Monitoring impacts of WASH interventions: the case of SHEWA-B

UNICEF and its government counterpart are implementing a large WASH programme with explicit behavioural change goals. A baseline survey showed that handwashing with soap (HWWS) was most frequent after defecation (17%) or cleaning a child’s anus (23%), and lowest around foodrelated events (<1%). Observed practices are sharply poorer than selfreported behavior. After one year, significant improvement was noted in handwashing practices following contact with faecal matter, but HWWS before preparation, serving or eating of food remained stubbornly low. Open defecation had declined, most notably in the poorest quintile. Morbidity was not significantly different in control and intervention households. However, intervention households were significantly more likely to have coliformfree household water (48%) than were control households (32%). This robust monitoring framework has allowed the project to understand WASH practices in the target communities in detail, and to identify areas of success and areas where efforts need to be redoubled.