Walker CL, Rudan I, Liu L, Nair H, Theodoratou E, Bhutta ZA, O'Brien KL, Campbell H, Black RE, 2013. Global burden of childhood pneumonia and diarrhoea. Lancet 381: 1405ā1416.
NIPORT, 2009. Bangladesh Demographic and Health Survey 2007. Dhaka, Bangladesh and Calverton, MD: National Institute of Population Research and Training, Mitra and Associates and Macro International.
Liu L, Li Q, Lee RA, Friberg IK, Perin J, Walker N, Black RE, 2011. Trends in causes of death among children under 5 in Bangladesh, 1993ā2004: an exercise applying a standardized computer algorithm to assign causes of death using verbal autopsy data. Popul Health Metr 9: 43.
Curtis VA, Danquah LO, Aunger RV, 2009. Planned, motivated and habitual hygiene behaviour: an eleven country review. Health Educ Res 24: 655ā673.
Halder AK, Tronchet C, Akhter S, Bhuiya A, Johnston R, Luby SP, 2010. Observed hand cleanliness and other measures of handwashing behavior in rural Bangladesh. BMC Public Health 10: 545.
Aiello AE, Coulborn RM, Perez V, Larson EL, 2008. Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis. Am J Public Health 98: 1372ā1381.
Ejemot RI, Ehiri JE, Meremikwu MM, Critchley JA, 2008. Hand washing for preventing diarrhoea. Cochrane Database Syst Rev CD004265.
Zeitlyn S, Islam F, 1991. The use of soap and water in two Bangladeshi communities: implications for the transmission of diarrhea. Rev Infect Dis 13 (Suppl 4): S259āS264.
Hoque BA, 2003. Handwashing practices and challenges in Bangladesh. Int J Environ Health Res 13 (Suppl 1): S81āS87.
Affleck W, Pelto G, 2012. Caregivers' responses to an intervention to improve young child feeding behaviors in rural Bangladesh: a mixed method study of the facilitators and barriers to change. Soc Sci Med 75: 651ā658.
Bloomfield SF, Nath KJ, 2009. Use of ash and mud for handwashing in low income communities: an International Scientific Forum on Home Hygiene (IFH) expert review. Published on http://WWW.ifh-homehygiene.org.
Hoque BA, Mahalanabis D, Alam MJ, Islam MS, 1995. Post-defecation handwashing in Bangladesh: practice and efficiency perspectives. Public Health 109: 15ā24.
Anuradha PP, Devi Yasoda P, Prakash MS, 1999. Effect of handwashing agents on bacterial contamination. Indian J Pediatr 66: 7ā10.
Luby SP, Halder AK, Huda T, Unicomb L, Johnston RB, 2011. The effect of handwashing at recommended times with water alone and with soap on child diarrhea in rural Bangladesh: an observational study. PLoS Med 8: e1001052.
Baker KK, Farzana FD, Ferdous F, Ahmed S, Das SK, Faruque ASG, Nasrin D, Kotloff KL, Nataro JP, Kolappaswamy K, Levine MM, 2014. Association between moderate- to severe diarrhea in young children in the Global Enteric Multicenter Study (GEMS) and types of handwashing materials used by caretakers in Mirzapur, Bangladesh. Am J Trop Med Hyg 91: 181ā189.
Luby SP, Halder AK, Tronchet C, Akhter S, Bhuiya A, Johnston RB, 2009. Household characteristics associated with handwashing with soap in rural Bangladesh. Am J Trop Med Hyg 81: 882ā887.
Huda TM, Unicomb L, Johnston RB, Halder AK, Yushuf Sharker MA, Luby SP, 2012. Interim evaluation of a large scale sanitation, hygiene and water improvement programme on childhood diarrhea and respiratory disease in rural Bangladesh. Soc Sci Med 75: 604ā611.
Nizame FA, Unicomb L, Sanghvi T, Roy S, Nuruzzaman M, Ghosh PK, Winch PJ, Luby SP, 2013. Handwashing before food preparation and child feeding: a missed opportunity for hygiene promotion. Am J Trop Med Hyg 89: 1179ā1185.
Guest G, Bunce A, Johnson L, 2006. How many interviews are enough? An experiment with data saturation and variability. Field Methods 18: 59ā82.
