Category Archives: Hygiene Promotion

Handwashing/hygiene research by the SHARE Project

Below are links to selected studies, videos, etc. by the SHARE project. share_logo_main_strap_rgb

Hygiene Promotion Resource: Choose Soap – The RIU Summary provides an overview of the objectives and intended RIU impact of the SHARE-commissioned Choose Soap toolkit.

Complementary Food Hygiene – An Overlooked Opportunity in the WASH, Nutrition and Health Sectors – This policy brief highlights the often overlooked opportunity that addressing complementary food hygiene offers the WASH, nutrition and health sectors for improving health outcomes.

The Impact of Water, Sanitation and Hygiene on Key Health and Social Outcomes: Review of Evidence – This evidence paper developed by SHARE and UNICEF looks at 10 areas identified collaboratively on which WASH can plausibly have a strong impact: diarrhoea, nutrition, complementary food hygiene, female psychosocial stress, violence, maternal and newborn health, menstrual hygiene management, school attendance, oral vaccine performance, and neglected tropical diseases.

Hygiene Intervention Reduces Contamination of Weaning Food in Bangladesh – This journal paper summarises the findings of a small, SHARE-funded intervention study that sought to reduce the contamination of weaning foods in Bangladesh by using the HACCP approach.

Focus on Handwashing in Emergency Settings – This event report summarises the proceedings of the ‘Focus on Handwashing in Emergency Settings’ event held at LSHTM on 19th December 2012.

Handwashing With Soap Guidelines – This four-page guidance note, produced by SHARE and LSHTM, explains the benefits of handwashing with soap, highlights when it has the most significant public health impact, and provides tips on how to encourage the practice.

Estimating the Potential Impact of Sanitary Child Stool Disposal – This policy brief highlights the often overlooked and enormous potential of hygienic child stool disposal to considerably reduce the prevalence of diarrhoeal diseases.

Effect of a Behaviour Change Intervention on Handwashing with Soap in India (SuperAmma): A Cluster Randomised Trial – This paper summarises the findings of a cluster randomised trial that tested whether a scalable village-level intervention based on emotional drivers of behaviour, rather than knowledge, could improve handwashing behaviour in rural India.

What Drives Handwashing Behaviour? – In this video, Dr Valerie Curtis, Director of the Hygiene Centre at LSHTM, discusses what drives us to wash our hands with soap.

Handwashing in the news

Oct 13 – Hilton Launches Major Expansion of Industry’s Largest Soap Recycling Program to Help Communities in Need – -Hilton announced that all 750 properties across its All Suites brands will recycle discarded soap and amenity bottles and donate them to reduce hygiene-related illnesses for communities in need

Oct 12 – Students can Become ‘Hand Washing Champions’ in Celebration of Global Handwashing Day on October 15th – Each year on October 15th, over 200 million people in over 100 countries take part in celebrations to mark Global Handwashing Day. Once again, Deb Group is heavily involved in this day of advocacy.

Oct 11 – Dettol aims to educate millions across 19 countries on Global Handwashing Day  – As a part of the Global Handwashing Day celebrations, Dettol has launched a global campaign which aims to reach out to millions of people across 19 countries and educate them about importance of handwashing.

Oct 10 – WaterAid: Global Handwashing Day – It’s time to talk about the world’s simplest life-saver.

Oct 7 – Habits matter for Global Handwashing Day. This is why you should promote them! – Celebrated annually on October 15, Global Handwashing Day is a global advocacy day dedicated to increasing awareness and understanding about the importance of handwashing with soap as an easy, effective, and affordable way to prevent diseases and save lives. This year’s theme is “Make Handwashing a Habit!”. In light of this theme, I would like to take this opportunity to discuss how promoting habits as part of your celebration might lead to the development of sustained handwashing behavior.

Recently published studies on handwashing

Am J Trop Med Hyg. 2016 Oct 3. pii: 16-0420. Chlorination of Household Drinking Water among Cholera Patients’ Households to Prevent Transmission of Toxigenic Vibrio cholerae in Dhaka City: CHoBI7 Trial.

Authors: Rashid MU, George CM, et. al.

Household members of cholera patients are at a 100 times higher risk of cholera infections than the general population because of shared contaminated drinking water sources and secondary transmission through poor household hygiene practices. In this study, we investigated the bactericidal concentration of free chlorine required to inactivate Vibrio cholerae in household drinking water in Dhaka city. Findings suggest that point-of-use chlorine tablets present an effective approach to inactivate V. cholerae from drinking water in households of cholera patients in Dhaka city.

