Many governments in Asia and Africa have set themselves target dates for becoming open defecation free (ODF). A number have mounted major national campaigns with a strong behaviour change component to achieve this, for example Bangladesh, Ethiopia, India, Indonesia, Nepal, Nigeria, Pakistan, Tanzania, and Timor-Leste among others. In the meantime, much experience has been gained with a number of behaviour change methods and approaches.

Campaigns need to be more creative and move away from knowledge and education-style messaging; learning from Community-Led Total Sanitation and other sectors which already do this effectively will also be essential. Successful campaigns have leveraged a wide range of community members and WASH influencers (including health workers, children, teachers, and community, political traditional or religious leaders).

Identifying and working with broader social influencers and local celebrities can be a powerful advocacy tool to raise the profile of campaigns. Analysis of the successes and weaknesses of these campaigns is needed to improve the realism of feedback and reporting, along with the quality and sustainability of what is achieved.

Central to the success of these campaigns is an openness and commitment to learn about ground realities from the very start of a campaign, with regular feedback, reflection and adaptation – and building this into monitoring processes. Both negative and positive impacts around national campaigns need to be better understood.

It is important to carefully consider campaign messaging so it does not have unintentional repercussions on individuals and communities, particularly already vulnerable and marginalised people.

Care must also be taken when engaging children in campaigns, something which has been seen in some countries, making sure not exposing them to the risk of confrontation. Furthermore, lessons from countries where sanitation campaigns become a political and administrative priority indicate that figures can be inflated for political gain.

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