger the questions. It makes it easy for the communities to participate and engage more. Being more interactive helps to us to get at the true cause of the problem. We were also able to analyse the data quickly and easily after the field visit.

“Being more interactive [by using the Wash’Em tools] helps to us to get at the true cause of the problem.”

 

Give an example of one particularly interesting insight you gained from using the Wash’Em tools or something you wouldn’t otherwise have known.

During interviewing with the “personal histories tool”, the IDPs said they were washing their clothes regularly and I was wondering how that is possible in this particular setup. However, through using this tool I learned that it was because they only have one or two items of clothing so washing them becomes a necessity.

 

How does your organisation intend to use the findings?

We will endeavour to design our programmes based on the recommendations and the key behavioural change challenges that we identified. We will keep focusing on making soap and adequate water more available to IDPs. We will consider the latrine handwashing facilities more attractive and accessible to kids. For the hygiene promotion package we engage IDPs in various committees to foster the feeling that they are capable and have meaningful roles in this new setting. Since our audience already gathers at churches and coffee ceremonies, we will link the hygiene promotion to church leaders and community meetings.

How can implementers use evidence to inform their handwashing programme design?

Over the last twenty years we have seen a growing number of publications about handwashing with soap and behaviour change. It can be hard to keep up with the literature. It can also be hard to know how to apply research findings to your programmes. In this blog I outline five key programme recommendations based on our current state of knowledge about handwashing.

 

1. Knowledge is not the answer

Almost everyone has a basic understanding of disease transmission and can explain the benefits of handwashing in simple terms – even populations with low levels of formal education (1,2). Unfortunately, having bio-medical knowledge does not mean that people are more likely to wash their hands with soap. Several studies have demonstrated that handwashing programmes which only focus on improving bio-medical knowledge have no effect on behaviour (3-6). Maybe this is not so surprising. If about 90% of people already know the benefits of handwashing, then increasing this by a few percentage points is not going to create a change of public health significance. Research also suggests that bio-medical ‘facts’ sit alongside a range of other beliefs and competing priorities (1, 7-10). Just think about your own behaviour. At the times when you need to wash your hands, say for example when you are about to sit down and enjoy a nice homemade dinner, you are not likely to be contemplating the transmission of faecal-oral pathogens! You will be smelling the tasty food, worrying about all the things you have to do, talking to your family, etc. All these other distractions mean that we rarely activate the health knowledge we possess at the times when it could be most useful.

 

2. Infrastructure really matters

Handwashing promotion programmes often deprioritise the most important mode of changing behaviour: improvements to handwashing infrastructure and products. Did you know that if households have access to a handwashing facility they up to 60% more likely to wash their hands with soap (6, 9, 11-16)? If soap and water are always available at that handwashing facility then people are 2-3 times more likely to wash their hands with soap than if these things were absent (13, 17-22). When handwashing facilities are conveniently located near the kitchen or toilet (20) and desirable and attractive (e.g. the facility has bright colours, has a soap container, has a mirror) (11, 15, 23-25) this can increase handwashing rates even further. This means that if we design handwashing promotion programmes comprising of only ‘soft’ behaviour change techniques in areas where the basic handwashing ingredients are lacking, then we may see no effect on behaviour. We may also risk offending or disengaging local populations who might wonder why we are promoting a behaviour that is not feasible for them to practice.

Handwashing programmes should also think carefully about how physical environments can be modified to cue handwashing behaviour. Using ‘behavioural nudges’ is one way of doing this. For example, one study showed that if you paint footprints on the path between the toilet and the handwashing facility handwashing behaviour increases by 64% (26). Another study paced an image of eyes above a handwashing facility, resulting in people being 10% more likely to wash hands (27). Lastly a study in a displacement camp found that putting toys in soap made handwashing more fun for children and made them 4 times more likely to wash their hands with soap (28).

 

3. Focus on getting people to wash their hands more frequently rather than more thoroughly

You will have all have seen posters which spell out the multiple steps of ‘correct and thorough handwashing with soap’. It might surprise you though that we don’t have good evidence to support most of these steps. We know that the following things can be beneficial: running water that allows you to rub both hands against each other to create a good soapy lather, cleaning under your nails and under jewelry, and drying your hands (29-35). We know that your hands do get cleaner the longer you wash them for but we do reach a point of diminishing returns (where lots of effort is required for fairly minimal additional pathogen removal)(33). On average people wash their hands for less than 10 seconds (36-38) – this nowhere near the WHO recommended 40-60 seconds. We also know that within an hour hands typically get as dirty as they were prior to them being washed (39). This means that if we want to make a public health difference we should focus on getting people to wash their hands more frequently even if they do it for a shorter, more realistic amount of time. Having said all this, thorough handwashing for longer durations, is much more important in healthcare settings or outbreak situations.

