How the WASH initiative adapted to respond to COVID-19

Pelagie Boko-Collins, November 2020
A poster saying 'Coronavirus has not gone away. Keep your friends and family protected. Stay at least 1 metre apart'. There are illustrations of a man and woman with a vehicle separating them, illustrating one metre.

Once it became clear that the water, sanitation and hygiene (WASH) activities we use to combat neglected tropical diseases (NTDs) could help stop the spread of COVID-19, we lost no time in putting a plan in place.

Together with our partners, we devised behaviour change campaigns to encourage millions of people in Africa to adopt WASH and social distancing behaviours. However, to make these campaigns successful we first needed to understand the diverse communities we were working with and their individual cultural, linguistic and religious characteristics, as well as tackle the patterns of misinformation around the virus that existed in many places.

When the COVID-19 pandemic struck earlier this year, our mass drug administration (MDA) work in Africa inevitably had to pause. However, when encouraged by UK aid to adapt one of its flagship health programmes, Ascend West and Central Africa, we consulted with national ministries of health to find ways to support governments in this humanitarian crisis. We drew on the expertise of our Ascend partners, including the SCI Foundation, the Liverpool School of Tropical Medicine and Mott MacDonald.

As a result, we began working with these ministries and other organisations on behavioural messaging campaigns in nine African countries to reach millions of people across radio, television, social media and via billboards and leaflets.

A man washes his hands.

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When designing the campaigns with M&C Saatchi World Services and their partner network across Africa, we sought to understand and incorporate the different cultural as well as informational needs of countries and the regions within them.

For example, in Nigeria, we used the slogan ‘Spread the Truth, not the Virus’, as we needed to take into account not just local differences in knowledge, language, religion and local dress, but also what kind of misinformation was being spread.

In Benin, we were told that some religious leaders and herbal healers may be giving out false information they believed to be true. However, as they are one of the pillars of more traditional communities, we understood they could play a vital role in helping us to spread the right information. For instance, in a focus group discussion to ascertain the knowledge, attitudes and practices of the communities against COVID-19 in Benin, a religious leader in Porto-Novo claimed he avoids the virus by drinking ‘Sodabi’, the country’s local liquor, every morning.

The saying ‘Alodokpo non klo ka a’, meaning ‘one hand does not wash the bowl’, was also discussed in these focus groups. This is thought to suggest that the government alone cannot handle COVID-19 so it is important that they utilise local leaders and known healers to support the response.

We also understood the importance of using relevant cultural symbols. In Nigeria, a thermometer to signify fever has no meaning in an area where the population had never seen one. Instead, depicting a person shivering and wrapped in blankets was more culturally appropriate and effective. Also, our communication materials had to depict the right kind of community hand washing stations and one-metre distance examples, so posters instead depicted a bucket tap as opposed to a modern tap, and a tuc tuc (or ‘keke’), as opposed to a shopping trolley.

In Nigeria, we used the slogan ‘Spread the Truth, not the Virus’.

As well as taking local differences in knowledge, language, religion and local dress into account, there were discussions on how to target different groups, such as young people and women. An example of this approach is a video aimed at young people in Ghana, which was shared on social media:

We look forward to sharing the impact of these visuals once the campaign finishes later this year. However, we have already had encouraging feedback from Mr Divine Gadogbe, head of social behaviour change communications material development unit of the health promotion unit at Ghana Health Services.

He said: “We knew that to respond quickly and effectively to the COVID-19 communication needs in the country, we needed to focus on children and people in broader communities. By working collaboratively with the Ascend West and Central Africa programme and M&C Saatchi World Services, we were able to provide guidance on making the materials inclusive and culturally relevant. As a result, they have produced some of the best COVID-19 materials we have seen.”


Sightsavers logo.Pelagie Boko-Collins is Sightsavers’ country neglected tropical disease manager for Benin.

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