Hygiene promotion is fundamental to the success of Water, Sanitation and Hygiene (WASH) interventions. To maximize health bene? ts and produce evidence of the reduction of WASH associated diseases, an effective monitoring system and framework for the different WASH stages is crucial. This paper reports on operational experiences from monitoring of various projects in the ? eld during the period of January 2007 to March 2009. Rapid-assessment provides for a quick appraisal of expected project areas and is also instrumental for gathering and identifying high-risk behaviours and areas. A Baseline is crucial for describing the status and trends of the existing situation, against which predicted changes can be compared and evaluated, and actual change can be realized by monitoring. Progress Monitoring is instrumental to tracking changes in people’s knowledge, attitude, and behaviour after programme implementation, and helps to initiate necessary actions for further improvements using the Rapid Convenient Survey tool. The Community based monitoring system is used by the community members themselves to self-monitor their hygiene behaviour change. Impact-assessment is important for measuring the success of the hygiene promotion against the baseline. Finally, Long term sustainability monitoring explores the potential of hygienic behaviour, institutional mechanisms and availability of water and sanitation facilities to sustain the outcomes and impact of hygiene programme. A systematic monitoring mechanism for the different stages is imperative, and monitoring indicators applied from baseline to impact assessment should be consistent and coherent. Full-phase monitoring of hygiene practices with backup by programme is the only evidence-based means to show the attributable contribution from WASH for reducing associated diseases and improving health status.