Tag Archives: handwashing

Sept 23, 2015 – Creativity in Behavior Change Symposium

Whether it be washing hands with soap, driving sanitation demand, or purifying water, almost every area of public health requires behaviour change. The field of behaviour change is transforming.

There is a growing evidence base to suggest that traditional health education messages are insufficient to achieve sustained change and that more might be achieved by being more creative, for example by learning from product marketing, psychology and behavioural economics. logo

The ‘Creativity in Behaviour Change Symposium‘ will bring together behaviour change practitioners from academia, government and the private sector with the ambition of sparking an ongoing network of collaborators.

In addition to creative case studies and provocative discussions the event will feature interactive activities throughout the day, a ‘behaviour change cinema’ which will screen materials from creative projects from around the globe and there will be a ‘soap box’ where anyone can share their big ideas for the future of behaviour change.

For those who are not in the UK, all the sessions will also be filmed and available on our website at ehg.lshtm.ac.uk

The disgust box: a novel approach to illustrate water contamination with feces

Below are links to 5 Aug 2015 studies on digust, handwashing and maternal mortality, handwashing and NTDs, water quality awareness and breastfeeding and household characteristics and diarrhea.

The disgust box: a novel approach to illustrate water contamination with feces. Health & Science Bulletin, June 2015.

Link: http://goo.gl/3xDeen

Inadequate drinking water, sanitation and hand hygiene are responsible for approximately 800,000 deaths per year in low and middle-income countries. We evaluated the benefits of a behaviour change communication method to motivate water treatment practices in urban low income communities in Dhaka. We used a device called the ‘Disgust Box’ to provide a vivid demonstration of how piped water is contaminated with faeces to motivate people to chlorinate water. Most of the respondents were able to recall the demonstration at both four-month and one year qualitative assessments. At four months, the majority of participants stated that they still felt disgusted by the demonstration and mentioned it as a motivator for water chlorination. However, after one year, despite being able to recall the demonstration, disgust was no longer mentioned as a motivator to chlorinate water. The Disgust Box has the potential to be an effective communication method to motivate water treatment but additional research is necessary to establish a more sustainable approach to reinforce behaviour change.

Using Observational Data to Estimate the Effect of Hand Washing and Clean Delivery Kit Use by Birth Attendants on Maternal Deaths after Home Deliveries in Rural Bangladesh, India and Nepal. PLoS One, Aug 2015. Authors: Nadine Seward, et al.

Link: http://goo.gl/02uiRi

Our evidence suggests that hand washing in delivery is critical for maternal survival among home deliveries in rural South Asia, although the exact magnitude of this effect is uncertain due to inherent biases associated with observational data from low resource settings. Our findings indicating kit use does not improve maternal survival, suggests that the soap is not being used in all instances that kit use is being reported.

Assessment of water, sanitation, and hygiene practices and associated factors in a Buruli ulcer endemic district in Benin (West Africa). BMC Public Health, Aug 2015.

Link: http://goo.gl/CZvJPJ

BU is an important conditions in the district of Lalo with 917 new cases detected from 2006 to 2012. More than 49 % of the household surveyed used unimproved water sources for their daily needs. Only 8.7 % of the investigated household had improved sanitation facilities at home and 9.7 % had improved hygiene behavior. The type of housing as an indicator of the socioeconomic status, the permanent availability of soap and improved hygiene practices were identified as the main factors positively associated with improved sanitation status.

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Aug 10 – Weekly Update of Selected WASH Studies

Effectiveness of emergency water treatment practices in refugee camps in South Sudan. WHO Bulletin, Aug 2015. Authors: Syed Imran Ali, Syed Saad Ali & Jean-Francois Fesselet.
Link: http://goo.gl/BtnQVh

Current guidelines for free residual chlorine in emergency water supplies are not based on field evidence and offer inadequate protection after distribution in refugee camps in South Sudan. We recommend that the free residual chlorine guideline be increased to 1.0 mg/L in all situations, irrespective of disease outbreak, pH, or turbidity conditions. This is a tentative recommendation because the degree to which these findings can be generalized to other camps in different settings is unknown.

