Improving Lives through Handwashing

By Luckson Katsi, WASH Advisor & Technical Specialist, and Sonia Ehrlich Sachs, Health Director, The Earth Institute

Improving Lives through Handwashing

Unilever’s health soap brand Lifebuoy is working with the Millennium Villages Project (MVP), an innovative model for helping poor rural African communities reach all the Millennium Development Goals (MDGs). MVP is a community-led development approach based on an integrated package of interventions in all sectors including agriculture, health, education, infrastructure and business development. In 2012, the Millennium Villages Project and Unilever launched a new partnership to promote hygiene education and behavioural change in order to decrease incidence of childhood diarrhoea and pneumonia, which are a major cause of child mortality. Central to this WASH (water, sanitation and hygiene) partnership is promoting hand washing with soap at specified key moments. The “School of Five” is a 21 day school-based behavioural change programme targeting primary school children to promote hand washing practices and therefore decrease incidence of illnesses and ultimately save children’s lives. The programme also works on developing Hand Washing with Soap Ambassadors, encouraging school children to take the behaviour change messages home and into their community, helping reduce the spread of germs and diseases.

Hand washing with soap is one of the most cost-effective public health interventions and has been shown to significantly reduce the transmission of infectious diseases, including diarrhoea and pneumonia. Together, MVP and Unilever aim to further progress toward Millennium Development Goal (MDG) 4, – reducing child mortality – by encouraging hand washing with soap, and to demonstrate a sustainable and scalable model for hygiene behaviour change in sub-Saharan Africa.

The collaboration supports hygiene education by working with WASH technical experts at the Earth Institute at Columbia University in New York, technical experts in Columbia’s regional centres in Dakar and Nairobi and with WASH facilitators in Millennium Village field offices in ten countries in sub-Saharan Africa. To date, the hand washing with soap “School of 5” programme has been piloted at Millennium Villages schools in Nigeria, Kenya, Ghana and Uganda. To replicate this project in schools in other Millennium Villages, the partnership trained MVP personnel from Malawi, Rwanda, Tanzania and Ethiopia in July 2013 and staff from Mali and Senegal received the same Training of Trainers in August 2013. This training process equips MVP staff to train Master Teacher Trainers who can then roll out the school-based behaviour change programme in their schools in the broader cluster of Millennium Villages (total population of around 500,000 villagers). Community Health Workers have been key in supporting and strengthening our health and hygiene education and so will also be key in rolling out this hand washing with soap initiative.

The project is also intensifying efforts to block contamination pathways of water drawn from protected sources to ensure the water remains safe for human consumption. We’re tackling this through raising awareness on the importance of proper safe water withdrawal, transportation, storage, handling and usage. This programme, which also distributes the message of hand washing with soap at the critical times, will be further spread by involving mothers and other members of the communities. To complement this training, all the MVP offices and sites participated in the annual commemoration of Global Handwashing Day.

Challenges faced

  • Despite clear evidence that simple hand washing with soap interventions can reduce the rate of diarrhoeal disease, the practice is not universal. Making it habitual at all critical occasions is still a challenge but the project’s approach of developing hand washing ambassadors among school children seems promising.
  • A lack of soap, water and hand washing stations at schools and at household level hinders faster progress. However, the project has been encouraging low cost simple hand washing facilities such as tippy taps to be used in all sites. In some Millennium Villages, such as the Potou cluster in Senegal, the project has been supporting village women groups in the community production of soap.

Lessons learnt

  • Hand washing with soap offers measurable health benefits and governments should be encouraged to prioritise hygiene education in primary schools and communities.
  • Community women offer a unique platform to enhance health and hygiene education and should be empowered.
  • A preliminary evaluation of Lifebuoy’s hand washing behavior change programme in the Bonsaaso Millennium Village cluster in Ghana has demonstrated the effectiveness of the programme in sub-Saharan Africa
  • There was a significant, 22%, increase in hand washing among “School of 5” children compared to control children.
  • Their average length of hand washing with soap was also much longer and, together with frequency increase, meant they spent 40% longer washing their hands each day.

What does this mean for business?

  • Roll out and policy implications: we can use the positive results of our hand washing programme to justify hand washing with soap education in schools with key African governments. We’ve demonstrated a model, which is efficacious, cost effective and can be deployed at scale. Businesses can also then justify this social investment to their stakeholders.
  • The globalised world becomes ever more connected and new markets continue to emerge. Hand washing practices will increase demand in markets for water installations and for soap. Therefore developing business and entrepreneurship will be vital to sustain the gains of the Millennium Villages Project and meet the demands of growing economies.
Editor’s Note:

This blog is one in a five-part series with Unilever-Lifebuoy.

Click here to donate to the Lifebuoy Help a Child Reach 5 Campaign.

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