 

4. Meaningful behaviour change is not cheap, quick or easy

Handwashing promotion is often cited as one of the most cost-effective public health interventions (40, 41). These figures tend to be misinterpreted by donors and implementers alike and this commonly results in hygiene programmes being underfunded (42). The evidence suggests that sustained handwashing behaviour change is not normally cheap – nor is it quick to design and implement (43, 44). Achieving sufficient ‘dose’ seems to be a critical factor which can make or break a handwashing promotion programme (45-47). The easiest way to conceptualize ‘dose’ is to think about an analogy of a vaccine. Some vaccines are effective after only one dose but for many vaccines a person needs more than one injection in order for the vaccine to work. Similarly, most behaviour change programmes need to interact with target populations on multiple occasions, over an extended period of time, in order to be effective (48, 49). Handwashing programmes also seem to be successful when they target multiple delivery channels (50-53). Ideally programme implementers should consider combining mass media strategies with interpersonal techniques which reach the target population at the community and household level.

 

5. Everyone wants to be seen to wash their hands

Handwashing with soap is a socially desirable behaviour in all cultures. This has several implications for hygiene programmes. Firstly, it means that people are almost 50% more likely to wash their hands if there are other people in a public bathroom (27, 54, 55). Handwashing interventions which remind people that others might judge them on their handwashing behaviour have been shown to be effective (54). Secondly, it can make measuring handwashing behaviour rather challenging. If you ask people if they wash their hands with soap at critical times, most people know that the ideal answer is ‘yes’. This is one of the reasons why we find that self-reported measures handwashing behaviour typically overestimate actual practice. Although there is no perfect way of measuring handwashing behaviour (56-58) the Joint Monitoring Programme now suggests dropping self-reported handwashing measures in favour of using the new global handwashing indicator (59). This is a proxy measure which is rapid and cheap to assess and provides a meaningful comparable indicator.

This article will also be published by the Global Handwashing Partnership.

 


