Exploring the gap between hand washing knowledge and practices in Bangladesh: a cross-sectional comparative study

Sifat E Rabbi,Nepal C Dey

doi:10.1186/1471-2458-13-89

Abstract

BackgroundHand washing is considered as one of the most effective hygiene promotion activities for public health in developing countries. This study compared hand washing knowledge and practices in BRAC’s water; sanitation and hygiene (WASH) programme areas over time.MethodsThis study is a cross-sectional comparative study between baseline (2006), midline (2009) and end-line (2011) surveys in 50 sub-districts from the first phase of the programme. Thirty thousand households from 50 sub-districts were selected in two steps: i) 30 villages were selected from each sub-district by cluster sampling, and ii) 20 households were chosen systematically from each village. The matched households were considered (26,404 in each survey) for analysis. Data were collected from households through face-to-face interview using a pre-tested questionnaire. Respondents were the adult female members of the same households, who had knowledge of day-to-day household activities related to water, sanitation and hygiene.ResultsA gap between perception and practice of proper hand washing practices with soap was identified in the study areas. Hand washing practice with soap before eating was much lower than after defecation. In baseline data, 8% reported to wash their hands with soap which significantly increased to 22% in end line. Hand washing knowledge and practices before cooking food, before serving food and while handling babies is considerably limited than other critical times. A multivariate analysis shows that socio-economic factors including education of household head and respondent, water availability and access to media have strong positive association with hand washing with soap.ConclusionGap between knowledge and practice still persists in hand washing practices. Long term and extensive initiatives can aware people about the effectiveness of hand washing.

Highlights

Hand washing is considered as one of the most effective hygiene promotion activities for public health in developing countries
Gap between knowledge and practice of hand washing with soap A gap between hygienic hand washing knowledge and self-reported practices was identified in baseline, midline and end-line data
Overall 95% respondents reported that hand washing is essential before taking food whereas 8% of them wash their hands with soap in baseline which increased in midline to 20% and in end-line to 22% (Figure 1)

Summary

Introduction

Hand washing is considered as one of the most effective hygiene promotion activities for public health in developing countries. An average of 65% of death caused by diarrheal diseases could be reduced if good hygiene practice accompanies the provision of water and sanitation [2]. Evidence shows that hand washing can reduce the occurrence of diarrheal diseases by 14-40% [6]. The effectiveness of hand washing with soap can reduce diarrheal risk up to 47% [10]. Many studies carried out in Bangladesh suggested that hand washing is one of the factors which decreases the incidence of diarrhea in intervention areas [11,12]. Studies revealed that WASH intervention improve the water, sanitation and hygiene situation in Bangladesh; reduce diarrheal prevalence associated with lower number of fecal-colony forming bacteria on hands [13]

Methods

Results

Discussion

Conclusion