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Does anyone have good examples of monitoring for urban hygiene behaviour change?

related country: Mozambique
related country: Mozambique

We are hoping to run a hygiene promotion campaign in 2 small towns in Mozambique, including door to door visits, a hygiene fair, radio announcements and posters. However we want to be able to measure impact to some extent. Are there any good examples of projects like this being monitored, both in terms of the sort of data collected and the method of collection?


Dear Joanne

Thanks for your question. This is just to let you know I've sent it directly to our WASH, sanitation and hygiene promotion experts so, hopefully, you should be getting some answers soon!

Kind regards,


LC Jones RedR TSS/KP

RedR TSS gravatar imageRedR TSS ( 2015-07-01 12:28:37 )

1 Answer

Om Prasad Gautam
Cristian Anton

Thanks Joanne for the important question!

From your question it is not clear which particular hygiene behaviours you are targeting to improve/measure, and whether you will also have control group to compare results? Therefore, my inputs will be general to all behaviours but hope these can be useful!

Since you are going to implement behaviour change campaign using mix methods, firstly it is important to know what you want to measure and how accurate you want to be. Ideally, it would be worth assessing at two levels:

• First: ‘reach/compliance/utilisation assessment of services’ to ascertain whether or not the intervention reached the intended target group and to assess exposure (this is often an easy work).

• Second: the effects / effectiveness of the intervention (outcome / impact) depending on project outcomes of interest (improved behaviours, or reduced microbiology or reduced diseases prevalence?).

Secondly you need to decide when you want to measure. Are you planning to do it before and after (baseline and follow-up) or time series, or longitudinal or cross-sectional? You need to decide based on your time and budget availability and how thorough you want to be based on the nature of the project? The complexity will depend on your need. Since you are also using mass media, it would be difficult to have control group for that component due to fear of contamination but there are ways by which control can be established.

Third stage ‘what actual methods’ can we use in order to assess the outcomes / impact of hygiene intervention (collection of data) in different settings including small towns? Various methods has been used to assess behaviours in past with its own limitations those includes: structured observation, self-report, video-observation, behaviour demonstration, presence of behavioural products in behavioural places, availability of physical structure with cleaning agents, observed cleanliness, and microbiology.

None of these standalone method shown to be enough. Therefore, multiple methods have been used in many of the large scale trial such as on hand washing with soap, food hygiene and water treatment. Same can be applied in small town case but need careful planning. Ideally, it would be worth using ‘structured observation’ methods to observe behaviours as gold standard. But observer’s bias, influence on behaviours, and reactivity between participants and observers need to minimize.

At the same time these are often costly and may not be feasible in large scale campaign. Structured observation checklist can be used in order to record the observed behaviours with code. In any community based behaviour change intervention, complete blinding would be difficult because people will know they have received intervention. Therefore they will act accordingly if the propose of the observation is revealed. But some masking is possible to minimise such threat. Such as observer should not know whether there was an intervention? Participants should not know the purpose of observation, and implementation and assessment should be dis-link (this can be altogether two separate events).

Different studies used different methods and tools based on targeted behaviours and nature of ... (more)