Process evaluation of "the Hygienic Family" intervention: a community-based water, sanitation and hygiene project in rural Malawi

Mindy Francis Panulo, Kondwani Chidziwisano, Tara K. Beattie, Elizabeth Tilley, Christabel Kambala, Tracy Morse

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
30 Downloads (Pure)


Process evaluations of environmental health interventions are often under-reported and under-utilized in the development of future programs. The “Hygienic Family” intervention targeted improvements in hygiene behaviors of caregivers with under five-year-old children in rural Malawi. Delivered through a combination of open days, cluster meetings, household visits, and prompts, data were collected from two intervention areas for ten months. A process evaluation framework provided indicators that were measured through intervention implementation and expenditure reports, focus groups discussions, interviews, and household surveys. The collected data assessed the intervention fidelity, dose, reach, acceptability, impact, and cost. Results indicated that all planned hygiene promotion messages were delivered, and study participants were better reached primarily through household visits (78% attended over 75% of the intervention) than cluster meetings (57% attended over 75% of the intervention). However, regression found that the number of household visits or cluster meetings had no discernible effect on the presence of some household hygiene proxy indicators. Intervention implementation cost per household was USD 31.00. The intervention delivery model provided good fidelity, dose, and reach and could be used to strengthen the scope of child health and wellbeing content. The intensive face-to-face method has proven to be effective but would need to be adequately resourced through financial support for community coordinator remuneration.
Original languageEnglish
Article number6771
Number of pages19
JournalInternational Journal of Environmental Research and Public Health
Issue number11
Publication statusPublished - 1 Jun 2022


  • process evaluation
  • hygiene
  • WASH
  • Malawi
  • food safety
  • food hygiene
  • community health


Dive into the research topics of 'Process evaluation of "the Hygienic Family" intervention: a community-based water, sanitation and hygiene project in rural Malawi'. Together they form a unique fingerprint.

Cite this