In 2014, the Sustainable Sanitation and Hygiene for All (SSH4A) program was introduced in Tanzania to raise mothers’ and caregivers’ awareness of the importance of washing hands with soap after changing their babies’ nappies. Relying heavily on the creation of norms, social diffusion, and modeling behaviors, this in-person intervention was designed to take place in a group setting at local vaccination centers. To start each intervention, a trained facilitator would welcome participants into the meeting space, and soon after, a mother would change her baby in front of the group then proceed to offer biscuits to other individuals in the room without taking time in between to wash her hands. Once biscuits had been offered, the facilitator would engage with the group, asking participants that did not accept a biscuit what their reasons were for declining the offer. The facilitator would then proceed by asking the mother what she could have done differently and what handwashing practices at her home looked like. After hearing from participants, the facilitator provided information about the importance of handwashing for preventing the spread of disease, shared five critical times for handwashing with soap, and ended the session by demonstrating the proper procedure for handwashing. A survey conducted in one of the thirteen districts where this intervention was implemented showed that the rate of handwashing with soap in local households had increased from 20% to 40%.
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