USAID’s Real Impact series highlights examples of water sector projects around the world. Each case example provides from-the-field insights about successful approaches, challenges faced, and lessons learned.

When the Hygiene Improvement Project (HIP) began in 2004, nearly 80 percent of the total population of the Amhara Region in Ethiopia (an estimated 15.2 million people) lived in rural areas where access to sanitation was extremely low and hygiene behaviors were not widely practiced.