  
The challenge in reducing disease transmission is not only in providing toilets and other hardware but also in effective hygiene promotion to change peoples’ behavior. Hygiene here refers to the set of behaviors related to safe management of excreta, such as washing hands with soap at appropriate times, disposing safely of household wastewater, and the safe disposal of child feces. Together with sanitation, hygienic behavior is critical for control of diarrheal diseases and parasitic infections that cost lives and contribute to malnutrition.
Recognizing the need for improved at-scale hygiene promotion, the World Bank and several other organizations have come together to work with governments to raise awareness, enhance political commitment, and assist with fund raising through coordinated country programs. The World Bank has recently been working in partnership with others to develop national hygiene campaigns and strategies in Ghana, Senegal, Ethiopia, and Madagascar. These campaigns make use of commercial marketing to sell sanitation and hygiene.
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