Participatory Hygiene and Sanitation Transformation (PHAST)

Compiled by:
Juri Lienert (seecon international gmbh)

Executive Summary

PHAST stands for “Participatory Hygiene and Sanitation Transformation”. The approach is a participatory learning methodology that seeks to help communities improve hygiene behaviours, reduce diarrhoeal disease and encourage effective community management of water and sanitation services (WSSCC 2009). It aims at empowering communities to improve hygiene behaviours, preventing diarrhoeal diseases, and encouraging community-management of water and sanitation facilities. It uses a participatory approach to community learning and planning that follows a seven step framework (NETSSAF 2008). The approach was introduced from the World Health Organisation (WHO).

The Concept of PHAST

PHAST works on the premise that as communities gain awareness of their water, sanitation and hygiene situation through participatory activities, they are empowered to develop and carry out their own plans to improve this situation (WSSCC 2009).

Besides, PHAST seeks to help communities to improve their hygiene behaviours, to prevent diarrhoeal diseases and to encourage community-management of water and sanitation facilities. PHAST hence demonstrates the relationship between sanitation and health status (see also health and hygiene issues).

Furthermore, the method tries to enhance the self-esteem of the participating community members by involving them into the planning process. Empowering the community helps to plan environmental improvements and to own and to operate water and sanitation facilities. For the achievement of these goals, the PHAST approach is using participatory methods to encourage the participation of individuals in a group process (WHO 1998).

PHAST is based on another participatory methodology called SARAR, which stands for self-esteem, associative strengths, resourcefulness, action-planning and responsibility.

The Seven Step Participatory Approach

PHAST uses a seven-step participatory approach to facilitate a community planning process (see below).

Each step contains between one to four activities a group has to go through to improve their community planning on hygiene and sanitation. These activities shall take place in a participatory manner to enhance the participation of individuals.

 WHO 1998

The seven steps to community planning of PHAST. Source: WHO (1998)


In general, the PHAST approach is applicable for all kind of communities who are trying to improve their hygiene and sanitation planning and who want to start a process for community hygiene behaviour change.


  • Extremely rewarding for both community members and community workers, by involving the communities in their project planning and implementation through participatory techniques.
  • Communities gain confidence and responsibility for their own projects and have a clear say in what they want and do not want.
  • Effective involvement of the community in monitoring and evaluation ensures that the services put in place respond to the needs of the community and that essential direct feedback provided can serve to change activities as necessary.
  • Trained community workers in participatory techniques, with proper guidance and management, can become a lasting asset to the program and the community (WORLD BANK 2007).


  • Requires in-depth training of community workers in participatory techniques, including regular refresher courses. This has budget implications.
  • It is generally necessary to select experienced community workers to take part in the training. A basic two-weeks training does not guarantee that the community workers are able to successfully use the approach in their communities.
  • It requires an intensive management structure. This is feasible in smaller “grass-roots” projects but becomes problematic if the aim is to “go to scale” at a programmatic or national level.
  • Relatively time-intensive in their use. The approach requires that the beneficiary communities are available to go through the participatory exercises. This may be seen as a burden if not properly discussed with the community beforehand (WORLD BANK 2007).

References Library

BARRETO DILLON, L.; BUZIE FRU, C.; ONADIPE, E. ; ROBERTI PÉREZ, L. (Editor) (2008): Introduction to the NETSSAF Participatory Planning Approach, a tutorial and guideline for sustainable sanitation planning . (= Proceedings of the NETSSAF Final Conference “Pathways towards Sustainable Sanitation in Africa"). Ouagadougou: NETSSAF. URL [Accessed: 02.04.2010].

WHO (Editor) (1998): PHAST Step-by-Step Guide: A Participatory Approach for the Control of Diarrhoeal Disease. Geneva: World Health Organisation WHO. URL [Accessed: 20.04.2010].

WORLD BANK (Editor) (2007): Hygiene and Sanitation Promotion. Washington: World Bank. . URL [Accessed: 22.04.2012].

WSSCC (Editor) (2009): 2009 Annual Report. Geneva: Water Supply & Sanitation Collaborative Council (WSSCC). URL [Accessed: 06.01.2011].

Further Readings Library

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This guidebook is based on the WHO guidebook and provides the same information in a more compact form. It comes with selected participatory activities for the single planning steps

See document in SOMALI

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NETSSAF (Editor) (2008): The NETSSAF Participatory Planning Approach. South Africa: Network for the Development of Sustainable Approaches for Large Scale Implementation of Sanitation in Africa. URL [Accessed: 10.02.2010].

This document presents an overview of some existing participatory sanitation planning tools, illustrating the scope of the steps and some of the common methodologies employed in the various frameworks.

