Thoughts from SWWW: What Next for Handwashing?

 Hanna photo 2by Hanna Woodburn

About the author: Hanna Woodburn is the Deputy Secretariat Director, Public Private Partnership for Handwashing (PPPHW). Follow her on Twitter @WASH_Hanna.

I’ve been at the 2014 Stockholm World Water Week (SWWW) for over three days now. As someone solidly in the water, sanitation, and hygiene sector, I’ve found the conference to be an interesting mix of people with a wide range of interests and technical backgrounds. In addition to my own session on the role of hygiene in achieving the full benefits of water investment, I’ve attended sessions on gender, inequity, WASH service deliver in emergencies, and more. These are my reflections both from these sessions and the many conversations that I have had with other attendees. 

First, while much energy has been devoted by the Public Private Partnership for Handwashing (PPPHW) and others to the promotion of hygiene at the policy level, there are is a knowledge gap within the larger sector as to the definition and role of hygiene in development. And it’s true: hygiene can encompass many different specifics, such as menstrual hygiene management, food hygiene, facewashing, toothbrushing, and of course handwashing with soap. These behaviors, and their supporting “hardware”, such as materials and facilities, can be quite different from one another. They have different evidence bases, different measurements, and different challenges. This was a good reminder that there is more that we need to do within the hygiene sector to better communicate, educate, and advocate – not only at the global level, but also amongst our colleagues in the water and sanitation  sector. 

Secondly, a word about working within a system. My favorite session thus far was convened by the GermanWASH Network and the German Federal Foreign Office on the subject of streamlining strategies for humanitarian aid within the WASH sector. This session included  a robust discussion on the role of governments, INGOs, and local actors in delivering WASH services within the humanitarian context. While there were many valid and salient points raised, this session for me emphasized the role that hygiene plays within a larger system. We actively work to promote integration of hygiene within correlate sectors, such as nutrition and education, but hygiene is also embedded within a context. And that context influences not only what program, but how, and what we measure. There isn’t a “magic bullet” or a “one size fits all” approach to hygiene behavior change. We need flexibility. 

Finally, I’ve been struck by the number of people who have mentioned the need to move from conversation to action. There’s a great emphasis within the sector on ensuring that we not only have evidence, that we have perfect evidence, before moving to action. This can have an unintended consequence of stifling innovation and reducing our willingness to take risks. To be clear, I am certainly not advocating for acting foolishly, or minimizing the importance of strong evidence, but there is a feeling that there needs to be more room for failure and a greater aptitude for trying and doing, rather than being overly cautious where our knowledge is imperfect. Indeed, even projects that aren’t successful can contribute to our knowledge base about handwashing promotion and behavior change. PPPHW can contribute to innovation leadership within the hygiene sector. 

I’m excited to take these and other learnings from the conference and apply them to our work in handwashing advocacy and knowledge leadership.

Committed to work towards ending open defecation! WASHplus’ Orlando Hernandez shows his support!

Global Handwashing Day is just around the corner….ready, set, plan! 


This blog post is authored by Hanna Washburn. Hanna is the Deputy Secretariat Director for the Public Private Partnership for Handwashing (PPPHW). Follow Hanna on Twitter @WASH_Hanna.

Each year, on October 15, over two hundred million people gather together in countries around the world and celebrate Global Handwashing Day. This international day of advocacy and action shines a spotlight on the state of handwashing in each country or community where it is celebrated and helps to raise awareness about the benefits of handwashing.  Why such a big focus on handwashing? This simple action, when practiced regularly can significantly reduce the risk of illness and death from diarrheal disease and pneumonia. With 1.7 million children dying from these causes each year, we certainly think that is a reason to celebrate!

To help individuals and organizations plan Global Handwashing Day celebrations in their community, region, or country, the Global Public-Private Partnership for Handwashing has developed a Planner’s Guide. This year, the Planner’s Guide was updated to reflect the changing nature of Global Handwashing Day celebrations and the corresponding needs of planners.

Based on consultations with partners and others who have utilized the guide, we have attempted to create an updated guide that is action-oriented and provides planners with resources and inspiration to help as they implement a successful Global Handwashing Day celebration, and to encourage handwashing promotion throughout the year.

