Combining sanitation and hand washing promotion: an example from Amhara, Ethiopia

Given the importance of the MDGs, sanitation coverage is a focus of many programs. Hand washing is often not integrated into sanitation promotion even though hand washing with soap at certain junctures helps reduce morbidity and mortality associated with diarrheal disease and is easy to incorporate into sanitation programming. With support of the World Bank-AF’s Water and Sanitation Program and USAID’s Hygiene Improvement Project, the Amhara Regional Health and Education Bureaus in Ethiopia implemented a program promoting sanitation uptake together with the installation of a hand washing device at latrines, fully supplied with water and a cleansing agent, in accordance with the national hygiene and sanitation strategy. This document reviews the results. Although statistically significant drops in sanitation uptake were observed, hand washing device installation kept pace with existing (substandard) trends but did not surpass them. Hand washing promotion may need to rely on social mobilization approaches as much as sanitation does.