“I heard it from all directions”: Maximizing media mix to increase handwashing

Every year 4 million children die of handwashing preventable diseases such as diarrhea and respiratory infections. The Global Public-Private Partnership for Handwashing with Soap (PPPHW) promotes a commercial marketing communications approach to create evidence-based messages to increase handwashing rates. To reach the maximum number of target audience the PPPHW uses multiple media channels and encourages word of mouth communication and discussion. The media mix is carefully researched and selected and includes traditional media such as television and radio and nontraditional media such as cellphone text messages and water bills to reach out to the general public as well as policy makers and local community leaders.

Results from Ghana, the longest running PPPHW program, indicate that rates of handwashing with soap before eating rose 41 percentage points and rates of handwashing after defecation rose 13 percentage points. Mass media appeared to have more of an awareness raising effect while community events and the support of local leaders and policy makers transformed this awareness into action and appears to suggest that mass media should be sequenced before community events. Results revealed the importance of word of mouth communication and the importance of encouraging people to discuss the issue with friends and family. This discussion creates ownership of the issue, enables people to put handwashing in the context of their lives, and triggers mutual problem solving to remove real or perceived barriers to handwashing such as water scarcity or washing with recycled or untreated water.