Nongovernmental Organization Practitioners’ Perspectives on the Challenges and Solutions to Changing Handwashing Behavior in Older Children: A Qualitative Study

Figures & Tables

TABLE 1.

Characteristics of Participants in Interviews on Perceived Challenges to HWWS Interventions Targeting Older Children

Position (N=25)	Gender	Current Professional Location
Global level
Global WASH Advisor	F	Belgium
Senior Behavior Change Advisor	F	Canada
Global WASH Advisor	F	India
Health Promotion and Community Engagement Advisor	F	Netherlands
Global Public Health Promotion Advisor	F	United Kingdom
Senior WASH Advisor	M	United Kingdom
WASH Consultant	F	United Kingdom
WASH Technical Advisor	F	United Kingdom
Senior WASH Advisor	M	United States
National level
Hygiene Promoter	F	Lebanon
WASH Technical Working Group Head	M	Myanmar
Health Promotion and Community Engagement Specialist	M	Pakistan
National WASH Advisor	M	Philippines
Public Health Team Leader	M	Tanzania
Regional level
WASH Regional Advisor	M	Lebanon
Local level
Senior Innovation Officer (Public Health Promotion)	F	Bangladesh
Public Health Promotion Officer	M	Bangladesh
Organization Founder and Director	M	Cameroon
Senior Behavior Change Advisor	F	Madagascar
WASH Program Officer	F	Madagascar
Hygiene Promoter	F	Nigeria
Hygiene Promoter Manager	M	Nigeria
Hygiene Promoter Supervisor	M	Pakistan
Program Officer for School and Nutrition	F	Philippines
WASH Project Manager	M	Uganda

Abbreviations: HWWS, handwashing with soap; WASH, water, sanitation, and hygiene.

TABLE 2.

Summary of Emergent Themes From Participant Interviews on Perceived Challenges to Handwashing With Soap Interventions Targeting Older Children

Program Cycle Stage	Theme
Funding acquisition	Lack of prioritization
Funding acquisition	Funding inconsistency
Design	Insufficient formative research
	Demand on resources
	Unengaging intervention content
	Non-enabling physical environments
Delivery	Availability of skilled implementers
	Reaching out-of-school children
	Community mistrust
	Lack of coordination
Evaluation	Lack of evaluation rigor
Evaluation	Failure to assign older children’s handwashing as a primary outcome in evaluations of hygiene interventions