Those who have used the Planner’s Guide in years past will be familiar with the overall structure of the document; indeed, some sections such as the Five Facts about Handwashing are still very much the same. The biggest changes are found in the hands-on portion of the Guide. Here planners will find a step-by-step guide to planning an event, which is supplemented by fact boxes, event ideas, and tips for success. The annexes feature ideas for celebrations depending on the audience, an event planning checklist, facts about handwashing, and more.

Whether you’ve celebrated Global Handwashing Day for years, or this is your first, we hope that the Planner’s Guide will have provide you with the tools and ideas necessary to make your event a success. Let us know how it goes by uploading pictures and stories to our interactive, online map. And don’t forget, always wash your hands with soap!

Falling in Love All Over Again

“Life in rural Zambia is unbearable.” This is the story that is always heard among newly trained teachers who are posted in rural areas. This reaction is due to the perception that rural schools have poor or inadequate water and sanitation facilities. 

Mr. and Mrs. Fwankila, teachers at Chamsebe Primary School who have been married for two years, have a different story. When they were first posted at this school in the Lundazi District in late 2013, they did not know what to expect because they have spent most of their time in urban Lusaka.

When they arrived at the school, Mrs. Fwankila was surprised but relieved to hear that their official house was almost completed. The second thing she asked to see was the latrine, which according to her is very important and critical to her stay at the school. Each time she goes to a new place the first thing she looks out for is a toilet because she values clean facilities coupled with availability of safe and clean water. “I also love my family too much to expose them to unhygienic environments,” she said.

She sighed with relief when she saw a row of ventilated improved pit latrines. She later learned that the latrines were constructed by SPLASH, a USAID-supported project.

“I want to applaud USAID/SPLASH for the great work that they are doing. They have made my stay in Lundazi easy and very comfortable because of their facilities. I don’t complain about drinking contaminated water because of the water pump, which is available. Because of this I am always revitalized and energized to carry out my duties in the school because I have clean water, a clean latrine, and I know that even the pupils that I teach are well taken care of. This has helped me to spend more time in school thus increasing contact time between me and the pupils,” she says. The new facilities have contributed to helping young girls who have reached puberty to stay in school throughout the term, a phenomena that is unheard of in other schools.

Mrs. Fwankila explains, “The availability of water and sanitation facilities has made me not to see any big difference between rural and urban areas. My husband and I don’t even miss living in the city. We are much happier and spend a lot of time together. We will forever remain grateful to USAID /SPLASH facilities.”

Mr. Fwankila was quick to add, “My wife and I have fallen in love all over again because we have much more time to spend together. We don’t have to go long distances looking for water. SPLASH has brought clean and safe water right at our doorstep. We have a clean house, a backyard garden, and we love our new community.”

USAID/SPLASH continues to impact schools and communities in eastern Zambia by building latrines and installing boreholes, water tanks, drinking water, and hand washing stations, making sure that hygiene is a regular practice. The project has provided WASH facilities in 337 schools and its program has reached over 260,000 children.

Kenya – Ministry alarmed by ‘long calls’ along highways, to build toilets along Nairobi-Nakuru highway

Originally posted on Sanitation Updates:

Kenya – Ministry alarmed by ‘long calls’ along highways, to build toilets along Nairobi-Nakuru highway | Source: by Antony Gitonga, Standard Digital, Aug 8, 2014 |

NAKURU COUNTY: The ministry of health has expressed its concern over the high number of people who defecate in the open mainly along the main highways in the country. Following the revelation, Nakuru County has announced plans in major centres along the Nairobi-Nakuru and Naivasha-Mai Mahiu road to construct public toilets. According to the department of health, the open defecation was one of the leading causes in the increase in the number of typhoid and diarrhoea cases in the county.

Nakuru County director of health Dr Benedict Osore with county public health officer Samuel King’ori and USAID's WASHplus project manager Evelyn Makena examine some chairs used for defecation for the disabled at Longonot village in Naivasha. He said that around 300 of the 1,949 villages in the county had been declared open defecation free.  [PHOTO: ANTONY GITONGA/STANDARD] Nakuru County director of health Dr Benedict Osore with county public health officer Samuel King’ori and USAID’s WASHplus project manager Evelyn Makena examine some chairs used for defecation for the disabled at Longonot village in Naivasha. He said that around 300 of the…

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A World with WASH: Envisioning a Cleaner, Healthier World Post-2015

hanna photo thumbnail

Hanna Woodburn is the Secretariat Deputy Director for the Public Private Partnership for Handwashing (PPPHW).