References

1. Curtis V, Danquah LO, Aunger RV. Planned, motivated and habitual hygiene behaviour: an eleven country review. Health education research. 2009;24:655-73.
2. Rabbi SE, Dey NC. Exploring the gap between hand washing knowledge and practices in Bangladesh: a cross-sectional comparative study. BMC public health. 2013;13:89.
3. Biran A, Schmidt WP, Wright R, Jones T, Seshadri M, Isaac P. The effect of a soap promotion and hygiene education campaign on handwashing behaviour in rural India: a cluster randomised trial. Trop Med Int Health. 2009;14.
4. Scott E, Herbold N. An in-home video study and questionnaire survey of food preparation, kitchen sanitation, and hand washing practices. Journal of Environmental Health. 2010;72(10):8-13.
5. Clayton DA, Griffith CJ, Price P. An investigation of the factors underlying consumers’ implementation of specific food safety practices. British Food Journal. 2003;105(7):434-53.
6. Contzen N, Meili IH, Mosler H-J. Changing handwashing behaviour in southern Ethiopia: A longitudinal study on infrastructural and commitment interventions. Social Science & Medicine. 2015;124:103-14.
7. Kaltenthaler EC, Drasar BS. Understanding of hygiene behaviour and diarrhoea in two villages in Botswana. J Diarrhoeal Dis Res. 1996;14(2):75-80.
8. Rheinlander T, Samuelsen H, Dalsgaard A, Konradsen F. Teaching minority children hygiene: investigating hygiene education in kindergartens and homes of ethnic minority children in northern Vietnam. Ethnicity & Health. 2015;20(3):258-72.
9. Biran A, Tabyshalieva A, Salmorbekova Z. Formative research for hygiene promotion in Kyrgyzstan. Health Policy Plan. 2005;20(4):213-21.
10. Rauyajin O, Pasandhanatorn V, Rauyajin V, Na-nakorn S, Ngarmyithayapong J, Varothai C. Mothers’ hygiene behaviours and their determinants in Suphanburi, Thailand. Journal of Diarrhoeal Diseases Research. 1994;12(1):25-34.
11. Ashraf S, Nizame FA, Islam M, Dutta NC, Yeasmin D, Akhter S, et al. Nonrandomized Trial of Feasibility and Acceptability of Strategies for Promotion of Soapy Water as a Handwashing Agent in Rural Bangladesh. American Journal of Tropical Medicine & Hygiene. 2017;96(2):421-9.
12. George CM, Monira S, Sack DA, Rashid M-u, Saif-Ur-Rahman KM, Mahmud T, et al. Randomized Controlled Trial of Hospital-Based Hygiene and Water Treatment Intervention (CHoBI7) to Reduce Cholera. Emerging Infectious Diseases. 2016;22(2):233-41.
13. Nizame FA, Leontsini E, Luby SP, Nuruzzaman M, Parveen S, Winch PJ, et al. Hygiene practices during food preparation in Rural Bangladesh: Opportunities to improve the impact of handwashing interventions. American Journal of Tropical Medicine and Hygiene. 2016;95(2):288-97.
14. Mbuya MN, Tavengwa NV, Stoltzfus RJ, Curtis V, Pelto GH, Ntozini R, et al. Design of an Intervention to Minimize Ingestion of Fecal Microbes by Young Children in Rural Zimbabwe. Clinical Infectious Diseases. 2015;61 Suppl 7:S703-9.
15. Biswas D, Nizame FA, Sanghvi T, Roy S, Luby SP, Unicomb LE. Provision versus promotion to develop a handwashing station: the effect on desired handwashing behavior. BMC public health. 2017;17(1):390.
16. Dobe M, Mandal RN, Jha A. Social determinants of good hand-washing practice (GHP) among adolescents in a rural Indian community. Family & Community Health. 2013;36(2):172-7.
17. Luby SP, Halder AK, Tronchet C, Akhter S, Bhuiya A, Johnston RB. Household characteristics associated with handwashing with soap in rural Bangladesh. The American journal of tropical medicine and hygiene. 2009;81(5):882-7.
18. Oswald WE, Hunter GC, Kramer MR, Leontsini E, Cabrera L, Lescano AG, et al. Provision of private, piped water and sewerage connections and directly observed handwashing of mothers in a peri-urban community of Lima, Peru. Tropical Medicine & International Health. 2014;19(4):388-97.
19. Halder AK, Tronchet C, Akhter S, Bhuiya A, Johnston R, Luby SP. Observed hand cleanliness and other measures of handwashing behavior in rural Bangladesh. BMC public health. 2010;10(1):545.
20. Hirai M, Graham JP, Mattson KD, Kelsey A, Mukherji S, Cronin AA. Exploring Determinants of Handwashing with Soap in Indonesia: A Quantitative Analysis. Int J Environ Res Public Health. 2016;13:868.
21. Luby SP, Halder AK. Associations among handwashing indicators, wealth, and symptoms of childhood respiratory illness in urban Bangladesh. Trop Med Int Health. 2008;13(6):835-44.
22. Scott BE, Lawson DW, Curtis V. Hard to handle: understanding mothers’ handwashing behaviour in Ghana. Health policy and planning. 2007;22:216-24.
23. Jenkins MW, Anand AR, Revell G, Sobsey MD. Opportunities to improve domestic hygiene practices through new enabling products: a study of handwashing practices and equipment in rural Cambodia. International Health. 2013;5(4):295-301.
24. Hulland KR, Leontsini E, Dreibelbis R, Unicomb L, Afroz A, Dutta NC, et al. Designing a handwashing station for infrastructure-restricted communities in Bangladesh using the integrated behavioural model for water, sanitation and hygiene interventions (IBM-WASH). BMC public health. 2013;13:877.
25. Rahman MJ, Nizame FA, Unicomb L, Luby SP, Winch PJ. Behavioral antecedents for handwashing in a low-income urban setting in Bangladesh: an exploratory study. BMC public health. 2017;17(1):392.
26. Dreibelbis R, Kroeger A, Hossain K, Venkatesh M, Ram PK. Behavior Change without Behavior Change Communication: Nudging Handwashing among Primary School Students in Bangladesh. International journal of environmental research and public health. 2016;13(1).
27. Pfattheicher S, Strauch C, Diefenbacher S, Schnuerch R. A field study on watching eyes and hand hygiene compliance in a public restroom. Journal of Applied Social Psychology. 2018;48(4):188-94.
28. Watson J, Dreibelbis R, Aunger R, Deola C, King K, Long S, et al. Child’s play: Harnessing play and curiosity motives to improve child handwashing in a humanitarian setting. Int J Hyg Environ Health. 2018.
29. Hoque BA. Handwashing practices and challenges in Bangladesh. Int J Environ Health Res. 2003;13 Suppl 1:S81-7.