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UNDP & WSP (Editor) (1998): Prospective Review of PHAST. Nairobi: UNDP-World Bank Regional Water and Sanitation Group East and Southern Africa. URL [Accessed: 10.02.2010].

The review also comments on the status of implementation of PHAST in the eastern and southern Africa region. Furthermore it provides some specific country information of selected African countries and presents concrete lessons learnt.

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WATERAID (Editor) (2012): Hygiene framework. London: WaterAid. URL [Accessed: 29.01.2013].

This document sets out WaterAid’s framework for hygiene promotion and behaviour change in the countries where it works. It will also help organisations that work on hygiene in the context of water, sanitation and hygiene (WASH) programmes.

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WHO (Editor) (1997): The PHAST Initiative. A New Approach to Working With Communities.. Geneva: World Health Organisation. URL [Accessed: 22.04.2012].

In this document, the PHAST approach is explained from a methodological and historical point of view in a brief and concise manner.

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WORLD BANK (Editor) (2007): Hygiene and Sanitation Promotion. Washington: World Bank. . URL [Accessed: 22.04.2012].

The World Bank document also provides some common approaches of hygiene and sanitation planning tools including PHAST.

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WHO; WHO (Editor) (2015): Improving nutrition outcomes with better water, sanitation and hygiene: Practical solutions for policy and programmes. Geneva: WHO. URL [Accessed: 24.11.2015].

This document, jointly prepared by WHO, UNICEF and USAID, summarizes the current evidence on the benefits of WASH for improving nutrition outcomes and describes how WASH interventions can be integrated into national nutrition policies and programmes to add value.

Case Studies Library

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NUNOO, D. (2009): Participatory Hygiene and Sanitation Transformation (PHAST): A methodology for sustainable hygiene and sanitation behaviour change with experience from the Bawku West District of Ghana. pdf presentation. Accra: West Africa Regional Sanitation and Hygiene Symposium.. URL [Accessed: 10.02.2010].

Experiences with PHAST in western Ghana.

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UNDP & WSP (Editor) (1998): Prospective Review of PHAST. Nairobi: UNDP-World Bank Regional Water and Sanitation Group East and Southern Africa. URL [Accessed: 10.02.2010].

The review also comments on the status of implementation of PHAST in the eastern and southern Africa region. Furthermore it provides some specific country information of selected African countries and presents concrete lessons learnt.

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WORLD BANK (Editor) (n.y.): Participatory Hygiene and Sanitation Transformation (PHAST) prevent child parasitic enteric infections in Kyrgyz villages. pdf presentation. WORLD BANK . URL [Accessed: 10.02.2010].

This PowerPoint presentation deals with the connection between hygiene, water supply and an enhancement of the health situation in the Kyrgyz Republic.

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FAVIN, M.; WSP (Editor) (2011): Endline Assessment of the Enabling Environment in Peru. Washington DC: Water and Sanitation Program (WSP). URL [Accessed: 24.10.2011].

A new endline report discusses how Peru’s enabling environment for handwashing with soap has progressed since 2007. The research, conducted by the Water and Sanitation Program (WSP), indicates that the enabling environment has been strengthened at both national and regional levels. In addition, efforts to integrate and institutionalize handwashing with soap behavior change into national, regional, and local policies related to health and nutrition, education, water, and sanitation have largely been achieved.

Awareness Raising Material Library

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WSP (Editor) (2012): Behavioral Determinants of Handwashing with Soap Among Mothers and Caretakers: Emergent Learning from Senegal and Peru. Washington, D.C: Water and Sanitation Program (WSP). URL [Accessed: 27.02.2012].

A new Water and Sanitation Program (WSP) Learning Note found that beliefs and ease of access to soap and water were correlated with handwashing with soap behaviors for given proxy measures among mothers and caretakers in Peru and Senegal.

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USAID; USAID (Editor) (2015): Small Doable Actions: A Feasible Approach to Behavior Change.. Washington : USAID. URL [Accessed: 25.11.2015].

A small doable action is a behavior that, when practiced consistently and correctly, will lead to personal and public health improvement. Although the behavior may not be an “ideal practice,” more households likely will adopt it because it is considered feasible within the local context.

Important Weblinks [Accessed: 10.03.2010]

This link brings you to the official homepage of the WHO and its water and sanitation department. [Accessed: 06.04.2010]

The NETSSAF tutorial for sustainable sanitation planning introduces a participatory planning approach. It targets planners of sanitation programmes in West Africa and provides guidance in facilitating “informed choices” in consultation with users and other stakeholders. [Accessed: 11.10.2013]

This annotated bibliography was compiled by WASHplus and contains citations and abstracts to 20 peer-review handwashing studies that were published from January through September 2013. Links are also provided to the abstract or full-text for each article.