Nutrition in Ethiopia: An emerging success story? Author: Headey, Derek D.
Link: https://goo.gl/tmMCqX

Research does not always provide the results that we expect. At the recent conference on improving nutrition in Ethiopia, Together for Nutrition 2015, we learnt about the rapid progress in Ethiopia in child nutritional outcomes that are linked to improved birth size and, hence, improved maternal health. However, most of the improvement in maternal health seems related to better sanitation, rather than to diet, care, or health factors.

Diet and specific microbial exposure trigger features of environmental enteropathy in a novel murine model. Nature Communications, Aug 2015. Authors: Eric M. Brown, et al.
Link: http://goo.gl/Sgx6XP

Here we demonstrate that early-life consumption of a moderately malnourished diet, in combination with iterative oral exposure to commensal Bacteroidales species and Escherichia coli, remodels the murine small intestine to resemble features of EE observed in humans. We further report the profound changes that malnutrition imparts on the small intestinal microbiota, metabolite and intraepithelial lymphocyte composition, along with the susceptibility to enteric infection. Our findings provide evidence indicating that both diet and microbes combine to contribute to the aetiology of EE, and describe a novel murine model that can be used to elucidate the mechanisms behind this understudied disease.

An internet-delivered handwashing intervention to modify influenza-like illness and respiratory infection transmission (PRIMIT): a primary care randomised trial. The Lancet, Aug 2015. Authors: Paul Little, Beth Stuart, et al.
Link: http://goo.gl/hHLnLI

Handwashing to prevent transmission of respiratory tract infections (RTIs) has been widely advocated, especially during the H1N1 pandemic. However, the role of handwashing is debated, and no good randomised evidence exists among adults in non-deprived settings. We aimed to assess whether an internet-delivered intervention to modify handwashing would reduce the number of RTIs among adults and their household members.

Associations between school- and household-level water, sanitation and hygiene conditions and soil-transmitted helminth infection among Kenyan school children. Parasit Vectors. 2015 Aug. Authors: Freeman MC, Chard AN, et al.
Link: http://goo.gl/HkdIyS

Results suggest mixed impacts of household and school WASH on prevalence and intensity of infection. WASH risk factors differed across individual worm species, which is expected given the different mechanisms of infection. No trend of the relative importance of school versus household-level WASH emerged, though some factors, like water supply were more strongly related to lower infection, which suggests it is important in supporting other school practices, such as hand-washing and keeping school toilets clean.

Modelling Optimal Control of Cholera in Communities Linked by Migration. Comput Math MethodsMed. 2015. Authors: Njagarah JB, Nyabadza F
Link: http://goo.gl/VU6I5G

A mathematical model for the dynamics of cholera transmission with permissible controls between two connected communities is developed and analysed. The dynamics of the disease in the adjacent communities are assumed to be similar, with the main differences only reflected in the transmission and disease related parameters. This assumption is based on the fact that adjacent communities often have different living conditions and movement is inclined toward the community with better living conditions. Our results indicate that implementation of controls such as proper hygiene, sanitation, and vaccination across both affected communities is likely to annihilate the infection within half the time it would take through self-limitation. In addition, although an infection may still break out in the presence of controls, it may be up to 8 times less devastating when compared with the case when no controls are in place.

Funky Sink Gets Kids In Cambodia To Wash Up, Could Save Thousands Of Young Lives

Funky Sink Gets Kids In Cambodia To Wash Up, Could Save Thousands Of Young Lives | Source: Huffington Post, July 8 2015 |

Cambodia has the lowest access to sanitation in all of Southeast Asia, and as a result more than 10,000 children die every year due to diarrheal diseases, according to WaterAid. watershed

To help curb those figures, nonprofit WaterSHED recently released the LaBobo, a portable and inexpensive sink whose colorful design encourages kids to improve their hygiene habits.

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Raise your hand for hygiene: Sign on to call for a global hygiene indicator in the SDGs!

Join the call for a global-level hygiene indicator in the Sustainable Development Goals! Source: Global Public-Private Partnership for Handwashing

The issue: The Post-2015 Sustainable Development Goals are the successors to the Millennium Development Goals; a draft was published, and the details of the SDGs are being negotiated now. Hygiene is essential for achieving global development, and is therefore included as a target as part of Goal 6. Countries will commit to demonstrating progress on achieving the targets by reporting on indicators. However, in the recent list of global-level indicators being considered by the UN Statistical Commission, hygiene has been deleted. This is likely because the decision makers want a shorter list of indicators. However, demoting hygiene to a huge, secondary list of ‘optional’ indicators will not give hygiene the priority needed for the SDGs to have real impact on both hygiene and the areas that it influences—such as health, education, and equity.

home-learn-photoObjective: The JMP Communications and Advocacy Group is coordinating delivery of a persuasive message about the importance of hygiene to encourage decision makers and stakeholders to act and recommend the reinstatement of a hygiene indicator in the list of global-level indicators for the SDGs.

