WATER AND SANITATION PROGRAM: LEARNING NOTE
56910
Global Scaling Up Handwashing Project
Key findings
� The project's focus on emergent learning
and emphasis on performance monitoring
Senegal: A Handwashing allowed for critical mid-term adjustments,
correcting the course of the behavior
Behavior Change Journey change journey to become more effective
in reaching and communicating to families.
September 2010 � Men are a critical part of the behavior
change journey. Initially the behavior
change interventions focused on women,
but learnings emerged from the field
INTRODUCTION indicating that the project needed to better
In 2003, the Public-Private Partnership A second phase of activities was initiated leverage the roles men play in their families
for Handwashing with Soap (PPPHW) in early 2008 through WSP's Global (provider, protector, and role model) to
was created in Senegal with technical Scaling Up Handwashing Project. This help promote handwashing with soap.
project is focused on learning how to
assistance from the Water and Sanitation
apply innovative promotional approaches � Having a tangible product supports
Program (WSP). Housed initially within the to behavior change to generate behavior change intentions. A sample
Office Nationale de L'Assainissement, the widespread and sustained improvements handwashing station helps make the
government unit overseeing sanitation in handwashing with soap at scale among solution more tangible and concrete, and
within the Ministry of Health, the PPPHW's women of reproductive age (ages 15�49)
facilitates women's intention and planning
main objective was to catalyze and and primary school-aged children (ages
to ensure handwashing with soap occurs
5�9). Local and national governments are
coordinate multi-sectoral involvement in in the household.
implementing the project in Peru, Senegal,
the promotion of handwashing with soap.1 Tanzania, and Vietnam with technical � Just-in-time coaching and a performance
support from WSP.3
monitoring system are critical in
A first phase of activities, initiated
in 2004, culminated in a 10-month transforming community outreach workers
During this second phase, activities
communications campaign launched in Senegal were expanded to eight of (the relays) into valuable community
in 2007. Anchored around the theme, the country's then 11 regions, with the resources--beyond conveying information
"Water Rinses but Soap Cleans," the objective of reaching over 1.5 million to facilitating mothers' problem-solving
campaign focused on conveying "first mothers with children under the age abilities and fortifying their intentions to
generation messages" to improve of five through an integrated behavior wash hands with soap.
knowledge around the critical times for change approach. The final objective is to
washing hands and the importance of improve the handwashing with soap � A simple game can be a powerful tool
using soap. Campaign activities included practices of over 500,000 mothers and for engaging men, women, and children.
nationally aired television and radio children. In parallel, efforts were directed A handwashing-themed board game
spots; entertainment-education events at strengthening the enabling environment designed by an advertising agency
in market places and schools; and to ensure that activities and outcomes provides a way for the community-based
small-group discussions conducted with would be sustained after the project end. promoter to "break the ice" and introduce
women's associations (called m'botayes) the main messages to everyone in the
and in the waiting rooms of local health This Learning Note serves to document the
household in an engaging and fun way.
centers.2 behavior change component of the project
1
For more information on the PPPHW, see www.globalhandwashing.org.
2
Small group discussions were conducted in three regions, Thi�s, Diourbel, and Dakar, and in one
department, Velingara.
3
For more information on the Global Scaling Up Handwashing Project, see www.wsp.org/
scalinguphandwashing.
2 Senegal: A Handwashing Behavior Change Journey Global Scaling Up Handwashing Project
in Senegal, including key strategies, results, challenges, and the factors or determinants that influence handwashing with
lessons learned. soap. Previous studies undertaken in Senegal focused primarily
on knowledge and motivation and did not examine the full
spectrum of determinants identified in FOAM.
PROBLEM STATEMENT
Diarrhea prevalence among children under the age of three in
The 2008 "doer/non-doer" study reported the following:
Senegal was last estimated at 22 percent and the prevalence
of acute respiratory infections within the same age group at
� Asked when it is important to wash one's hands, unaided
13 percent.4 A study conducted by the PPPHW5 indicated that,
responses were "after going to toilet" (78 percent), "before
based on observations, handwashing rates with soap were
eating" (32 percent), "before preparing food" (30 percent),
relatively low:
and "before feeding child" (18 percent). Assisted recall was
considerably higher: the percentage of respondents declaring
� 23 percent after going to toilet
they "always" washed their hands was 95 percent after going
� 18 percent after cleaning a child
to toilet, 93 percent after touching child's bottom, 86 percent
� 18 percent before handling food
before eating, 67 percent before preparing food, and 62
percent before feeding child.
