Author:
- Introduction
- Methods
- Results
- Enrollment.
- Demographic and socioeconomic characteristics.
- Assessment of change in behaviors from baseline to follow-up among friends and relatives.
- Factors associated with improved water treatment and hand hygiene practices.
- Concordance of behavior change among friend/relative and hygiene kit recipient pairs
- Discussion
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Parashar UD, Bresee JS, Glass RI, 2003. The global burden of diarrhoeal disease in children. Bull World Health Organ 81: 236.
-
2.
National Statistical Office of Malawi and UNICEF, 2008. Malawi Multiple Indicator Cluster Survey 2006, Final Report. Lilongwe, Malawi: National Statistical Office and UNICEF. Available at: http://www.childinfo.org/files/MICS3_Malawi_FinalReport_2006_eng.pdf. Accessed March 14, 2010.
-
3.
Fewtrell L, Kaufmann RB, Kay D, Enanoria W, Haller L, Colfor JM Jr, 2005. Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis. Lancet Infect Dis 5: 42– 53.
-
4.
Clasen T, Schmidt WP, Rabie T, Roberts I, Cairncross S, 2007. Interventions to improve water quality for preventing diarrhoea: systemic review and meta-analysis. BMJ 334: 755– 756.
-
5.
Curtis V, Cairncross S, 2003. Effect of washing hands with soap on diarrhoea risk in the community: a systematic review. Lancet Infect Dis 3: 275– 281.
-
6.
Stockman LJ, Fischer TK, Deming M, Ngwira B, Quick RE, 2007. Point-of-use water treatment and use among mothers in Malawi. Emerg Infect Dis 13: 1077– 1080.
-
7.
Bryce J, Daelmans B, Dwivedi A, Fauveau V, Lawn JE, Mason E, Newby H, Shankar A, Starrs A, Wardlaw T, 2008. Countdown to 2015 for maternal, newborn, and child survival: the 2008 report on tracking coverage of interventions. Lancet 371: 1247– 1258.
-
8.
Sheth, AN, Russo E, Menon M, Wannemuehler K, Weinger M, Kudzala AC, Tauzie B, Masuku HD, Msowoya TE, Quick R, 2010. Impact of the integration of water treatment and hand washing incentives with antenatal services on hygiene practices of pregnant women in Malawi. Am J Trop Med Hyg 83: 1315– 1321.
-
9.
Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O, 2004. Diffusion of Innovations in Service Organization: Systematic Review and Recommendation. Milbank Q 82: 581– 629.
-
10.
Rogers EM, 1995. Diffusion of Innovations, Fourth edition. New York: The Free Press.
-
11.
Parker AA, Stephenson R, Riley PL, Ombeki S, Komolleh C, Sibley L, Quick R, 2006. Sustained high levels of stored drinking water treatment and retention of hand-washing knowledge in rural Kenyan households following a clinic-based intervention. Epidemiol Infect 134: 1029– 1036.
-
12.
Blanton E, Ombeki S, Oluoch GO, Mwaki A, Wannemuehler K, Quick R, 2010. Evaluation of the role of school children in the promotion of point-of-use water treatment and handwashing in schools and households, Nyanza Province, western Kenya, 2007. Am J Trop Med Hyg 82: 664– 671.
-
13.
Filmer D, Pritchett LH, 2001. Estimating wealth effects without expenditure data–or tears: an application to educational enrollments in states of India. Demography 38: 115– 132.
-
14.
Eliasziw M, Donner A, 1991. Application of the McNemar test to non-independent matched pair data. Stat Med 10: 1981– 1991.
-
15.
Goldman N, Pebleyb AR, Beckett M, 2001. Diffusion of ideas about personal hygiene and contamination in poor countries: evidence from Guatemala. Soc Sci Med 52: 53– 69.
-
16.
Institute of Medicine, 2001. Health and Behavior: The Interplay of Biological, Behavioral and Societal Influences. Washington, DC: National Academy Press.
-
17.
McLeroy KR, Bibeau D, Steckler A, Glanz K, 1988. An ecological perspective on health promotion programs. Health Educ Q 15: 351– 377.
-
18.
Freeman MC, Quick RE, Abbott DP, Ogutu P, Rheingans R, 2009. Increasing equity of access to point-of-use water treatment products through social marketing and entrepreneurship: a case study in western Kenya. J Water Health 7: 527– 534.
-
19.
