Behaviour-centred design can be used to trigger changes in sanitation and hygiene practices. SNV Netherlands Development Organization used behaviour-centred design in an intervention to address the motivators of washing hands with soap in its Sustainable Sanitation and Hygiene For All (SSH4A) programme. This paper describes the use of emotional demonstrations (emo-demos) for triggering handwashing behaviour changes. The targets were the caregivers of children. Emo-demos focused on the motives of nurture (desire to care for one’s offspring) and disgust (a feeling of revulsion to avoid disease vectors and contamination). The paper provides practical information for implementing a small-scale handwashing promotion emo-demo within a WASH programme intervention. It concludes with lessons learned for wider practice.

Abdi, R. and Gautam, O.P. (2016) Approaches to Promoting Behaviour Change around Handwashing with Soap [online], WaterAid <https://www.susana.org/en/knowledge-hub/resources-and-publications/library/details/2767> [accessed 19 July 2019].

Aunger, R. and Curtis, V. (2016) ‘Behaviour centred design: towards an applied science of behaviour change’, Health Psychology Review 10(4): 425−46 <http://dx.doi.org/10.1080/17437199.2016.1219673>.

Biran, A., Schmidt, W.P., Varadharajan, K.S., Rajaraman, D., Kumar, R., Greenland, K., Gopalan, B., Aunger, R. and Curtis, V. (2014) ‘Effect of a behaviour-change intervention on handwashing with soap in India (SuperAmma): a cluster-randomised trial’, Lancet Global Health 2(3): 145−54 <http://dx.doi.org/10.1016/S2214-109X(13)70160-8>.

Briceño, B., Coville, A., Gertler, P. and Martinez, S. (2017) ‘Are there synergies from combining hygiene and sanitation promotion campaigns: evidence from a large-scale cluster-randomized trial in rural Tanzania’, PLoS ONE 12(11): e0186228 <https://doi.org/10.1371/journal.pone.0186228>.

Coombes, Y. and Paynter, N. (2011) Tanzania: A Handwashing Behavior Change Journey [online], Water and Sanitation Program Learning Note, Washington, DC: WSP, World Bank <https://openknowledge.worldbank.org/bitstream/handle/10986/11683/648550WSP0Tanz00Box361546B00PUBLIC0.pdf?sequence=1&isAllowed=y> [accessed 19 July 2019].

Curtis, V.A., Danquash, L. and Aunger, R.V. (2009) ‘Planned, motivated and habitual hygiene behaviour: an eleven country review’, Health Education Research 24(4): 655−73 <http://dx.doi.org/10.1093/her/cyp002>.

De Buck, E., Van Remoortel, H., Hannes, K., Govender, T., Naidoo, S., Avau, B., Vande veegaete, A., Musekiwa, A., Lutje, V., Cargo, M., Mosler, H.J., Vandekerckhove, P. and Young, T. (2017) Approaches to Promote Handwashing and Sanitation Behaviour Change in Low- and Middle-Income Countries: A Mixed Method Systematic Review [pdf], A Campbell Systematic Review, International Development Coordinating Group <https://doi.org/10.4073/csr.2017.7> [accessed 14 October 2019].

Dreibelbis, R., Kroeger, A., Hossain, K., Venkatesh, M. and Ram, P.K. (2016) ‘Behavior change without behavior change communication: nudging handwashing among primary school students in Bangladesh’, International Journal of Environmental Research and Public Health 13(1): 129 <http://dx.doi.org/10.3390/ijerph13010129>.

Greenland, K., Iradati, E., Ati, A., Maskoen, Y.Y. and Aunger, R. (2013) ‘The context and practice of handwashing among new mothers in Serang, Indonesia: a formative research study’, BMC Public Health 13: 830 <https://doi.org/10.1186/1471-2458-13-830>.

Lindbladh, E. and Lyttkens, C.H. (2002) ‘Habit versus choice: the process of decision-making in health-related behaviour’, Social Science and Medicine 55: 451−65 <http://dx.doi.org/10.1016/s0277-9536(01)00180-0>.

Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC), Ministry of Health (MoH), National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), and ICF (2016) Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHSMIS) 2015−16: Final Report [pdf], Dar es Salaam, Tanzania, and Rockville, MD: MoHCDGEC, MoH, NBS, OCGS, and ICF <https://dhsprogram.com/pubs/pdf/fr321/fr321.pdf> [accessed 19 July 2019].

O’Brien, C. and Favin, M. (2012) Four-Country Synthesis of the Enabling Environment for Hand Washing with Soap: Endline Analysis, Water and Sanitation Program Working Paper, Washington, DC: WSP, World Bank <https://openknowledge.worldbank.org/handle/10986/17378> [accessed 19 July 2019].

Obrist, B. (2004) ‘Medicalization and morality in a weak state: health, hygiene and water in Dar Es Salaam, Tanzania’, Anthropology & Medicine 11(1): 43−57 <https://doi.org/10.1080/1364847042000204924>.

Parveen, S., Nasreen, S., Allen, J.V., Kamm, K.B., Khan, S., Akter, S., Lopa, T.M., Zaman, K., El Arifeen, S., Luby, S.P. and Ram, P.K. (2012) ‘Barriers to and motivators of handwashing behavior in the neonatal period: findings from a formative research study on maternal handwashing in Habiganj, Bangladesh’, BMC Public Health 18: 483 <https://doi.org/10.1186/s12889-018-5365-1>.

Scott, B., Curtis, V., Rabie, T. and Garbrah-Aidoo, N. (2007) ‘Health in our hands, but not in our heads: understanding hygiene motivation in Ghana’, Health Policy Plan 22: 225−33 <https://doi.org/10.1093/heapol/czm016>.

SNV (2017) Sustainable Sanitation and Hygiene For All Programme: Programme Factsheet 2016, Tanzania [pdf], Dar es Salaam, Tanzania: SNV <http://www.snv.org/public/cms/sites/default/files/explore/download/tanzania_extensionbrief_20180130.pdf> [accessed 19 July 2019].

SNV Tanzania (2019) Emotional Demonstrations (Emo-Demos) of Handwashing with Soap at Vaccination Centres [online], Case study, Dar es Salaam, Tanzania: SNV <https://www.ircwash.org/resources/emotional-demonstrations-emo-demos-handwashing-soap-vaccination-centres> [accessed 19 July 2019].

Tetra Tech (2017) Toward a Hygienic Environment for Infants and Young Children: A Review of the Literature [online], IDS <http://www.communityledtotalsanitation.org/resources/toward-hygienic-environment-infants-and-young-children-review-literature-washpals> [accessed 2 August 2019].

Thomas, J., Holbro, N. and Young, D. (2013) A Review of Sanitation and Hygiene in Tanzania, Ifakara, Tanzania: Msabi <https://assets.publishing.service.gov.uk/media/57a08a2fed915d3cfd000628/tanzania-sanitationreview.pdf> [accessed 19 July 2019].

TMS International (2006) Understanding the Tanzanian Consumer in Respect to Handwashing with Soap, unpublished report prepared for the World Bank, Dublin: TMS International.

White, S. (2016) Hygiene and Behaviour Change Document Analysis [pdf], London School of Hygiene and Tropical Medicine <http://ehg.lshtm.ac.uk/files/2017/05/Systematic-qualitative-literature-review.pdf> [accessed 19 July 2019].

Abdi, R. and Gautam, O.P. (2016) Approaches to Promoting Behaviour Change around Handwashing with Soap [online], WaterAid <https://www.susana.org/en/knowledge-hub/resources-and-publications/library/details/2767> [accessed 19 July 2019].

Aunger, R. and Curtis, V. (2016) ‘Behaviour centred design: towards an applied science of behaviour change’, Health Psychology Review 10(4): 425−46 <http://dx.doi.org/10.1080/17437199.2016.1219673>.

