This paper introduces "hygiene effectiveness levels" as a tool for standardized analysis of costs and outcomes of hygiene promotion interventions. At the time of publication, the framework was being tested in WASHCost focus countries.
- The benefits of water and sanitation services cannot be fully realized unless they are used effectively and hygienically. Conversely, hygiene is unlikely to improve if behavior change interventions are introduced without sanitation and water facilities.
- Ideal hygiene service is environmental or public-health driven hygiene promotion that is integrated to water and sanitation infrastructure development.
- The costs of a hygiene intervention include those incurred by the planning organization and those incurred by the household, including financial elements and time commitment. After the intervention, the cost of sustaining behavioral change must be factored in (e.g. continued expenditure on soap and water).
- The hygiene effectiveness ladder assesses three key indicators of hygiene--fecal containment and latrine use, hand washing with soap, and drinking water source and management--on a 5-level scale from 'none' to 'highly improved'.