Join Us for a Series of Deep Dives
Welcome to our special blog series, Deep Dives, where we take an in-depth look at the unique strategies, evidence, and challenges our team and partners encounter in global WASH (Water, Sanitation, and Hygiene) operations. We’d love to hear your thoughts—whether it’s feedback, questions, or requests for specific topics. Ending global WASH poverty is a collective effort, and collaboration is key! Join the conversation in the LinkedIn comments or reach out to us directly at info@waterforgood.org.
Written by: Zerihun Desta, Chief Operating Officer, and Adrienne Lane, VP of Strategic Initiatives
What to Expect in This Series
We’ll be covering several key areas where we believe innovation, transparency, and collaboration can lead to sustainable change:
- Integrated WASH: We’ll present evidence of the health, economic, and social impacts achieved through door-to-door, intensive, and community-wide strategies via the Vision of a Healthy Village model.
- Sustainability: Expect candid discussions on what’s working, where gaps remain, and how experimentation and partnerships can help fill those gaps.
- Becoming a Truly Global Organization: We’ll share updates on our ongoing journey toward localization, subsidiarity, and fostering south-south collaboration.
Now, let’s dive into the first topic: a unique aspect of the Vision of a Healthy Village model—household-level behavior change beyond traditional methods.
Going Beyond Community-Led Total Sanitation (CLTS)
A critical feature of the Vision of a Healthy Village model is its emphasis on sustained, household-level behavior change. This approach builds on and improves the traditional Community-Led Total Sanitation (CLTS) framework by focusing on monitoring individual households’ sustained behavior change.
One key difference is the time invested in registering and monitoring sanitation and hygiene behaviors for every household. Local WASH facilitators visit homes door-to-door, certifying progress based on seven Healthy Home criteria. These facilitators map each household using mWater and track progress over 15 months of intensive training and engagement. By the end of this phase, the goal is for over 90% of households to achieve Healthy Home certification.
The data gathered during this intensive phase is critical to continuously refining our efforts. It allows us to evaluate how to create durable private household demand for safe water, sanitation, and hygiene. This approach isn’t about delivering advice and leaving. It’s about walking alongside communities, listening to their needs, and helping them reach their goals.
Mobilizing Local Health Facilitators for Door-to-Door WASH Outreach
Achieving significant and long-lasting behavior change is not quick or easy. One of the primary challenges is the cost and time associated with such personalized outreach. To address this, we’ve developed a targeted social mobilization network:
- We identify early adopters within the community and train them to support broader adoption of WASH practices.
- Local facilitators lead about 25 households each, guiding them toward achieving healthy home status.
- Water for Good’s staff provide intensive training and stipends to facilitators, empowering them to become sanitation and hygiene champions within their communities.
What It Takes and the Impact
In each focus program area/subdistrict, on average:
- 8 Water for Good staff recruit and train 150 local facilitators.
- Each facilitator is assigned 25 households.
- Each household receives 12+ hours of peer-to-peer hygiene training.
Over a 15-month intensive phase, local facilitators will collectively spend over 50,000 hours training their neighbors on sanitation and hygiene, impacting ~20,000 people.
Those training efforts are paying off. Over the last five years, we’ve consistently documented a 90% reduction in childhood diarrhea from baseline to endline, with sustained improvements in post-project evaluations.
Questions Driving Our Next Deep Dives
We’re committed to continuous learning and collaboration. As we move forward, we’ll explore key questions shaping the future of this model, including:
- How can this model complement market-based sanitation approaches?
- How long and how consistently do households maintain the Healthy Home criteria after certification?
- How do national public health regulations, customary laws, and social or religious norms influence long-term WASH behavior change in rural areas?
- What barriers do households face in sustaining sanitation and hygiene practices and infrastructure?
We look forward to diving deeper into these questions—and more—in the upcoming blogs. Your insights and questions are welcome as we work together to drive sustainable change in WASH. Stay tuned for the next post in our Deep Dive series!
