WASH and Behavior Change: Six Key Lessons from an Evidence-based “Learning Expedition” in Haiti, Mali, Benin, and Mozambique

First published on Washfunders.org on April 12, 2017

Helvetas is a Swiss-based international development organization. Our vision is a just world in which all men and women determine the course of their lives in dignity and security, using environmental resources in a sustainable manner. In addition to our regular work undertaken in the context of programs and mandates, Helvetas occasionally identifies topics that require deeper investigation through what we call a“learning expedition.” A learning expedition is a combination of conceptual and action research and reflection that contributes to understanding of a topic, both within the organization and with key partners. We have found them to be very useful for creating the impacts that we hope to see in our work.

After realizing that our traditional hygiene interventions fell short – in particular after a disappointing impact assessment of a program in Benin – Helvetas started an evidencebased “learning expedition in behavior change” in 2014. We enlisted the help of Eawag, the Swiss Federal Institute of Aquatic Science and Technology, to help us create a new, smarter approach. The goal: to adapt the RANAS (Risks, Attitudes, Norms, Abilities, and Self-regulation) model and create simple, evidence-based, practical guidelines for field practitioners from nongovernmental organizations (NGOs) and local community-based organizations.

The RANAS method measures psychological determinants of behavior so that we can identify the most effective point for intervention in hygiene-related projects. We have now conducted RANAS trainings in Haiti, Mali, Benin, and Mozambique with local staff, partners, and authorities. The pilot projects were used to identify determining factors related to handwashing in Mali and sustained latrine use in Mozambique. In Benin, Helvetas is developing improved hygiene interventions to prevent recontamination of water during transport, storage, and handling.

Here are some lessons that we learned during our work:

1. Challenge your assumptions: If program outcomes fall short, you might want to question whether the same intervention approach – in this case, hygiene education – is capable of producing different outcomes. Challenging your assumptions and changing course requires an open organizational culture and the willingness to take risks. When embarking on the behavior change learning expedition, we had the opportunity to see whether redesigning our interventions around the desired outcomes could lead to more effective results.
2. Collaboration with academic partners is key: Eawag, the Swiss Federal Institute of Aquatic Science and Technology, brought important psychological academic know-how and rigor to our efforts. The challenge was to simplify and adapt Eawag’s sophisticated RANAS model to field realities without compromising the integrity of the research. It’s been an interesting and invaluable learning opportunity for both sides.
3. Put an afterthought front and center: Psychological “software” considerations, the way that people’s minds are programmed to adopt new behaviors, used to be more of an afterthought in our program design. We have now learned to turn this situation on its head. We can help build a million wells, but if people don’t wash their hands and apply safe water handling and latrine use, our efforts will fall short.
4. Don’t always trust your instincts: The impulse just to inform communities about the risk associated with contaminated water often seems to be a logical step. But a strictly rational approach doesn’t necessarily do the trick. It turned out that much more important levers are norms, habit formation, and self-regulation. Additionally, our surveys showed that the levers that change people’s behavior are likely to vary from country to country, and sometimes even among regions. We can’t assume that we already know all of the answers even if a project worked somewhere else.
5. Evidence-based pilots and rigorous monitoring and evaluation is paramount: The data and analysis allows us to know what works and what does not, which takes a lot of guesswork out of the equation.
6. Our teams sometimes need to change their behavior as well: Our local teams were initially doubtful of our new approach. We had to invest in capacity building and persuasion. When the results of the adapted intervention design showed improved hygiene behaviors, our teams were ultimately convinced.

As a learning organization, Helvetas remains committed to constantly improving our work and expanding the body of knowledge around WASH interventions. We have already begun to implement the lessons from this learning expedition in our new and existing programs in other parts of the world. We look forward to seeing the growing results of these efforts in the years to come.

Download the new behavior manual here.