Although 95 percent of households had some sort of soap available
� The importance of soap--the focus of the first phase--seemed
for bathing or laundry, previous studies pointed to issues around its
to be well understood: 34 percent strongly disagreed and
availability and access for handwashing purposes such as:
52 percent disagreed with a statement that "water alone is
enough."
� Soap is usually far from the toilet or source of water6
� The link between soap and germ removal was also
� Soap is controlled by women7 and/or often in the hands of
understood: close to 80 percent agreed or strongly agreed
someone who doesn't want to share it8
that to remove dirt and invisible germs you need to wash
� Most households do not have a specific place for handwashing.9
hands with soap. Almost all (98 percent) agreed or strongly
agreed that washing hands with soap protects the health of
Early in the second phase, the project team undertook a large
your children.
quantitative "doer/non-doer" study among 2,040 mothers to
identify which behavioral determinants were correlated with
The study further revealed that access/availability was statistically
handwashing with soap. The project had developed a simple
correlated with handwashing. In particular, having a designated
behavior change framework called FOAM (Figure 1)10 to analyze
place for handwashing with soap in the home, the ability to buy
soap without having to ask someone else, and the ability to find
Figure 1: FOAM Behavior Change Framework soap each time it was needed were salient characteristics found
among mothers classified as handwashers.
Focus Opportunity Ability Motivation
Based on the findings of the "doer/non-doer" study, the project
Access/ Belief and
Target attitudes team decided there was no need to continue emphasizing
availability Knowledge
behavior either the importance of soap for handwashing or the link
Outcome between handwashing with soap and disease prevention as
Product expectations
attributes these knowledge areas seemed well established. Knowledge
Target Social
Threat around excreta-related critical times (after going to the toilet
population Social support and cleaning baby) was also relatively sound, but knowledge
norms Intention
around the critical importance of handwashing with soap at
food-related times (before eating and preparing food) required
some improvement.
4
Ndiaye, Salif, and Mohamed Ayad. 2006. Enqu�te D�mographique et de Sant� au S�n�gal 2005. Calverton, Maryland: Centre de Recherche pour le D�veloppement
Humain [S�n�gal] and ORC Macro.
5
Aunger, B. 2004. Public-Private Partnership for Handwashing: Senegal: Report on Behavioural Trials. London: Hygiene Center, London School of Hygiene and
Tropical Medicine.
6
Ibid.
7
Kane, M. 2009. Rapport �tude lavage des mains au savon S�n�gal. Unpublished study, Water and Sanitation Program, World Bank.
8
Aunger 2004.
9
Kane 2009.
10
This framework is based on the PERForM framework of Population Services International. For additional information, see Introducing FOAM: A Framework to Analyze
Handwashing Behaviors to Design Effective Handwashing Programs, available at www.wsp.org/scalinguphandwashing.
www.wsp.org
Global Scaling Up Handwashing Project Senegal: A Handwashing Behavior Change Journey 3
Figure 2: Process of Habit Formation � Mental simulation involves thinking through the what, when,
where, and how of the intended behavior, making it harder
to forget.13 These plans of action are also referred to as
"implementation intentions."
Based on the results of the "doer/non-doer" study and findings
Behavior from the literature review on the sustainability of behavior,
Implementation
Repetition in relegated to the project team decided to evolve to a "second generation"
Intentions
stable context cues communications program focused on awakening, fortifying, and
(conscious)
(automatic) supporting intentions to wash hands with soap. The "second
generation" communications program centered on improving
availability of soap and water in the household when and
where needed, identified in the "doer/non-doer" study as a key
behavioral determinant of handwashing with soap. In addition
to improving handwashing with soap rates at four critical times
The process of habit formation starts with a conscious intention (before eating and preparing food, after going to the toilet and
("I must wash my hands after going to the toilet") and is fortified cleaning a baby), the team identified creating a designated place
through repetition in a stable context ("I wash my hands for handwashing with soap as a behavioral objective.
at this handwashing station"). As the behavior is practiced
repeatedly it becomes more automatic and can be triggered ACTION
by an environmental cue or reminder ("seeing the handwashing
Communications Strategy: From First to Second
station when I exit the latrine reminds me to wash my hands").
