September 2025 — In Sofala province, Mozambique, UNICEF is leading an innovative initiative to improve child health by promoting better water, sanitation, and hygiene (WASH) practices and supporting the certification of ‘Model Families.’ Although awareness about hygiene is high, many rural communities still struggle to put critical behaviours—like regular handwashing and proper latrine use—into practice. These gaps contribute to preventable illnesses and high rates of child morbidity and mortality. By combining practical tools with behaviorally informed guidance, the program aims to help families adopt healthier habits that can protect children and strengthen community well-being.

A Two-Pronged Behavioural Approach

The program, implemented in partnership with Nudge Lebanon, targets 210 families in treatment communities and 216 families in control communities, with carefully selected districts based on their Open Defecation Free (LIFECA) status. The intervention is structured around two complementary strategies.

First, the Behaviorally Informed WASH Communication Guide equips Community Health Committees (CHCs) with insights and strategies for communicating the importance of hygiene in ways that align with local beliefs and cultural norms. For example, the guide suggests ways to frame handwashing not just as a health practice but as a way to protect children and demonstrate care for family members—messages that resonate more strongly with caregivers.

Second, the Practical WASH Toolkit provides families with accessible, low-cost tools to make hygiene behaviours easier to adopt. Toolkits include items such as soap, handwashing stations, water storage containers, and cleaning materials. By combining tangible resources with behavioural messaging, the intervention addresses both motivation and opportunity, making it simpler for families to change daily habits sustainably.

Capturing Real Impact: Insights from Families

UNICEF employs a mixed-methods approach to monitor and evaluate the program, capturing both numerical trends and personal experiences. Quantitative analysis uses a cluster-level Difference-in-Differences methodology to measure changes in behaviours such as latrine use, handwashing at critical moments, and perceived risk of waterborne diseases. Meanwhile, qualitative research includes 30 in-depth interviews with families across both treatment and control communities and 2 focus group discussions with families exposed to the intervention. This approach ensures a deep understanding of both the successes and challenges encountered by participants.

Early feedback suggests substantial improvements in household hygiene practices. Families report a 70% increase in handwashing at critical moments, such as after using the toilet and before meals. Latrine use increased by 55% in households receiving both the toolkit and behavioural guidance. Meanwhile, 95% of CHC members indicated that the communication guide significantly enhanced their ability to encourage consistent hygiene practices.

"Before we had the toolkit, it was difficult to get my children to wash their hands at the right times. Now, with the handwashing station at our home, it has become part of our daily routine," shared one mother, illustrating how a simple tool can transform everyday habits. A community health worker added: "The behaviorally informed guide has helped us communicate in ways that families understand and relate to. We are seeing more consistent latrine use than before, and families are proud of becoming ‘Model Families’ in their communities."

Lessons and Recommendations

Initial observations suggest that combining simple tools with behaviorally informed communication can significantly increase healthy WASH practices. To sustain and expand these gains, UNICEF recommends:

1. Scaling the Model Families approach to additional districts across Mozambique, ensuring that more families can benefit from behaviorally informed WASH practices.

2. Providing ongoing training for CHCs, focusing on communication techniques that resonate culturally and encourage sustained behaviour change.

3. Integrating WASH Toolkits into national health programs, so that families consistently receive practical tools to support hygiene behaviours.

4. Establishing continuous monitoring systems to track long-term behaviour changes, identify challenges early, and adapt strategies as needed. 

This initiative demonstrates how low-cost interventions, rooted in behavioural insights, can transform everyday practices, reduce waterborne diseases, and improve child health outcomes. As endline data collection continues, UNICEF hopes to use these findings to guide future programs across Mozambique, supporting the broader goal of Sustainable Development Goal 6: Clean Water and Sanitation for all.