Tag Archives: handwashing

How to Trigger for Handwashing with Soap

How to Trigger for Handwashing with Soap.  Frontiers of CLTS:  Innovations and Insights, Issue 02, January 2014.

Author: Jolly Ann Maulit for UNICEF Malawi Frontiers

The Open Defecation Free (ODF) Malawi 2015 Strategy and National Hand Washing Campaign have been contributing to an increased focus on handwashing with soap (HWWS) in Malawi. This is a very positive development!

Some studies estimate that washing hands with soap can reduce diarrhoeal disease rates by up to 50 per cent and respiratory disease rates by up to 25 per cent. This makes handwashing with soap one of the most cost-effective interventions for reducing illness and preventable deaths among children in Malawi. It is therefore quite worthwhile for us to be working together to increase handwashing practices.

Since Community-Led Total Sanitation (CLTS) is our key intervention for sanitation and hygiene promotion in Malawi, it provides an excellent opportunity to facilitate handwashing behaviour change. However, up till now, the ‘triggering tools’ for achieving HWWS behaviour change from CLTS have not been well known by implementers in Malawi. The purpose of this document is to outline several practical tools which can be used as a part of CLTS in order to trigger realisation among communities of the importance of handwashing with soap, as well as eliminating open defecation.

 

 

 

Annotated Bibliography of 2013 Handwashing Studies

An Annotated Bibliography of 2013 Handwashing Studies

This annotated bibliography was compiled by WASHplus and contains citations and abstracts to 20 peer-review handwashing studies that were published from January through September 2013. Links are also provided to the abstract or full-text for each article. Please email WASHplus if you have additional studies to include. somalia

JOURNAL ARTICLES, BY PUBLICATION DATE

SEPTEMBER 2013

1 — Handwashing before Food Preparation and Child Feeding: A Missed Opportunity for Hygiene Promotion. Am J Trop Med Hyg, Sep 2013. F Nizame. (Abstract)
From 50 randomly selected villages in Bangladesh, we collected quantitative and qualitative data on handwashing linked to child feeding to integrate handwashing promotion into a young child complementary feeding program. Most participants cited the unavailability of soap and water near the cooking place as a barrier to handwashing before food preparation. Most caregivers ranked nurturing messages as the best motivator to encourage handwashing with soap.

2–Designing a Handwashing Station for Infrastructure-Restricted Communities in Bangladesh Using the Integrated Behavioural Model for Water, Sanitation and Hygiene Interventions (IBM-WASH). BMC Public Health, Sep 2013. K Hulland. (Full text)
Handwashing stations — a dedicated, convenient location where both soap and water are available for handwashing — are associated with improved handwashing practices. Our aim was to identify a locally feasible and acceptable handwashing station that enabled frequent handwashing for two subsequent randomized trials testing the health effects of this behaviour. Factors that influenced selection of candidate designs were market availability of low cost, durable materials that were easy to replace or replenish in an infrastructure-restricted and shared environment. Water storage capacity, ease of use and maintenance, and quality of materials determined the acceptability and feasibility of specific handwashing station designs. A number of contextual, psychosocial and technological factors influence use of handwashing stations at five aggregate levels, from habitual to societal.

3–A Qualitative Evaluation of Hand Drying Practices among Kenyans. PLoS One, Sept 2013. B Person. (Full text)
Recommended disease prevention behaviors of hand washing, hygienic hand drying, and covering one’s mouth and nose in a hygienic manner when coughing and sneezing appear to be simple behaviors but continue to be a challenge to successfully promote and sustain worldwide. We conducted a qualitative inquiry to better understand current hand drying behaviors associated with activities of daily living, and mouth and nose covering practices, among Kenyans. We conducted 7 focus group discussions; 30 in-depth interviews; 10 structured household observations; and 75 structured observations in public venues in the urban area of Kisumu; rural communities surrounding Kisumu; and a peri-urban area outside Nairobi, Kenya. Using a grounded theory approach, we transcribed and coded the narrative data followed by thematic analysis of the emergent themes. Hand drying, specifically on a clean towel, was not a common practice among our participants. Most women dried their hands on their waist cloth, called a leso, or their clothes whether they were cooking, eating or cleaning the nose of a young child. If men dried their hands, they used their trousers or a handkerchief.

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Designing a handwashing station for infrastructure-restricted communities in Bangladesh

Designing a handwashing station for infrastructure-restricted communities in Bangladesh using the integrated behavioural model for water, sanitation and hygiene interventions (IBM-WASH). BMC Public Health, Sept 2013, 13:877.

Kristyna RS, et al.

Background – In Bangladesh diarrhoeal disease and respiratory infections contribute significantly to morbidity and mortality. Handwashing with soap reduces the risk of infection; however, handwashing rates in infrastructure-restricted settings remain low. Handwashing stations — a dedicated, convenient location where both soap and water are available for handwashing — are associated with improved handwashing practices. Our aim was to identify a locally feasible and acceptable handwashing station that enabled frequent handwashing for two subsequent randomized trials testing the health effects of this behaviour.