Matern Child Nutr. 2016 Oct;12 (4):869-84. Handwashing, sanitation and family planning practices are the strongest underlying determinants of child stunting in rural indigenous communities of Jharkhand and Odisha, Eastern India: a cross-sectional study.

Authors: Saxton J, Rath S, et. al.

We sought to identify the strongest determinants of stunting among indigenous children in rural Jharkhand and Odisha, India, to highlight key areas for intervention. In the adjusted model, the strongest protective factors for linear growth included cooking outdoors rather than indoors, birth spacing ≥24 months, and handwashing with a cleansing agent (HAZ +0.32).

Int J Environ Res Public Health. 2016 Sep 1;13(9). Exploring Determinants of Handwashing with Soap in Indonesia: A Quantitative Analysis.

Authors: Hirai M, Graham JP, et. al.

This study analyzes rural Indonesian households’ hygiene behaviors and attitudes to examine how motivations for handwashing, locations of handwashing space in the household, and handwashing moments are associated with handwashing with soap as potential determinants of the behavior. Our results showed that determinants that had a significant association with handwashing with soap included: (1) a desire to smell nice; (2) interpersonal influences; (3) the presence of handwashing places within 10 paces of the kitchen and the toilet; and (4) key handwashing moments when hands felt dirty, including after eating and after cleaning child stools. This study concludes that handwashing with soap may be more effectively promoted through the use of non-health messages.

January – June 2016 Handwashing Research Summary – Between January and June 2016, 32 relevant peer-reviewed studies on handwashing were identified. Learn about key findings during this time period .

Authors: PPPHW

Robert Dreibelbis on Handwashing Behavior Change in Bangladesh

Robert Dreibelbis on Handwashing Behavior Change in Bangladesh: Global Waters Radio.

“What we are hoping to do with this study is assess the feasibility of using nudges to change handwashing behavior — so instead of changing how people make decisions, you change the context in which those decisions are actually made.” dreibel.png

Robert Dreibelbis is a Lecturer at the London School of Hygiene & Tropical Medicine and an Assistant Professor in the University of Oklahoma’s Department of Anthropology and Department of Civil Engineering and Environmental Sciences.

In honor of Global Handwashing Day (October 15th), Dreibelbis shares with Global Waters Radio his experiences with a handwashing behavior change pilot project in Bangladesh that delivered promising results obtained using subconscious environmental cues called “nudging.”

Without the use of additional handwashing education interventions, the nudge-based intervention implemented by Dreibelbis and his team increased handwashing among school children by 72 percent during the trial period.

Habits matter for Global Handwashing Day. This is why you should promote them!

Habits matter for Global Handwashing Day. This is why you should promote them! Source: by Bijan Manavizadeh, PPPHW, Oct 7 2016 |

Celebrated annually on October 15, Global Handwashing Day is a global advocacy day dedicated to increasing awareness and understanding about the importance of handwashing with soap as an easy, effective, and affordable way to prevent diseases and save lives. 5things-to-do-after-ghd-1

This year’s theme is “Make Handwashing a Habit!”. In light of this theme, I would like to take this opportunity to discuss how promoting habits as part of your celebration might lead to the development of sustained handwashing behavior.

Habit formation is an ongoing process and it requires continuous effort to encourage practitioners to not lose motivation and revert back to poor handwashing behavior. In order to effectively promote routine handwashing, stations must be accessible, properly maintained, and always stocked with soap and water.

So, for instance, if you host a handwashing demonstration at a community center for Global Handwashing Day, make sure permanent, functional handwashing facilities are available so the behavior can be sustained.

Pairing habit-formation initiatives with small doable actions can be an effective strategy. Behaviors are more likely to be adopted into a routine when they are both desirable and feasible for the practitioner.

Read the complete article.

Recent WASH related research

Exploring Determinants of Handwashing with Soap in Indonesia: A Quantitative AnalysisInternational Journal of Environmental Research and Public Health , September 2016. This study analyzes rural Indonesian households’ hygiene behaviors and attitudes to examine how motivations for handwashing, locations of handwashing space in the household, and handwashing moments are potential determinants of handwashing behavior.