Wood S, Foster J, Goodyear LE, 2011. Motivations for use and non-use of WaterGuard by mothers in an antenatal water treatment and hygiene program in Malawi. Soc Sci Med 73: 351– 377.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 22 | 22 | 3 |
| Full Text Views | 286 | 63 | 0 |
| PDF Downloads | 55 | 8 | 0 |
Water Treatment and Handwashing Behaviors among Non-Pregnant Friends and Relatives of Participants in an Antenatal Hygiene Promotion Program in Malawi
Elizabeth T. Russo
Elizabeth T. Russo
Division of Foodborne, Waterborne, and Environmental Diseases, and Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; United States Agency for International Development, Arlington, Virginia; United Nations Children’s Fund, New York, New York; Government of Malawi Ministry of Health, Blantyre, Malawi
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Anandi Sheth
Anandi Sheth
Division of Foodborne, Waterborne, and Environmental Diseases, and Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; United States Agency for International Development, Arlington, Virginia; United Nations Children’s Fund, New York, New York; Government of Malawi Ministry of Health, Blantyre, Malawi
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Manoj Menon
Manoj Menon
Division of Foodborne, Waterborne, and Environmental Diseases, and Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; United States Agency for International Development, Arlington, Virginia; United Nations Children’s Fund, New York, New York; Government of Malawi Ministry of Health, Blantyre, Malawi
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Kathleen Wannemuehler
Kathleen Wannemuehler
Division of Foodborne, Waterborne, and Environmental Diseases, and Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; United States Agency for International Development, Arlington, Virginia; United Nations Children’s Fund, New York, New York; Government of Malawi Ministry of Health, Blantyre, Malawi
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Merri Weinger
Merri Weinger
Division of Foodborne, Waterborne, and Environmental Diseases, and Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; United States Agency for International Development, Arlington, Virginia; United Nations Children’s Fund, New York, New York; Government of Malawi Ministry of Health, Blantyre, Malawi
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Amose C. Kudzala
Amose C. Kudzala
Division of Foodborne, Waterborne, and Environmental Diseases, and Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; United States Agency for International Development, Arlington, Virginia; United Nations Children’s Fund, New York, New York; Government of Malawi Ministry of Health, Blantyre, Malawi
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Blessius Tauzie
Blessius Tauzie
Division of Foodborne, Waterborne, and Environmental Diseases, and Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; United States Agency for International Development, Arlington, Virginia; United Nations Children’s Fund, New York, New York; Government of Malawi Ministry of Health, Blantyre, Malawi
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Humphreys D. Masuku
Humphreys D. Masuku
Division of Foodborne, Waterborne, and Environmental Diseases, and Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; United States Agency for International Development, Arlington, Virginia; United Nations Children’s Fund, New York, New York; Government of Malawi Ministry of Health, Blantyre, Malawi
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Tapona E. Msowoya
Tapona E. Msowoya
Division of Foodborne, Waterborne, and Environmental Diseases, and Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; United States Agency for International Development, Arlington, Virginia; United Nations Children’s Fund, New York, New York; Government of Malawi Ministry of Health, Blantyre, Malawi
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Robert Quick
Robert Quick
Division of Foodborne, Waterborne, and Environmental Diseases, and Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; United States Agency for International Development, Arlington, Virginia; United Nations Children’s Fund, New York, New York; Government of Malawi Ministry of Health, Blantyre, Malawi
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Access to safe drinking water and improved hygiene are essential for preventing diarrheal diseases. To integrate hygiene improvement with antenatal care, free hygiene kits (water storage containers, water treatment solution, soap) and educational messages were distributed to pregnant women at antenatal clinics in Malawi. We assessed water treatment and hygiene practices of 275 non-pregnant friends and relatives of the hygiene kit recipients at baseline and follow-up nine months later to measure program impact on non-participants in the same communities. At follow-up, friends and relatives who did not receive kits or education were more likely than at baseline to purchase and use water treatment solution (25% versus 1%; P < 0.0001) and demonstrate correct handwashing practices (60% versus 18%; P < 0.0001). This antenatal clinic–based program resulted in improved water treatment and hygiene behaviors among non-pregnant friends and relatives living in the same communities as hygiene kit recipients, suggesting that program benefits extended beyond direct beneficiaries.
Author Notes
Financial support: This study was supported by the United States Agency for International Development.
Authors’ addresses: Elizabeth T. Russo, Anandi Sheth, and Manoj Menon, Division of Foodborne, Waterborne, and Environmental Diseases, and Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: elizabeth.russo@gmail.com, asheth@cdc.gov, and mmenon@gmail.com. Kathleen Wannemuehler, Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: kpw9@cdc.gov. Merri Weinger, United States Agency for International Development, Arlington, VA, E-mail: mweinger@usaid.gov. Amose C. Kudzala, Blessius Tauzie, and Tapona E. Msowoya, United Nations Children’s Fund, New York, NY, E-mails: akudzala@unicef.org, btauzie@unicef.org, and tmsowoya@unicef.org. Humphreys D. Masuku, Government of Malawi Ministry of Health, Blantyre, Malawi, E-mail: dzanjom@yahoo.co.uk. Robert Quick, Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: rquick@cdc.gov.
