Global Scaling Up Handwashing Project : Results, Impacts, and Learning from Vietnam

The Vietnam Handwashing Initiative (HWI) began in January 2006 with the goal of reducing morbidity and mortality from diarrheal diseases in children less than five years of age. In December 2006, Vietnam became one of four countries in the Water and Sanitation Program's (WSP) Global Scaling Up Handwashing Project. The objective of the project was to learn how to stimulate improved hand washing behaviors at large scale, sustain the activities after the project ended, and measure the impact on behavioral, health, and welfare outcomes. This learning note presents the achievements, learning, and reflections that resulted from implementing a large-scale hand washing program in Vietnam and provides recommendations for future hygiene promotion initiatives. During the four-year implementation (2006-2010), the program achieved all four of its key objectives. However, a randomized control trial (RCT) impact evaluation found no significant changes in hand washing behavior and no impact on health in children under two. Although much has been learned about how to implement a nation-wide communication program in Vietnam, behavior change at scale has proven challenging.