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1.
Kelly P , Prendergast A , 2012. Enteropathies in the developing world: neglected effects on global health. Am J Trop Med Hyg 86: 756–763.
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2.
Humphrey JH , 2009. Child undernutrition, tropical enteropathy, toilets, and handwashing. Lancet 374: 1032–1035.
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Null C et al., 2018. Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Kenya: a cluster-randomised controlled trial. Lancet Glob Health 6: e316–e329.
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Luby SP et al., 2018. Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Bangladesh: a cluster randomised controlled trial. Lancet Glob Health 6: e302–e315.
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Ercumen A et al., 2017. Animal feces contribute to domestic fecal contamination: evidence from E. coli measured in water, hands, food, flies, and soil in Bangladesh. Environ Sci Technol 51: 8725–8734.
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Morita T et al., 2017. Mouthing of soil contaminated objects is associated with environmental enteropathy in young children. Trop Med Int Health 22: 670–678.
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Ngure FM , Reid BM , Humphrey JH , Mbuya MN , Pelto G , Stoltzfus RJ , 2014. Water, sanitation, and hygiene (WASH), environmental enteropathy, nutrition, and early child development: making the links. Ann N Y Acad Sci 1308: 118–128.
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Lao Statistics Bureau and UNICEF , 2018. Lao Social Indicator Survey II 2017, Survey Findings Report. Available at: https://dhsprogram.com/pubs/pdf/FR356/FR356.pdf. Accessed June 28, 2023.
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Freeman MC , Ellis AS , Ogutu EA , Caruso BA , Linabarger M , Micek K , Muga R , Girard AW , Wodnik BK , Jacob Arriola K , 2020. Impact of a demand-side integrated WASH and nutrition community-based care group intervention on behavioural change: a randomised controlled trial in western Kenya. BMJ Glob Health 5: e002806.
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Kuhl J et al., 2021. Formative research for the development of baby water, sanitation, and hygiene interventions for young children in the Democratic Republic of the Congo (REDUCE program). BMC Public Health 21: 427.
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Williams C et al., 2021. Identifying psychosocial determinants of water, sanitation, and hygiene (WASH) behaviors for the development of evidence-based Baby WASH interventions (REDUCE program). Int J Hyg Environ Health 238: 113850.
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Slekiene J , Mosler HJ , 2018. Does depression moderate handwashing in children? BMC Public Health 18: 82.
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21.
Slekiene J , Mosler HJ , 2019. The link between mental health and safe drinking water behaviors in a vulnerable population in rural Malawi. BMC Psychol 7: 44.
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Role of Psychosocial Factors and Mental Well-Being for Baby WASH- and Nutrition-Related Behaviors in Lao PDR
Jurgita Slekiene
Jurgita Slekiene
Global Health Engineering, Department of Mechanical and Process Engineering, ETH Zurich, Zurich, Switzerland;
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Claire Chase
Claire Chase
The World Bank, Water Global Practice, Washington, District of Columbia;
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Simi Mishra
Simi Mishra
The World Bank, Water Global Practice, Washington, District of Columbia;
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Hans-Joachim Mosler
Hans-Joachim Mosler
RanasMosler spin-off of EAWAG (Swiss Federal Institute of Aquatic Science and Technology), Zurich, Switzerland
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ABSTRACT.
In Lao PDR, 30% of children under age 5 years are affected by stunting. Stunting in childhood is associated with poorer outcomes for both physical and cognitive development. Baby WASH is a focused approach to water supply, sanitation, and hygiene for infants and children that targets numerous contextual and psychosocial factors including child handwashing, food hygiene, clean play spaces, and management of animal feces in the household environment. Using the risks, attitudes, norms, abilities, and self-regulation approach to behavior change (BC), the objective of this study was to investigate psychosocial factors of Baby WASH and nutrition related-behaviors, considering caregivers mental well-being, to design evidence-based BC interventions. A cross-sectional survey of 616 caregivers of a child under 2 years was conducted in Lao PDR. Caregivers well-being was significantly associated with handwashing before feeding a baby, controlling “mouthing,” and the intention to exclusively breastfeed for the first 6 months. All psychosocial factors of the three behaviors were correlated with mental well-being. Results suggest that attitudinal and ability factors underlying handwashing with soap before feeding a child should be the primary focus of BC interventions. For controlling mouthing factors, interventions should target attitude and norm factors. To increase the intention of exclusive breastfeeding for the first 6 months attitude, ability, and self-regulation factors should be targeted through BC interventions. The findings of this study can be used to support the inclusion of vulnerable caregivers with poor mental well-being with BC interventions designed to improve child health and prevent stunting.
- Supplemental Materials (PDF 318.17 KB)
Author Notes
Financial support: This study was financially supported by the
Disclosure: The study protocol was approved by the National Ethics Committee for Health Research of the Lao People’s Democratic Republic (ID: 2019.51.NW) and permission obtained from the Lao PDR Ministry of Agriculture and Forestry. The participants were informed of the research objectives and advised that they had the freedom to refuse participation or withdraw from the study at any time. Participants written informed consent was obtained before inclusion in the study. Participants were provided with a unique identifying number, and data were anonymized during data analysis. Data were accessed only by the authors.
Current contact information: Jurgita Slekiene, Global Health Engineering, Department of Mechanical and Process Engineering, ETH Zurich, Zurich, Switzerland, E-mail: jslekiene@ethz.ch. Claire Chase and Simi Mishra, The World Bank, Water Global Practice, Washington, DC, E-mails: cchase@worldbank.org and simim.email@gmail.com. Hans-Joachim Mosler, RanasMosler spin-off of EAWAG (Swiss Federal Institute of Aquatic Science and Technology), Zurich, Switzerland, E-mail: hmosler@ranasmosler.com.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Kelly P , Prendergast A , 2012. Enteropathies in the developing world: neglected effects on global health. Am J Trop Med Hyg 86: 756–763.