By Hanna M. Woodburn

In early July my colleague Orlando Hernandez, from the USAID-funded WASHplus project, and I traveled to London to participate in a two-day meeting of WHO/UNICEF’s Joint Monitoring Programme’s Communications and Advocacy working group. In addition to learning about the upcoming process to establish a new set of global development goals and exploring future advocacy opportunities, we lead a strategy session on how the sector can better advocate for hygiene in the Post-2015 agenda.

As the international community works to agree upon a set of new global development goals, targets, and indicators, it is increasingly important that the value of water, sanitation, and hygiene (WASH) be recognized at the global level.  Water, sanitation, and hygiene are the basic components of a healthy community. Without them, the ability of children to grow, develop, and thrive is inhibited.

From the current Ebola crisis in West Africa to the news that a diarrhea outbreak in Swaziland recently killed nearly 40 children, it is evident that these basics are desperately needed. And for this to happen, they must be prioritized by governments. The best way to ensure this is through a dedicated goal on water, sanitation, and hygiene in the Post-2015 agenda.

Water and sanitation were both addressed in the Millennium Development Goals, but progress on sanitation continues to lag. Clearly, to build further momentum, these issues should be addressed again in the post-2015 agenda. With the establishment of new goals, there is an opportunity to include (handwashing with soap) and drive development forward. This opportunity must not be overlooked, and the Global Public-Private Partnership for Handwashing and the USAID/WASHplus project remain committed to ensuring that the “H” in WASH does not get forgotten.

We know that the full benefit of investments in water and sanitation are not achieved if hygiene is not also addressed. A cleaner, healthier world is possible, but governments must act and now is the time to do so.


In 2000, the United Nations adopted the Millennium Declaration and member states agreed to work towards the achievement of the Millennium Development Goals by 2015.  Given the imminent expiration of these goals, the United Nations and the international community is working to outline and agree upon a set of new global development goals, targets, and indicators. These goals and targets, often referred to as the post-2015 agenda or the Sustainable Development Goals (SDGs), will replace the Millennium Development Goals when they expire.  The UN process to develop the post-2015 agenda includes global consultations on a variety of themes including water, health, education and inequities—of particular importance for water, sanitation and hygiene.

The post-2015 goals and targets that will be enacted will function as a “report card” against which governments’ progress can be tracked. Furthermore, these post-2015 goals will be a driver behind the work of governments, donors, and non-governmental organizations over the next 15 years. This is an important opportunity to ensure that WASH is a global priority. Water, sanitation and hygiene are essential for health, welfare and livelihoods. Increased access and better services lead to higher levels of school achievement and improved economic productivity. Yet too many people do not have these basic human rights. After 2015, we must do better.

The JMP has put forth recommended WASH targets for inclusion in the post-2015 agenda. The recommendations have been developed through an extensive technical consultation; over 100 experts from over 60 organizations worldwide have debated them during the last three years. They are ambitious, yet achievable.

Vision: Universal access to safe drinking water, sanitation, and hygiene.

By 2030:

  • to eliminate open defecation;
  • to achieve universal access to basic drinking water, sanitation, and hygiene for households, schools, and healthcare facilities;
  • to halve the proportion of the population without access at home to safely managed drinking water and sanitation services; and
  • to progressively eliminate inequities in access.

Of the range of hygiene behaviors considered important for health, two key behaviors were prioritized for the post-2015 agenda – handwashing with soap and menstrual hygiene management. These behaviors will be measured by the presences of handwashing facilities with soap and water and facilities for hygienic, safe, and private menstrual hygiene management for girls and women.