30. Luby SP, Halder AK, Huda T, Unicomb L, Johnston RB. The effect of handwashing at recommended times with water alone and with soap on child diarrhea in rural Bangladesh: an observational study. PLoS medicine. 2011;8.
31. Lin CM, Wu FM, Kim HK, Doyle MP, Michael BS, Williams LK. A comparison of hand washing techniques to remove Escherichia coli and caliciviruses under natural or artificial fingernails. J Food Prot. 2003;66(12):2296-301.
32. Friedrich MN, Julian TR, Kappler A, Nhiwatiwa T, Mosler HJ. Handwashing, but how? Microbial effectiveness of existing handwashing practices in high-density suburbs of Harare, Zimbabwe. American journal of infection control. 2017;45(3):228-33.
33. Bloomfield S, Aiello A, Cookson B, O’Boyle C, L. Larson E. The Effectiveness of Hand Hygiene Procedures in Reducing the Risks of Infections in Home and Community Settings Including Handwashing and Alcohol-Based Hand Sanitizers2007.
34. Patrick DR, Findon G, Miller TE. Residual moisture determines the level of touch-contact-associated bacterial transfer following hand washing. Epidemiol Infect. 1997;119(3):319-25.
35. Huang C, Ma W, Stack S, editors. The hygienic efficacy of different hand-drying methods: a review of the evidence. Mayo Clinic Proceedings; 2012: Elsevier.
36. Borchgrevink CP, Cha J, Kim S. Hand washing practices in a college town environment. J Environ Health. 2013;75(8):18-24.
37. Lee M-S, Hong SJ, Kim Y-T. Handwashing with soap and national handwashing projects in Korea: focus on the National Handwashing Survey, 2006-2014. Epidemiology and health. 2015;37:e2015039-e.
38. Garbutt C, Simmons G, Patrick D, Miller T. The public hand hygiene practices of New Zealanders: a national survey. The New Zealand medical journal. 2007;120(1265):U2810.
39. Devamani C, Norman G. A simple microbiological tool to evaluate the effect of environmental health interventions on hand contamination. International journal of environmental research and public health. 2014;11(11):11846-59.
40. Cairncross S, Valdmanis V. Water supply, sanitation, and hygiene promotion. In: Disease Control Priorities in Developing Countries (2nd Edition). New York: Oxford University Press. 771-792. 2006.
41. Townsend J, Greenland K, Curtis V. Costs of diarrhoea and acute respiratory infection attributable to not handwashing: the cases of India and China. Tropical Medicine & International Health. 2017;22(1):74-81.
42. Moreland LD, Gore FM, Andre N, Cairncross S, Ensink JHJ. Monitoring the inputs required to extend and sustain hygiene promotion: findings from the GLAAS 2013/2014 survey. Tropical Medicine and International Health. 2016;21(8):1029-39.
43. Greenland K, Chipungu J, Chilekwa J, Chilengi R, Curtis V. Disentangling the effects of a multiple behaviour change intervention for diarrhoea control in Zambia: a theory-based process evaluation. Global Health. 2017;13(1):78.
44. Rajaraman D, Varadharajan KS, Greenland K, Curtis V, Kumar R, Schmidt WP, et al. Implementing effective hygiene promotion: lessons from the process evaluation of an intervention to promote handwashing with soap in rural India. BMC public health. 2014;14:1179.
45. Greenland K, Chipungu J, Curtis V, Schmidt WP, Siwale Z, Mudenda M, et al. Multiple Behaviour Change Intervention for Diarrhoea Control in Lusaka, Zambia: Cluster Randomised Trial. Lancet Global Health 2016.
46. Lewis HE, Greenland K, Curtis V, Schmidt WP. Effect of a School-Based Hygiene Behavior Change Campaign on Handwashing with Soap in Bihar, India: Cluster-Randomized Trial. The American journal of tropical medicine and hygiene. 2018.
47. Chase CD, Quy-Toan. Handwashing Behavior Change at Scale: Evidence from a Randomized Evaluation in Vietnam 2012.
48. Cairncross S, Shordt K. It does last! Some findings from a multi-country study of hygiene sustainability. Waterlines. 2004;22(3):4-7.
49. Tidwell JB, Gopalakrishnan A, Lovelady S, Sheth E, Unni A, Wright R, et al. Effect of Two Complementary Mass-Scale Media Interventions on Handwashing with Soap among Mothers. J Health Commun. 2019:1-13.
50. Scott BE, Schmidt WP, Aunger R, Garbrah-Aidoo N, Animashaun R. Marketing hygiene behaviours: the impact of different communication channels on reported handwashing behaviour of women in Ghana. Health education research. 2008;23:392-401.
51. Galiani S, Gertler P, Ajzenman N, Orsola-Vidal A. Promoting Handwashing Behavior: The Effects of Large-scale Community and School-level Interventions. Health Econ. 2016;25(12):1545-59.
52. Gautam OP, Schmidt WP, Cairncross S, Cavill S, Curtis V. Trial of a Novel Intervention to Improve Multiple Food Hygiene Behaviors in Nepal. American Journal of Tropical Medicine & Hygiene. 2017;96(6):1415-26.
53. Biran A, Schmidt W, Varadharajan K, Rajaraman D, Kumar R, Greenland K, et al. Effect of a behaviour-change intervention on handwashing with soap in India (SuperAmma): a cluster-randomised trial. Lancet. 2014;In print.
54. Judah G, Aunger R, Schmidt WP, Michie S, Granger S, Curtis V. Experimental pretesting of hand-washing interventions in a natural setting. American Journal of Public Health. 2009;99 Suppl 2:S405-11.
55. Nalbone DP, Lee KP, Suroviak AR, Lannon JM. The Effects of Social Norms on Male Hygiene. Individual Differences Research. 2005;3(3):171-6.
56. Ram P. Practical Guidance for Measuring Handwashing Behavior. WSP website: Water and Sanitation Program 2010.
57. Ram PK, Halder AK, Granger SP, Jones T, Hall P, Hitchcock D, et al. Is Structured Observation a Valid Technique to Measure Handwashing Behavior? Use of Acceleration Sensors Embedded in Soap to Assess Reactivity to Structured Observation. The American journal of tropical medicine and hygiene. 2010;83(5):1070-6.
58. Contzen N, De Pasquale S, Mosler H-J. Over-Reporting in Handwashing Self-Reports: Potential Explanatory Factors and Alternative Measurements. PLOS ONE. 2015;10(8):e0136445.
59. WHO, UNICEF. Monitoring Hygiene JMP website,: JMP; 2015 [Available from: https://washdata.org/monitoring/hygiene.

