42981 January 2008 SOAPBOX The Public-Private Partnership for Handwashing Newsletter UPDATES FROM THECOUNTRY The motivational "triggers" that were generated PROGRAMS were pre-tested in the field on the fourth day of the workshop to identify the ones that resonated most AFRICA UPDATE strongly with mothers. Preliminary analysis suggests that the most promising concept is that mothers are Tanzania the central pillar (Mama ninguzo in Swahili) of the Workshop Held to Develop Key Triggers household. This trigger is similar to the one A key activity of the Tanzania PPPHW since the identified in Uganda earlier in the year ("the power last SoapBox update, the Tanzania Trigger/FOAM1 is in your hands"). workshop, was conducted October 8­12, 2007. The purpose of the workshop was to generate The triggers from the workshop were used to communication concepts to persuade rural mothers develop the creative brief for the Tanzania in Tanzania to improve their habits of handwashing handwashing communication campaign. with soap (HWWS) at critical times. Procurement of an agency to design core creative concepts and messages began after the workshop. Participants in the workshop included Contracting was scheduled for January, the representatives from the Ministry of Health, concepts and materials are scheduled to be tested Ministry of Water, local government, WaterAid, and and validated in February, and launch is scheduled UNICEF, as well as handwashing coordinators and for April 2008. WSP staff from Kenya, Senegal, and Uganda. World Toilet Day Celebrations in Iringa Region Unilever's Marketing Academy and Lifebuoy For the first time since its inception in 2005, World developed the format as part of their "In Safe Toilet Day events in Tanzania were held outside Hands" program. It uses a series of group work and Dar es Salaam. In November 2007, Iringa region, "immersions" into local communities to gain the first of Tanzania's regions to host World Toilet insight about the consumers' thoughts and to Day, carried out activities in various villages in the develop motivational "triggers." Ifunda ward, about 500 kilometers southeast of Dar es Salaam. Events on November 19, World Toilet This workshop marked the first time a behavior Day, and the two preceding days included change model (FOAM) was introduced to structure edutainment, distribution of educational materials, some of the initial analysis that will be used to and training of community-based resource persons inform the design of the handwashing behavior to promote sanitation and hygiene messages. The change program. It proved particularly helpful in main event on was chaired by the Honorable Hajat setting the stage for the workshop and in Amina Said Mrisho, regional commissioner for the identifying which behavioral factors (determinants) Iringa region on behalf of the Minster for Health can be addressed through communications and and Social Welfare. Representatives from the those that need to be addressed through other Ministry of Health, Ministry of Water, UNICEF, interventions (such as advocacy). WaterAid, all districts in Iringa, various NGOs and CBOs in Iringa region, and more than 1,000 people from villages around Ifunda ward attended the 1FOAM (Focus, Opportunity, Ability, and Motivation) event, which was covered widely by local, regional, is a model for handwashing behavior change and national media. developed by the Scaling up Handwashing Behavior Contributed by Abdul Badru, Handwashing Task Change Project. Manager, WSP, Tanzania SOAPBOX NEWSLETTER JANUARY 2008 Kenya The consistent and correct use of soap in the Baseline and Consumer Study community, based on observations, is 5 percent In 2007, the Water and Sanitation Program (WSP) nationally. Handwashing with soap in school was on behalf of Ministry of Health commissioned a almost nonexistent: only 1 percent washed hands research agency to carry out a baseline and with soap and 28 percent washed hands in some consumer study on handwashing with soap. The way. research used qualitative and quantitative methods of data collection. It was executed at two levels: the Handwashing with soap is a low priority at the community and in schools in eight districts around household level. It is ranked fourth after bathing; the country. At the community level, the study used laundry and washing dishes are higher priorities. a variety of research methods--including structured Bar soap has high usage in Kenyan households observations, household interviews, behavior trials, because of its multiple applications. Overall, 97 focus groups discussions, and in-depth percent of the households were found to have interviews--to gain insights into handwashing access to soap. Women are the key decision makers behavior, barriers, and motivators. At the school on soap use at the household level. level, in addition to structured observations, behavior trials, and focus group discussions, the Motivators for Handwashing study used innovative methods to develop an At the community level, three motivators for understanding of the children's universe and their handwashing emerged: handwashing motivators and barriers. The § Disgust isthestrongestmotivatorwherethereis innovative methods, adapted from tools in the strong smell and physical dirt; it is a significant Unilever/Lifebuoy "Handwashing in Schools motivator after toilet use and contact with Toolkit" developed by Dr. Myriam Sidibe, included stool. § Nurtureisastrongemotionalmotivatorto § Drawingstoidentifyperceivedrisky protect children from illness and to see them handwashing behavior among pupils in school; grow to achieve their parents' dreams. § Socialmapping todevelopanoverviewofthe § Comfortisamotivatorthatgivesamotherthe children's social networks; flexibility and freedom to continue her § Moneygametoidentifywhatisofvalueand activities. interest to the children (who were given a photocopy of money then asked how they In the school context, the motivators of would use it); and handwashing included § Diarytogetanoverviewofachild'stypicalday. § Justification:The needtowashawaygermsthat cause disease resulted from covering Teacher focus group discussions and in-depth handwashing in the syllabus. interviews assessed the teachers' opinions on the § Fun:Handwashingwithsoapwasfoundtobe campaign. fun and provided a form of play for children. § Fittingin:Washinghandsafterusingthetoiletis Study Findings the accepted code of conduct in school. The Handwashing with Soap presence of other children washing hands acted Based on the events observed, caregivers are more as a trigger to handwashing. likely to wash hands with soap. The study found the following rates of handwashing with soap at key Facilitators of Handwashing moments among this group: § Convenientaccesstosoapandwaterfacilitated handwashing at both the community and § 31percent aftersuspecteddefecation. school levels. § 37percentafterothercontactwithstool. § Teachersasrolemodelsandremindersofthe § 36percentaftercleaningachild'sbottom. importance of washing hands facilitated the § 15percentbeforeservingorhandlingfood. adoption of the behavior. § 11percentbeforefeedingorservingachild § Perfumedsoapwasafacilitatorinschools. under the age of 5 years. 2 SOAPBOX NEWSLETTER JANUARY 2008 Barriers to Handwashing manage the preparation for the second phase of the communication program. Ali Diouf continues as Households coordinator of the Senegal PPPHW and is § Soapforhandwashingmaybelimitedbecause spearheading the partnership's efforts to soap is reserved for high-priority use. Poverty institutionalize handwashing. minimizes the perceived risk of not washing hands with soap, where the mother has During the last half of 2007, the PPPHW behavior knowledge. change strategy was reviewed and several § Poorplacementofthesoapfailstotrigger adjustments were made in preparation for phase handwashing behavior. two. The revised strategy places a stronger § Lackofadesignatedplaceforhandwashingisa emphasis on involving NGOs and CBOs in the barrier. delivery of handwashing messages through § Thedistancebetweenthetoiletandwater interpersonal communication activities. The source is a barrier if it is too far for PPPHW's training-of-trainers (TOT) curriculum handwashing. was revised and recruitment of an agency to carry § Perfumedsoapaffectsthetasteofthefood out the activity is underway. touched by hands. Further, the Senegal PPPHW is preparing for spot Schools formative research through a handwasher and § Handwashingfacilitiesinmostschoolsaretoo nonhandwasher study. The study is the first of its high to reach, especially for children in the kind to be carried out by a PPPHW country and is lower primary classes. expected to provide valuable information regarding § Limitedhandwashingfacilitiesfortheschool the determinants of handwashing behavior. The population leads to pushing. results will be used to inform the development of § Soapdisappearsandiswastedinschools. mass media materials for phase two of the § Waterdrainageispoororlackingin communication program. handwashing facilities. Contributed by Seydou Koita, Handwashing Task § Supportfrom teachersislacking. Manager, WSP, Senegal Contributed by Rufus Eshuchi, Handwashing Coordinator, WSP, Kenya Uganda After a three-month pilot phase in 2007, the Senegal handwashing campaign in Uganda is being assessed The first phase of communication activities for any course correction deemed necessary before implemented by the PPPHW initiative concluded the national rollout in 2008. The pilot assessment October 31, 2007. During the first phase, more has been preceded by physical evaluation visits to than 240,000 persons were sensitized to the sites in pilot districts to establish the occurrence handwashing through 700 activities in elementary and quality of campaign activations, their overall schools, 300 activities at traditional Islamic schools, reception, and reach of the pilot in each district. and 210 events at markets carried out by a marketing and events management firm. Another The assessment of the campaign will use tools such 51,000 persons were reached with handwashing as focus group discussions, a critical review of messages through activities carried out by a second literature, in-depth interviews, and a discussion communication agency with women's groups and at forum (for a force-field matrix) to inform the health centers. national rollout of the campaign. The results from the assessment will be used to finalize the national Preparations for a second phase of the implementation strategy and to inform the communication activities are underway. The second communication strategy, especially the creative phase will be funded primarily via the WSP Scaling direction and communication channels used in the up Handwashing Behavior Change Project. In campaign. August 2007, social marketing specialist Seydou Koita was brought on board by WSP-Senegal to 3 SOAPBOX NEWSLETTER JANUARY 2008 The effectiveness of communication channels