In humanitarian settings, transmission of disease is high because public health infrastructure is often compromised, access to key services, such as drinking water and sanitation can be limited, and the environment highly contaminated. The simple act of handwashing with soap (HWWS) is an effective means of preventing transmission of important diseases, such as diarrhoea and pneumonia. However, it is infrequently practised. Children can account for more than 50% of a crisis-affected population and account for most diarrhoeal and pneumonia cases. Thus, increasing HWWS among children in these settings has the potential to substantially improve health outcomes for populations at risk.
Our Surprise Soap innovation aims to increase hand washing with soap among children in humanitarian settings. Surprise Soap is a novel transparent soap containing an incentive inside – a small toy – that can only be reached as the soap is used up. It therefore incentivises frequent hand washing: the more you wash the quicker you get the toy! The idea is similar to that of the popular ‘Kinder Egg’- a chocolate egg with a hidden reward/toy inside.
Existing HWWS interventions are designed using health-based messages and rely on these messages to promote behaviour change, despite evidence that health is not an effective motivator for behaviour change. Our Surprise Soaps are delivered in short, fun, household sessions and provide a child-specific incentive based on fun, curiosity and psychological reward to improve children’s handwashing behaviour.
Through robust testing, we are building empirical evidence on the impact of the Surprise Soaps innovation to support the innovation to scale.
In 2017, with funding from the HIF, we designed the Surprise Soap innovation and piloted it in an IDP camp in Northern Iraq, showing that it can work to increase hand washing with soap among children living in this camp.
Beyond Proof of Concept
To help the innovation to scale we will now move beyond proof of concept to further test Surprise Soaps in parallel randomised controlled trials in two humanitarian settings in Somalia and Sudan, and over extended follow-up periods. This will tell us if the Surprise Soap innovation still works in different and more challenging humanitarian settings and if children’s interest in the Surprise Soap, and hence increased handwashing, can be sustained over several months.
When results are in, we will know if Surprise Soaps can be responsibly scaled across humanitarian settings and for how long they should be used to achieve maximum impact.
This intervention includes soap with embedded toys delivered through a short household session comprising a glitter game, instruction of how and when to wash hands, and HWWS practice. Whilst promising, this approach has not been evaluated at programmatic scale in a complex humanitarian setting. This paper seeks to do that.View
Surprise Soaps has received further funding from the WASH Evidence Challenge
After morale-sapping delays, as bureaucratic stumbling blocks and political insecurity saw the location of our hand-washing trial move continent, this February we were finally ready to start the fun part – the interactive product design and development workshop!View
So, the journey has begun! Save the Children UK and the London School of Hygiene and Tropical Medicine have successfully secured funding from the Humanitarian Innovation Fund to develop our exciting innovation we call ‘The Hidden Incentives’.View
Learn more about this WASH project, and many others, in our Humanitarian WASH Innovation Catalogue.
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