Biran, A., Schmidt, W.P., Varadharajan, K.S., Rajaraman, D., Kumar, R., Greenland, K., Gopalan, B., Aunger, R. and Curtis, V. (2014) ‘Effect of a behaviour-change intervention on handwashing with soap in India (SuperAmma): a cluster-randomised trial’, Lancet Global Health 2(3): 145−54 <http://dx.doi.org/10.1016/S2214-109X(13)70160-8>.

Briceño, B., Coville, A., Gertler, P. and Martinez, S. (2017) ‘Are there synergies from combining hygiene and sanitation promotion campaigns: evidence from a large-scale cluster-randomized trial in rural Tanzania’, PLoS ONE 12(11): e0186228 <https://doi.org/10.1371/journal.pone.0186228>.

Coombes, Y. and Paynter, N. (2011) Tanzania: A Handwashing Behavior Change Journey [online], Water and Sanitation Program Learning Note, Washington, DC: WSP, World Bank <https://openknowledge.worldbank.org/bitstream/handle/10986/11683/648550WSP0Tanz00Box361546B00PUBLIC0.pdf?sequence=1&isAllowed=y> [accessed 19 July 2019].

Curtis, V.A., Danquash, L. and Aunger, R.V. (2009) ‘Planned, motivated and habitual hygiene behaviour: an eleven country review’, Health Education Research 24(4): 655−73 <http://dx.doi.org/10.1093/her/cyp002>.

De Buck, E., Van Remoortel, H., Hannes, K., Govender, T., Naidoo, S., Avau, B., Vande veegaete, A., Musekiwa, A., Lutje, V., Cargo, M., Mosler, H.J., Vandekerckhove, P. and Young, T. (2017) Approaches to Promote Handwashing and Sanitation Behaviour Change in Low- and Middle-Income Countries: A Mixed Method Systematic Review [pdf], A Campbell Systematic Review, International Development Coordinating Group <https://doi.org/10.4073/csr.2017.7> [accessed 14 October 2019].

Dreibelbis, R., Kroeger, A., Hossain, K., Venkatesh, M. and Ram, P.K. (2016) ‘Behavior change without behavior change communication: nudging handwashing among primary school students in Bangladesh’, International Journal of Environmental Research and Public Health 13(1): 129 <http://dx.doi.org/10.3390/ijerph13010129>.

Greenland, K., Iradati, E., Ati, A., Maskoen, Y.Y. and Aunger, R. (2013) ‘The context and practice of handwashing among new mothers in Serang, Indonesia: a formative research study’, BMC Public Health 13: 830 <https://doi.org/10.1186/1471-2458-13-830>.

Lindbladh, E. and Lyttkens, C.H. (2002) ‘Habit versus choice: the process of decision-making in health-related behaviour’, Social Science and Medicine 55: 451−65 <http://dx.doi.org/10.1016/s0277-9536(01)00180-0>.

Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC), Ministry of Health (MoH), National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), and ICF (2016) Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHSMIS) 2015−16: Final Report [pdf], Dar es Salaam, Tanzania, and Rockville, MD: MoHCDGEC, MoH, NBS, OCGS, and ICF <https://dhsprogram.com/pubs/pdf/fr321/fr321.pdf> [accessed 19 July 2019].

O’Brien, C. and Favin, M. (2012) Four-Country Synthesis of the Enabling Environment for Hand Washing with Soap: Endline Analysis, Water and Sanitation Program Working Paper, Washington, DC: WSP, World Bank <https://openknowledge.worldbank.org/handle/10986/17378> [accessed 19 July 2019].

Obrist, B. (2004) ‘Medicalization and morality in a weak state: health, hygiene and water in Dar Es Salaam, Tanzania’, Anthropology & Medicine 11(1): 43−57 <https://doi.org/10.1080/1364847042000204924>.

