Rajgir block in Nalanda district of Bihar had high rates of open defecation due to lack of sanitation facilities and awareness. Through community meetings, demonstrations, and involvement of local leaders and organizations, over 76,000 people gained access to handwashing facilities and nearly 10,000 gained access to toilets. Regular monitoring and education efforts helped change behaviors and social norms. As a result, within 4 months the entire block was declared free of open defecation, improving health, safety, education, and quality of life for residents.