and baseline data collection exercise on hygiene and the trigger, "Maama the power is in your hands," sanitation had the practice of handwashing with will be examined to establish whether the campaign soap as one of the key indicators; the findings is on the right track to change behavior. Although it indicate that awareness on handwashing with is not possible to measure any tangible soap is high. improvement in handwashing behavior after only three months of communication, proof of intent to § MinistryofWomenandChildrenAffairs:The change and improvement in key determinants for ministry organized handwashing with soap for handwashing is needed. It is envisioned that this participants and more than 500 school children exercise will identify the "take-home message" and during the World Environmental Day. the stakeholders who are critical to the success of Orientation for Kayayes (immigrant girls from the handwashing campaign in Uganda. the rural areas to the city as porters) included handwashing with soap. It is worth noting that in addition to efforts of the communication committee--which includes § ChurchofChrist:TheChurchofChristlaunched UNICEF, UWASNET, and German Technical community-based volunteers in two regions for Cooperation (GTZ)--technical assistance has been the sensitization of handwashing with soap at offered by WSP World Bank and Unilever the community level. The Church of Christ has (Lifebuoy) to support this process, continuing to started preparations to integrate handwashing demonstrate that public-private partnerships not with soap into the training curriculum of only work but are critical for quality delivery of Church of Christ College. campaign objectives. Contributed by Chris Nsubuga-Mugga, Handwashing § MinistryofHealth/GhanaHealthServices: Coordinator, WSP, Uganda Handwashing with soap activities are integrated into all public health programs. Due to the bird flu outbreak experienced in Ghana in 2007, Ghana handwashing with soap was intensified through Since the last update, the PPPHW has been public health programs under the Ghana launched in five newly established districts. All Health Services. district- and community-level training for stakeholders included an orientation on PPPHW. § UNICEF:Handwashingwithsoapwas The training is ongoing for district school health incorporated into the communication materials coordinators, circuit supervisors, district training used to create awareness on the bird flu officers, and other stakeholders such as district program. water and sanitation teams, environmental health assistants, and community development officers. Production of School Materials The Ghana PPPHW school materials were Mainstreaming of Handwashing into Partner reviewed, reproduced, and distributed to all the Work regions. Overall, the focus of the Ghana PPPHW is now shifting from the creation of increased awareness to CWSA Collaboration with Ministry of Food and sustained behavioral change. Almost all activities Agriculture use interpersonal communication approaches to The Community Water Supply and Sanitation promote handwashing. The mainstreaming of Agency supported the Ministry of Food and handwashing in all water and sanitation projects and Agriculture to create awareness of handwashing activities of partners is being strengthened. The with soap as a preventive measure against bird flu following partners and members of the National transmission. Among other activities, CWSA has Steering Committee are giving visibility to integrated handwashing with soap in social events, handwashing through their activities: created a handwashing display, and demonstrated handwashing with soap at the 2007 Easter Picnic. § WaterAid:Hygienepromotionisacoreactivity Contributed by Theodora Adomako-Adjei, Handwashing and includes handwashing with soap. A Coordinator, CWSA, Ghana 4 SOAPBOX NEWSLETTER JANUARY 2008 ASIA UPDATE objectives for Vietnam's HW Initiative, using the Vietnam FOAM model. Vietnam Handwashing Initiative Launches Activities The Ministry of Health of Vietnam launched the implementation of the Vietnam Handwashing Initiative on January 21, 2008, at a formal ceremony in Hanoi. The launch was led by Dr. Nguyen Huy Nga, Director of the Department of Preventive Medicine. The Initiative's activities will be implemented with funding from the Danish Embassy in Vietnam and the Bill and Melinda Gates Foundation. Interpersonal communication activities have been started in January 2008, with training workshops for Vietnam Women's Union (VWU) members. The VWU will be a key implementing partner for interpersonal communication activities. On November 17­18, 2007 an initial workshop was Partners from PPP worked on communication held with national and provincial VWU objectives at a workshop. (Nga Nguyen/WSP) representatives to discuss the program. Outputs from the meeting included selection of more than More than 20 participants attended the workshop, 500 communes for the first year and a draft action including representatives from the Ministry of plan for the next five months. Health, the Departments of Health of Phu Tho and Hung Yen provinces, the National Target Program Development of mass media materials is in the II, several NGOs, UNICEF, Unilever, and Grey advanced stage with pre-testing to begin at the end Advertising, the firm that will develop the of January. Launch of the mass media activities of handwashing campaign in Vietnam. the Vietnam HWI has tentatively been scheduled