Achieving handwashing with social art for a behavioural change: the experience of the Lazos de Agua programme in Latin America

Abstract

The effectiveness of different hygiene behaviour change approaches is inconsistent. Proven effective elements of behaviour promotion include the following: involving the community, adding psychosocial theory-derived elements and using interpersonal communication with active teaching methods and innovative and culturally sensitive messaging. The One Drop Foundation Social Art for Behaviour Change (SABC) approach encompasses those elements and is embedded in a system-strengthening approach involving users, service providers and policymakers within the Lazos de Agua Programme. Halfway into the programme, the SABC approach has been implemented in more than 280 rural and urban communities in five Latin American countries. According to its midline outcome measurement, the programme's efforts have contributed to a 15% point increase in the population practising proper handwashing within intervention areas. Story-based interviews revealed that SABC interventions are believed to have caused lasting changes in behaviour, perception and skills which transcend beyond the individual and are felt at the household and community levels. While the SABC approach is mostly limited to addressing psychosocial factors, the experience of this programme proves that artists can serve as behaviour change facilitators to accompany water, sanitation and hygiene (WASH) system projects. The SABC approach builds capacity, both within artist groups as permanent local institutions which can act as behaviour change facilitation service providers, and within service users, who become empowered and can continue influencing behaviour change among their peers.