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WHAT DO WE KNOW ABOUT HAND WASHING PRACTICES? A review of the results of the formative research studies from the Global Public-Private Partnership for Hand washing with Soap and other sources DRAFT FOR REVIEW (Not for citation)

LSHTM/Hygiene Centre for Unilever PLC

Lisa Danquah Valerie Curtis Robert Aunger February 2007

WHAT DO WE KNOW ABOUT HAND WASHING PRACTICES? A review of the results of the formative research studies from the Global Public-Private Partnership for Hand washing with Soap and other sources Lisa Danquah, Valerie Curtis, Robert Aunger Summary HWWS and health Handwashing with soap is one of the most effective and cost-effective means of preventing the infections that kill millions of children in the developing world each year. However, good handwashing practice is rare and handwashing practices are private and difficult to change. The most effective behaviour change programmes are those that are based on detailed knowledge of the practices, their context and the factors that hinder and facilitate them. Formative research for HWWS The Global PPPHW and a number of other hygiene promotion programmes have been carrying out formative research into handwashing over the past decade including the ten countries reviewed here (Ghana, Senegal, Peru, Kyrgyzstan, Madagascar, China (Sichan and Shaanxi), India (Kerala),Vietnam, Tanzania, Uganda). This report brings together the results of this work, asks what is common and what is different about handwashing in these diverse settings and suggests some directions for the future. Our review employs a meta-model of behaviour change which treats behaviour as an outcome of psychological factors (cognitions, motivations and habits) and environmental factors (physical, biological and social). HWWS at key junctures Findings suggest that HWWS at key junctures, such as after the toilet, or after cleaning up a child, is not a common practice, occurring on average at only 17% and 13% of occasions. However, the use of...