Learning the fundamentals of hygiene promotion : a review of three large-scale projects in India

In India, the integration of sanitation with drinking water projects is a relatively recent development. Numerous studies indicate that the provision of water supply without hygiene promotion and sanitation reduces the impact on people's health and well-being and may further deteriorate the quality of the environment, including sanitation and drainage. Currently all externally-assisted Rural Water Supply and Sanitation Projects in India include an integrated package of water supply, sanitation and hygiene promotion. However, the nature of the efforts and the manner of their implementation differ. Three World Bank-assisted projects in the states of Maharashtra, Karnataka and Uttar Pradesh recently participated in a review of their hygiene promotion work to learn from experience, and to take the first step in building a body of better practice for hygiene promotion in India.
The objectives of the review were : 1) to identify design factors which contributed to or detracted from the sustainability of hygiene promotion in large projects in India; 2) to draw some preliminary assumptions for better practice; 3) to create a platform for exchange of ideas and experiences about hygiene promotion and jointly develop approaches and recommend processes for long-term work.
The key lesson learned is that greater emphasis is needed on the creation, use and extension of participatory methods and tools for hygiene promotion. Community design and implementation is the key to effective and sustainable hygiene promotion.