Methods – We conducted formative research in the form of household trials of improved practices in urban and rural Bangladesh. Seven candidate handwashing technologies were tested by nine to ten households each during two iterative phases. We conducted interviews with participants during an introductory visit and two to five follow up visits over two to six weeks, depending on the phase. We used the Integrated Behavioural Model for Water, Sanitation and Hygiene (IBM-WASH) to guide selection of candidate handwashing stations and data analysis. Factors presented in the IBM-WASH informed thematic coding of interview transcripts and contextualized feasibility and acceptability of specific handwashing station designs.

Results – Factors that influenced selection of candidate designs were market availability of low cost, durable materials that were easy to replace or replenish in an infrastructure-restricted and shared environment. Water storage capacity, ease of use and maintenance, and quality of materials determined the acceptability and feasibility of specific handwashing station designs. After examining technology, psychosocial and contextual factors, we selected a handwashing system with two different water storage capacities, each with a tap, stand, basin, soapy water bottle and detergent powder for pilot testing in preparation for the subsequent randomized trials.

Conclusions – A number of contextual, psychosocial and technological factors influence use of handwashing stations at five aggregate levels, from habitual to societal. In interventions that require a handwashing station to facilitate frequent handwashing with soap, elements of the technology, such as capacity, durability and location(s) within the household are key to high feasibility and acceptability. More than one handwashing station per household may be required. IBM-WASH helped guide the research and research in-turn helped validate the framework.

Handwashing With Soap Can Help Us Achieve the Millennium Development Goals

Handwashing With Soap Can Help Us Achieve the Millennium Development Goals by Myriam Sidibe, Global Social Mission Director, Unilever-Lifebuoy | Source: Huffington Post blog, July 6, 2013

Being able to live a clean, active and healthy life should be a basic human right. Yet, this is not a privilege that everyone has — a point underscored by two high level reports last week.

Myriam Sidibe is Lifebuoy’s Global Social Mission Director.

Myriam Sidibe is Lifebuoy’s Global Social Mission Director.

UNICEF’s latest report reminds us that pneumonia and diarrhoea are the biggest killers of children globally, causing the deaths of approximately two million children under the age of five, every year. Meanwhile the World Health Organisation (WHO) reported that despite significant progress, the world is unlikely to meet the fourth Millennium Development Goal – to reduce child mortality by two-thirds from 1990 levels.

Both reports come at a critical point in time: the world has less than three years to scale-up efforts to achieve the Millennium Development Goals. At Unilever we want to scale-up our own efforts on this front.

UNICEF’s report points to areas where business can help achieve the fourth Millennium Development Goal. Not only can diarrhoea and pneumonia be prevented through basic best practices, including frequent handwashing with soap at key occasions, but also more awareness raising campaigns could reduce deaths caused by pneumonia by 30 percent and diarrhoea by 60 percent — potentially saving more than two million children by 2015. This would be a significant progress in the aim to achieve the fourth Millennium Development Goal and reduce infant mortality.

Although we’re seeing a steady increase in awareness raising campaigns that demonstrate the link between health and good hygiene — from the WHO’s Clean Care is Safe Care programme through to the Global Public Private Partnership for Handwashing with Soap – more needs to be done to ensure that governments prioritise hygiene education programmes.

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WASH for Life grants for the HappyTap and six other innovations

WaterSHED’s Vietnamese HappyTap. Photo: WaterSHED

The HappyTap, a low-cost handwashing device for the Vietnamese market, is one of seven innovations to receive a grant from the WASH for Life Partnership. This US$ 17 million initiative is co-funded by the Bill & Melinda Gates Foundation and USAID’s Development Innovation Ventures (DIV).

In 2010, with USAID support, the WaterSHED program teamed with the Water and Sanitation Program (WSP) to develop and market a new handwashing device. The design came from IDEO.org, which itself has received a WASH for Life grant for Clean Kumasi, an digitally-supported approach to Community-Led Total Sanitation (CLTS). Together with Water and Sanitation for the Urban Poor (WSUP), IDEO.org is working to combat open defecation in Kumasi, Ghana using mobile phones and open-source mapping.

Examples of signs  posted to prompt residents to flash Clean Kumasi. Photo: IDEO.org

Examples of signs posted to prompt residents to flash Clean Kumasi. Photo: IDEO.org

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Save Lives, Clean your Hands – BRAC video

The BRAC WASH programme in Bangladesh has produced a new handwashing promotion video. It shows slides of handwashing promotion sessions for different groups (children, adolescent girls, women, men), as well as for schools, village WASH committees and mosques (imams).

The video was released on 5 May to coincide with the World Health Organization’s (WHO) annual global campaign  to promote better hand hygiene in health care.

 

 

Educational cartoon boosts worm infection prevention

Cover of the Cartoon “The Magic Glasses.

Cover of the Cartoon “The Magic Glasses.