Unfortunately, a comprehensive WASH target in the SDGs is not yet guaranteed. While some high-level reports and proposals have incorporated WASH, they often focus on water and sanitation, but fail to include hygiene.  The reasons for this are myriad. Some argue, for example, that hygiene is a personal behavior, and governments cannot be held accountable. While good hygiene is a behavior, the facilities to make the behavior possible (i.e. gender segregated toilets, handwashing facilities with soap and water), can be measured and governments should be held responsible for their provision. It is clear that there are many misunderstandings about the role of hygiene in the global development agenda. This toolkit seeks to address these falsities and ensure that all member of the WASH sector are armed with the necessary facts and talking points to successfully advocate for the inclusion of hygiene in the SDGs. We must continue to advocate for all three components of WASH: water, sanitation, and hygiene, equally Hygiene is not a WASH extra, but an essential.

Laying the framework for water and sanitation sustainability


WASHplus\FHI360 and CARE/Zambia are implementing a 4-year USAID-funded initiative targeting primary schools in the Eastern Province called SPLASH (Schools Promoting Learning Achievement through Sanitation and Hygiene).  Working alongside local government ministries, this project aims to bring clean drinking water, child and gender-friendly latrines, hand washing stations and hygiene education to rural schools across four districts of the Eastern Province of Zambia.

As a WASH consultant over the summer, my primary task was to work with the SPLASH staff to develop tools for the operation and maintenance of implemented infrastructure. Sustaining water, sanitation and hygiene (WASH) resources at these schools after the life of this project, is a key component of this initiative. My time in Zambia has been split between working out of the SPLASH offices in Lusaka and Chipata, with school visits sprinkled throughout the span of two months. Working with the FHI360/CARE staff and officials from the Ministry of Education has been a unique and enjoyable learning experience.

Effective monitoring is one of the biggest challenges in the water and sanitation sector, with over 40% of infrastructure failing within five years of implementation. Crucial to infrastructure sustainability is developing a mechanism for school and district level officials to routinely monitor and report on the functionality of water points and latrines constructed during the project. Using a tool called TextIt, I developed a mobile-based survey through which schools can directly relate information about the functionality of WASH infrastructure. Using any cell phone that sends text messages, rural communities can access this service, allowing for timely, accurate and transparent monitoring of services. Once this data is reported, it is automatically analyzed using a tool called Water Point Mapperwhich produces a map displaying the various infrastructure across the area of operation, and up-to-date information about each WASH facility.

Phone WaterPoint Mapper Screenshot

The use of mobile-based reporting bypasses paper-based surveys conducted periodically by the Ministry of Education and Ministry of Local Government and Housing. Conducting paper-based surveys is an expensive and time-intensive process, requiring staff to travel to rural communities, over roads that are often impassible during the rainy season. On the other hand, mobile-based surveys can be initiated at the instance of infrastructure failure and significantly reduces human error. However, the use of mobile phones to access these services requires communities to bear the cost of sending text messages. These costs are considerably lower than the cost of transportation and salaries of surveyors and data entry staff. Moreover, cell phone credit can be transferred from the accounts of government ministries directly to these communities, so as not to pass the cost onto the users. There is also potential for private sector partnerships with cell service provides within Zambia.

Once the map of WASH infrasructure is generated, it will be accessible to staff at government ministries, project implementing organizations, funding agencies and members of community WASH committees. Engagement of all these stakeholders is vital for the sustainability of infrastructure and services. Working in unison, they will be able to report and address any issues that may arise with the implemented water system, latrines, handwashing stations, menstrual hygiene facilities and drinking water points. These tools will also aid organizations to efficiently allocate resources, recognize trends in performance and service levels and have a visual, easy-to-understand representation of project progress. The use of WASH mapping all allow monitoring organizations to easily detect points of failure in service delivery and generate user-friendly reports for funders and partners. Through this structure of reciprocal monitoring where communities can directly communicate with the project implementer, communities are encouraged to take ownership of their water and sanitation resources, and play an active stake in operation and maintenance.

During my last week at SPLASH, I presented these WASH monitoring tools to representatives from USAID, Ministry of Education, Ministry of Local Government and Housing, FHI360, CARE and other NGOs working in this sector in Zambia. The various entities called for adoption of these monitoring tools and increased cooperation for WASH sustainability. In the coming months, SPLASH will implement these tools in conjunction with the Ministry of Education in the schools in the Eastern Province where SPLASH is currently working.


