Hygiene promotion, defined as a systematic approach to adopting handwashing and safe fecal disposal, is critical for reducing diarrheal diseases, a leading cause of child mortality. Unlike hygiene education, promotion integrates broader strategies like community engagement and social marketing. The Hygiene Improvement Framework (USAID) emphasizes three pillars: behavior change campaigns, access to water/sanitation infrastructure, and supportive policies. Evidence highlights handwashing with soap reduces diarrheal risk by 42-47%, yet rigorous trials on behavior change interventions remain scarce. Approaches like Programme Saniya (marketing-based in Burkina Faso) and participatory methods (PHAST, Community Health Clubs) show success but face evaluation challenges. Monitoring should prioritize behavior over health outcomes due to confounding factors. Lessons stress combining education, community mobilization, and marketing, alongside sustained efforts and formative research to address contextual barriers.