 This study found that a multi-level intervention designed to improve access to water, sanitation, and hygiene, wash, services in rural Ethiopia had no significant impact on behavioral outcomes or mental well-being. Despite the fact that the intervention improved access to wash infrastructure such as latrines and handwashing stations, it failed to increase the use of these facilities or reduce exposure to feces. Additionally, the intervention did not improve mental well being among participants. These findings suggest that more research is needed to identify effective strategies for improving access to and use of wash services in low-resource settings. This article was authored by Matthew C. Freeman, Mary N. G. Delia, Jetta Daya S. Snyder, and others.