Global evidence suggests deeply embedded structural and behavioral determinants, including restrictive norms and inequalities related to gender, sustain poor sanitation and hygiene conditions. However, not enough is known about the specific dynamics that drive sanitation and hygiene behaviors in Mozambique. USAID completed a participatory assessment in February 2019, identifying the need for further research to design robust, evidence-based hygiene behavior change programs, particularly those which address gender-related determinants. In response, the USAID WASHPaLS Project led by Iris Group conducted formative research on gender, sanitation, and hygiene in the Nampula and Zambezia provinces of Mozambique. The objective of the research was to identify barriers and motivations for select sanitation and hygiene behaviors, namely, latrine construction and use, safe disposal of child feces, handwashing, and MHM, and to develop practical recommendations for gender-transformative WASH programming.

As a foundational step, the team led by Iris Group first conducted key informant interviews (KIIs) and a stakeholders' meeting with representatives of WASH implementing partners. The team used information gathered from these consultations to refine the study questions and develop the study protocol, specifically the guides for focus group discussions (FGDs) with community members and KIIs with district WASH officials. Covering nine communities in four districts in Nampula and Zambezia, the team conducted discussions with 433 participants and interviews with 22 key informants. After concluding data collection, the team conducted a participatory analysis of the findings and developed a set of programming recommendations for USAID and WASH implementing partners.

The formative research revealed that although there was widespread knowledge of ideal sanitation and hygiene behaviors brought about by past WASH and health programs, there were deeply embedded gender inequalities that would need to be addressed through more gender-integrated and gender-transformative programs such as initiatives that promote critical reflection on the gendered roles and responsibilities associated with household sanitation and hygiene.