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Our Approach

Wherever we work, Tearfund takes an integrated approach to water, sanitation and hygiene (WASH). This means that by coordinating our work on these three areas, we can have a bigger impact on improving community health and well-being. 

Working with communities

We are committed to working in full participation with communities, empowering them to own and manage sustainable, safely managed water and sanitation services and transformed hygiene practices whenever possible, yet at the same time realising that communities require ongoing guidance. In our support we explicitly consider environmental impact, the differing role and need of genders and vulnerable groups, and solutions which are conflict-sensitive. 

Working with local governments and building partnerships

Tearfund works with local governments through influencing, advocating and supporting local policy development for better access to WASH. Through this work we help build a more supportive environment, particularly in conflict-affected and fragile states. 

Through partnerships with community groups, NGOs, government bodies and the private sector, we build capacity to manage water resources and mainstream environmental and economic sustainability.


Today, over 700 million people still live without access to safe water.

Access to water is not just about survival. People use water for all sorts of cultural activities as well as for everyday tasks like bathing, cleaning, farming and cooking. Tearfund works with communities to understand the importance of all these activities in the local setting, meeting both the basic needs as well as the culturally valued uses for water.

Tearfund’s water supply programming covers the choice of water source, water source development, abstraction (taking water from the source), transport (or conveyance), water treatment and water quality testing.

Water safety plans are a commonly used management system that rely on active community participation and leadership.

Demand-led approaches to sanitation

Demand can vary for water, sanitation and hygiene. Usually the demand for safe and accessible water already exists, but the demand for sanitation and hygiene facilities may need to be stimulated. Today, 2.3 billion people still live without access to safe sanitation services. The safety, privacy, comfort and dignity of an accessible toilet should be an everyday reality for all. 

Getting the local community actively involved is a key part of demand-led approaches. Using methods that encourage participation, individuals and their communities work together to analyse their own situation. This can create a ‘light-bulb’ moment, where the need for change is realised. Evidence suggests that when there is a high level of ownership and involvement, supported by capacity building, long-term change is more likely. 

Demand-led approaches also help to broaden out the choice of technologies that are available to communities. Using their local knowledge and skills, they can identify the best low-cost and sustainable options. 

Tearfund employs a combination of demand-led and supply-driven approaches to WASH at different stages of response, when evidence and context suggest they are the most appropriate. Although demand-led approaches are preferred, emergency response often requires the construction of communal latrines and the distribution of temporary water supply to collection points to meet the needs and rights of communities affected by disaster. 

Community-led total sanitation (CLTS)

Community-led total sanitation is an innovative methodology that gets communities working together to eliminate open defecation. Facilitation provides communities with the opportunity to conduct their own investigation and analysis of open defecation and discuss the impacts. Communities are then encouraged to find their own solutions and to organise themselves to become open defecation free.

This reflective learning process, coupled with an understanding of what triggers can change people's behaviour, is essential to initiating a process of sustained behaviour change.

Explore Tearfund’s resources on sanitation

Sanitation marketing 

Sanitation marketing uses social and commercial marketing to scale up the demand and supply for improved sanitation and water supply, particularly among those living in poverty.
It assumes that many people, including those living in poverty, are willing to pay for water and sanitation facilities that will meet their needs, if the technology is packaged and marketed appropriately, and the supply mechanism is easily accessible. The approach links very well with demand-led, livelihood approaches such as CLTS.


Together, water, sanitation and good hygiene practices play an important role in preventing disease. However, providing clean water and decent toilets does not necessarily mean good hygiene practice follows. That is why we focus on changing hygiene behaviours. The simple act of washing hands with soap at critical times can reduce the number of diarrhoea cases by over 40 per cent. 

Poor hygiene has an impact on health and dignity, resulting in lower school attendance and a loss of income. There are many different types of diseases linked to poor hygiene that affect people’s health and contribute to malnutrition. Globally, diarrhoea-type diseases are the second most common cause of death of children under the age of five. 

The importance of handwashing with soap 

Handwashing with soap is one of the most cost-effective and successful ways of combating infectious diseases. But simply providing soap and water is not enough. That is why behaviour change around handwashing with soap at critical times is one of the key focuses of our hygiene promotion programmes. 