Parveen, S., Nasreen, S., Allen, J.V., Kamm, K.B., Khan, S., Akter, S., Lopa, T.M., Zaman, K., El Arifeen, S., Luby, S.P. and Ram, P.K. (2012) ‘Barriers to and motivators of handwashing behavior in the neonatal period: findings from a formative research study on maternal handwashing in Habiganj, Bangladesh’, BMC Public Health 18: 483 <https://doi.org/10.1186/s12889-018-5365-1>.

Scott, B., Curtis, V., Rabie, T. and Garbrah-Aidoo, N. (2007) ‘Health in our hands, but not in our heads: understanding hygiene motivation in Ghana’, Health Policy Plan 22: 225−33 <https://doi.org/10.1093/heapol/czm016>.

SNV (2017) Sustainable Sanitation and Hygiene For All Programme: Programme Factsheet 2016, Tanzania [pdf], Dar es Salaam, Tanzania: SNV <http://www.snv.org/public/cms/sites/default/files/explore/download/tanzania_extensionbrief_20180130.pdf> [accessed 19 July 2019].

SNV Tanzania (2019) Emotional Demonstrations (Emo-Demos) of Handwashing with Soap at Vaccination Centres [online], Case study, Dar es Salaam, Tanzania: SNV <https://www.ircwash.org/resources/emotional-demonstrations-emo-demos-handwashing-soap-vaccination-centres> [accessed 19 July 2019].

Tetra Tech (2017) Toward a Hygienic Environment for Infants and Young Children: A Review of the Literature [online], IDS <http://www.communityledtotalsanitation.org/resources/toward-hygienic-environment-infants-and-young-children-review-literature-washpals> [accessed 2 August 2019].

Thomas, J., Holbro, N. and Young, D. (2013) A Review of Sanitation and Hygiene in Tanzania, Ifakara, Tanzania: Msabi <https://assets.publishing.service.gov.uk/media/57a08a2fed915d3cfd000628/tanzania-sanitationreview.pdf> [accessed 19 July 2019].

TMS International (2006) Understanding the Tanzanian Consumer in Respect to Handwashing with Soap, unpublished report prepared for the World Bank, Dublin: TMS International.

White, S. (2016) Hygiene and Behaviour Change Document Analysis [pdf], London School of Hygiene and Tropical Medicine <http://ehg.lshtm.ac.uk/files/2017/05/Systematic-qualitative-literature-review.pdf> [accessed 19 July 2019].

Abdi, R. and Gautam, O.P. (2016) Approaches to Promoting Behaviour Change around Handwashing with Soap [online], WaterAid <https://www.susana.org/en/knowledge-hub/resources-and-publications/library/details/2767> [accessed 19 July 2019].

Aunger, R. and Curtis, V. (2016) ‘Behaviour centred design: towards an applied science of behaviour change’, Health Psychology Review 10(4): 425−46 <http://dx.doi.org/10.1080/17437199.2016.1219673>.

Biran, A., Schmidt, W.P., Varadharajan, K.S., Rajaraman, D., Kumar, R., Greenland, K., Gopalan, B., Aunger, R. and Curtis, V. (2014) ‘Effect of a behaviour-change intervention on handwashing with soap in India (SuperAmma): a cluster-randomised trial’, Lancet Global Health 2(3): 145−54 <http://dx.doi.org/10.1016/S2214-109X(13)70160-8>.

Briceño, B., Coville, A., Gertler, P. and Martinez, S. (2017) ‘Are there synergies from combining hygiene and sanitation promotion campaigns: evidence from a large-scale cluster-randomized trial in rural Tanzania’, PLoS ONE 12(11): e0186228 <https://doi.org/10.1371/journal.pone.0186228>.

Coombes, Y. and Paynter, N. (2011) Tanzania: A Handwashing Behavior Change Journey [online], Water and Sanitation Program Learning Note, Washington, DC: WSP, World Bank <https://openknowledge.worldbank.org/bitstream/handle/10986/11683/648550WSP0Tanz00Box361546B00PUBLIC0.pdf?sequence=1&isAllowed=y> [accessed 19 July 2019].

