Analysis of hand washing behaviors measured in baseline impact evaluation surveys : findings from Peru, Senegal, and Vietnam

Hand washing with soap has been shown to reduce diarrhea and respiratory disease, the two leading causes of childhood deaths in low- and middle-income settings. Global scaling up hand washing was initiated in 2006 by the water and sanitation program (WSP) in Peru, Senegal, Tanzania, and Vietnam. The hand washing promotion interventions deployed in the global scaling up countries were developed using a framework known as focus, opportunity, ability, and motivation (FOAM). A hand washing promotion intervention can only result in improved health or other downstream benefits if it results in increased hand washing behavior. In the impact evaluation of global scaling up hand washing, hand washing is measured using self-reports, rapid observations, and structured observations, recognizing that each method provides useful insights into awareness about hand washing, the availability of materials necessary for hand washing, and the practice of washing hands at critical times. Specifically, with respect to the FOAM framework, this report addresses constructs within the focus, opportunity, and ability domains. The goal of this report is to describe hand washing behavior of households included in the project impact evaluation, as measured during the baseline surveys conducted in Peru, Senegal, and Vietnam. The baseline surveys of global scaling up hand washing indicate opportunities to improve hand washing behavior in all of the countries where interventions are being tested. In the future, correlations can be described between measures and relationship with disease risk and other hygiene behaviors in the home, including sanitation and household water treatment.