Contributed by Nga Kim Nguyen, Handwashing Task for February/March 2008. Manager, WSP, Vietnam Workshop on Behavior Change Communication Indonesia Among the key activities of the Vietnam In Indonesia, the PPPHW was started in the second Handwashing Initiative over the past six months half of 2007. UNICEF estimates that about 160,000 was an interactive workshop on behavior change children under age 5 die each year in Indonesia. communications for partnership members on Most of these deaths are caused by two diseases August 28­29, 2007. The overall objectives of the preventable by handwashing: respiratory infections workshop were to (i) explain and illustrate how the and diarrhea. design of effective, evidence-based communication campaigns are based on theories of behavior change During this planning phase of the Indonesia and follow a process; and (ii) to provide an PPPHW, attention is focused on three main overview of several major behavior change models elements: establishment and coordination of the used to develop program objectives and messages, partnership, preparation of partnership documents, and then select communication channels. The and development of key messages. workshop also provided a chance for participants to gain a better understanding of the FOAM behavior On July 9, 2007 the Indonesia PPPHW conducted change model recently developed for handwashing an open partnership meeting to introduce the programs, and to apply formative research findings program to a broader group of public-, private-, and on handwashing in Vietnam to the FOAM model. civil-sector stakeholders. The event was attended by Finally, participants developed communication 58 participants and 15 media outlets and resulted in 5 SOAPBOX NEWSLETTER JANUARY 2008 the formation of a core group that consists of all One of the partnership's members, the partners who have relevant activities, possess Environmental Services Program, carried out expertise, and are committed to participate in formative research on handwashing in Indonesia in partnership meetings at least once a month. The 2006. Key study results included the following: current core group consists of members from two multinational soap producers, one local soap § PeopleperceiveHWWSas women'sdomain, producer, two private nonsoap industries, two because women practice handwashing more public-sector industries, and four donor agencies. often in the daily life and are the main actors in reminding family members to practice Indonesia is unique in handwashing promotion in handwashing. that nearly half of the current core group members § Theresearchalsoshowsthat have conducted previous handwashing promotion activities. In 2006, the Minister of Health, Dr. o 12 percent of respondents practice Fadilah Supari, inaugurated a national call for handwashing with soap after defecating improved personal hygiene through handwashing o 9 percent wash hands with soap after with soap. A year later, in May 2007, the cleaning a child after he or she defecates Coordinator Minister of Public Welfare, Aburizal o 14 percent reported washing their hands Bakrie, joined forces with USAID in a successful with soap before eating event to launch the National Handwashing o 7 percent reported washing their hands Movement. with soap before feeding their child o 6 percent reported washing their hands with soap before preparing food. The core group meets regularly to maintain effective communications and to discuss specific topics, in particular the development of a partnership agreement and branding/co-branding guidelines. In response to a decentralization policy adopted by local government, the core group also discusses integration of the program at the provincial level. Handwashing messages are delivered through diverse channels, such as Iptek Voice (radio program), Voice of America (TV program), and Children performed a handwashing song at the press conferences prior to conducting events. A Handwashing Stakeholder Assembly on November successful Handwashing Stakeholder Assembly, 19, 2007. (Ida Rafiqah/WSP) which included all partners, was conducted as part of the National Sanitation Conference, November The current Indonesia PPPHW is tasked with the 19, 2007. The Minister of Health endorsed the important role of carrying the work of previous Indonesia PPPHW as the official committee for initiatives forward without being a competing behavior change for health improvement. initiative. To do so, it supports the continuation of Contributed by Ida Rafiqah, Handwashing Coordinator, previous initiatives and encourages the involvement WSP, Indonesia of new partners with complementary or shared objectives. 