Contact details

Submitted by: 

• London School of Hygiene and Tropical Medicine
• Action Contre la Faim 
• Centre for Affordable Water and Sanitation Technology (CAWST)

Email: 

Sian White, Research Fellow, London School of Hygiene and Tropical Medicine - [email protected]

Website: washem.info/

Social:  Facebook  /  Twitter

Introduction to the project 

Countries

Global

Including: Iraq, DR Congo, Philippines, Myanmar, Bangladesh, Afghanistan, Lebanon, Jordan, Zimbabwe, Tanzania, South Sudan, Ethiopia, Nigeria, Haiti, Yemen, Cameroon and Colombia

Duration

Wash’Em began in October 2016. The first phase of the project was exploratory, aiming to learn more about the determinants of handwashing behaviour in different types of crises and understand the constraints humanitarians faced when designing hygiene behaviour change programmes for crises. From October 2018 we launched the rapid assessment tools and have since been supporting humanitarian actors to use these. In early 2020 we will launch the Wash’Em software.

The current phase of funding is due to end in March 2020. However we have sought funding for a final phase of work which will look more at the impact and sustainability of the Wash’Em process. 

Description

Wash’Em is a one-week process for designing hand-washing behaviour change programmes. It involves using 5 rapid assessment tools. Findings are then entered into a decision-making software which generates context-adapted recommendations.

Project aims 

To provide humanitarians with a process for designing rapid, evidence-based and context-specific handwashing behaviour change programmes for emergencies.

Resources used 

We spent two years conducting literature reviews, interviewing humanitarians and working with crisis affected populations. Through this research we identified that many of the current available tools are not fit for purpose and are not being utilised in emergencies. This insight shaped our desire to help humanitarians do better. USAID/OFDA saw the value in this and has supported the project financially since its inception.

Main activities of the Good Practice

The Wash’Em process involves using 5 rapid assessment tools to understand behaviour. Then you enter your findings into the Wash’Em software which will give you tailored programme recommendations.

Partners

• Wash’Em is a partnership between LSHTM, ACF and CAWST.
• 45 local and International NGOs, UN Agencies and Government agencies have been in testing Wash’Em in contexts where they work
• Wash’Em is made possible by the generous support of the American people through the United States Agency for International Development (USAID)

Challenges and how they were overcome

Challenge 1: Learning how humanitarians learn 

We realised that one of the main reasons resources aren’t used is that the format and length of current documents means they are overlooked in emergencies or resources are not in the hands of those who need them most.

How the challenge was overcome: 

We have created Wash’Em materials in a range of formats. For example, we have created simple 2 page briefs in a range of languages, short videos to demonstrate how the rapid assessment tools should be conducted, face-to-face training manuals and slide decks, an online support hub for users to ask questions, and programme recommendations that are as simple as following a recipe.

Challenge 2: Bridging the gap between perfect and possible

Through our research we learned that most humanitarians think behaviour change is something that is beyond their capacity. We wanted to help them understand behavioural theory and use existing evidence but also wanted the Wash’Em process to be accessible for someone with no prior experience.

How the challenge was overcome: 

The Wash’Em development process has been highly iterative and has brought together experts with different skills. We have endeavoured to regularly check in with humanitarians and crisis affected populations to make sure all our decisions make sense to practitioners. We have kept to simple language and have embedded options to allow users to read and learn more if they wish, while keeping the basic content to a minimum.

Challenge 3: Different organisational ways of working

One barrier to uptake of new innovative processes is that most organisations already have standard ways of operating.

How the challenge was overcome: 

In many countries we have rolled out training on the tools through the WASH Cluster. This has proved very effective as it encourages actors to collaborate, share experiences and findings and seek funding together. We have identified ‘Wash’Em champions’ within organisations who can support the use of the tools across their country programmes.

Results of the Good Practice 

• Humanitarians have reported that the Wash’Em Rapid Assessment tools give them a much richer understanding of hand-washing behaviour but also of the broader experiences of refugees and crisis affected populations. They feel that the Wash’Em process allows them to put the voices of crisis affected populations at the centre of their programme design.
• Crisis affected populations find the rapid assessment tools fun to take part in and value having the opportunity to share their own experiences and priorities.
• Since this is a relatively new process, most Wash’Em designed programmes are still being implemented. In our next phase of work we intent to track impact of Wash’Em programmes on behaviour.

How the project meets the GCR Objectives

The Good Practice contributes to Objective 2: Enhance refugee self-reliance

Wash’Em places a strong focus on designing hygiene programmes which are sensitive to the needs of crisis-affected populations and which build refugee agency and dignity. Handwashing behaviour change may at first seem a strange platform through to champion this. However, maintaining hygiene is at the core of what it is to be human and hygiene programmes done poorly can be offensive and cause harm. Hygiene promotion activities promoted within Wash’Em link hygiene with livelihoods and mental health care and protection. Activities also promote creativity and local innovation, helping refugees to re-build their sense of agency and make their situation more comfortable.

Next steps 

We continue to support interested users to try out the tools to aid their programme design processes.