UNICEF and its government counterpart are implementing a large WASH programme with explicit
behavioural change goals. A baseline survey showed that handwashing with soap (HWWS) was most
frequent after defecation (17%) or cleaning a child’s anus (23%), and lowest around foodrelated
events
(<1%). Observed practices are sharply poorer than selfreported
behavior. After one year, significant
improvement was noted in handwashing practices following contact with faecal matter, but HWWS
before preparation, serving or eating of food remained stubbornly low. Open defecation had declined,
most notably in the poorest quintile. Morbidity was not significantly different in control and intervention
households. However, intervention households were significantly more likely to have coliformfree
household water (48%) than were control households (32%). This robust monitoring framework has
allowed the project to understand WASH practices in the target communities in detail, and to identify
areas of success and areas where efforts need to be redoubled
