For years, handwashing with soap (HWWS) in Uganda has faced a frustrating plateau. Despite massive investments in hygiene education, the national rate remained stubbornly stuck at 36.5%.
The stakes for moving this needle are incredibly high. Poor sanitation and hygiene are among the top five drivers of infant mortality in the country. Routine handwashing with soap alone can prevent roughly four out of every ten cases of diarrhoea—a leading killer of children under five. To reach the national goal of 50% HWWS by 2025, it was clear that simply telling people how and why to wash their hands was no longer enough. We needed a new playbook.
The Human-Centered Shift
To break the stalemate, UNICEF Uganda partnered with the S4P Group to completely re-strategize the Social and Behavior Change (SBC) approach.
Rather than deploying top-down messaging, the team anchored the entire campaign in Human-Centered Design (HCD). This meant moving through rigorous desk reviews, deep co-creation, and continuous iteration. Crucially, priority audience representatives were brought to the table to co-design and pretest the messaging, ensuring the final campaign resonated with the lived realities of the communities.
Reframing the Problem: Collective Responsibility
The breakthrough came from shifting the narrative. Handwashing is typically framed as an individual responsibility—a personal failure if ignored. The HCD process revealed that framing hygiene as a collective responsibility resonated much deeper.
By tying individual handwashing to community pride and shared health, the campaign moved away from finger-pointing and toward communal action. Even during the rollout stage, HCD principles guided the interpersonal communication, ensuring that the dialogue felt supportive rather than prescriptive.
The Results: Scaling Through Community Action
The impact of this reframed, co-created campaign was immediate and highly measurable. Priority audiences reported significantly improved attitudes and higher self-efficacy regarding handwashing practices.
When you design a campaign that a community actually owns, the results scale organically:
- 670,000 people were directly reached through interpersonal communication interventions across just three districts.
- 47% increase in access to handwashing facilities in highly populated slum areas—environments where infrastructure challenges usually block progress.
- 90% compliance in high-traffic public areas, such as taxi parks, which successfully maintained functional handwashing facilities throughout the campaign.
The Private Sector Steps Up
Perhaps the strongest evidence of the “collective responsibility” messaging working was its expansion into the Karamoja region.
The campaign’s ethos inspired local businesses and private individuals to take ownership of the region’s hygiene. In a remarkable show of private-sector support, local business initiatives contributed 20,000 pieces of soap directly to Karamoja schools. This demonstrated that when SBC campaigns successfully tap into community values, they can unlock alternative funding and resource streams outside of traditional NGO channels.
By trusting the audience to co-design the solution, we didn’t just improve handwashing metrics; we built a sustainable culture of shared health.