Access and behavioral outcome indicators for water, sanitation, and hygiene

This document reflects the evidence that has accumulated to date on how to measure in a reliable and valid way hygiene practices that are critical for the prevention of diarrheal disease and the reduction of child morbidity and mortality. The indicators proposed here fit the general objectives and the measurement of outputs and outcomes commonly sought by international donors and development assistance interventions. Most of the indicators presented here track output and outcomes at the household level. Community-based indicators associated with community-led total sanitation (CLTS) are included. The indicators are grouped into the categories: Access to water supply and use of household water treatment technologies and safe storage; The practice of hand washing with soap at critical moments; and Access to and use of sanitary facilities for the disposal of human excreta. Two distinct categories of indicators presented in separate sections: the first one is defined as “Essential Indicators,” the second category are “Essential and Expanded Indicators”. The document begins with a list of all the indicators organized as described above. This manual aims to help program planners, managers, and evaluators design, implement, and evaluate WASH interventions. It is intended for use either in programmes and projects with a principal focus on WASH or with a broad child health agenda.