Access to WASH at household level: combining behaviour change communication with cash distribution for improved nutrition outcomes in Burundi

Burundi is one of the poorest countries in the world, with over 65% of the population living below the poverty line and with the prevalence of stunting far exceeding the thresholds set by the WHO. According to the national survey on nutrition and mortality using the SMART methodology conducted in 2024, 52.8% of children aged 6 to 59 months are affected by chronic malnutrition, 8% by acute malnutrition and 28.3% by underweight at the national level. This high rate of chronic malnutrition hinders human capital development, compromising children's immune function, psychomotor and cognitive development, and long-term educational and economic outcomes. 

This learning paper presents a pilot project in Burundi built around three key innovations:

• Linking awareness-raising with income‑enhancing initiatives to address financial barriers that limit households’ ability to adopt recommended WASH and nutrition behaviours.
• Integrating hygiene and nutrition messaging with efforts to engage men, encouraging reflection on the division of WASH-related tasks and motivating greater male involvement.
• Using simple visual tools and streamlined messages focused on a select set of priority behaviours chosen by households.

Together, these approaches have helped narrow the persistent gap between knowledge and practice commonly observed in similar Concern interventions.