6 SOAPBOX NEWSLETTER JANUARY 2008 LATIN AMERICA UPDATE program that includes a handwashing component. Peru Each pilot school is visited and their directors are The design of the second phase of the Peru invited to include the HW initiative in their annual Handwashing Initiative (funded as part of the plans for 2008. Currently, 90 schools have joined. Scaling up Handwashing Behavior Change Project) Handwashing with soap is among the performance is well underway. The second phase of the program indicators for MINED to monitor. will have two components: the school and community component, and the mass media and As local communities are reached, an additional promotional events component. The school and effort is made to identify the "faces" of the process, community component consists of a process of with the purpose of following and learning from change that engages several actors in the them. An internet journal is fed daily with pictures community as agents of change. A special focus is and stories from within the country through the placed on children as agents of behavioral change in Peru Handwashing blog at handwashing- their families. This component has five sub- peru.blogspot.com. components: advocacy and partnership building Contributed by Rocio Florez, Handwashing Task Manager, (underway), capacity building, social mobilization, WSP, Peru and mass media. The school and community component will be implemented in 271 randomly selected districts of Peru. Colombia The Handwashing Initiative in Colombia has The mass media and promotional events finalized the design and production of the component will be implemented in 55 provinces handwashing campaign "Life is in your hands, wash also randomly selected from the 25 regions of the them with soap and water," which has the main country. In both cases the target audience is women message "Wash your hands with soap and water, ages 15­29 and children up to age 12. they will say no to diarrhea and yes to life." The campaign was shared and validated with all Following a review of the formative research used members of the public-private partnership with the to inform the design of the first phase of the participation of entities such as the Ministry of communication program, the Peru HWI carried out National Education, the Colombian Institute of additional formative research with children in Family Welfare, UNICEF, Unilever, and the December 2007 and January 2008. Results of the National Association of Manufacturers (ANDI). study will be ready in January and will be used in the design of the communication strategy and in the The Minister of Environment, Housing, and products for both components during the second Territorial Development, Juan Lozano Ramírez, phase of the initiative. launched the campaign at a national level at an event attended by mainstream media. The campaign Implementation of the school and community launch received broad coverage in newscasts and component started in January 2008 with advocacy television programs; the practice of handwashing visits by the Peru Handwashing Initiative team to with soap and its impact on the health and welfare local authorities, school directors, health on Colombian children featured prominently on the professionals, and private- and community-based news agenda. representatives in an effort to raise awareness and build commitment among potential key actors of The handwashing campaign's TV and radio spots the process. The team has a busy travel schedule are being aired during Colombian prime-time because all 25 regions will be visited between programs. As a result of the campaign's success, January and March 2008. An additional objective of private companies are showing an interest in the visits will be to assess the local enabling supporting it financially to allow communication environment for sustainable change. activities--such as radio and TV spots--to continue beyond the first campaign phase. The The Ministry of Education (MINED) has chosen Ministry of Environment is preparing an agreement nearly 300 schools in the country as pilot schools in that will allow the companies to provide this the implementation of a national environmental support. 7 SOAPBOX NEWSLETTER JANUARY 2008 Contributed by Erica Ortiz, Coordinator of Sector Policies 1.2 episodes(P = 0.08) and 1.9 days (P = 0.14) of and Planning, Vice Ministry of Water and Sanitation, absence per 100 student-weeks.Children in Ministry of Housing and Territorial Development, expanded intervention schools experienced a Colombia. median1.2 episodes (P = 0.03) and 1.2 days (P = 0.03) of absence per100 student-weeks. The study concludes that provision of a large-scale Panama handwashing promotionprogram and soap was The Ministry of Health has allocated funding for a associated with significantly reduced absenteeism. national handwashing program as part of the Similar programs could improve the health of PASAP (Water and Sanitation in Low-Income children worldwide. Communities) project. The second phase of the PASAP project started implementation in Citation: December 2007. Dayra Moreno of the Ministry of Bowen, A., H. M. Jianming Ou, W. Billhimer, T. Health has assumed the role as coordinator of the Long, E. Mintz, R. M. Hoekstra, and S. Luby. "A Panama handwashing program. Cluster-Randomized Controlled Trial Evaluating the Effect of a Handwashing-Promotion Program The program is in the process of establishing a in Chinese Primary Schools." American Journal of partnership for handwashing that includes public- Tropical Medicine and Hygiene 76, no. 6 (2007): 1166­ and private-sector partners. A workshop for more 73. than 25 interested stakeholders from the public and private sectors in Panama was held on December 4­5, 2007. Participants were exposed to the Can Hygiene Be Cool and Fun? successful experience of a public-private This WSP Field Note summarizes formative handwashing partnership in Peru and undertook a research that looked at motivating factors participatory mapping of stakeholders in Panama. underlying the behavior of Senegalese primary A preliminary plan of action for a PPP for school children. Specifically, the research looked at handwashing in Panama was defined and a what motivates children in this age group to adopt preliminary steering committee was