Webinar: Doing hygiene programming better (March 26th, 2019)

Wash’Em produced a webinar on March 26th, 2019 introducing Wash’Em and case studies of the tools being used Here is the recording.

Wash’Em produced a webinar on March 26th, 2019 introducing Wash’Em and case studies of the tools being used. Below is the recording.


About this project

“This project is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of Action contre la Faim (ACF), The London School of Hygiene and Tropical Medicine (LSHTM), and CAWST (Centre for Affordable Water and Sanitation Technology) and do not necessarily reflect the views of USAID or the United States Government.

 

Democratic Republic of the Congo – Kasai

Case Study Context

Country: Democratic Republic of Congo
Context: Internal Displacement in Kasai
Organisation: Medair
Point Person: Tom Russell, WASH Advisor, Medair & Anna Mutula, Trainer (responses from Anna)
Duration of Training: 1 day
Number of People Trained: 3 WASH staff and a security officer
Duration of Data Collection: 3 days
Number of Locations: 3 villages where IDPs live

Having tried the Wash’Em tools, what is different about them compared to the standard processes you used for WASH assessments in crises?

The Wash’Em tools are strategic, fast and easy to learn. Based on testimonies from the staff I trained, the other tools that they are used to using require many days to conduct. They felt that the other tools didn’t really allow them to become aware of the real problems faced by the community. But the Wash’Em tools, on the other hand, have very clear questions and create a climate of trust between the assessor and participant, which allows you to understand the problem and its solution. This has also allowed us to know what exactly the community needs. With KAP questionnaires, the questions are only superficial and the answers are taken out of context. That’s why organizations always think of ‘sensitizing’ the population over and over again even though they are already aware. Wash’Em helps to focus on the behavioural part that is missing.
 

The Wash’Em tools are strategic, fast and easy to learn. Wash’Em helps to focus on the behavioural part that is missing.

 

Give an example of one particularly interesting insight you gained from using the Wash’Em tools or something you wouldn’t otherwise have known.

With Medair, I have conducted  two assessments using the Wash’Em tools in Kasai and Goma. These are very different regions with people facing different issues. But I realised that the activities NGOs are doing in Goma are the same as in Kasai: ‘sensitization or education on handwashing’ but unfortunately that has not brought any positive results. I was surprised to realize that people know the critical moments for handwashing, and how to wash their hands (even children do); but no one was actually practicing it. This is due to unavailability of handwashing facilities, water and soap in their homes. It is great that the Wash’Em tools do also suggest a response to this challenge.