Curtis, V.A., Danquash, L. and Aunger, R.V. (2009) ‘Planned, motivated and habitual hygiene behaviour: an eleven country review’, Health Education Research 24(4): 655−73 <http://dx.doi.org/10.1093/her/cyp002>.

De Buck, E., Van Remoortel, H., Hannes, K., Govender, T., Naidoo, S., Avau, B., Vande veegaete, A., Musekiwa, A., Lutje, V., Cargo, M., Mosler, H.J., Vandekerckhove, P. and Young, T. (2017) Approaches to Promote Handwashing and Sanitation Behaviour Change in Low- and Middle-Income Countries: A Mixed Method Systematic Review [pdf], A Campbell Systematic Review, International Development Coordinating Group <https://doi.org/10.4073/csr.2017.7> [accessed 14 October 2019].

Dreibelbis, R., Kroeger, A., Hossain, K., Venkatesh, M. and Ram, P.K. (2016) ‘Behavior change without behavior change communication: nudging handwashing among primary school students in Bangladesh’, International Journal of Environmental Research and Public Health 13(1): 129 <http://dx.doi.org/10.3390/ijerph13010129>.

Greenland, K., Iradati, E., Ati, A., Maskoen, Y.Y. and Aunger, R. (2013) ‘The context and practice of handwashing among new mothers in Serang, Indonesia: a formative research study’, BMC Public Health 13: 830 <https://doi.org/10.1186/1471-2458-13-830>.

Lindbladh, E. and Lyttkens, C.H. (2002) ‘Habit versus choice: the process of decision-making in health-related behaviour’, Social Science and Medicine 55: 451−65 <http://dx.doi.org/10.1016/s0277-9536(01)00180-0>.

Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC), Ministry of Health (MoH), National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), and ICF (2016) Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHSMIS) 2015−16: Final Report [pdf], Dar es Salaam, Tanzania, and Rockville, MD: MoHCDGEC, MoH, NBS, OCGS, and ICF <https://dhsprogram.com/pubs/pdf/fr321/fr321.pdf> [accessed 19 July 2019].

O’Brien, C. and Favin, M. (2012) Four-Country Synthesis of the Enabling Environment for Hand Washing with Soap: Endline Analysis, Water and Sanitation Program Working Paper, Washington, DC: WSP, World Bank <https://openknowledge.worldbank.org/handle/10986/17378> [accessed 19 July 2019].

Obrist, B. (2004) ‘Medicalization and morality in a weak state: health, hygiene and water in Dar Es Salaam, Tanzania’, Anthropology & Medicine 11(1): 43−57 <https://doi.org/10.1080/1364847042000204924>.

Parveen, S., Nasreen, S., Allen, J.V., Kamm, K.B., Khan, S., Akter, S., Lopa, T.M., Zaman, K., El Arifeen, S., Luby, S.P. and Ram, P.K. (2012) ‘Barriers to and motivators of handwashing behavior in the neonatal period: findings from a formative research study on maternal handwashing in Habiganj, Bangladesh’, BMC Public Health 18: 483 <https://doi.org/10.1186/s12889-018-5365-1>.

Scott, B., Curtis, V., Rabie, T. and Garbrah-Aidoo, N. (2007) ‘Health in our hands, but not in our heads: understanding hygiene motivation in Ghana’, Health Policy Plan 22: 225−33 <https://doi.org/10.1093/heapol/czm016>.

SNV (2017) Sustainable Sanitation and Hygiene For All Programme: Programme Factsheet 2016, Tanzania [pdf], Dar es Salaam, Tanzania: SNV <http://www.snv.org/public/cms/sites/default/files/explore/download/tanzania_extensionbrief_20180130.pdf> [accessed 19 July 2019].

SNV Tanzania (2019) Emotional Demonstrations (Emo-Demos) of Handwashing with Soap at Vaccination Centres [online], Case study, Dar es Salaam, Tanzania: SNV <https://www.ircwash.org/resources/emotional-demonstrations-emo-demos-handwashing-soap-vaccination-centres> [accessed 19 July 2019].