Generation Messages
The three main communication channels from the first phase
have been retained to reach mothers for the following reasons:
While the "doer/non-doer" data was being analyzed, the Mass media. Billboards, television, and radio are useful to
project team initiated a literature review on the sustainability of convey the overarching concept of a campaign and provide an
behavior. This review identified a considerable body of research umbrella slogan or visuals for all other channels. Senegal enjoys
around habit formation. In particular, Verplanken and Wood a good coverage of mid-sized billboards even in peri-urban
suggest that habit formation begins with a conscious period of areas. For habitual behaviors such as handwashing, TV and
implementation intentions,11 similar to the "intention" determinant radio spots also provide reminders or cues to action, particularly
in the FOAM framework. Because handwashing requires easy if aired during times when mothers are preparing meals.
access to soap and water when and where needed, some Television and radio broadcasting in Senegal have relatively
level of planning and intention is required. Once the behavior high coverage. Ownership of radio and TV is respectively
is repeatedly practiced in a stable context automaticity can set 87.2 percent and 40.1 percent; however, access is assumed to
in (Figure 2). be higher due to sharing among households, particularly in rural
areas.14 Listenership among women is particularly large during
The literature review further highlighted that: broadcast of South American and Indian soap operas.
� Interventions should make people aware of the resources Direct Consumer Contact (DCC). Used by commercial firms in
they have to change behavior (skills, or strategies such as brand marketing efforts, DCC provides an opportunity to engage
planning).12 and interact with the audience through community events. In
� Planning is critical to one's progress from behavioral intention behavior change interventions, DCC uses an entertainment-
to actual performance of the behavior. Success scenarios, education approach and invites local authorities to participate. In
preparatory strategies, and mental simulation encourage Senegal, market areas allow DCC to reach mothers while they are
performance of actual behavior. purchasing food staples and supplies for the day. By including
11
Verplanken, B., and W. Wood. 2006. Interventions to Break and Create Consumer Habits. Journal of Public Policy and Marketing, 25(1):90�103.
12
Schwarzer, R., B. Sch�z, J. P. Ziegelmann, S. Lippke, A. Luszczynska, U. Scholz. 2007. Adoption and maintenance of four health behaviors: Theory-guided
longitudinal studies on dental flossing, seat belt use, dietary behavior, and physical activity. Annals of Behavioral Medicine, 33(2):156�166.
13
Ibid.
14
Ndiaye 2006.
www.wsp.org
4 Senegal: A Handwashing Behavior Change Journey Global Scaling Up Handwashing Project
Figure 3: Fortifying Intentions to Handwash with Soap by specially trained animateurs, the program includes, among
others things, presentations of the television spot, handwashing
with soap demonstrations, and a question and answer session to
engage audience members and refresh basic knowledge. The
events also include testimonials from women and government
I have a authorities to reinforce commitment and intentions from mothers
I have handwashing through the emerging local norms.
a plan with soap
station and IPC focuses on building skills and self-confidence among
I am
committed wash my hands mothers to make soap and water available when needed and to
create a designated place for handwashing with soap. Research
This figure represents the process through which intentions to suggests that generating discussion around how, when, and
wash hands with soap are fortified through the intervention. where mothers handwash with soap can contribute to translating
intention and commitment (awakened and fortified through the
Women commit themselves and formulate a plan to "make
mass media) into action.15 Group discussion provides a forum
handwashing happen" at home. The intended end-result is to
for problem-solving on issues such as how to make soap easily
have and use a handwashing station.
accessible, how to prevent waste or theft, and how to convince
another household member to buy soap.
A consultant was recruited to develop a curriculum and
testimonials or handwashing demonstrations by local leaders,
training materials to help mothers plan the steps they could
DCC also allows the program to mirror emerging social norms.
take to make soap and water available for handwashing in
their home and to set up a dedicated handwashing station.
Interpersonal Communication (IPC). Conducted at the
IPC is integrated with mass media through the distribution
household level, IPC enables mothers to be reached in a real-life
of campaign materials such as stickers. In addition, at the
setting and allows behavior change interventions to influence
conclusion of an IPC session, mothers are asked to repeat the
determinants such as beliefs and skills, for which mass media
spot's slogan to pledge their commitment. In a limited number
is less suited.
of cases, a plastic handwashing station has been left behind
as a promotional item.
Communications Concept: Fortifying Intentions
The communications intervention's main concept of fortifying
intentions to handwash with soap is illustrated in Figure 3. The Figure 4: "Second Generation" Billboard
mass media and DCC efforts focus on securing a commitment
from mothers to get their family to wash their hands with soap,
and IPC follow-up helps mothers think through a plan for making
this happen.