Bangladesh Bureau of Statistics (BBS), 2012. Population and Housing Census 2011, Socio-Economic and Demographic Report. National series, Volume 4. Dhaka, Bangladesh: Statistics and Informatics Division (SID), Ministry of Planning.
NIPORT, 2013. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, MD: National Institute of Population Research and Training, Mitra and Associates and MEASURE DHS, ICF International.
Kaplan LM, McGuckin M, 1986. Increasing handwashing compliance with more accessible sinks. Infect Control 7: 408ā410.
Graham M, 1990. Frequency and duration of handwashing in an intensive care unit. Am J Infect Control 18: 77ā81.
Story M, Neumark-Sztainer D, French S, 2002. Individual and environmental influences on adolescent eating behaviors. J Am Diet Assoc 102: S40āS51.
Gielen AC, Sleet D, 2003. Application of behavior-change theories and methods to injury prevention. Epidemiol Rev 25: 65ā76.
Saelens BE, Sallis JF, Black JB, Chen D, 2003. Neighborhood-based differences in physical activity: an environment scale evaluation. Am J Public Health 93: 1552ā1558.
Dreibelbis R, Winch PJ, Leontsini E, Hulland KR, Ram PK, Unicomb L, Luby SP, 2013. The integrated behavioural model for water, sanitation, and hygiene: a systematic review of behavioural models and a framework for designing and evaluating behaviour change interventions in infrastructure-restricted settings. BMC Public Health 13: 1015.
Ram PK, Halder AK, Granger SP, Jones T, Hall P, Hitchcock D, Wright R, Nygren B, Islam MS, Molyneaux JW, Luby SP, 2010. Is structured observation a valid technique to measure handwashing behavior? Use of acceleration sensors embedded in soap to assess reactivity to structured observation. Am J Trop Med Hyg 83: 1070ā1076.
Pedersen DM, Keithly S, Brady K, 1986. Effects of an observer on conformity to handwashing norm. Percept Mot Skills 62: 169ā170.
Drankiewicz D, Dundes L, 2003. Handwashing among female college students. Am J Infect Control 31: 67ā71.
Munger K, Harris SJ, 1989. Effects of an observer on handwashing in a public restroom. Percept Mot Skills 69: 733ā734.
Scott BE, Schmidt WP, Aunger R, Garbrah-Aidoo N, Animashaun R, 2008. Marketing hygiene behaviours: the impact of different communication channels on reported handwashing behaviour of women in Ghana. Health Educ Res 23: 392ā401.
Porzig-Drummond R, Stevenson R, Case T, Oaten M, 2009. Can the emotion of disgust be harnessed to promote hand hygiene? Experimental and field-based tests. Soc Sci Med 68: 1006ā1012.
Scott B, Curtis V, Rabie T, Garbrah-Aidoo N, 2007. Health in our hands, but not in our heads: understanding hygiene motivation in Ghana. Health Policy Plan 22: 225ā233.
Amin N, Pickering AJ, Ram PK, Unicomb L, Najnin N, Homaira N, Ashraf S, Abedin J, Islam MS, Luby SP, 2014. Microbiological evaluation of the efficacy of soapy water to clean hands: a randomized, non-inferiority field trial. Am J Trop Med Hyg 91: 415ā423.
Hulland KR, Leontsini E, Dreibelbis R, Unicomb L, Afroz A, Dutta NC, Nizame FA, Luby SP, Ram PK, Winch PJ, 2013. 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 13: 877.
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Bangladeshi communities have historically used ash and soil as handwashing agents. A structured observation study and qualitative interviews on the use of ash/soil and soap as handwashing agents were conducted in rural Bangladesh to help develop a handwashing promotion intervention. The observations were conducted among 1,000 randomly selected households from 36 districts. Fieldworkers observed people using ash/soil to wash their hand(s) on 13% of occasions after defecation and on 10% after cleaning a child's anus. This compares with 19% of people who used soap after defecation and 27% after cleaning a child who defecated. Using ash/soil or soap was rarely (< 1%) observed at other times recommended for handwashing. The qualitative study enrolled 24 households from three observation villages, where high usage of ash/soil for handwashing was detected. Most informants reported that ash/soil was used only for handwashing after fecal contact, and that ash/soil could clean hands as effectively as soap.
Financial support: The structured observation study protocol was funded by United Kingdom Department for International Development (DFID) through UNICEF Bangladesh, and the qualitative investigation protocol was funded by the US Agency for International Development (USAID).
