This manual is part of UNICEF's guidelines series on water, the environment and sanitation. The manual is based on the experiences of the UNICEF supported Saniya project; a public health communication project in a West African town. The manual presents methodologies to assist development workers in the promotion of behavioural change for safer hygiene practices and to help make hygiene promotion programmes more effective. It is a tool that will contribute towards a reduction in diarrhoeal diseases. The manual desribes a methodology for bottom up programming for hygiene promotion; first finding out what people know about hygiene through formative research in people's knowledge and practices and then combining this state-of-the art expert knowledge and appropriate communication strategies to develop effective and sustainable programming models