Article type
Year
Abstract
Background: In order to improve handwashing and sanitation practices in low- and middle-income countries, a range of programs to promote behaviour change have been designed. It is not always clear to policy makers which of these approaches is the most effective in relation to learning outcomes, behaviour change and health outcomes. We engaged stakeholders in the development of a systematic review (funded by 3ie/WSSCC).
Objectives: Our first objective in the development of this systematic review was to build a Theory of Change (ToC) framework illustrating how (elements of) handwashing and sanitation promotional approaches are expected to lead to the outcomes, and how different factors can influence the implementation of the promotional approaches. This ToC was then used to guide subsequent steps of the systematic review.
Methods: Different sources of information were used to inform the ToC (existing WASH behavioural models and systematic reviews, and frameworks providing equity and implementation factors). The draft ToC was discussed in a three day face-to-face meeting and/or via electronic means by the team and the project Advisory Group members, including methodological (ToC/quantitative and qualitative research) and content experts (WASH/behaviour change), as well as end-users, policy makers and donors.
Results: Discussion with the different stakeholders resulted in an improved version of our ToC, containing a more complete representation of the different promotional approaches, a clear distinction between outputs and short/intermediate/longer term outcomes, and three groups of factors that influence the implementation of promotional approaches. In a next step the ToC was used for defining the selection criteria and creating a coding sheet for data extraction. Conclusions from the systematic review will be coupled back to the ToC.
Conclusions: The involvement of relevant stakeholders resulted in a ToC that is more relevant to our target groups. This theory-based approach will help policy makers to understand the important role of implementation, and the processes determining behaviour change in handwashing and sanitation.
Objectives: Our first objective in the development of this systematic review was to build a Theory of Change (ToC) framework illustrating how (elements of) handwashing and sanitation promotional approaches are expected to lead to the outcomes, and how different factors can influence the implementation of the promotional approaches. This ToC was then used to guide subsequent steps of the systematic review.
Methods: Different sources of information were used to inform the ToC (existing WASH behavioural models and systematic reviews, and frameworks providing equity and implementation factors). The draft ToC was discussed in a three day face-to-face meeting and/or via electronic means by the team and the project Advisory Group members, including methodological (ToC/quantitative and qualitative research) and content experts (WASH/behaviour change), as well as end-users, policy makers and donors.
Results: Discussion with the different stakeholders resulted in an improved version of our ToC, containing a more complete representation of the different promotional approaches, a clear distinction between outputs and short/intermediate/longer term outcomes, and three groups of factors that influence the implementation of promotional approaches. In a next step the ToC was used for defining the selection criteria and creating a coding sheet for data extraction. Conclusions from the systematic review will be coupled back to the ToC.
Conclusions: The involvement of relevant stakeholders resulted in a ToC that is more relevant to our target groups. This theory-based approach will help policy makers to understand the important role of implementation, and the processes determining behaviour change in handwashing and sanitation.