1. Hygiene Improvement Project (HIP) Add picture

2. Why Hygiene? Diarrhea accounts for 20% of childhood deaths globally Improved hygiene practices each can reduce diarrhea prevalence by 30-40% Low cost, high impact interventions exist to prevent diarrhea

3. Why HIP? Builds on USAID’s 30-year experience in hygiene programming Starts by working at scale Focuses on improving key hygiene practices

4. Key Hygiene Practices Safe feces disposal Hand washing with soap or equivalent substitute (e.g. ash) Safe storage and treatment of water at the point of use

5. Key HIP Tasks Implement hygiene improvement at scale in at least five countries Integrate hygiene considerations into existing health/non-health programs Share USAID’s global experience and knowledge in the field and advocate for hygiene improvement Provide support and capacity strengthening to PVOs, NGOs and networks in the field.

6. Characteristics of a Scale Effort Systems approach Behavior First Multiples Hygiene Improvement Framework Coverage

7. Systems Approach Examine: The WHOLE Relationships Degrees of freedom Mainstreaming Patterns Commonalities Opportunities Emphasize: Relationships and patterns of behavior That a small event in one sector can have tremendous impact elsewhere Key influence points

8. Behavior First Focus on improving key individual hygiene practices Identify, promote and facilitate improved practices Behaviors that people are both willing and able to practice Design interventions that motivate and facilitate these improved practices

9. Multiples Multiple stakeholders Multiple levels Multiple interventions Multiple options

10. Hygiene Improvement Framework (HIF) Communication Social mobilization Community participation Social marketing Training Hygiene Promotion Water Supply Sanitation systems Available Household Technologies and Materials Access to Hardware Policy improvement Institutional strengthening Financing and cost-recovery Cross-sectoral coordination Partnerships Enabling Environment Hygiene Improvement Diarrheal Disease Prevention

11. Coverage Ensure Large Scale through: Health impact realized Total population covered and/or Geographic areas covered Ensure Sustainability by: Intervention concentration Activity saturation Systems interaction Critical mass behavioral impact

12. Illustrative HIP assistance Design, plan, implement and monitor HI programs at scale Integrate HI into other programs, e.g. HIV/AIDS, education, nutrition Assure and use the right mix of approaches and interventions Build coalitions and develop capacity of interested stakeholders Engage private sector partners to improve hygiene practices

13. How HIP operates 1. HIP identifies countries interested in long-term collaborative HI efforts at scale and offers modest start-up funding. 2. HIP partners with PVOs, NGOs and private commercial organizations to strengthen hygiene behavior change capacity and hygiene programs and to share knowledge.

14. How HIP operates (2) 3. HIP forges collaborative relationships with other agencies and institutions in this sector to exchange information and collaborate. 4. HIP creates working relationships with other health and non-health programs where HI can enhance the goals of these sectors.

15. HIP Partners Academy for Educational Development with ARD, Inc The Manoff Group International Water and Sanitation Centre (IRC), the Netherlands and Resource partners: Aga Khan Foundation, Hindustan Lever, International Rescue Committee

16. Contact Information Hygiene Improvement Project (HIP) Academy for Educational Development 1825 Connecticut Avenue, NW Washington, DC 20009 USA 202-884-8700 hip@aed.org www.hip.watsan.net