Working with the SPLASH team in Zambia has been an incredibly fulfilling experience and has solidified my passion for working in the WASH sector. I have learned a lot about the challenges that organizations face in sustaining implemented infrastructure, and strategies used to overcome these challenges. Working with SPLASH has allowed me the opportunity to innovate and create novel technologies to ensure WASH sustainability. I am excited to see how these tools are implemented in the field over the coming months and whether they are effective over the coming years.

While not in office or the field, I have had the opportunity to explore the natural beauty of Zambia at its many wildlife reserves. From visiting elephant orphanages, helicopter rides over the Victoria Falls, and bungee jumping, my time here in Zambia has been exhilarating to say the least.

The views expressed in this article are those of the author and do not represent those of USAID or the U.S. Government.

Meet Dr. Justin Lupele

lupele_justin_2013_200x220My name is Justin Lupele. I am the Chief of Party of a United States Agency for International Development (USAID) funded project in Zambia called SPLASH (Schools Promoting Learning Achievements through Sanitation and Hygiene). SPLASH is implemented through the USAID-funded WASHplus project.

SPLASH’s overall objective is to sustainably improve access to safe water, adequate sanitation, hygiene information and health practices to improve learning environments and educational performance in Zambian primary schools.

Education quality is generally seen in terms of provision of books, teacher deployment, ICT, mobile technology, classroom construction, and learner test score performance, among others. But just as critical (if not more so!) is access to water, sanitation and hygiene infrastructure. If clean drinking water, hygienic toilets, and places for hygiene practices such handwashing are absent in a school – we cannot talk about quality education.

Gender parity – equal enrolment for girls and boys – is a step towards the Education For All (EFA) goal of full gender equality in education. Gender equality includes making sure the school environment is safe, has good infrastructure such as separate latrines for girls and boys as well as menstrual hygiene management facilities for girls. When these are lacking, learners underperform, and girls may cease attending school altogether.

Unfortunately, ministries of education in most African countries often feel that WASH is better left to engineers. The WASH sector assumes that the MOE is providing WASH in schools.  Sadly, this pillar of quality education is often neglected. A survey by UNICEF found that in 41 priority countries, fewer than 50% of schools had adequate water and sanitation.

SPLASH and other MOE partners are committed to provide equity of access to quality education.  The project works in 616 schools in Eastern Province of Zambia to improve WASH facilities such as boreholes and latrines (with washrooms in girls’ latrines).

The SPLASH project also provides a comprehensive hygiene improvement program focusing on healthy habits such as treating drinking water and hand washing with soap. Key activities related to the subject of discussion this afternoon include:

  • Constructing and rehabilitating school WASH facilities such as boreholes for safe clean water, toilets and pit latrine;
  • Introducing enabling technologies for good hygiene habit formation e.g. handwashing facilities;
  • Inclusion of washrooms in girls toilets for the purposes for menstrual hygiene management so that girls are kept longer in school once they attain puberty; and
  • Assuring a sustainable operations and maintenance system for the built facilities within existing Government of Zambia institutions and community structures.

Opportunities to learn

Investing in water, sanitation and hygiene (WASH) infrastructure in schools improves learners’ opportunities to learn. This is translated into:

  • Improved teacher pupil contact time. Teachers and learners spend more time on the pedagogical processes of teaching and learning due to reduced illness and absenteeism;
  • Improved attendance – anecdotal evidence from our work shows that attendance is improving in schools were SPLASH has intervened; and
  • Teacher/learner attendance (girls and females), and retention.

Teachers are reluctant to work in underserved and remote rural areas, which lack basic facilities such as water and sanitation, electricity, good housing and health care.

  • Improved pupil enrolment – from our work we have seen that enrolment numbers are increasing in schools with better WASH; and 
  • Increased  days available for instruction especially for adolescent girls.

In order to achieve its objectives SPLASH works with a number of government, private partners and local communities around the schools. Local communities’ contributions in kind and financial terms add up to 35% of the total cost of the construction of sanitation infrastructure.

We cannot talk about quality of education in a school without water, sanitation and hygiene even if such a school had all the necessary text books and technology.