CAWST in the News: World Water Day 2019

CAWST was featured in the news for sparking knowledge and action across Canada for World Water Day.

Calgary, March 22, 2019

For sparking action across Canada, CAWST was featured in multiple media channels on World Water Day.

The Weather Network

The Weather Network aired a story nationally on TV. The online story can be viewed here.

 

660 News Calgary and Edmonton

Tune into 660 News to hear the story (all day on March 22), or check out the article online. This story was also picked up by Edmonton City News.

In observance of World Water Day, CAWST spreads the word on water, with multiple events, and organizing landmarks and national monuments to light blue for the day. Pete Thomson, CAWST’s Senior Director of Training & Consulting, was interviewed on 660 News and talked about this important issue:

World Water Day draws attention to the fact that whoever you are, wherever you are, water is a human right, and it is a big issue in the world right now.

In the world, right now, there are approximately 2.1 billion people (about a third of the world’s population) that don’t have access to safe, readily available water. That’s something I think everybody should care about.

Canadians may not have to put much thought to having access to safe drinking water, yet the daily reality for nearly a third of the world’s population is very different. As Pete shared in the interview, “In the world, right now, there are approximately 2.1 billion people, about a third of the world’s population, that doesn’t have access to safe, readily available water. That’s something I think everybody should care about.”

We are Water

On World Water Day, CAWST premiered a short video on its social media channels, “We are Water“, which was also shared on 660 News.


The United Nations has designated March 22 as World Water Day. This year, the theme for World Water Day is “Leaving No One Behind”. This theme represents the global goal to reach all people with access to safe drinking water and recognizes that a lack of safe drinking water disproportionately affects marginalized groups.

World Water Day only happens one day a year, but here at CAWST we work on it every day! To find out more and to get involved, check out our Paint It Blue page.

Lebanon

Case Study Context

Country: Lebanon
Context: Informal settlements of Syrian refugees
Organisation: Concern Worldwide
Point Person: Olivia Leroux – WASH & Shelter Program Manager, Concern Worldwide
Duration of Training: Half a day
Number of People Trained: 2 hygiene promoters and 2 hygiene volunteers
Duration of Data Collection: 4 days
Number of Locations: 4 tented settlements

What appealed to you about the Wash’Em tools and made your organisation want to try them?

In Lebanon, all WASH actors use the same standards tool to assess the WASH situation in informal tented settlements. Those tools are often quantitative and not qualitative, and also time consuming.

We had been looking for something simpler instead. A qualitative tool to better understand the motivations and obstacles behind handwashing, that did not create survey fatigue among our beneficiaries.

 

Having tried the Wash’Em tools, what is different about them compared to the standard processes you have used for WASH assessments in crises?

Instead of asking the same standards questions about whether or not people know the 5 moments of handwashing, this tool explores the motives behind them. It tries to get a sense of how the context has evolved so that they have changed/adapted their behaviours. The tools go beyond asking whether or not people wash their hands: they help to quickly understand why people do what they do, why they develop some fears, and how their environment is impacting their practices.

The Wash’Em tools are also fun to use and people do not get bored in participating, compared to most of the traditional tools I have used before.

 

These tools go beyond asking whether or not people wash their hands: they help to quickly understand why people do what they do, why they develop some fears, and how their environment is impacting their practices.

 

Give an example of one particularly interesting insight you gained from using the Wash’Em tools or something you wouldn’t otherwise have known.

Here’s one example. We discovered that even if the level of knowledge related to diarrhea and handwashing is high, beneficiaries do not think that diarrhea can actually lead to death or have major health complications, meaning they do not consider diarrhea as a risk, when they reported increased diarrhea after the crisis.

This, of course, is a misconception. In the aftermath of an emergency, about 40% of all deaths are due to diarrhea.

 

How does your organisation intend to use the findings?

Based on the findings, Concern Worldwide has started brainstorming about installing new handwashing facilities adapted to people with specific needs (such as elderly people, and persons with disabilities) and to children (at child height). The doors of the latrines have also been modified to feature a drawing about handwashing, to remind people to wash their hands after visiting the latrines. The drawing chosen will be based on the results of a drawing competition between the children living in the camp.

Some mirrors will also be distributed to these populations for the beautification of the handwashing space. Concern Worldwide would like also to try this tool in a location where no hygiene promotion has ever taken place, to compare the results and also adapt strategies.

As far as the other suggested activities and messages, we will be discussing them at a national level and with UNICEF, who are keen to see more innovative hygiene promotion approaches.

