Behavior change campaigns are very important to raise the awareness of the need for proper hygiene, but as awareness increases they have diminishing returns in cost-per-outcome. When implemented alone, awareness campaigns typically fail to result in observed, widespread HWWS practice at critical times.
- Promotion without product: Discussions with mothers, and results from pre-testing handwashing stations, revealed that although knowledge of handwashing with soap after using the toilet is high, they will forget if there is not a physical reminder right outside the latrine.” [WSP, 2011]
- The lack of substantial changes in handwashing behavior resulting from the project suggests the difficulty of changing behavior at scale, even under seemingly optimal conditions where knowledge about handwashing with soap and access to soap and water are not key barriers. [WSP, 2011]
The launch of a purpose-built handwashing device, available for purchase by households, is a considerably distinct approach. As awareness rises, the remaining barrier to HWWS is no longer a lack of knowledge but the absence of a fixed place for washing hands with soap in rural homes.
This partly explains the history of provision by various NGO agencies of enabling technologies such as buckets with valves, tippy-taps, splashy jugs, and other crude devices with the purpose of storing and regulating the flow of water. Makeshift solutions, albeit subsidized or free, have not gained traction with rural end-users nor made a significant impact on HWWS behavior. WaterSHED does not foresee these Do-It-Yourself products as significantly competitive or hindering, and does not consider them to be particularly relevant comparables for costs per development impact. Indeed, during its stage 1 DIV project, WaterSHED confirmed that 72 percent of consumers were not aware of any products on the market.
WSP. Vietnam: A Handwashing Behavior Change Journey for the Caretakers’ Program. Global Scaling Up Handwashing Project. December 2011.