As of 2015, 20% of all global children-under-five mortality from diarrhea or pneumonia occurs in India. Handwashing with soap and improved sanitation are effective measures for reducing illness and death from diarrheal diseases and acute respiratory infections. Hygiene with Chhota Bheem was developed in partnership with Green Gold Animation, the Indian Red Cross Society, the Mary Anne Charity Trust, Hygiene Heroes, a Working Group of NGOs, and civil society groups dedicated to improving sanitation and hygiene in Tamil Nadu.
The game is centered around characters from Chhota Bheem, a popular children’s television show in India, working to defeat an evil Germ Wizard who has been spreading germs and filth through their village, Dholakpur. In each lesson, children watch narrated stories involving Chhota Bheem, play games and activities related to the stories, and take part in weekly challenges to defeat the Germ Wizard from the stories. Learning goals are also reinforced through a digital Android game. The curriculum teaches children how to use a squat toilet and wash hands with soap, when it is important to wash hands with soap in order to prevent germ transfer, why handwashing and toilet use are important for individual and community health, and how to convince friends and family to practice healthy hygiene and sanitation. It was playtested over several months with primary school children in Tamil Nadu.
The pilot evaluation of the curriculum with 2,614 students in 30 schools showed that children who participated in the curriculum had a significantly higher increase in handwashing and toilet use knowledge, and more favorable attitudes and behaviors than children in the comparison group. The study showed a positive change in attitudes toward handwashing and toilet use, and an increase in the proportion of children who reported advocating for handwashing and toilet use. Finally, there was a positive change in observed handwashing with soap at school and an increase in self-reported toilet use. The Lab was awarded the International Society for Neglected Tropical Diseases Gaming Award 2018 for this project.