1. Improving Training

• In Uzbekistan, the promotion team discovered that trained providers were not performing as well as needed.  In the second training they decided to increase the time for supervised practice of new skills.  Continued monitoring showed improved performance.
• In Kazakhstan, as service providers were observed at the end of the training, team members found that they needed more time role playing the problem situations they would encounter when dealing with unhappy customers.  The training program was adapted to provide this time.
• In another Central Asian nation, when reports from their early impact monitoring (observations and exit interviews) were negative, water delivery staff were invited to a second, refresher training course.

2. Redesigning Programs

• Early on in a hand washing with soap program, it became clear that insufficient attention had been given to the hygiene promoters and their communication skills and mothers were unhappy with their treatment.  The team immediately added a program component focusing on the service improvements.  Promoters learned better communication skills such as being nice, welcoming mothers, giving them key information only, and providing clear instructions on hand washing practices.  Monitoring showed mothers were quite happy with the changes.
• This same communication team found out during monitoring that fathers felt very left out of the campaign and as a result they were not supportive.  By pulling program funds from several different sources, the team was able to produce and distribute additional buttons that simply included the new words "Dad, you too!"  Further monitoring showed fathers responded very positively to the action taken.
• In this same country, radio spots had been developed.  However, when airing time came, it was discovered that few people were actually hearing the spots because the station refused to run them when requested.  The team removed the spots from the national radio and began to run them over local broadcasting systems.  Listenership and knowledge of the spots increased dramatically.
• This program also realized, through several interviews, that “Friday Hand washing Day” had lost its charm in the eyes of the audience after about six weeks of being exposed to it.  The team encouraged local kiosks to include hand washing activities at their shops on Friday to reinforce the message and intent.  Soap sales almost doubled at most kiosks after three weeks of message transmission and the team planned to again add new benefits after five weeks in an effort to continual give the audience something new.