Zimbabwe

Case Study Context

Country: Zimbabwe
Context: Cholera Outbreak
Organisation: Action contre la Faim
Point Person: Tom Heath – WASH Advisor
Duration of Training: Half a day
Number of People Trained: 6 Hygiene Promoters
Duration of Data Collection: 1 day
Number of Locations: 1 urban cholera hotspot

What appealed to you about the Wash’Em tools and made your organisation want to try them?

We believed Wash’Em allowed you to understand a population, to get into the context that matters quickly, with sufficient specificity to use the information  and it gives you activities.

 

Having tried the Wash’Em tools, what is different about them compared to the standard processes you used for WASH assessments in crises?

Wash’Em provides formative data quickly, it digs into beliefs, stories and actual practices, enabling you to develop a better picture of the day-to-day realities. It cuts quickly into the aspects that are interesting when collecting data on hygiene.
 

Wash’Em provides formative data quickly, it digs into beliefs, stories and actual practices, enabling you to develop a better picture of the day-to-day realities. It cuts quickly into the aspects that are interesting when collecting data on hygiene.

 

Give an example of one particularly interesting insight you gained from doing the Wash’Em tools or something you wouldn’t otherwise have known.

We found out that there was no stigma for households with cholera, that people feel out of control. From the perceptions tool we found two interesting conflicting views of risk: one group reported cholera as a spiritual matter, a curse that can only be prevented through prayer. In sharp contrast, in another group which included two people who had experienced cholera, there was more fear. In addition, we found that households who had experienced cholera re-evaluated their priorities in life and spent more time with their family and less time playing snooker!

 

How does your organisation intend to use the findings?

We shared the findings with the Global WASH Cluster during cholera responses. We also tried to incorporate the recommendations into a new proposal and into our intervention strategy.

The Philippines

Case Study Context

Country: Philippines
Context: Super Typhoon Ompong Recovery
Organisation: WASH Cluster (including ACF, Oxfam, Samaritan’s Purse and UNICEF)
Point Persons: Paul Del Rosario – WASH Programme Coordinator and co-WASH Cluster lead, UNICEF
Sandra Corpuz – Hygiene Promoter, Samaritan’s Purse
Nayco Yap – WASH Coordinator ACF
Duration of Training: Half a day
Number of People Trained: 10 WASH program managers, and government
Duration of Data Collection: 2.5 days
Number of Locations: 4 rural villages

Responses from Paul Del Rosario, UNICEF

 

What appealed to you about the Wash’Em tools and made your organisation want to try them?

The ease and speed of gathering and analysing information compared to our usual way of collecting insights on people’s hygiene behaviour, e.g., through Knowledge, Attitude and Practice (KAP) surveys, especially in an emergency, life-saving situation where things necessarily need to be done in the shortest possible time. Potentially also cheaper compared to surveys (e.g., no need to hire enumerators, encoders, etc). We understand the tools were developed through the Global WASH Cluster, which also added to the appeal when introduced in the Philippines through the national WASH Cluster.
 

Having tried the Wash’Em tools, what is different about them compared to the standard processes you used for WASH assessments in crises?

The process is definitely more participatory (compared to a mere survey which tends to be too stiff) and with this, there’s also the opportunity to link up with other WASH issues, for example, water and sanitation. There’s even the opportunity to link to other sectors; for example, from our pre-testing experience in typhoon-affected areas, the link between livelihoods and hygiene behaviour became more apparent.

 

The [Wash’Em tools] process is definitely more participatory (compared to a mere survey which tends to be too stiff) and with this, there’s also the opportunity to link up with other WASH issues, for example, water and sanitation. There’s even the opportunity to link to other sectors.

 

How does your organisation intend to use the findings?

As co-lead of the national WASH Cluster, promotion of the tools to the wider Cluster partners for application during emergency and disaster situations. Possibly also with the wider emergency WASH stakeholders.

 


 

Responses from Sandra Corpuz, Samaritan’s Purse

 

What appealed to you about the Wash’Em tools and made your organisation want to try them?

The Wash’Em tools appeared to be interesting for two reasons: (1) their speed of analysis, where in a matter of 2-3 days, we could come up with a hygiene promotion program; and (2) the holistic data gathering where not only could we get information specifically about handwashing behaviour, but also other factors that affect human behaviour.

Having tried the Wash’Em tools, what is different about them compared to the standard processes you used for WASH assessments in crises?

Unlike the KAP survey which only captures knowledge, attitude and practices, the Wash’Em tools help us gauge what are the factors driving and preventing the community from having proper hygiene practices and proper sanitation facilities. These tools help us see the bigger picture of why people are not washing their hands, so that in return, we can address these issues and get good hygiene practices results.

