WASH’ Nutrition

1.4. “Small Doable Actions” for improving WASH conditions and
Nutrition outcomes
“Small Doable Actions” is an effective approach for addressing communities that are facing constraints with finding sufficient
resources by themselves to initiate improvements in their WASH services and facilities or adopt expensive, “ïdeal” solutions
from the start. This approach encourages households to move step by step in adopting better WASH practices, with a
minimum need for additional resources. It involves:
1 Assessing current household WASH practices;
2 Identifying existing good WASH practices to be
reinforced or modified;
3 Identifying feasible incremental steps that move
people from a current practice toward the ideal
practice;
4 Identifying practices to be improved and
negotiated with family member(s). 125
For example, an interim step or small doable action from
not washing hands with soap and water after visiting
the toilet, to washing hands correctly with ash after
visiting the toilet. Although the behaviour might not be
an “ideal” practice, a broader number of households are
likely to adopt it because it is considered feasible within
the local context. The “Small Doable Actions” approach
has the potential to lead to further improvements in
behaviour, when/if resources become available. 126
Picture 2: Example of “Small Doable Action” for hand washing from Myanmar
Plastic bottles with screw caps filled with water, and a hole pierced in the
bottom, can provide a convenient flow of water when the screw cap is loosened
to let air in and allow water to flow from the hole. After washing the hands,
simply tighten the screw cap again and the water flow will stop.
© Arno Coerver, Malteser Interventional, 2015
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More about “Small Doable Actions” approach:
http://www.fhi360.org/sites/default/files/media/documents/Sol_681_014421.pdf
1.5. Improving hygiene practices: hand washing at critical times
When done properly and at critical times (Box 9), hand washing has a huge potential to prevent diarrhea and other fecal-oral
diseases. Good hand-washing practice should include water, a washing agent such as soap or ash and a drying phase (or
alternatively, hand rubbing with an alcohol-based solution). While hand washing at any time would be a good practice and
beneficial, nutritionists do not recommend the promotion of hand washing before breastfeeding. IYCF tries to remove as many
barriers to breastfeeding as possible, so adding hand washing would be creating another barrier and would reduce the times
and commitment of mothers to exclusively breastfeed.
In a household setting, a hand washing station or other enabling products such as “tippy taps” should be located in close
proximity to the latrine or the food preparation area. Hand-washing stations influence individuals’ opportunities to adopt a
behaviour, regardless of their ability and motivation to do so. An emerging hypothesis is that convenient and easy access to
both water and soap at critical times is a key behavioural determinant of hand washing with soap among women and children.
If a busy mother needs to look for soap before preparing a meal, or a child does not have easy access to water and soap after
using the latrine, the probability of hand washing with soap actually taking place is lower. 127
125 - WASHPlus (2014) “Integrating Safe Water, Sanitation, and Hygiene into Infant and Child Nutrition Programmes; A Training and Resource Pack for Uganda”
126 - Ibid
127 - WSP (2010) “Insights from Designing a Hand washing Station for Rural Vietnamese Households”
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WASH’Nutrition
A practical guidebook