title: Monitoring the inputs required to extend and sustain hygiene promotion: findings from the GLAAS 2013/2014 survey.
abstract: OBJECTIVE
  There are significant gaps in information about the inputs required to effectively extend and sustain hygiene promotion activities to improve people's health outcomes through water, sanitation and hygiene (WASH) interventions. We sought to analyse current country and global trends in the use of key inputs required for effective and sustainable implementation of hygiene promotion to help guide hygiene promotion policy and decision-making after 2015.
  
  
  METHODS
  Data collected in response to the GLAAS 2013/2014 survey from 93 countries of 94 were included, and responses were analysed for 12 questions assessing the inputs and enabling environment for hygiene promotion under four thematic areas. Data were included and analysed from 20 External Support Agencies (ESA) of 23 collected through self-administered surveys.
  
  
  RESULTS
  Firstly, the data showed a large variation in the way in which hygiene promotion is defined and what constitutes key activities in this area. Secondly, challenges to implement hygiene promotion are considerable: include poor implementation of policies and plans, weak coordination mechanisms, human resource limitations and a lack of available hygiene promotion budget data.
  
  
  CONCLUSIONS
  Despite the proven benefits of hand washing with soap, a critical hygiene-related factor in minimising infection, GLAAS 2013/2014 survey data showed that hygiene promotion remains a neglected component of WASH. Additional research to identify the context-specific strategies and inputs required to enhance the effectiveness of hygiene promotion at scale are needed. Improved data collection methods are also necessary to advance the availability and reliability of hygiene-specific information.
authors.affiliation: Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.|Water, Sanitation, Hygiene and Health Unit, World Health Organization, Geneva, Switzerland.
authors.forename: Leslie D
authors.initials: LD
authors.lastname: Moreland
authors.affiliation: Water, Sanitation, Hygiene and Health Unit, World Health Organization, Geneva, Switzerland.
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Gore
authors.affiliation: Water, Sanitation, Hygiene and Health Unit, World Health Organization, Geneva, Switzerland.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Andre
authors.affiliation: Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Sandy
authors.initials: S
authors.lastname: Cairncross
authors.affiliation: Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Jeroen H J
authors.initials: JH
authors.lastname: Ensink
keywords: GLAAS report; ONU-Agua; UN-Water; financiación; financing; gobernanza; governance; human resources; hygiene policy; hygiene promotion; informe GLAAS; monitoring; monitorización; política de higiene; promoción de la higiene; promotion de l'hygiène; rapport GLAAS; recursos humanos