A young boy demonstrates how to wash his hands

Abdisa Kasim demonstrates how to wash hands at a waterpoint at Shashamene Referral Hospital, Ethiopia. Photo: Will Boase Photography

Achieving sustainable behaviour change

There are many other behaviours related to hygiene that also reduce illness and disease, from safe food preparation and the protection of water sources to the safe disposal of human waste and animal dung. 

Sustainable behaviour change is an important part of WASH, but it can be hard to achieve. Lots of factors can influence if and how people change their behaviour, including their traditions and habits, their belief in whether they can make the change, and even whether the resources needed are available locally (eg soap, tippy taps, water filters). 

Different people may be motivated to change their behaviour and to adopt safe hygiene practices for different reasons, for example the desire to keep their family healthy or feeling the need to fit in with their community. 

Key approaches to behaviour change in sanitation and hygiene

Gender and WASH

Addressing the needs of women and girls in relation to water, sanitation and hygiene is key to achieving gender equality. 

Globally, women and girls are still the primary water collectors in their household. They are still the main carers when children or others get sick with diarrhoeal diseases. Day after day, they secure water that is essential for food security and livelihoods. 

Yet despite these responsibilities, unequal access to water and land means that women are disproportionately affected by the lack of water. 

Women and girls are particularly vulnerable to abuse and attack, often having to wait until dark to relieve themselves in the open and in unsafe toilets, or where they have to fetch water from remote locations. 

Tearfund involves both women and men in planning and managing water and sanitation services. We prioritise women's needs, concerns and preferences through a gender-responsive approach to projects. We work to empower women to share their knowledge, develop their skills and strengthen their decision-making powers.  

Evidence supports that this approach to gender mainstreaming can increase women's influence, visibility and participation within their own communities and in community-based WASH initiatives. 

Explore Tearfund’s guidance notes on gender and WASH

Conflict and WASH

When working in conflict contexts, it is important for projects to be sensitive to their impact on the dynamics and drivers of the conflict. In the case of water, sanitation and hygiene (WASH) projects it may be possible to design activities to have a positive impact on the conflict itself, rather than just on WASH needs.

Tearfund's conflict-sensitive approach to WASH in conflict-affected and fragile states is based on a growing understanding of the contribution of WASH service delivery to peacebuilding and state-building. WASH programming can provide a key entry point for capacity building (strengthening governance and accountability) and infrastructural development, as well as acting as a vehicle for citizen engagement, community mobilisation and empowerment.

Explore Tearfund’s guidance notes on WASH in fragile and conflict-affected states

Environment and WASH

All projects are both affected by and affect the environment. Environmental sensitivity and sustainability are key in any WASH programme. 

Universal access to water, secure sanitation and hygiene are fundamental to achieving sustainable development. Although the Millennium Development Goal for Water was met, the United Nations Member States have established new commitments to Sustainable Development Goals (SDGs), which aim to end extreme poverty by 2030. The SDGs recognise the need for sustainable hygiene practices, water and sanitation services and systems, so that WASH provision can continue to meet people's needs over the long term by adapting to changing circumstances, stresses and shocks. 

Tearfund recognises the dynamics and feedback processes between water users and the environment and the need to base WASH approaches on an understanding of these processes in the local context as well as on national and global influences. 

Explore Tearfund’s guidance notes on the environment and WASH

Inclusivity and WASH

Tearfund works with everyone in the local community – men, women and children – to make sure they have equal access to suitable, secure and sustainable water and sanitation services. Often greater support is needed for people who are vulnerable, marginalised or discriminated against to ensure their rights and needs are equally recognised. This can mean working with local government to help them to address taboo issues like gender-based violence. 

Even where there are WASH services, certain people are more likely to be excluded from accessing these, due to their vulnerability or marginalisation, or due to active discrimination. In almost all societies, this includes women and children, people living with disabilities and chronic illness, people with certain gender identities, people who belong to specific ethnic groups, religions and castes, people who have been displaced and those living in remote areas. These groups often experience limited opportunities, limited choices and limited freedoms, which makes them more vulnerable to poverty. 

Evidence suggests that disadvantaged and marginalised groups are least able to provide sustainable WASH facilities for themselves and they are often excluded from relief and rehabilitation processes. Realising the rights of all to WASH will require us to target the most marginalised and disadvantaged groups as well as tackling many cross-cutting issues such as gender-based violence and land tenure insecurity. 

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