handwashing behaviour change programs in humanitarian crises

A software-based decision-making tool that helps humanitarian actors design rapid, evidence-based and context-specific hygiene programs

Find rapid assessment tools, learning modules and practitioner resource guides

Why Handwashing?

Handwashing with soap can reduce diarrhoeal diseases by 48% and reduce the spread of outbreak-related diseases. In the aftermath of an emergency, about 40% of all deaths are due to diarrhoea – handwashing has the potential to make a lifesaving difference.

We believe we can do handwashing behaviour change better!

At the moment, hygiene promotion in emergencies is done by distributing hygiene kits, or educating people about disease transmission. Evidence shows that these approaches alone are insufficient to change handwashing behaviour.

We provide...

Rapid formative research methods

Rapid Assessment

There are many existing needs assessment tools. However, these take time and expertise to conduct; they are generally poor at understanding actual hygiene behaviour; and it is difficult to translate the findings into context-specific program recommendations. We offer a set of rapid and easy-to-use rapid assessment tools, which are specifically designed for emergency contexts and linked to program design.

A new rapid tool for program design

A new rapid tool for program design

Existing behaviour change resources often go unread since they are typically long documents which lack details about how to contextualise recommendations.
We provide an easy-to-use, software-based decision support tool. The tool will help you design a hygiene program, identify delivery channels and develop innovative activities appropriate for your context.

How Wash’Em Works


Rapid Assessment Tools


Do the Rapid Assessment Tools


Input data in Wash’Em software


Get recommendations and decision support on what to include in your design of hygiene programs

Software Availability

Wash’Em software will be free and vailable on USB stick, on the web and offline. The software is currently under development. Sign up now to get updates on the progress.

Wash'Em USB software
Wash'Em USB software

The Project Team

This initiative brings together the expertise of Action contre la Faim (ACF), the London School of Hygiene and Tropical Medicine (LSHTM), and CAWST (Centre for Affordable Water and Sanitation Technology).

ACF are at the forefront of Water, Sanitation and Hygiene (WASH) programming in emergencies. In 2015, they responded to 24 humanitarian crises and delivered WASH services to 8.8 million people.

The Environmental Health Group at LSHTM is a multidisciplinary team of engineers, anthropologists, social psychologists and epidemiologists. Over the last 20 years the Group has generated an extensive range of innovative and rigorous evidence about the importance of handwashing and behaviour change.

CAWST are the sector leaders in WASH related knowledge dissemination. Their capacity-development and knowledge-sharing activities reach more than 5000 organisations, and indirectly impact more than 15 million people.

Meet the team

What have we done so far?

  • A literature review of the determinants of handwashing behaviour
  • Interviews with representatives of the global WASH cluster and national WASH clusters
  • In-depth qualitative research in Iraq and the Democratic Republic of Congo to better understand the determinants of handwashing behaviour in different types of crises
  • Developed a set of rapid assessment tools and developed written and video-based guides for these

What have we learned along the way?

  • There is an increasing amount of research on handwashing, yet the quality of evidence about the factors that determine behaviour remains weak. This is particularly true of hygiene behaviour in emergencies
  • Knowledge about the link between handwashing and disease avoidance is high among crisis-affected populations, but has no impact on actual practice
  • Creating attractive, easy-to-use handwashing facilities that trigger the right behaviour at the right times is likely to have the strongest impact on handwashing
  • Programs can be designed more rapidly by focusing on the determinants, which vary most by context. In emergencies, these are likely to be risk perception, behavioural motives, physical settings (including water and soap), and role and identity shifts

Recent Updates From Our Field Work

See all news
  • By Tom Heath | WASH Technical Advisor

Testing the Wash’Em tools in the acute phase of a cholera outbreak

As a result of a recent collaboration between Action contre la Faim (ACF), The London School of Hygiene and Tropical Medicine (LSHTM), and CAWST (Centre for Affordable Water and Sanitation Technology) I am optimistic that as a sector we can do better. Now I find myself putting that belief to the test. I am standing next to 200 broiler chickens as we record a middle-aged mother wash her hands in the middle of cholera hot-spot zone in Harare.

  • By Sian White | GHP

If crisis disrupts your life – how does your handwashing behavior change?

A Global Handwashing Partnership case study. If crisis disrupts your life – how does your handwashing behavior change? Understanding drivers of handwashing behavior in emergency settings

  • By Olivier Mills

Designing Learning and Decision Support Software: Wash’Em

Behind the scenes of developing software-based learning and decision support tools for WASH practitioners.


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This website is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of Wash’Em and do not necessarily reflect the views of USAID or the United States Government.