This paper presents the results of two large-scale, government-led handwashing and sanitation promotion campaigns in rural Tanzania. Their results highlight the importance of focusing on intermediate outcomes of take-up and behavior change as a critical first step in large-scale programs before realizing the changes in health that sanitation and hygiene interventions aim to deliver.
- Wards that received sanitation promotion increased latrine construction rates from 38.6 to 51 percent and reduced regular open defecation from 23.1 to 11.1 percent.
- Wards that received handwashing promotion showed marginal improvements in handwashing behavior related to food preparation, but not at other critical junctures.
- Wards that received both handwashing and sanitation promotion were less likely to have feces visible around their latrine and more likely to have a handwashing station close to their latrine facility relative to individual treatment groups.