Authors' addresses: Fosiul A. Nizame, Amal K. Halder, and Leanne Unicomb, Water, Sanitation and Hygiene (WASH) Research Group, Centre for Communicable Diseases, icddr,b, Dhaka, Bangladesh, E-mails: fosiul@icddrb.org, amalk@icddrb.org, and leanne@icddrb.org. Sharifa Nasreen, Gainesville, FL, E-mail: drsharifa74@gmail.com. Shaila Arman, Toronto, Canada, E-mail: shailaarman@icddrb.org. Peter J. Winch, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, E-mail: pwinch@jhsph.edu. Stephen P. Luby, Woods Institute of the Environment, Stanford University, Yang and Yamazaki Environment and Energy Building, Stanford, CA, E-mail: sluby@stanford.edu.
Walker CL, Rudan I, Liu L, Nair H, Theodoratou E, Bhutta ZA, O'Brien KL, Campbell H, Black RE, 2013. Global burden of childhood pneumonia and diarrhoea. Lancet 381: 1405ā1416.
NIPORT, 2009. Bangladesh Demographic and Health Survey 2007. Dhaka, Bangladesh and Calverton, MD: National Institute of Population Research and Training, Mitra and Associates and Macro International.
Liu L, Li Q, Lee RA, Friberg IK, Perin J, Walker N, Black RE, 2011. Trends in causes of death among children under 5 in Bangladesh, 1993ā2004: an exercise applying a standardized computer algorithm to assign causes of death using verbal autopsy data. Popul Health Metr 9: 43.
Curtis VA, Danquah LO, Aunger RV, 2009. Planned, motivated and habitual hygiene behaviour: an eleven country review. Health Educ Res 24: 655ā673.
Halder AK, Tronchet C, Akhter S, Bhuiya A, Johnston R, Luby SP, 2010. Observed hand cleanliness and other measures of handwashing behavior in rural Bangladesh. BMC Public Health 10: 545.
Aiello AE, Coulborn RM, Perez V, Larson EL, 2008. Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis. Am J Public Health 98: 1372ā1381.
Ejemot RI, Ehiri JE, Meremikwu MM, Critchley JA, 2008. Hand washing for preventing diarrhoea. Cochrane Database Syst Rev CD004265.
Zeitlyn S, Islam F, 1991. The use of soap and water in two Bangladeshi communities: implications for the transmission of diarrhea. Rev Infect Dis 13 (Suppl 4): S259āS264.
Hoque BA, 2003. Handwashing practices and challenges in Bangladesh. Int J Environ Health Res 13 (Suppl 1): S81āS87.
Affleck W, Pelto G, 2012. Caregivers' responses to an intervention to improve young child feeding behaviors in rural Bangladesh: a mixed method study of the facilitators and barriers to change. Soc Sci Med 75: 651ā658.
Bloomfield SF, Nath KJ, 2009. Use of ash and mud for handwashing in low income communities: an International Scientific Forum on Home Hygiene (IFH) expert review. Published on http://WWW.ifh-homehygiene.org.
Hoque BA, Mahalanabis D, Alam MJ, Islam MS, 1995. Post-defecation handwashing in Bangladesh: practice and efficiency perspectives. Public Health 109: 15ā24.
Anuradha PP, Devi Yasoda P, Prakash MS, 1999. Effect of handwashing agents on bacterial contamination. Indian J Pediatr 66: 7ā10.
Luby SP, Halder AK, Huda T, Unicomb L, Johnston RB, 2011. The effect of handwashing at recommended times with water alone and with soap on child diarrhea in rural Bangladesh: an observational study. PLoS Med 8: e1001052.
Baker KK, Farzana FD, Ferdous F, Ahmed S, Das SK, Faruque ASG, Nasrin D, Kotloff KL, Nataro JP, Kolappaswamy K, Levine MM, 2014. Association between moderate- to severe diarrhea in young children in the Global Enteric Multicenter Study (GEMS) and types of handwashing materials used by caretakers in Mirzapur, Bangladesh. Am J Trop Med Hyg 91: 181ā189.
Luby SP, Halder AK, Tronchet C, Akhter S, Bhuiya A, Johnston RB, 2009. Household characteristics associated with handwashing with soap in rural Bangladesh. Am J Trop Med Hyg 81: 882ā887.
