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World Bank Assesses Results of Handwashing Initiative in Peru

December 2012: A recent study released by the Water and Sanitation Programme of the World Bank assesses the results of the Handwashing Initiative (HWI), and reveals the limits of mass-media tools for hygiene behavioral change and child health improvement in Peru.

The report, titled "Promoting Handwashing Behavior: The Effect of Mass Media and Community Level Interventions in Peru," highlights that in poor regions, diarrhea and acute respiratory infections account for two-thirds of deaths among children under five. To prevent diseases by minimizing the transmission of harmful pathogens present in fecal matter, the World Bank launched "The Global Scaling Up Handwashing," a Water and Sanitation (WSP) project aimed at fostering new behavior approaches towards handwashing practices among women of reproductive age (ages 15-49) and primary school-age children (ages 5-9). With technical support of the WSP, local and the Governments of Peru, Senegal, Tanzania, and Viet Nam have implemented the programme.

In the case of Peru, HWI developed marketing and strategic communication activities aiming to reach a large part of the population by applying two levels of behavior change interventions, between September 2009 and December 2010. In this period, two methods were used: mass media and direct consumer contact (DCC) proceedings at the provincial level, and additional activities delivered in communities and schools.

However, this project is reported to have demonstrated the limits of radio, print and public events alone as drivers of behavior change. According to a WSP research brief, the programme could positively affect handwashing practices of caretakers and children when combined with more intensive activities at the community-level, but only to a limited extent since child health did not considerably improve.

The main lesson of the HWI is that future work should focus on the identification of "other complementary interventions and removing environmental barriers to ensure significant and sustainable improvements in child health." [Publication: Promoting Handwashing Behavior: The Effect of Mass Media and Community Level Interventions in Peru]