A creative brief for the contracted advertising agency called
for a warm, engaging, and positive communications concept
(i.e., without an emphasis on disease or threat) that could
be adapted across all channels. After several iterations and
pre-testing with the target audience, the final concept for
print communications such as billboards featured a mother
declaring, "I commit myself to get my family to wash their
hands with soap!" A "second generation" billboard is shown A billboard developed as part of the project's second generation
in Figure 4.
mass media campaign targeted women's commitment to the
DCC events organized in market areas and open spaces such health of their family: "I commit myself to get my family to wash
as soccer fields reach 500 to 2,000 people at a time (attendance their hands with soap!"
tends to be higher in rural areas than in peri-urban ones). Delivered
15
Schwarzer, R., B. Sch�z, J. P. Ziegelmann, S. Lippke, A. Luszczynska, U. Scholz. 2007. Adoption and maintenance of four health behaviors: Theory-guided
longitudinal studies on dental flossing, seat belt use, dietary behavior, and physical activity. Annals of Behavioral Medicine, 33(2):156�166.
www.wsp.org
Global Scaling Up Handwashing Project Senegal: A Handwashing Behavior Change Journey 5
Implementation Arrangements: From The project team set up a robust integrated performance
Grass-Roots Organizations to Commercial Firms monitoring system to follow both the quantity of activities
(outputs) and the quality of the intervention. The main
Mass media. To implement the mass media component, the
components include:
project completed a competitive bid process to procure two
separate firms: one to design the communications concept and
produce the materials, another to develop the media plan and Management Information System (MIS). A MIS was
purchase radio, television, and billboard space. This same firm designed to generate standard and customized reports,
also monitors the airwaves to ensure the media plan is followed enabling the project team to track actual results against
by the broadcast stations and oversees the billboards to ensure targets and to analyze the situation along a variety of
they are in prime condition (e.g., not knocked down during a dimensions (e.g., region, implementing agency, and others).
storm). A first wave of mass media ran from the end of June A consultant was recruited to design the MIS to track outputs
to December 2009 and included 92 television and 1,496 radio from the implementing agencies, including key indicators
spots. A second wave of mass media, now underway, will from country and global results frameworks. Firms recruited
conclude in October 2010. to manage DCC and IPC activities have been trained to use
forms to capture standard information for each household
visit and event conducted (such as number and profile of
DCC. Two firms were procured and contracted to implement
participants, materials used, challenges encountered, etc.)
DCC in northern and southern regions. The firms conducted
and these forms are collected and entered into the MIS on a
events more or less simultaneously, totaling 161 events by
regular basis.
December 2009. A second wave of DCC, now underway, is also
scheduled to end in October 2010.
Media monitoring. As discussed above, a firm was contracted
to monitor airwaves to ensure that the media spots are broadcast
IPC. In the first phase, IPC was conducted with small groups
according to plan by individual television and radio stations. In
of women in public places by commercial firms. In the second
the event of discrepancies, the firm negotiates directly with the
phase, IPC is implemented at the household level, mostly
station to request adjustments.
by non-government organizations (NGOs). Few functions in
Senegal have devolved to local government agencies and
over the years, numerous NGOs have been established to Field supervision. Four individual consultants were hired
implement behavior change projects, from family planning and trained to supervise the IPC and DCC firms. Part of their
to maternal and child health. As in the case of DCC, the mandate is to confirm that events and activities recorded in
IPC intervention is implemented geographically. A non- the MIS have taken place. The field supervisors also shadow
profit organization (APAPS), two consulting firms, and two community relays during household visits to provide real-time
communications firms were procured. These organizations coaching, attend DCC events, and provide immediate feedback
were required to contract, supervise, and monitor community- to the implementing teams.
based organizations (CBOs) to deliver basic information and
services through outreach workers called community relays. Meetings with implementation agencies. The project team
Using these implementation arrangements, the project has holds monthly meetings with the field supervisors and project
tapped into a rich network of relays with experience in health- managers of all implementation agencies. In this way, the
related IPC. agencies have become part of the behavior change journey.