-
2.
Humphrey JH , 2009. Child undernutrition, tropical enteropathy, toilets, and handwashing. Lancet 374: 1032–1035.
-
3.
Null C et al., 2018. Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Kenya: a cluster-randomised controlled trial. Lancet Glob Health 6: e316–e329.
-
4.
Luby SP et al., 2018. Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Bangladesh: a cluster randomised controlled trial. Lancet Glob Health 6: e302–e315.
-
5.
Ercumen A et al., 2017. Animal feces contribute to domestic fecal contamination: evidence from E. coli measured in water, hands, food, flies, and soil in Bangladesh. Environ Sci Technol 51: 8725–8734.
-
6.
Morita T et al., 2017. Mouthing of soil contaminated objects is associated with environmental enteropathy in young children. Trop Med Int Health 22: 670–678.
-
7.
Motarjemi Y , Käferstein F , Moy G , Quevedo F , 1993. Contaminated weaning food: a major risk factor for diarrhoea and associated malnutrition. Bull World Health Organ 71: 79–92.
-
8.
Lanata C. Studies of food hygiene and diarrhoeal disease. Int J Environ Health Res 13 (Suppl 1):S175–S183.
-
9.
Ngure FM , Reid BM , Humphrey JH , Mbuya MN , Pelto G , Stoltzfus RJ , 2014. Water, sanitation, and hygiene (WASH), environmental enteropathy, nutrition, and early child development: making the links. Ann N Y Acad Sci 1308: 118–128.
-
10.
Lao Statistics Bureau and UNICEF , 2018. Lao Social Indicator Survey II 2017, Survey Findings Report. Available at: https://dhsprogram.com/pubs/pdf/FR356/FR356.pdf. Accessed June 28, 2023.
-
11.
Freeman MC , Ellis AS , Ogutu EA , Caruso BA , Linabarger M , Micek K , Muga R , Girard AW , Wodnik BK , Jacob Arriola K , 2020. Impact of a demand-side integrated WASH and nutrition community-based care group intervention on behavioural change: a randomised controlled trial in western Kenya. BMJ Glob Health 5: e002806.
-
12.
Kuhl J et al., 2021. Formative research for the development of baby water, sanitation, and hygiene interventions for young children in the Democratic Republic of the Congo (REDUCE program). BMC Public Health 21: 427.
-
13.
Williams C et al., 2021. Identifying psychosocial determinants of water, sanitation, and hygiene (WASH) behaviors for the development of evidence-based Baby WASH interventions (REDUCE program). Int J Hyg Environ Health 238: 113850.
-
14.
Mosler HJ , 2012. A systematic approach to behavior change interventions for the water and sanitation sector in developing countries: a conceptual model, a review, and a guideline. Int J Environ Health Res 22: 431–449.
-
15.
Mosler HJ , Contzen N , 2016. Systematic Behavior Change in Water, Sanitation and Hygiene. A Practical Guide using the RANAS Approach. Version 1.1. Available at: https://www.susana.org/_resources/documents/default/3-2976-7-1519390106.pdf. Accessed June 28, 2023.
-
16.
Fisher S , Bellinger DC , Cropper ML , Kumar P , Binagwaho A , Koudenoukpo JB , Park Y , Taghian G , Landrigan PJ , 2021. Air pollution and development in Africa: impacts on health, the economy, and human capital. Lancet Planet Health 5: e681–e688.
-
17.
Bennett IM , Schott W , Krutikova S , Behrman JR , 2016. Maternal mental health, and child growth and development, in four low-income and middle-income countries. J Epidemiol Community Health 70: 168–173.
-
18.
Harpham T , 2005. Maternal mental health and child nutritional status in four developing countries. J Epidemiol Community Health 59: 1060–1064.
-
19.
Ranasinghe S , Ramesh S , Jacobsen KH , 2016. Hygiene and mental health among middle school students in India and 11 other countries. J Infect Public Health 9: 429–435.
-
20.
Slekiene J , Mosler HJ , 2018. Does depression moderate handwashing in children? BMC Public Health 18: 82.
-
21.
Slekiene J , Mosler HJ , 2019. The link between mental health and safe drinking water behaviors in a vulnerable population in rural Malawi. BMC Psychol 7: 44.
-
22.
Slekiene J , Mosler HJ , 2021. Does poor mental health change the influence of interventions on handwashing in a vulnerable population of rural Malawi? The key role of emotions. J Water Sanit Hyg Dev 11: 350–361.
-
23.
Jiang Q et al., 2021. Postnatal mental health, hand washing practices, and infant illness in rural China. Front Glob Womens Health 2: 735264.
-
24.
Stewart-Brown S , Platt S , Tennant A , Maheswaran H , Parkinson J , Weich S , Tennant R , Taggart F , Clarke A , 2011. The Warwick–Edinburgh Mental Well-Being Scale (WEMWBS): a valid and reliable tool for measuring mental well-being in diverse populations and projects. J Epidemiol Community Health 65 (Suppl 2): A38–A39.
-
25.
Cohen J , 1992. A power primer. Psychol Bull 112: 155–159.
-
26.
Armitage CJ , Conner M , 2001. Efficacy of the theory of planned behaviour: a meta-analytic review. Br J Soc Psychol 40: 471–499.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 479 | 479 | 170 |
| Full Text Views | 23 | 23 | 6 |
| PDF Downloads | 26 | 26 | 10 |