arrow_backEmergency WASH

T.21 Integrated Behavioural Model (IBM) for WASH

The Integrated Behavioural Model (IBM) for WASH is a conceptual model and tool to help understand the numerous environmental, psychosocial and technical factors influencing WASH behaviours.

The IBM for WASH brings together several existing behavioural theories and models such as SaniFOAM and FOAM F.19 and others. It was compiled in 2013 following a systematic review of 15 existing models and frameworks used in the WASH sector. Whilst all the models comprised important determinants of WASH behaviours, no single model addressed all the specific and unique aspects of water, sanitation and hygiene behaviour change, such as reliance on technology, the habitual nature of WASH behaviours and multiple levels of influence. IBM WASH has three dimensions: contextual, psychosocial and technological. It considers the interaction between the different determinants for each dimension at five levels: societal, community, interpersonal, individual and habitual. Successful interventions need to support and maintain behaviour change in all three dimensions and at all five of these levels. Time is needed to assess and understand the different determinants and their appropriateness in each context.


It can be applied to all contexts, situations and phases but different determinants may be more or less important in certain situations and contexts. It needs time. It is a useful tool for programme planning, providing an overview of all of the factors that influence WASH and enabling the identification of gaps in knowledge and understanding.  


  • Use the model to guide programme assessment and implementation and identify gaps in understanding 

  • Use the model early in programme planning and design 

  • Consider the habitual nature of WASH behaviours and how they are informed by technology, psychological and social theory and the broader context


  • Do not address every determinant in the IBM-WASH framework: identify the most important for your population, setting and behaviours

  • Do not attempt to measure and quantify every determinant; the framework is largely informed by anthropological approaches and is often better suited for qualitative research than survey methods.

Practical Example

In Bangladesh formative research using the IBM model was used to select the most appropriate trial handwashing stations. Elements of the technology, such as capacity and durability, were critical to acceptability, as were contextual factors such as consistent access to water and the physical location of the technology. Psychosocial factors such as disgust also affected whether a handwashing station facilitated or inhibited handwashing at key times. For example, disgust associated with handwashing stations placed near latrines could prevent handwashing at other times, requiring additional handwashing stations

Key Decision Critria

Response Phase
Acute Response
+ +
+ +
Protracted Crisis
+ +
+ +
HP Component
Preconditions and Enabling Environment
+ +
Community Engagement and Participation
Assessment, Analysis and Planning
+ +
Social and Behaviour Change
+ +
Monitoring, Evaluation, Accountability and Learning (MEAL)
+ +
Target Group
Older People
Persons with Disabilities
Local Leaders
Society as a whole
+ +
Application Level
Individual / Household
+ +
Community / Municipality
+ +
+ +
+ +
+ +
+ +


Academic paper describing the model and how it came about

Dreibelbis, R., Winch, P. et al. (2013): The Integrated Behavioural Model for WASH: A Systematic Review of Behavioural Models and a Framework for Designing and Evaluating Behaviour Change Interventions in Infrastructure-Restricted Settings, BMC Public Health 13:1015

Academic paper illustrating a case study from Bangladesh

Hulland, K., Leontsini, E. et al. (2013): Designing a Handwashing Station for Infrastructure-Restricted Communities in Bangladesh Using the Integrated Behavioural Model for Water, Sanitation and Hygiene Interventions (IBM-WASH), BMC Public Health 13:877