Give an example of one particularly interesting insight you gained from using the Wash’Em tools or something you wouldn’t otherwise have known.

It is very common for humanitarian actors to provide the community with what we think they need. Having tried the Wash’Em tools, we appreciate the fact that more than giving them the aid to meet their basic needs based on our perspective, we can design interventions that are more sustainable and effective as they are based on their actual needs. This is what was provided by the results of the Wash’Em tools.

How does your organisation intend to use the findings?

We are planning to administer the Wash’Em tools where we currently have WASH programs.

 


 

Responses from Nayco Yap, Action contre la Faim

 

Having tried the Wash’Em tools what is different about them compared to the standard processes you used for WASH assessments in crises?

In general, the tools offer a very logical and systemic approach to get evidence in the field, and a fast approximation for hygiene behaviour programs in emergencies. We had several attempts in the past to address some of the bottlenecks in the Knowledge, Attitude and Practice (KAP) survey with the use of online platforms and real-time approaches. However, there were more misses on opportunities that we failed to look into versus what Wash’Em have achieved in a very short period. Wash’Em is not a perfect tool but it is perfect enough to address some of the issues we had with resource intensive KAPs. The appeal of the tool is pretty straightforward for those who are involved in emergency response programs. It is easy and practical to use, it involves the participation of everyone when analyzing results and you don’t need a specialist to interpret and analyse the data for you. So yes, we are keen in using Wash’Em in our emergency response.

The appeal of the tool is pretty straightforward for those who are involved in emergency response programs. It is easy and practical to use, it involves the participation of everyone when analyzing results and you don’t need a specialist to interpret and analyse the data for you. So yes, we are keen in using Wash’Em in our emergency response.

 

Give an example of one particularly interesting insight you gained from using the Wash’Em tools or something you wouldn’t otherwise have known.

Wash’Em provides a logical, systematic and planned approach for your hygiene behaviour programs. Beyond handwashing, Wash’Em was able to surface other issues that links handwashing practice to other sectors such as livelihoods. I believe that non-WASH people who were facilitating the Wash’Em tool were able to gain a fair understanding of the relationships between hygiene practices and other things, such as people’s livelihoods. Therefore the tools provide organizations a dynamic, creative, innovative and collaborative opportunity to discuss and design humanitarian programs. The tools are not static and they can easily draw a spontaneous response from people’s experiences, including local knowledge, without being too mechanical and predictable. However, there are areas in the tools itself and in their processes that need to be improved.

How does your organisation intend to use the findings?

Action Against Hunger is responding to Wash’Em results by designing a hygiene behaviour program to address and prioritise some of the key issues in handwashing. Action Against Hunger will use Wash’Em in its future response to contribute to the knowledge base on behaviour change.

South Sudan

Case Study Context

Country: South Sudan
Context: Long-term displacement camps
Organisation: Concern Worldwide
Point Person: Eunice Whande, Hygiene Specialist, Concern Worldwide
Duration of Training: Spread across 6 days
Number of People Trained: 20 hygiene promoters (with limited literacy) and two WASH supervisors.
Duration of Data Collection: 4 days
Number of Locations: 1 camp setting

A group using the Wash'Em tools

What appealed to you about the Wash’Em tools and made your organisation want to try them?

We have tried other methods in our communities without really understanding handwashing, and we had been unable to plan effective activities for handwashing with soap.

Having tried the Wash’Em tools, what is different about them compared to the standard processes you used for WASH assessments in crises?

I liked the handwashing demonstration tool the most. With this tool I could get a lot of information by just watching the videos. It gives a true reflection of handwashing practices in the community. It showed how likely it really was that handwashing is practiced—unlike when using other tools where we just rely on what the interviewee says or thinks. The videos were easy to share with the team to discuss the findings, analysis and implementation. We are still using the videos for discussions and implementation of some activities. The other tools were also very helpful and much better to use than the questionnaires or group discussions I had used before.

I liked the handwashing demonstration tool the most. With this tool I could get a lot of information by just watching the videos. It gives a true reflection of handwashing practices in the community. It showed how likely it really was that handwashing is practiced—unlike when using other tools where we just rely on what the interviewee says or thinks.

 

Give an example of one particularly interesting insight you gained from using the Wash’Em tools or something you wouldn’t otherwise have known.

I was surprised where soap for handwashing is kept and the time it would take people to wash their hands with soap in these circumstances.

How does your organisation intend to use the findings?

We will continue to use them for assessments and monitoring. We will also use the videos and the findings to facilitate handwashing discussions.