2008年-世界发展银行全球_Enabling_Environment_Assessment_and_Baseline_for_Scaling_Up_Handwashing_Programs___Peru_113页_2mb

Summary of Enabling Environment Assessment and Baseline for Scaling Up Handwashing Programs: Peru

Core Content

This report is part of the Global Scaling Up Handwashing Project (GSUHP) by the Water and Sanitation Program (WSP), funded by the Bill & Melinda Gates Foundation. The objective of the project is to test whether innovative promotional approaches can lead to widespread and sustained increases in handwashing with soap (HWWS) among the poor and vulnerable in four countries: Peru, Senegal, Tanzania, and Vietnam. The report focuses specifically on Peru, detailing the enabling environment assessment and baseline conducted in May 2007.

The assessment aimed to evaluate the conditions for scalability and sustainability of handwashing programs and to recommend actions to improve these conditions. It followed a structured methodology involving individual and group in-depth interviews, an electronic survey, and a document review. The findings and recommendations are documented in this report and its appendices.

Main Objectives of the Handwashing Initiative

• Inculcate the HWWS habit among millions of mothers and children in the target countries.
• Develop a strong monitoring and evaluation (M&E) component to enhance program conceptualization and management.
• Establish sustainable programs that can continue and expand beyond the four-year grant period.

Target Population

The primary target audience is poor women of childbearing age (15–49) and poor children aged 5–9.

Handwashing Targets by Country

Key Findings

The assessment identified nine critical dimensions for the scalability and sustainability of HWWS programs:

1. Policy, Strategy, and Direction

   • A shared vision and political will are essential for program success.
   • Strong coordination and motivation across all levels are necessary.

2. Partnerships

   • A robust public-private partnership (PPPHW) has been established in Peru since 2002.
   • Partners include government agencies, international organizations, NGOs, and the private sector.

3. Institutional Arrangements

   • Clear roles, responsibilities, and authorities are required at all levels.
   • Coordination mechanisms must be in place to ensure smooth implementation.

4. Program Methodology

   • A seven-step methodology was adapted to the local context.
   • All key stakeholders must agree on the methodology for successful implementation.

5. Implementation Capacity

   • Institutions need adequate human resources and skills.
   • There must be an “organizational home” within the institution to manage responsibilities.

6. Availability of Products and Tools

   • Soap and handwashing station supplies (e.g., basins, towels) must be easily accessible and affordable.

7. Financing

   • Adequate funding arrangements are necessary for program costs, including training, staff salaries, and material development.

8. Cost-Effective Implementation

   • Understanding cost changes during scaling is crucial.
   • Data collection is needed to evaluate cost-effectiveness at the end of the project.

9. Monitoring and Evaluation (M&E)

   • Regular M&E is required to adjust and improve program effectiveness.
   • M&E must be based on local data and involve all levels of the program.

Key Recommendations

• Develop a dynamic advocacy strategy that continues throughout the project.
• Implement a strong communication strategy targeting partners, decision-makers, and the public.
• Create an exit strategy to ensure program sustainability after implementation.
• Formalize partnerships with clear roles, responsibilities, and monitoring mechanisms.
• Ensure local-level commitment from key partners to support implementation.
• Conduct thorough regional, provincial, and district assessments to identify potential champions and conditions for success.

Assessment Methodology

• Primary data sources: Interviews with key stakeholders, including government agencies, international and local NGOs, private sector organizations, and community-based organizations (CBOs).
• Secondary data sources: Document reviews and self-reporting questionnaires.
• Interviews conducted: 35 in total, with representatives from various organizations.
• Self-reports received: 10, from a range of stakeholders, including government and bilateral projects.
• Sampling: Purposive, with an emphasis on individuals who had participated in the program for at least six months.
• Data collection: Aimed at triangulating qualitative and quantitative findings for comparison with future assessments.

Conclusion

The Peru Handwashing Promotion Project has made significant progress since 2002, with a strong network of public-private partnerships and a mix of interpersonal communication (in schools and communities) and mass media (print and radio) contributing to behavior change. The enabling environment is considered favorable for program expansion, especially with political will and sustained funding. However, the team recommends further improvements in coordination, sustainability planning, and local engagement to ensure long-term success.

The study also emphasizes the importance of collaboration across sectors and the need for a clear, agreed-upon methodology and effective M&E systems to support scaling and replication.