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Using Wash’Em to Design Handwashing Programmes for Crisis-Affected Populations in Zimbabwe: A Process Evaluation

Author

Listed:
  • Astrid Hasund Thorseth

    (London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK)

  • Jennifer Lamb

    (London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK)

  • Constancia Vimbayi Mavodza

    (Biomedical Research and Training Institute, 10 Seagrave Road, Avondale, Harare, Zimbabwe)

  • Mandikudza Tembo

    (London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
    Biomedical Research and Training Institute, 10 Seagrave Road, Avondale, Harare, Zimbabwe)

  • Anesu Petra Mushangari

    (Action contre la Faim, 21 Giraffe Crescent, Borrowdale West, Harare, Zimbabwe)

  • Eddington Zinyandu

    (Action contre la Faim, 21 Giraffe Crescent, Borrowdale West, Harare, Zimbabwe)

  • Thomas Heath

    (Action contre la Faim, 102 rue de Paris, CS 10007, CEDEX, 93558 Montreuil, France)

  • Sian White

    (London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK)

Abstract

Wash’Em is a process that supports humanitarians in assessing and designing rapid but context-specific hygiene programmes in crises or outbreaks. The process consists of training implementers, using tools to learn from populations, and entering findings into a software which generates contextualised activities. A process evaluation of Wash’Em use was conducted in a drought-affected area in Midland province, Zimbabwe. Data were collected during the programme design and following implementation using a mix of qualitative methods. Findings were classified against the intended stages of Wash’Em, and the evaluation domains were defined by the UKRI Medical Research Council. The Wash’Em process was not fully implemented as intended. An abridged training was utilised, some of the tools for learning from populations were omitted, many of the recommended activities were not implemented, the delivery modalities were different from intended, the budget available was minimal, and the number of people exposed to activities were fewer than hoped. Despite these ‘on the ground’ challenges and adaptations, the Wash’Em process was considered feasible by implementers and was seen to be less top–down than most programme design approaches. The populations exposed to the intervention found the activities engaging, understood the content, and reportedly took action to improve handwashing behaviour. Programmes such as Wash’Em, which facilitate community participation and are underpinned by theory and evidence, are likely to yield positive results even if processes are followed imperfectly.

Suggested Citation

  • Astrid Hasund Thorseth & Jennifer Lamb & Constancia Vimbayi Mavodza & Mandikudza Tembo & Anesu Petra Mushangari & Eddington Zinyandu & Thomas Heath & Sian White, 2024. "Using Wash’Em to Design Handwashing Programmes for Crisis-Affected Populations in Zimbabwe: A Process Evaluation," IJERPH, MDPI, vol. 21(3), pages 1-25, February.
  • Handle: RePEc:gam:jijerp:v:21:y:2024:i:3:p:260-:d:1344713
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    References listed on IDEAS

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    1. Yvonne Erasmus & Desyreé Lötter & Natalie Tannous & Ruth Stewart, 2018. "Reflections on per diems in international development projects: Barriers to and enablers of the project cycle," Development Southern Africa, Taylor & Francis Journals, vol. 35(6), pages 717-730, November.
    2. Robert Dreibelbis & Anne Kroeger & Kamal Hossain & Mohini Venkatesh & Pavani K. Ram, 2016. "Behavior Change without Behavior Change Communication: Nudging Handwashing among Primary School Students in Bangladesh," IJERPH, MDPI, vol. 13(1), pages 1-7, January.
    3. Aiello, A.E. & Coulborn, R.M. & Perez, V. & Larson, E.L., 2008. "Effect of hand hygiene on infectious disease risk in the community setting: A meta-analysis," American Journal of Public Health, American Public Health Association, vol. 98(8), pages 1372-1381.
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