Tetra Tech (2017) Toward a Hygienic Environment for Infants and Young Children: A Review of the Literature [online], IDS <http://www.communityledtotalsanitation.org/resources/toward-hygienic-environment-infants-and-young-children-review-literature-washpals> [accessed 2 August 2019].

Thomas, J., Holbro, N. and Young, D. (2013) A Review of Sanitation and Hygiene in Tanzania, Ifakara, Tanzania: Msabi <https://assets.publishing.service.gov.uk/media/57a08a2fed915d3cfd000628/tanzania-sanitationreview.pdf> [accessed 19 July 2019].

TMS International (2006) Understanding the Tanzanian Consumer in Respect to Handwashing with Soap, unpublished report prepared for the World Bank, Dublin: TMS International.

White, S. (2016) Hygiene and Behaviour Change Document Analysis [pdf], London School of Hygiene and Tropical Medicine <http://ehg.lshtm.ac.uk/files/2017/05/Systematic-qualitative-literature-review.pdf> [accessed 19 July 2019].

Abdi, R. and Gautam, O.P. (2016) Approaches to Promoting Behaviour Change around Handwashing with Soap [online], WaterAid <https://www.susana.org/en/knowledge-hub/resources-and-publications/library/details/2767> [accessed 19 July 2019].

Aunger, R. and Curtis, V. (2016) ‘Behaviour centred design: towards an applied science of behaviour change’, Health Psychology Review 10(4): 425−46 <http://dx.doi.org/10.1080/17437199.2016.1219673>.

Biran, A., Schmidt, W.P., Varadharajan, K.S., Rajaraman, D., Kumar, R., Greenland, K., Gopalan, B., Aunger, R. and Curtis, V. (2014) ‘Effect of a behaviour-change intervention on handwashing with soap in India (SuperAmma): a cluster-randomised trial’, Lancet Global Health 2(3): 145−54 <http://dx.doi.org/10.1016/S2214-109X(13)70160-8>.

Briceño, B., Coville, A., Gertler, P. and Martinez, S. (2017) ‘Are there synergies from combining hygiene and sanitation promotion campaigns: evidence from a large-scale cluster-randomized trial in rural Tanzania’, PLoS ONE 12(11): e0186228 <https://doi.org/10.1371/journal.pone.0186228>.

Coombes, Y. and Paynter, N. (2011) Tanzania: A Handwashing Behavior Change Journey [online], Water and Sanitation Program Learning Note, Washington, DC: WSP, World Bank <https://openknowledge.worldbank.org/bitstream/handle/10986/11683/648550WSP0Tanz00Box361546B00PUBLIC0.pdf?sequence=1&isAllowed=y> [accessed 19 July 2019].

Curtis, V.A., Danquash, L. and Aunger, R.V. (2009) ‘Planned, motivated and habitual hygiene behaviour: an eleven country review’, Health Education Research 24(4): 655−73 <http://dx.doi.org/10.1093/her/cyp002>.

De Buck, E., Van Remoortel, H., Hannes, K., Govender, T., Naidoo, S., Avau, B., Vande veegaete, A., Musekiwa, A., Lutje, V., Cargo, M., Mosler, H.J., Vandekerckhove, P. and Young, T. (2017) Approaches to Promote Handwashing and Sanitation Behaviour Change in Low- and Middle-Income Countries: A Mixed Method Systematic Review [pdf], A Campbell Systematic Review, International Development Coordinating Group <https://doi.org/10.4073/csr.2017.7> [accessed 14 October 2019].

Dreibelbis, R., Kroeger, A., Hossain, K., Venkatesh, M. and Ram, P.K. (2016) ‘Behavior change without behavior change communication: nudging handwashing among primary school students in Bangladesh’, International Journal of Environmental Research and Public Health 13(1): 129 <http://dx.doi.org/10.3390/ijerph13010129>.