Behaviour Centered Design (BCD): Towards an Applied Science of Behaviour ChangeHealth Psychology Review , August 2016. This paper positions BCD as the foundation of an applied science of behavior change and outlines a sequence of five steps required to design an intervention to change specific behaviors. The BCD approach has been shown to change hygiene, nutrition, and exercise-related behaviors and has the advantages of being applicable to product, service, or institutional design.

The Water Report 2016. Stockholm International Water Institute , August 2016. Published prior to World Water Week, this annual report was meant to inspire discussions at the meeting and bring topical issues to the fore. None is more prominent this year than the issue of migration and its link to water issues. Other topics covered include the 2030 Agenda and sustainable growth.

Asian Water Development Outlook (AWDO) 2016: Strengthening Water Security in Asia and the PacificAsian Development Bank (ADB) , September 2016. The result of rigorous analysis, AWDO 2016 provides a snapshot of the region’s water security status, enabling policymakers, financing institutions, and planners to make informed decisions on how to improve their performance in the water sector. The six-part report describes the water challenges the region is facing, presents the AWDO approach, and provides information on how water security can be increased.

Water and Sanitation Interlinkages Across the 2030 Agenda for Sustainable DevelopmentUnited Nations , August 2016. This brief analyzes the central role of water and sanitation and describes the interlinkages between the targets of Sustainable Development Goal (SDG) 6 and those of other goals. The document emphasizes the mutually reinforcing nature of the interlinkages and the necessity for an integrated implementation approach, and also highlights the importance of mainstreaming water and sanitation in the policies and plans of other sectors.

Measuring Domestic Water Use: A Systematic Review of Methodologies that Measure Unmetered Water Use in Low-Income SettingsTropical Medicine and International Health , August 2016. More than 20 studies were included in this literature review of methods for measuring domestic water use in settings where water meters cannot be used. The review found no standardized methods for measuring unmetered water use and recommended that further research begin with pre-study observations during water collection periods to determine optimal methods for obtaining water use information in a survey.

Herd Protection from Drinking Water, Sanitation, and Hygiene InterventionsAmerican Journal of Tropical Medicine and Hygiene , September 2016. Although cluster-randomized trials of WASH interventions have reported the total or overall efficacy of WASH interventions, they have not quantified the role of herd protection. Through a literature review and modeling, researchers have established that WASH interventions are likely to provide some level of herd protection.

Enteric Pathogens and Factors Associated with Acute Bloody Diarrhoea, KenyaBMC Infectious Diseases , September 2016. This study found that good personal hygiene practices such as washing hands after defecation and storing drinking water separate from water for other uses were key protective factors, while presence of coliform in the main water source was found to be a risk factor for bloody diarrhea. Implementation of WASH interventions is therefore key to prevention and control.

Sustainable Sanitation Alliance – Thematic Online Discussion: “Managing WASH in Schools – Is the Education Sector Ready?”

The Sustainable Sanitation Alliance (SuSanA) is excited to announce the 10th Thematic Online Discussion on the topic of “Managing WASH in Schools – Is the Education Sector Ready?”

Starting on Monday, September 19, we invite you to join our discussion on the challenges of WASH in Schools (WinS) globally which is part of SuSanA’s Thematic Discussion Series (TDS).

The direct links of WinS to SDG2 (health), SDG6 (water and sanitation) and SDG4 (education) pose the chance for increased inter-sectoral cooperation. Thereby, the education sector’s leadership and management are critical to broad-scale implementation and success of WinS. Yet, how is the education sector taking WASH on board and how can the sector manage it? How does the reality look like in schools around the world? What does it take for better-managed WinS? What shifts/changes are necessary to see the situation change?

Building on the SuSanA Working Group 7 (Community, Rural & Schools) meeting during the Stockholm Water Week 2016, we would like to address these and other questions in order to get a better understanding of the challenges and needs of the education sector to successfully manage WASH in schools.

In particular, we will structure our discussion along two topics – (1) Policy Issues on the Regional and Global Level and (2) Implementation Level/Matters of Implementation.

For both topics, experts from both the WASH and the education sector will provide leadership, food for thought and a profound insight into the topic. Questions raised by Forum Users will also be addressed.

Discussing WASH in school and the education sector’s role and potential for leadership, we propose the following schedule:

Theme I – Policy Issues on the Regional and Global Level (September 19-30)
Theme II – Implementation Level (September 21-30)

We look forward to interested participants and an enriching discussion on WinS.

Kind regards,

Antonio S.D. on behalf of the Sustainable Sanitation Alliance