Behavior Profile: Handwashing with Soap
Improve maternal and child survival
Family members wash hands with soap under running water at 4 critical times [after defecation, after changing diapers, before food preparation and before eating]
Among households where place for handwashing was observed, percentage of households with soap and water. Soap includes soap or detergent in bar, liquid, powder or paste form.

Behavior Analysis

Strategy

BEHAVIOR AND STEPS

What steps are needed to practice this behavior?

Family members wash hands with soap under running water at 4 critical times [after defecation, after changing diapers, before food preparation and before eating]

  1. Construct or purchase handwashing station
  2. Obtain soap and water
  3. Maintain handwashing station with soap and water at all times

FACTORS

What factors may prevent or support practice of this behavior?
Structural
Accessibility: Family members are unable to wash their hands because they lack water and secured soap.
Social
Family and Community Support: Family members do not wash their hands with soap because family members often do not reinforce handwashing, especially among younger children.
Norms: Family members do not wash their hands at all critical times because it is not regularly practiced or reinforced by community members.
Internal
Attitudes and Beliefs: Family members wash their hands because they believe it is disgusting to not wash hands after defecation or before handling food.
Attitudes and Beliefs: Family members wash their children’s hands because they view it as a form of nurturing for children.
Knowledge: Family members do not always wash their hands because many are unaware of the diseases transmitted by unclean hands.
Knowledge: Family members do not always wash their hands at the critical moments because they forget.

SUPPORTING ACTORS AND ACTIONS

Who must support the practice of this behavior, and what actions must they take?
Institutional
Policymakers: Establish financing schemes for soap and handwashing stations.
Community
Community Leaders: Support local soap and handwashing station marketing efforts.
Community Leaders: Promote hand washing at community events and public locations like schools, maintain a handwashing station in own household, and find ways to create reminders for handwashing at home or in the community.
Household
Family Members: Encourage and assist children to wash their hands as a way of avoiding ingestion of feces.

POSSIBLE PROGRAM STRATEGIES

What strategies will best focus our efforts based on this analysis?

Strategy requires Communication Support

Enabling Environment
Policies and Governance: Monitor and ensure availability of low-cost soap and handwashing stations for the most vulnerable.
Systems, Products and Services
Products and Technology: Develop locally appropriate handwashing stations and train families how to construct stations themselves.
Products and Technology: Integrate soap storage into handwashing station designs that reduce the risk of spoilage or theft of the soap.
Quality Improvement: Train providers to promote handwashing with caregivers.
Demand and Use
Advocacy: Support community leaders with tools to make handwashing behavior public, including installation of handwashing stations in public locations and publicly tracking the behavior.
Communication: Use media channels to highlight the risks of not washing hands with soap and promote the benefits of handwashing with soap behaviors (not washing hands after defecation and before eating means eating feces).
Communication: Create context disruptions and visual cues in the community and household to provide reminders for handwashing.
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