Educational cartoon boosts worm infection prevention | Source: News-Medical, Apr 29, 2013 |

Researchers in China have found that a health education package targeted at schoolchildren can improve hygiene behaviors and reduce the incidence of soil-transmitted helminth infection.

The study, published in the New England Journal of Medicine, included 1718 school children aged 9 to 10 years, of whom 893 attended control schools (n=19), and 825 attended intervention schools (n=19). The research was conducted in rural Linxiang City District, Hunan province, where there is a high prevalence of helminth infection but limited awareness or educational activity about the risks.

Both control and intervention schools displayed an awareness poster. However, in the intervention schools, students also took part in an educational package, including a 12-minute cartoon promoting knowledge and prevention awareness, followed by classroom discussions. They also took part in drawing and writing competitions that reinforced the cartoon’s messages, and received a pamphlet summarizing the main points. All students received albendazole treatment at baseline.

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UNICEF/Malawi: CLTS Triggering Tools: How to Trigger for Hand Washing with Soap

UNICEF/Malawi: CLTS Triggering Tools: How to Trigger for Hand Washing with Soap, March 2013.

An Excerpt: The tools outlined by this document were developed based on actual field research in testing, done as a collaborative effort between UNICEF and Salima District Council. Salima was selected for the research and testing of new hand washing triggering tools because they already had experience attempting to incorporate hand washing into their triggering process, and also have data showing high numbers of new hand washing facilities being built after CLTS. Also, Salima was selected because they implement CLTS continuously as part of their routine extension staff work.

Nine different tools were tested for how well they instilled a realization of the importance of hand washing with soap (HWWS). When these tools were used, hand washing practice increased by 69% and soap availability at hand washing facilities increased by 15%, compared to when CLTS didn’t include specific
tools to trigger HWWS. However please take these guidelines with a grain of salt, as they are based on a small sample size, overall only a few villages.

THE 10 FIELD-TESTED HAND WASHING TRIGGERING TOOLS OUTLINED IN THIS DOCUMENT:

  • Anal Cleansing Materials
  • Shit and Shake
  • Cassava/Egg Demonstration
  • Charcoal
  • Smelly Hands
  • Charcoal Smearing
  • Scratch & Smell
  • Wall Contamination
  • Food Sharing
  • Dirt Under Fingernails

WASHplus Weekly: A Handwashing Update

Issue 97 | April 19, 2013 | A Hand Washing Update

The Global Public-Private Partnership for Handwashing with Soap (PPPHW) gave WASHplus permission to share this summary of recent hand washing literature that was recently prepared for the partnership. It includes 13 studies published in 2012 and one published in 2013. In one such study the authors suggest that hand washing promotion could improve child well‐being and societal productivity. According to the literature review, very little has been published in peer‐reviewed journals on motivators and barriers to hand washing behavior and the impact of hand washing promotion in humanitarian emergency settings. Links are provided to the abstracts or full text of articles in the citations section. washplus-weekly

Periodic Overview of Hand Washing Literature: Summary of Selected PeerReviewed and Grey Literature Published July–December 2012. 

Prepared for the PPPHW by: Jelena Vujcic (University at Buffalo), Pavani K. Ram (University at Buffalo), Dan Campbell (CARE), and Katie Carroll (FHI 360).

RISK FACTORS AND DIARRHEAL DISEASE PREVALENCE

  • A systematic review of cohort studies that reported diarrhea incidence in low- and middle-income countries showed that diarrhea incidence rates are declining slightly (1.9 billion episodes of childhood diarrhea in 1990 compared to almost 1.7 billion episodes in 2010), but the total burden on child health is still large (Fischer Walker et al. 2012).
  • One study in Tanzania found that hands and water are important sources of both viral and bacterial pathogens that cause diarrhea, underscoring the importance of efforts to promote hand washing (Mattioli et al. 2012).

Takeaway for implementers:

  • The burden of diarrheal disease among children is still unacceptably high in low- and middle-income countries.
  • Hands are an important vector of diarrheal pathogens.

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RFP: Research for Hygiene Behavioural Change among School Children in the Philippines

UNICEF has issued a request for proposal for “Research for Hygiene Behavioural Change among School Children in the Philippines”.

The aim of the consultancy to “craft a simple, scalable and sustainable strategy, program and tools based on the EHCP [Essential Health Care Program] that would lead to improved and sustained hygiene practice and toilet use”.

The EHCP is the Department of Education’s “flagship national health program for promoting group handwashing with soap, group toothbrushing with toothpaste and biannual deworming in public elementary schools”.

The consultancy will build on the findings of the Sustainable Sanitation in Schools Project, which was launched in 2011 by UNICEF, GIZ and Fit for School.

The main research question is: “Does daily group hand washing with soap in school result in the independent practice of hand washing with soap at critical times, particularly after using the toilet in school and before eating/handling food?”

Project Duration: 12 months (May 1, 2013 – April 30, 2014)

Deadline for submission: 10:00 am (GMT) on Monday, 15 April 2013

For more information read the full RFP.