During these meetings, results from the MIS are shared and
compared to targets. Challenges and issues are raised and
Monitoring and Evaluation: An Integrated
cross-agency solutions are proposed. For example, during
Performance Monitoring System for Purposive one meeting agencies reported that men had expressed
Learning and Program Improvements dissatisfaction and frustration because they were not included in
Prior to setting up its monitoring and evaluation strategy, the household visits. The project team organized a special learning
project team reached consensus on how indicators from event to probe the role of men.16 A second learning event with
the project's results chain would be measured in Senegal the agencies is planned to determine how to further improve
and identified additional indicators that need to be tracked, skill building in the areas of handwashing station placement and
particularly at input and output levels. soap management.
16
For more information, see Involving Men in Handwashing Interventions in Senegal, available at www.wsp.org/scalinguphandwashing.
www.wsp.org
6 Senegal: A Handwashing Behavior Change Journey Global Scaling Up Handwashing Project
Figure 5: "Second Generation" Revised Billboard Mid-Term Adjustments: Correcting the Course of
the Journey Based on Emergent Learning
As stated earlier, the performance monitoring system flagged
a frustration among men at not being involved in handwashing
promotion. After the learning event in late 2009, a meeting was
held with the advertising agency to iterate the mass media
communications to strengthen men's involvement. Both the
visuals and the slogan were revised. The modified slogan
proclaims, "We commit ourselves more than ever to get our family
to wash their hands with soap!" (Figure 5). The IPC curriculum
was also updated to further involve men during household visits
and community relays were given refresher training.
While the initial "second generation" campaign targeted
women), program activities and communications materials were
KEY CHALLENGES AND LESSONS LEARNED
later revised to include men. In the revised billboard, a couple Challenges
proclaims, "We commit ourselves more than ever to get our The behavior change journey has not always been an easy one.
family to wash their hands with soap!" Key challenges include:
Attracting qualified advertising agencies. Though there
Specific studies. In response to emerging questions from are several communications agencies in Senegal, the early
the performance monitoring process, the project team initiated stages of the procurement process (carried out in accordance
specific studies. In early 2010, a survey of approximately 400 with World Bank regulations) attracted mostly consulting firms
households was conducted to determine the level of satisfaction from the water and sanitation sector with little experience in
with existing handwashing stations. Research findings indicated creative design and media production. Lacking this expertise,
the need to conduct spot research among community relays. the lead consulting firm sub-contracted for media production
A follow-up learning event to share findings with implementing and considerable negotiations were needed to maximize the
agencies is also planned. production budget allocated to the sub-contracted firm.
In addition to monitoring activities or outputs, the project team Changing the mind-set of advertising agencies. The initial
will monitor outcomes as follows: concepts received from the firm selected used a negative
approach focusing on germs, even though the creative brief called
"Doer/non-doer" studies. A second "doer/non-doer" study for a positive message. Changing the mind-set of advertising
will assess if determinants targeted through the intervention are agencies designing behavior change communications in
moving in the "right" direction, particularly access and availability general--and hygiene promotion communications in particular--
to soap and water. Positive changes in targeted determinants requires considerable hand-holding. Monthly meetings with the
are assumed to mean that behavior change will follow. agency were held to ensure they were part of the journey.
Longitudinal surveys of impact evaluation. As part of the Measuring behavioral determinants. The quantitative
project's impact evaluation on health, ten rounds of longitudinal "doer/non-doer" study in Senegal represented the first
surveys are planned. Though the main purpose of these surveys time a handwashing study segmented those who practice
is to track diarrheal incidence, a limited number of questions will handwashing with soap from those who do not on the basis
be added to evaluate the intervention itself. Exposure to various of determinants--though organizations such as Population
activities will be measured in mid-2010. Services International have used segmentation for other
behaviors, such as condom use. The series of questions
Baseline and endline surveys of impact evaluation. Both used to measure each determinant in FOAM were created
the baseline and endline surveys of the impact evaluation will from "scratch" and then adapted into French and Wolof, two
measure handwashing behavior using the global measurements additional challenging steps. As a result, it was not possible
guidelines developed and other indicators such as diarrhea, to measure all of the determinants reliably. For the second
nutritional status, and household productivity.17 "doer/non-doer" study, more attention will be paid to piloting
17
For more information on measuring handwashing behavior, see Practical Guidance for Measuring Handwashing Behavior, available under "Publication and Tools" at
www.wsp.org/scalinguphandwashing.
www.wsp.org
Global Scaling Up Handwashing Project Senegal: A Handwashing Behavior Change Journey 7
the questionnaire to ensure more reliable measures of the families (provider, protector, and role model) to help promote
determinants. handwashing with soap.
