To follow up country work supported bythe Public-Private Partnership for Handwashing, the WorldBank Water and Sanitation Program (WSP) received fundingfrom the Bill and Melinda Gates Foundation to supportprojects to scale up the promotion of handwashing with soap(HWWS) in Peru, Senegal, Tanzania, and Vietnam. The majorproject objectives of the handwashing Initiative are: (i)inculcate the HWWS habit among millions of mothers andchildren in these countries; (ii) use a strong monitoringand evaluation (M&E) component to enhance theconceptualizing and management of such programs; and (iii)establish sustainable programs that will continue and expandafter this four-year grant ends. Evaluation of actual impacton knowledge, attitudes, and practice regarding HWWS showssome positive and some inconclusive findings. However, thestudy team feels that much excellent groundwork for theexpanded program in Peru has been solidly laid by efforts todate and that, in combination with strong political willfrom the national government and a certain level ofguaranteed funding, the outlook for effective expansion isvery good. The Peruvian program implemented activities atthe national level and developed partnerships and activitiesin 14 of Peru's 24 regions. Preliminary monitoring andevaluation showed mixed but promising improvements inknowledge, attitudes, and practices, particularly inhandwashing before eating and preparing food. Fosteringpartnerships at the national, regional, and local levels hasbeen a key project strategy. Although this has beendifficult and demanding at times, it has also been a majorreason for progress. Both interpersonal communication (inschools and communities) and mass media (mostly print andradio) made important contributions to changing knowledge,attitudes, and practices.
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