- Introduction
- Methods
- Results
- Enrollment.
- Demographic and socioeconomic characteristics.
- Assessment of change in behaviors from baseline to follow-up among friends and relatives.
- Factors associated with improved water treatment and hand hygiene practices.
- Concordance of behavior change among friend/relative and hygiene kit recipient pairs
- Discussion
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Parashar UD, Bresee JS, Glass RI, 2003. The global burden of diarrhoeal disease in children. Bull World Health Organ 81: 236.
-
2.
National Statistical Office of Malawi and UNICEF, 2008. Malawi Multiple Indicator Cluster Survey 2006, Final Report. Lilongwe, Malawi: National Statistical Office and UNICEF. Available at: http://www.childinfo.org/files/MICS3_Malawi_FinalReport_2006_eng.pdf. Accessed March 14, 2010.
-
3.
Fewtrell L, Kaufmann RB, Kay D, Enanoria W, Haller L, Colfor JM Jr, 2005. Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis. Lancet Infect Dis 5: 42– 53.
-
4.
Clasen T, Schmidt WP, Rabie T, Roberts I, Cairncross S, 2007. Interventions to improve water quality for preventing diarrhoea: systemic review and meta-analysis. BMJ 334: 755– 756.
-
5.
Curtis V, Cairncross S, 2003. Effect of washing hands with soap on diarrhoea risk in the community: a systematic review. Lancet Infect Dis 3: 275– 281.
-
6.
Stockman LJ, Fischer TK, Deming M, Ngwira B, Quick RE, 2007. Point-of-use water treatment and use among mothers in Malawi. Emerg Infect Dis 13: 1077– 1080.
-
7.
Bryce J, Daelmans B, Dwivedi A, Fauveau V, Lawn JE, Mason E, Newby H, Shankar A, Starrs A, Wardlaw T, 2008. Countdown to 2015 for maternal, newborn, and child survival: the 2008 report on tracking coverage of interventions. Lancet 371: 1247– 1258.
-
8.
Sheth, AN, Russo E, Menon M, Wannemuehler K, Weinger M, Kudzala AC, Tauzie B, Masuku HD, Msowoya TE, Quick R, 2010. Impact of the integration of water treatment and hand washing incentives with antenatal services on hygiene practices of pregnant women in Malawi. Am J Trop Med Hyg 83: 1315– 1321.
-
9.
Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O, 2004. Diffusion of Innovations in Service Organization: Systematic Review and Recommendation. Milbank Q 82: 581– 629.
-
10.
Rogers EM, 1995. Diffusion of Innovations, Fourth edition. New York: The Free Press.
-
11.
Parker AA, Stephenson R, Riley PL, Ombeki S, Komolleh C, Sibley L, Quick R, 2006. Sustained high levels of stored drinking water treatment and retention of hand-washing knowledge in rural Kenyan households following a clinic-based intervention. Epidemiol Infect 134: 1029– 1036.
-
12.
Blanton E, Ombeki S, Oluoch GO, Mwaki A, Wannemuehler K, Quick R, 2010. Evaluation of the role of school children in the promotion of point-of-use water treatment and handwashing in schools and households, Nyanza Province, western Kenya, 2007. Am J Trop Med Hyg 82: 664– 671.
-
13.
Filmer D, Pritchett LH, 2001. Estimating wealth effects without expenditure data–or tears: an application to educational enrollments in states of India. Demography 38: 115– 132.
-
14.
Eliasziw M, Donner A, 1991. Application of the McNemar test to non-independent matched pair data. Stat Med 10: 1981– 1991.
-
15.
Goldman N, Pebleyb AR, Beckett M, 2001. Diffusion of ideas about personal hygiene and contamination in poor countries: evidence from Guatemala. Soc Sci Med 52: 53– 69.
-
16.
Institute of Medicine, 2001. Health and Behavior: The Interplay of Biological, Behavioral and Societal Influences. Washington, DC: National Academy Press.
-
17.
McLeroy KR, Bibeau D, Steckler A, Glanz K, 1988. An ecological perspective on health promotion programs. Health Educ Q 15: 351– 377.
-
18.
Freeman MC, Quick RE, Abbott DP, Ogutu P, Rheingans R, 2009. Increasing equity of access to point-of-use water treatment products through social marketing and entrepreneurship: a case study in western Kenya. J Water Health 7: 527– 534.
-
19.
Wood S, Foster J, Goodyear LE, 2011. Motivations for use and non-use of WaterGuard by mothers in an antenatal water treatment and hygiene program in Malawi. Soc Sci Med 73: 351– 377.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 22 | 22 | 3 |
| Full Text Views | 286 | 63 | 0 |
| PDF Downloads | 55 | 8 | 0 |