WaterAid joined forces with the Hygiene and Behaviour Change Coalition, supported by UK Aid and Unilever, to help people change their lives through hygiene.

As part of our response to the COVID-19 pandemic, we increased our work in Ethiopia, Ghana, Nepal, Pakistan, Tanzania and Zambia as members of the Hygiene and Behaviour Change Coalition (HBCC). The coalition is a taskforce of 21 charities, two UN organisations and one academic partner. It is funded by UK Aid and supported by Unilever.

Between March 2020 and December 2021, the HBCC reached more than 1.2 billion people to help curb the spread of COVID-19 among those most vulnerable to infection in low- and middle-income countries through promoting handwashing and good hygiene. It is underpinned by a £100 million contribution – £50m in funding and £50m of vital hygiene goods.

Good hygiene saves lives

Without clean water and soap, it is impossible for the people living in the greatest poverty to stay safe from diseases, such as COVID-19, and protect themselves against future pandemics. These essentials are also vital in tackling the inequalities that keep communities locked in poverty. Health, education and livelihoods all suffer when these basic human rights are not fulfilled.

But worldwide, 785 million people – that’s one in ten – do not have clean water close to home. Some two in five people (3 billion) do not have handwashing facilities at home.

Working towards a sustainable future

Investing in hygiene has not only been essential to ending the COVID-19 pandemic, but also represents good value for money – it saves huge sums in health costs associated with poor hygiene. In many countries, however, hygiene remains undervalued and underfunded.

As part of our global hygiene behaviour change approach, our teams have been working alongside governments to make sure our work supports and extends their national programmes, contributing to a sustainable and equitable future for everyone, everywhere.

Our teams have been working side by side with communities, local authorities and national governments to embed hygiene behaviour change in policies and campaigns, helping to build a better future for millions. In early 2022, Unilever and the UK's Foreign, Commonwealth and Development Office extended the HBCC in response to Omicron and other new COVID-19 variants. This second round of the HBCC was designed to support preparedness for future health-related crises by strengthening local capacity. 

How are we supporting hygiene behaviour change?

Our teams have been delivering the Hygiene and Behaviour Change Coalition projects in four ways:

WaterAid/Mani Karmacharya

We worked with national governments to expand existing hygiene programmes to include new COVID-19 behaviours, for example mask wearing and physical distancing.


We have built contactless handwashing stations in health clinics and busy public areas, and low access handwashing stations for children and people with disabilities.

WaterAid/Mani Karmacharya

We have changed the behaviour of the public and healthcare workers so that they frequently wash their hands with soap, to help urgently improve hygiene practices. 


We have used Unilever products as part of our response programming, including soaps and sanitiser at handwashing stations.

What does hygiene behaviour change look like?

Building a handwashing station is just one part of ensuring good hygiene in communities.

At WaterAid, we’ve developed a five-step programme to design, implement and ensure sustained behaviour change. We call it our ABCDE approach to hygiene, which provides a concrete framework that can be used by anyone to design a theory-driven but context-specific behaviour change intervention. The HBCC programme is helping us expand and continue developing this area of our work.

A graphic explaining our ABCDE approach to hygiene behaviour change. Find detail of this approach at https://washmatters.wateraid.org/blog/a-systems-strengthening-approach-to-improve-hygiene-behaviours
A graphic explaining our ABCDE approach to hygiene behaviour change.

Using the ABCDE approach we developed a trio of cartoons to create a memorable emotional response to important hygiene messaging. With no spoken words, the films are quick and easy to use across the globe without the need for extensive translation. One frame includes our key hygiene and COVID-19 messages that can be adapted quickly. From Amharic to Urdu, Swahili to English, our teams have shared these films as part of their national campaigns to promote good hygiene messages as part of our COVID-19 response. Watch one of the films below.

The last phase – evaluation – never stops. With support from programmes like the Hygiene and Behaviour Change Coalition and others, we’re able to keep reflecting, learning and adapting to improve future initiatives, respond to changing circumstances and bring about the transformative change that underpins our ABCDE approach.

Even with awareness of good hygiene, factors such as poorly designed toilets or a lack of clean water or soap can hold back progress in ensuring a hygienic environment and improving people’s health. Tackling these inequalities has always been part of our hygiene behaviour change response, but is especially important during our response to the pandemic. In crises, marginalised people are more at risk than ever because of the effects of social measures or scarcity of resources. This particularly affects girls’ and women’s opportunities, health and dignity.

Working in partnership

In partnership with the London School of Hygiene and Tropical Medicine, we’re contributing our experience, resources and key learnings to the Hygiene Hub. The hub enables teams from across the world to share, design and adapt evidence-based hygiene work against COVID-19.

Through the Take Action! hub, Unilever is sharing our important messages – such as calling for increased government investment in water, sanitation and hygiene, and supporting fundraising efforts – with their customers around the world. The Take Action! hub enables and encourages people to act on the issues they care about, and, in doing so, change the world for better, together.

Learn more through our expert blogs

Read more about our global COVID-19 response

See WaterAid Nepal's work with the coalition

Visit the London School of Hygiene and Tropical Medicine's Hygiene Hub

Top image: A teacher instructing pupils about COVID-19 by demonstrating the importance of handwashing with soap and the use of sanitisers. Simango School, Kazungula District, Zambia, October 2020.