Audience: This letter will be sent to members of the UN Statistical Commission and others who may have the opportunity to influence discussions and decisions around the SDG Indicators process.

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Global Sanitation Fund reports large-scale advances in sanitation and hygiene in 13 countries

Lucie Obiokang with the toilet she built after being triggered.

Lucie Obiokang with the toilet she built after being triggered.

A new report shows that the Global Sanitation Fund (GSF) has supported governments and hundreds of their national partners in 13 countries, stretching from Cambodia to Senegal, to enable 7 million people in more than 20,500 communities to end open defecation.   

These results are published in the GSF’s latest Progress Report (link to report; link to photos), which highlights cumulative results from the start of the fund until the end of 2014. Nationally-led programmes supported by the GSF have enabled:

  • 4.2 million people with improved toilets
  • 7 million people and more than 20,500 communities to be open-defecation free
  • 8 million people with handwashing facilities

Currently, 2.5 billion people, or 40% of the global population, lack access to decent sanitation. Of those, more than a billion defecate in the open. Diarrheal disease, largely caused by poor sanitation and hygiene, is a leading cause of malnutrition, stunting and child mortality, claiming nearly 600,000 under-5 lives every year. Inadequate facilities also affect education and economic productivity and impact the dignity and personal safety of women and girls.

Established by the Water Supply and Sanitation Collaborative Council (WSSCC), the GSF funds behaviour change activities to help large numbers of poor people in the hardest-to-reach areas attain safe sanitation and adopt good hygiene practices. These activities are community-led, support national efforts, and bring together a diverse group of stakeholders in order to address, at a large scale, the severe deficiencies in access to sanitation and hygiene.

The GSF is a pooled financing mechanism with the potential to further accelerate access to sanitation for hundreds of millions of people over the next 15 years. Between 2013 and 2014 alone, the GSF reported an almost 90 percent increase in the number of people living open-defecation free in target regions of 13 countries[1] across Africa and Asia. During this same period, the GSF has also supported a 55 percent increase in the number of people with access to improved toilets in those same areas. The United Nations system has identified global funds as an important tool to enable member countries to achieve their national development targets, including those for sanitation and hygiene.[2]

“These results prove that we are moving closer to our vision of a world where everybody has sustained sanitation and hygiene, supported by safe water,” said Chris Williams, Executive Director of WSSCC.  “This is a crucial step towards achieving better health, reducing poverty and ensuring environmental sustainability for the most marginalized people in the world.”

These GSF results have been achieved due to the work of more than 200 partners, including executing agencies and sub-grantees composed of representatives from governments, international organizations, academic institutions, the United Nations and civil society. One of the strongest success factors in the GSF approach is that it allows flexibility for countries to develop their programmes within the context of their own institutional framework and according to their own specific sanitation and hygiene needs, sector capacity and stakeholders. This implementation methodology is used to reach large numbers of households in a relatively short period of time and is vital for scaling up safe sanitation and hygiene practices.

“GSF is one of the few funds for government-led, donor-funded sanitation and hygiene programmes,” said Williams. “It can uniquely serve as a catalyst to the wider sector as a model that is replicable for others interested in large-scale behaviour change.”

Reaching scale has required that sub-grantees can identify influential, strategic communities, and make effective use of natural leaders, religious and local leaders, or hundreds of others who serve as individual sanitation and hygiene champions. GSF supported programmes apply a local delivery mechanism that engages households in thousands of villages, which enables people to make informed decisions about their sanitation and hygiene behaviour that can improve their health, education and productivity.

The report also highlights the GSF’s impact on national programmes. In Uganda, there are now more than 1.4 million people living in open-defecation free (ODF) environments, thanks to GSF-funded activities, and close to three million people have been reached by hygiene messages as a result of decentralized local government intervention. In Madagascar, over 1.3 million people are now living in ODF environments – in all 22 of the countries regions – and India’s GSF-supported programme has over 782,000 people with handwashing facilities.