Greenland, K., Iradati, E., Ati, A., Maskoen, Y.Y. and Aunger, R. (2013) ‘The context and practice of handwashing among new mothers in Serang, Indonesia: a formative research study’, BMC Public Health 13: 830 <https://doi.org/10.1186/1471-2458-13-830>.

Lindbladh, E. and Lyttkens, C.H. (2002) ‘Habit versus choice: the process of decision-making in health-related behaviour’, Social Science and Medicine 55: 451−65 <http://dx.doi.org/10.1016/s0277-9536(01)00180-0>.

Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC), Ministry of Health (MoH), National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), and ICF (2016) Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHSMIS) 2015−16: Final Report [pdf], Dar es Salaam, Tanzania, and Rockville, MD: MoHCDGEC, MoH, NBS, OCGS, and ICF <https://dhsprogram.com/pubs/pdf/fr321/fr321.pdf> [accessed 19 July 2019].

O’Brien, C. and Favin, M. (2012) Four-Country Synthesis of the Enabling Environment for Hand Washing with Soap: Endline Analysis, Water and Sanitation Program Working Paper, Washington, DC: WSP, World Bank <https://openknowledge.worldbank.org/handle/10986/17378> [accessed 19 July 2019].

Obrist, B. (2004) ‘Medicalization and morality in a weak state: health, hygiene and water in Dar Es Salaam, Tanzania’, Anthropology & Medicine 11(1): 43−57 <https://doi.org/10.1080/1364847042000204924>.

Parveen, S., Nasreen, S., Allen, J.V., Kamm, K.B., Khan, S., Akter, S., Lopa, T.M., Zaman, K., El Arifeen, S., Luby, S.P. and Ram, P.K. (2012) ‘Barriers to and motivators of handwashing behavior in the neonatal period: findings from a formative research study on maternal handwashing in Habiganj, Bangladesh’, BMC Public Health 18: 483 <https://doi.org/10.1186/s12889-018-5365-1>.

Scott, B., Curtis, V., Rabie, T. and Garbrah-Aidoo, N. (2007) ‘Health in our hands, but not in our heads: understanding hygiene motivation in Ghana’, Health Policy Plan 22: 225−33 <https://doi.org/10.1093/heapol/czm016>.

SNV (2017) Sustainable Sanitation and Hygiene For All Programme: Programme Factsheet 2016, Tanzania [pdf], Dar es Salaam, Tanzania: SNV <http://www.snv.org/public/cms/sites/default/files/explore/download/tanzania_extensionbrief_20180130.pdf> [accessed 19 July 2019].

SNV Tanzania (2019) Emotional Demonstrations (Emo-Demos) of Handwashing with Soap at Vaccination Centres [online], Case study, Dar es Salaam, Tanzania: SNV <https://www.ircwash.org/resources/emotional-demonstrations-emo-demos-handwashing-soap-vaccination-centres> [accessed 19 July 2019].

Tetra Tech (2017) Toward a Hygienic Environment for Infants and Young Children: A Review of the Literature [online], IDS <http://www.communityledtotalsanitation.org/resources/toward-hygienic-environment-infants-and-young-children-review-literature-washpals> [accessed 2 August 2019].

Thomas, J., Holbro, N. and Young, D. (2013) A Review of Sanitation and Hygiene in Tanzania, Ifakara, Tanzania: Msabi <https://assets.publishing.service.gov.uk/media/57a08a2fed915d3cfd000628/tanzania-sanitationreview.pdf> [accessed 19 July 2019].

TMS International (2006) Understanding the Tanzanian Consumer in Respect to Handwashing with Soap, unpublished report prepared for the World Bank, Dublin: TMS International.

White, S. (2016) Hygiene and Behaviour Change Document Analysis [pdf], London School of Hygiene and Tropical Medicine <http://ehg.lshtm.ac.uk/files/2017/05/Systematic-qualitative-literature-review.pdf> [accessed 19 July 2019].