WASHplus Benin Hygiene Improvement Project Featured in Local Magazine

Armand AGUIDI AMOUSSOU, the coordinator of WASHplus project in Benin was recently interviewed by Rachel Araye KPANOU, Technical Assistant at CWP Benin, for Blue Pages magazine. Here is a brief description of the WASHplus Benin Hygiene Improvement Project followed by the interview with Armand.

About the Benin Hygiene Improvement Project

In Benin, WASHplus is implementing a three-year (2012-2015) behavior change program targeting key hygiene practices that directly affect children under 5, i.e., hand washing with soap and drinking safe water, in select urban poor neighborhoods.  The WASHplus peri-urban hygiene improvement program is working on creating urban WASH (water, sanitation, and hygiene) advocacy and resource leveraging platform, as well as implementing a pilot hygiene improvement activity in two peri-urban neighborhoods.

  • Partnering with the Ministry of Health/Direction Nationale de la Santé Publique (Public Health Service), WASHplus designed and carried out a baseline survey of vulnerable peri-urban zones of Cotonou, Abomey Calavi, and Porto Novo. The baseline survey results are being used to underpin a two-year, behavior-focused pilot hygiene improvement activity and to shape advocacy and WASH planning events.
  • WASHplus is building a platform with partners such as UNICEF to generate interest in WASH in Cotonou, where little investment in WASH exists, especially in the poorer neighborhoods. The partners intend to seek and create opportunities for convening stakeholders from the government, donor and NGO community, and private sector to address the critical WASH needs of peri-urban Cotonou.
  • WASHplus is working through a contracted implementing NGO (ABMS) to carry out social marketing and behavior change communications for improving hand washing and practices related to household drinking water quality in two of the most underserved neighborhoods of Cotonou. The program includes a strong monitoring and evaluation component to assess effectiveness of selected approaches.

The MOH/DNSP will utilize both the baseline methodology and the pilot program experiences to develop its own WASH strategy for urban and peri-urban zones in Benin.

Interview with Armand AGUIDI AMOUSSOU, Coordinator of the WASHplus Benin Hygiene Improvement Project


Please introduce yourself.

My name is Armand AGUIDI AMOUSSOU, environmental lawyer, and the coordinator of the  USAID-funded WASHplus program in Benin.

What activities does WASHplus carry out Benin?

For the past few years, WASHplus has implemented programs in various countries that aim to create healthy environments for households and communities by providing high-impact interventions in water supply, sanitation and hygiene (WASH). WASHplus uses proven interventions to reduce diarrheal diseases and acute respiratory infections: the two main causes of mortality in children under five in the world. WASHplus brings expertise in the integration of WASH in areas such as education, HIV/AIDS, maternal and child health, and nutrition. WASHplus builds strong partnerships in countries to increase the program’s impact. In addition, WASHplus’ mandate is to promote innovation in the WASH sector. WASHplus is funded by the U.S. Agency for International Development (USAID).

In 2012, USAID/Benin called upon WASHplus to carry out a hygiene improvement program in the poorest neighborhoods of urban Benin, especially to support other programs already being implemented targeting young children. After field visits the WASHplus team proposed a package of activities whose implementation started in October 2012.

The goal of the program is to reduce vulnerability of inhabitants of peri-urban zones of Cotonou through replicable and sustainable actions specifically targeting key hygiene behaviors shown to reduce diarrheal disease. WASHplus targets poor and underserved households while also involving neighborhood social and business partners.

What are the objectives of the WASHplus Programme?

Objectives of the WASHplus program are to:

  • Design and conduct a hygiene improvement program using evidence based interventions, based on the results of a baseline survey and a situational analysis of environmental health and conditions and practices in poor and underserved peri-urban areas;
  • Promote hygiene practices scientifically proven to reduce diarrheal diseases and cholera, such as washing hands with soap at critical times, and safe storage and treatment of drinking water;
  • Increase the availability of products, technologies and services that enable the adoption of improved hygiene practices;
  • Strengthen the technical capacity of local partners in the design, execution and monitoring of hygiene behavior change activities these peri-urban areas.

It is important to note that the geographic area covered by this program includes two representative peri-urban underserved neighborhoods in Cotonou.  The intention is to conduct pilot activities that will serve as models for technical services as Ministry of Health Basic Sanitation and Hygiene Service and the Municipality of Cotonou to better serve all urban and peri-urban areas.