Transforming community relays into community Having a tangible product supports behavior change
resources. The project has been fortunate to be able to intentions. Community-based promoters report that having a
tap into a robust network of community relays that operates sample handwashing station to distribute to women makes the
throughout Senegal. However, these relays have been solution more tangible and concrete, and facilitates women's
traditionally used to convey information. The second phase planning process to ensure handwashing with soap occurs
of the project requires outreach workers to facilitate mothers' in the household. Discussion with mothers can then focus on
problem-solving abilities and to fortify their intentions to where to place the handwashing station and how to ensure
handwash with soap. Performance monitoring, particularly that the station is always stocked with soap and water. As
just-in-time coaching, has proved critical to transforming mentioned above, a handwashing station provides a stable
relays into community resources. To reflect their enhanced context in which the behavior can take place and provides
role, community relays are now referred to within the project environmental cues. The project team will investigate the
as community-based promoters. possibility of scaling up the provision of handwashing stations
with other partners, both private and public.
Lessons Learned
The behavior change journey in Senegal has uncovered several A simple game can be a powerful platform. A handwashing-
lessons: themed board game was designed by the advertising agency
(Figure 6). The game provides a way for the community-
Men need to be part of the behavior change journey. based promoter to "break the ice" during a household visit
According to the "doer/non-doer" study, half of the women and introduce the main messages in an engaging and fun
surveyed consider their husbands the decision-makers when way. It can be played by up to four people at once and reach
it comes to purchasing soap. Though the initial brief prepared potentially more if given to the household as a promotional
by the project team for the advertising agency specified item. During the first phase, the game was designed for
that men should be portrayed as providing social support (a children (left). However, given the interest expressed by adults,
determinant in FOAM), this proved to be insufficient. Through particularly mothers, as well as young adults, the game was
its performance monitoring system, the project learned that revised (right) to appeal to a broader age range, as well as
it had been under-leveraging the roles men play in their to men, and include specific behaviors such as setting up a
Figure 6: Handwashing Board Game
A simple board game was initially designed for young children (left). A revised version targets a broader age range, as well as men
(right). The content of the game can be modified to prioritize key messages and behaviors.
www.wsp.org
8 Senegal: A Handwashing Behavior Change Journey Global Scaling Up Handwashing Project
handwashing station next to a latrine or through 161 direct consumer contact
practicing handwashing with soap after events; and approximately 30,000 Acknowledgements
cleaning a baby's bottom. The revised household visits were made by about The authors thank the Global Scaling
game has been tested and will be used 150 trained community relays. The Up Handwashing Project team,
during the next implementation wave. project has a robust and integrated especially Hnin Hnin Pyne, Nathaniel
performance monitoring systems in
Paynter, Momar Kane, Bernard Sene,
RESULTS place to track both the quantity and
quality of interventions. In addition to Alfred Dacosta, Libasse Diagne,
As of March 2010, the behavior change
reach, data on exposure, movement in Amy Grossman, Mamadou Lamine
intervention in Senegal have been
scaled up, reaching and in some cases the behavioral determinants, and the Mbengue, and Mamadou Thiam for
surpassing, targets. As a result of the behavior change itself are expected in their valuable inputs.
"second generation" communications the third quarter of 2010.
program, over 92 television and 1,496
--Jacqueline Devine and
About the project
radio spots have reached an estimated Global Scaling Up Handwashing is a
two million people; an estimated Seydou Nourou Koita
Water and Sanitation (WSP) project
140,000 people have been reached
focused on applying innovative
behavior change approaches
to improve handwashing with
soap behavior among women of
reproductive age (ages 15�49) and
primary school-age children (ages
5�9). It is being implemented by
local and national governments with
technical support from WSP in four
countries: Peru, Senegal, Tanzania,
and Vietnam. For more information,
please visit www.wsp.org/
scalinguphandwashing.
Contact us
For more information, please
visit www.wsp.org or email
Jacqueline Devine at
wsp@worldbank.org
and Seydou Nourou Koita at
wspaf@worldbank.org
The Water and Sanitation Program (WSP) is a multi-donor partnership created in 1978 and
administered by the World Bank to support poor people in obtaining affordable, safe, and
sustainable access to water and sanitation services. WSP's donors include Australia, Austria,
Canada, Denmark, Finland, France, the Bill & Melinda Gates Foundation, Ireland, Luxembourg,
Netherlands, Norway, Sweden, Switzerland, United Kingdom, United States, and the World Bank.
� 2010 Water and Sanitation Programs (WSP)