“Access to improved sanitation has to be a sustainable reality for every person in the community, regardless of age, gender or disability, in order for the health and other benefits to be enjoyed by all,” said David Shimkus, Programme Director of the GSF. “This report shows that GSF-supported programmes are making major strides in achieving improved sanitation and hygiene for the most vulnerable, and all stakeholders will continue to work together to ensure such progress continues.”

The Governments of Australia, Finland, the Netherlands, Sweden, Switzerland and the United Kingdom have contributed to the GSF since its establishment in 2008. Close to $105 million has been committed for 13 country programmes, which aim to reach 36 million people.

[1] Benin, Cambodia, Ethiopia, India, Kenya, Madagascar, Malawi, Nepal, Nigeria, Senegal, Tanzania, Togo and Uganda.

[2] See draft outcome document for the forthcoming Addis Ababa Accord of the Third International Conference on Financing for Development, and the UN Sustainable Development Solutions Network Financing for Sustainable Development report and its Role of Global Funds in a Post-2015 Development Framework.

Lifebuoy champions need for handwashing with soap public private partnerships at AfricaSan 4 to improve newborn survival

Photo credit: Lifebuoy/Unilever  #HelpaChildReach5

Photo credit: Lifebuoy/Unilever #HelpaChildReach5

Dakar, Senegal 25th May – Unilever, through health soap brand Lifebuoy is calling on African leaders gathering in Senegal this week for AfricaSan – the continent’s pre-eminent sanitation and hygiene conference – to recognise the role of public private partnerships in addressing newborn and child health. The move comes as Lifebuoy announces the renewal of its partnership with USAID and the expansion of newborn hygiene programmes across Kenya following a successful four-year partnership. Lifebuoy aims to reach 71 million across Africa by 2020 as part of its behaviour change programme which has engaged 257 million people in 24 countries, since 2010.

In its mission to reach 1 billion people with its lifesaving message of handwashing with soap, Lifebuoy joined forces with USAID and its Maternal and Child Survival Programme (MCSP), to create a dedicated newborn programme to make handwashing with soap commonplace among mothers. Worldwide, 40% of under-5 deaths occur in the newborn period and handwashing with soap is one of the most cost-effective ways to reduce preventable diseases like diarrhoea and pneumonia, the main causes of child mortality.

The programme will combine Lifebuoy’s marketing and consumer expertise and proven handwashing behaviour change methodology, with MCSP’s ability to deploy programmes on a large scale, allowing the partnership to reach millions of new mothers. The collaboration proves the vital role that public private partnerships play in public health interventions in Africa and beyond.

“Most newborn deaths due to infection could be averted through simple preventive measures, such as improving hygiene and ensuring curative care is available to sick children.   Unilever and USAID renew our commitment to scale up newborn hygiene programs together.  A simple hygiene message – handwashing with soap – can help save the lives of babies,” said Katie Taylor, Deputy Child and Maternal Survival Coordinator at the U.S. Agency for International Development. “With Unilever and Lifebuoy, we are combining our expertise to achieve real change for the mothers and children in Africa – so every child in Africa can live beyond their fifth birthday.”

Senegalese politician and award-winning singer Youssou N’Dour has pledged his support to Lifebuoy’s Help A Child Reach 5 campaign to highlight the importance of hygiene in reducing child mortality, particularly in Africa. He is described as one of the world’s greatest singers and has advocated for children in Africa and abroad. “50% of the world’s under-5 deaths happens in Africa, with 1 in every 10 children born dying before their 5th birthday,” said N’Dour. “The simple act of handwashing with soap can save children’s lives and should play a key part in the post-2015 development agenda. I am calling on policymakers and governments in Africa to help make this happen by expanding handwashing education programmes.”

The Fourth Regional Conference on Sanitation and Hygiene in Africa (AfricaSan 4) is focusing on the theme: Making Sanitation for All a Reality in Africa.  With the launch of the United Nations’ new Sustainable Development Goal (SDGs) in September, Lifebuoy is raising awareness of the need to track handwashing facilities and behaviours in the water and sanitation goal (SDG 6). How individual countries choose to implement the SDGs and build the targets and indicators into their own national plans will determine their success and Lifebuoy is working to ensure its message “Handwashing with soap saves lives” is heard at the highest levels in Africa.

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