What are the achievements that you can share with our readers at this stage of the project?

The main achievements of WASHplus program at this stage are first, obtaining an improved understanding of WASH issues in urban slums of Benin. WASHplus conducted a baseline study to identify the problems of hygiene, sanitation and water, as well as perceptions and knowledge of urban residents, to provide data on these issues. This study is available on the WASHplus website (

As a follow up, we are working in collaboration with local NGO PSI/ABMS who have conducted a situational analysis on the two pilot neighborhoods, to improve hygiene and support households and local schools and health facilities to adopt more positive health and hygiene behaviors. In addition, we are planning an advocacy event “call to action” with UNICEF to generate interest and possible investments by government and non-governmental actors in WASH improvements in peri-urban areas.

Your wrap-up words?

Finally I want to say that WASHplus is open to partnerships with local public or private entities working in the same sector because we believe that the combined efforts of different organizations will lead to the resolution of WASH-related problems facing our people. For more information on USAID/WASHplus please visit the website:


Meet Layla McCay

Handwashing was my first love in global health. I was a medical doctor in the UK when the opportunity arose for me to take time out from my clinical practice and work for the British Government’s Department of Health. I was leading on various aspects of national healthcare reform, like comparing health systems internationally, and designing and delivering a campaign to engage doctors in actively improving healthcare safety and quality. I realized that while I loved clinical medicine, I was also excited by the challenges and opportunities of public health and policy – and I wanted to look beyond my own country to understand the global context.

I started working for the World Health Organization in Geneva on national delivery of WHO’s first Global Patient Safety Challenge, Clean Care is Safer Care – focused on hand hygiene. This is where I first became a handwashing advocate, developing various WHO tools to support handwashing implementation by health workers across the world to reduce infections and improve patient safety. I still fondly remember having a tear in my eye the first time I heard the handwashing songs recorded by pop stars in Central America – my introduction to the first Global Handwashing Day.

After my time at WHO, I returned to the UK and diversified my international program management experience while developing a closer understanding of the global health stakeholders, including the private sector. I was appointed as Deputy Medical Director of Bupa, Britain’s largest international healthcare company where I led on health communications, quality and safety of care, and healthcare innovations around the world. I was concurrently appointed to the Board of Directors of global health NGO Basic Needs, and achieved a joint Masters degree in Health Policy, Planning and Financing from London School of Hygiene and Tropical Medicine and London School of Economics. My Masters studies focused on scaling up global health interventions, and was published by The Lancet medical journal.

My next move brought me fully back into international development. I relocated from London to Washington, DC in 2011 to continue my WHO patient safety research as a Visiting Scholar at Johns Hopkins Bloomberg School of Public Health, and taking up the position of Head of Policy and Advocacy for the Global Alliance for Improved Nutrition (GAIN). At GAIN, I worked with public private partnerships to improve nutrition, with a focus on policy and advocacy issues ranging from national and local legislation to the Post-2015 Development Agenda.

Most recently I have been working for the World Bank as a public health consultant, and for Georgetown University where I am Adjunct Assistant Professor in International Health. I run their Mental Health in Global Development course, co-run their Global Health Promotion course, and teach on their Maternal and Child Health course. For fun, I dabble in mHealth, and in my spare time I read, ride my bicycle, write for the Huffington Post and National Geographic, paddleboard on the Potomac River, run a monthly storytelling show, and travel around the world (53 countries and counting!).

I am delighted to be appointed to lead the PPPHW Secretariat, particularly at this exciting time for handwashing, where lessons and evidence in the field have the opportunity to come together to have real impact on the current global target setting processes like the Post-2015 Development Framework. I look forward to speaking to as many of you as possible to understand your different perspectives, ideas and expertise about how PPPHW can punch above its weight in the coming years, and the opportunities we can seize to have important, lasting positive impact on global health. The moment for a focus on handwashing is now, and I am delighted to be a part of it.

Author: Dr. Layla McCay is the new Director of the Public Private Partnership for Handwashing (PPPHW) Secretariat, housed at FHI 360. The USAID-funded WASHPlus Project supports the PPPHW in its efforts to promote handwashing and hygiene improvement. Follow Layla on Twitter: @LaylaMcCay





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