established. hygienic handwashing and toilet practices, and how Contributed by Lene Jensen, Handwashing Secretariat, this understanding can inform the design of simple WSP, HQ yet effective sanitation and hygiene programs in schools. Innovative tools were used to gather insights from children, and the children's voices on NEWPUBLICATIONS & RESEARCH sanitation and hygiene were heard. In the Field Note, the researchers share the insights gained from the research into some of the children's motivations School Handwashing Program in China for not doing what adults expect of them. The Field Shown to Reduce Student Absenteeism Note emphasizes the importance of systematically A recent study by Bowen et al. investigates whether exploring the child's point of view to design less-intensive, more-scalable handwashing effective hygiene and sanitation interventions for interventions can improve health. Previous studies schools, and it explores how to do this simply and have found intensive handwashing interventions to inexpensively. The research was carried out by the significantly reduce the rates of diarrheal and Hygiene Centre of the London School of Hygiene respiratory infections. The study evaluated a school- and Tropical Medicine in collaboration with based handwashing program, randomizing 87 UNICEF Senegal, WSP Africa, and the National Chinese schools to usual practices (control group), Office of Sanitation in Senegal. standard intervention (handwashing program), or expanded intervention (handwashing program, soap Electronic copies of the Field Note are available at for school sinks, and peer hygiene monitors). The www.wsp.org. Hard copies can be obtained by study compared student absence rates following the sending a request to info@wsp.org. interventions. In control schools, children experienced a median 2.0 episodes (median 2.6 days) of absence per 100 student-weeks.In standard intervention schools, children experienced a median 8 CAPACITY-BUILDING, OUTREACH, University of Handwashing 2007 AND ADVOCACY September 13­14, 2007, Washington DC, USA University of Handwashing 2007 brought together PPPHW Steering Committee Semi-Annual more than 40 participants from global PPPHW member organizations, national PPPHWs, and Meeting other handwashing stakeholder organizations September 12, 2007, Washington DC, USA including Rotary International and the Soap and At the semi-annual meeting of steering committee Detergent Association. The two-day event included of the global PPPHW, the Secretariat presented an updates from global PPPHW partners and PPPHW update on its work and the progress of current or countries. The updates gave an overview of the planned handwashing initiatives. WSP presented handwashing activities in which each partner or progress on the Scaling up Handwashing Behavior country program had engaged over the past year. Change Project. The semi-annual meeting focused on strategic planning for next three to five years of One of the highlights of this year's University of partnership work. Handwashing was a presentation by Leyla Rojas, Colombian Vice Minister of Water and Sanitation with an overview of the handwashing campaign, Handwashing Coordinator Training which the Ministry of Water developed in September 11­12, 2007, Washington DC, USA collaboration with Colombian PPPHW partners. Coordinating a handwashing partnership requires a Participants were also given a preview of the multitude of skills. Handwashing program campaign's media materials. coordinators deal with partnership building, project management, research, program design, public relations, and a host of other tasks. In 2007, the global PPPHW brought together 13 professionals, PPPHW Exhibit at the American Public who work for handwashing programs in eight Health Association's Annual Meeting different countries, for a two-day skill building November 3­7, 2007, Washington DC, USA training. The workshop aimed to enhance the skills For the third year, the global PPPHW exhibited at of the participants in two areas: media relations and the Annual Meeting of the American Public Health partnership building. Both were areas that Association. The exhibit was organized and staffed handwashing coordinators had expressed an by the Secretariat for the global PPPHW. interest in receiving training. Day one of the training consisted of a workshop that introduced This year's annual meeting also featured a participants to the dynamics of media relations and presentation by WSP Public Health Specialist Kate included on-camera training. The workshop was Tulenko on the maximization of media mix to conducted by media relations expert Nick Nichols. increase handwashing. The presentation was part of Day two of the training provided participants with a panel on the role of media advocacy in policy and an overview of the "dos and don'ts" of the social change. different stages of partnership building and had participants address many of the issues that partnerships face in case study sessions. This workshop was prepared and delivered by Renata Schiavo, a strategic communications consultant with extensive experience in partnership building in both the private and the public sector. We encourage and welcome your comments and contributions to SoapBox. Please send them to Lene Jensen at Ljensen@worldbank.org. Want to learn more about the global Public-Private Partnership for Handwashing with Soap? Visit our website at www.globalhandwashing.org. SOAPBOX NEWSLETTER JANUARY 2008 10