Using play-based learning to promote healthy habits

For some children, the path to good health might lead through a classroom. In Zambia, where over six million people lack access to clean water, a program called WASH UP! aims to teach children safe sanitation and hygiene practices to prevent infections and diseases that kill millions globally. A partnership between Stanford University’s Program on Water, Health and Development (WHD), World Vision and Sesame Workshop is working to assess the program’s effectiveness. James Winter, a Ph.D. candidate in the Civil and Environmental Engineering Department at Stanford, leads a study on the efficacy of the program.

Winter’s passion for health and development started in childhood. His father, a physician, worked in post-conflict areas with the NGO Americares and spent one month out of the year working in countries like Darfur, Rwanda, and Afghanistan.      

“Seeing the impact that specialized education can have not only at home but abroad had a really big impact on me,” Winter says. Unlike his father, he chooses to tackle the global health problem through sanitation rather than medicine and has carried that passion to Zambia.

Access to and knowledge of safe water practices can mean the differencebetween adverse outcomes – like diarrhea, illness and death – and good health. Through original story-telling, videos, songs, books and gameplay the WASH UP! curriculum – developed by educational powerhouse Sesame Workshop – takes a play-based approach to teaching children safe sanitation and hygiene practices. Affable Raya (a six-year old Muppet) along with her friend Elmo, help students learn and form healthy habits such as hand washing, food hygiene and proper latrine use.

Since 2017, Winter has been working alongside WHD Director Jenna Davis in Zambia. Together they trained twenty Zambian enumerators, fluent in the local language, to conduct interviews to determine how impactful the educational programming is on the sanitation practices of students and their families. The tablet-based survey was written by Davis and Winter in collaboration with World Vision, Sesame Workshop and a local translator. Interviewing teachers, parents and students helped the team understand how well the educational programming is being adopted by community members, and also how it is shaping health outcomes as a result.

“It is really fulfilling to be able to work so closely with the team members and the data,” Winter says. “It is eye-opening to have the opportunity to directly engage in the data collection, to see where it comes from and to see the people behind it.”

As gratifying as the fieldwork can be, he admits it is a learning experience and anticipates big challenges ahead in the water, sanitation and health sector.

“It’s way harder than you might think,” Winter notes. “In field work, there are always unexpected obstacles that can be challenging to prepare for. At one of our schools, interviews with students were disrupted when an eight-foot adolescent python was found in one of the school latrines, causing mass panic!”

Winter also points out that there are other mechanics at play such as infrastructure, technology, behavioral change and social change which impacts the work. In one instance he recalls losing electricity at his lodging and having to transport an incubator full of field samples to a milk processing facility with an independent generator. At another school, the team had to work closely with community partners to convince parents to even allow their children to participate in the program.  As Winter finishes research on WASH UP! Zambia, the WHD team will be using lessons learned to expand the program to India later this year. Winter, who will be leading the launch, looks forward to the challenge.