Huda TM, Unicomb L, Johnston RB, Halder AK, Yushuf Sharker MA, Luby SP, 2012. Interim evaluation of a large scale sanitation, hygiene and water improvement programme on childhood diarrhea and respiratory disease in rural Bangladesh. Soc Sci Med 75: 604ā611.
Nizame FA, Unicomb L, Sanghvi T, Roy S, Nuruzzaman M, Ghosh PK, Winch PJ, Luby SP, 2013. Handwashing before food preparation and child feeding: a missed opportunity for hygiene promotion. Am J Trop Med Hyg 89: 1179ā1185.
Guest G, Bunce A, Johnson L, 2006. How many interviews are enough? An experiment with data saturation and variability. Field Methods 18: 59ā82.
Bangladesh Bureau of Statistics (BBS), 2012. Population and Housing Census 2011, Socio-Economic and Demographic Report. National series, Volume 4. Dhaka, Bangladesh: Statistics and Informatics Division (SID), Ministry of Planning.
NIPORT, 2013. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, MD: National Institute of Population Research and Training, Mitra and Associates and MEASURE DHS, ICF International.
Kaplan LM, McGuckin M, 1986. Increasing handwashing compliance with more accessible sinks. Infect Control 7: 408ā410.
Graham M, 1990. Frequency and duration of handwashing in an intensive care unit. Am J Infect Control 18: 77ā81.
Story M, Neumark-Sztainer D, French S, 2002. Individual and environmental influences on adolescent eating behaviors. J Am Diet Assoc 102: S40āS51.
Gielen AC, Sleet D, 2003. Application of behavior-change theories and methods to injury prevention. Epidemiol Rev 25: 65ā76.
Saelens BE, Sallis JF, Black JB, Chen D, 2003. Neighborhood-based differences in physical activity: an environment scale evaluation. Am J Public Health 93: 1552ā1558.
Dreibelbis R, Winch PJ, Leontsini E, Hulland KR, Ram PK, Unicomb L, Luby SP, 2013. The integrated behavioural model for water, sanitation, and hygiene: a systematic review of behavioural models and a framework for designing and evaluating behaviour change interventions in infrastructure-restricted settings. BMC Public Health 13: 1015.
Ram PK, Halder AK, Granger SP, Jones T, Hall P, Hitchcock D, Wright R, Nygren B, Islam MS, Molyneaux JW, Luby SP, 2010. Is structured observation a valid technique to measure handwashing behavior? Use of acceleration sensors embedded in soap to assess reactivity to structured observation. Am J Trop Med Hyg 83: 1070ā1076.
Pedersen DM, Keithly S, Brady K, 1986. Effects of an observer on conformity to handwashing norm. Percept Mot Skills 62: 169ā170.
Drankiewicz D, Dundes L, 2003. Handwashing among female college students. Am J Infect Control 31: 67ā71.
Munger K, Harris SJ, 1989. Effects of an observer on handwashing in a public restroom. Percept Mot Skills 69: 733ā734.
Scott BE, Schmidt WP, Aunger R, Garbrah-Aidoo N, Animashaun R, 2008. Marketing hygiene behaviours: the impact of different communication channels on reported handwashing behaviour of women in Ghana. Health Educ Res 23: 392ā401.
Porzig-Drummond R, Stevenson R, Case T, Oaten M, 2009. Can the emotion of disgust be harnessed to promote hand hygiene? Experimental and field-based tests. Soc Sci Med 68: 1006ā1012.
Scott B, Curtis V, Rabie T, Garbrah-Aidoo N, 2007. Health in our hands, but not in our heads: understanding hygiene motivation in Ghana. Health Policy Plan 22: 225ā233.
Amin N, Pickering AJ, Ram PK, Unicomb L, Najnin N, Homaira N, Ashraf S, Abedin J, Islam MS, Luby SP, 2014. Microbiological evaluation of the efficacy of soapy water to clean hands: a randomized, non-inferiority field trial. Am J Trop Med Hyg 91: 415ā423.
Hulland KR, Leontsini E, Dreibelbis R, Unicomb L, Afroz A, Dutta NC, Nizame FA, Luby SP, Ram PK, Winch PJ, 2013. 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 13: 877.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 44 | 44 | 10 |
Full Text Views | 410 | 77 | 0 |
PDF Downloads | 137 | 18 | 0 |