Hand Washing Facilities Research Articles

Health related quality of life and associated factors among children living in previous leprosarium and nonleprosarium areas of Eastern Ethiopia

Children and their families living in leprosarium areas may have a lower quality of life than the general population. However, there is limited evidence on health-related quality of life and its associated factors among children living in previous leprosarium settlement areas. Hence, this study aimed to compare the health-related quality of life among children living in previous leprosarium and non-leprosarium settlement areas in eastern Ethiopia. A community-based comparative cross-sectional study was conducted among 515 randomly selected children aged 8 to 18 years living in the Amir Nur and Babile districts from January to February 30, 2024. Data were collected through interviews with children and parents using the Pediatric Quality of Life Inventory Version 4. The data were analyzed using STATA version 14. Simple and multiple linear regression was employed to identify associations between independent and outcome variables. The overall mean health-related quality of life scores were 73.98 ± 18.47 and 77.67 ± 14.72 in the child self-reports (P = 0.01) and 55.78 ± 12.03 and 55.61 ± 8.50 (P = 0.85) in the parent proxy reports in the previous leprosarium and nonleprosarium settlement areas, respectively. In multiple linear regression, child education (β = 14.69; 95% CI: 8.69, 20.69), the absence of neglected and tropical diseases (β = 4.02; 95% CI: 0.66, 7.37), and child face washing habits (β = 5.54, 95% CI: 2.14, 8.95) increase health-related quality of life. However, a previous history of neglected and tropical diseases (β = -8.54; 95% CI: -12.93, -4.15) and the absence of hand washing facilities (β = -8.57; 95% CI, -15.22, -1.92) decrease the mean health-related quality of life. Based on child self-reports, one in four children from previous leprosarium areas had poor health-related quality of life compared to children living in none leprosarium areas. Children’s educational status, their daily habits of washing their face, not having neglected, and tropical diseases had improved health-related quality of life. To improve health-related quality of life, stakeholders should pay attention to and work on the early detection and treatment of neglected and tropical diseases, child education, and proper sanitation practices in the leprosarium community.

An evaluation of interventions within a Growth Through Nutrition project aimed at enhancing optimal nutrition and water, sanitation and hygiene (WASH) and nutrition practices among nutritionally most vulnerable households (MVHHs) in Ethiopia.

Despite a downward trend, Ethiopia still faces significant challenges with high rates of stunting and acute malnutrition in children. To tackle these issues, the Feed the Future Ethiopia Growth Through Nutrition Activity, a USAID-funded project aligned with Ethiopia's National Nutrition Program, was executed from 2016 to 2023. This initiative aimed to enhance nutrition for women and young children across six regions through multisectoral interventions. Annual surveys conducted in 2017, 2018, and 2020 evaluated the impact of livelihood support and Water, Sanitation, and Hygiene (WASH)-focused social behavior change communication (SBCC) on vulnerable households with children under two. The results showed significant improvements in child nutrition. Dietary diversity among children increased from 12% to 34% (p<0.001), and the percentage of children receiving a minimal acceptable diet rose from 12% to 30.7% (p<0.001). Women's dietary diversity also improved markedly, from 2% to 16% (p<0.001). Handwashing practices saw improvements, with the proportion of households having handwashing facilities rising from 14% to 31% (p<0.001), and the adherence to critical handwashing moments increased from 16% to 23%. However, challenges in water treatment and latrine use persisted, with less than 25% improvement. The findings suggest that integrating livelihood support with SBCC interventions can positively enhance nutritional outcomes. Continued focus on these strategies is recommended to further support vulnerable households.

GEOGRAPHICALLY WEIGHTED MACHINE LEARNING MODEL FOR ADDRESSING SPATIAL HETEROGENEITY OF PUBLIC HEALTH DEVELOPMENT INDEX IN JAVA ISLAND

Random Forest (RF) machine learning models have emerged as a prominent algorithm, addressing problems arising from the sole use of decision trees, such as overfitting and instability. However, conventional RF has global coverage that may need to capture spatial variations better. Based on the analysis of the level of public health development, the relationship between the level of health development and risk factors can vary spatially. We use a modified RF algorithm called Geographically Weighted Random Forest (GW-RF) to address this challenge. GW-RF, as a tree-based non-parametric machine learning model, can help explore and visualize relationships between the Public Health Development Index (PHDI) as response variables and factors that are indicators at the district level. GW-RF output is compared with global output, which is RF in 2018 using the percentage of the population with access to clean/decent water (X1), consumption of eggs and milk per capita per week (X2), number of healthcare facilities per 1000 people (X3), number of doctors per 1000 people (X4), pure participation rate ratio female/male (X5), percentage of households that have hand washing facilities with soap and water (X6) as independent variables. Our results show that the non-parametric GW-RF model shows high potential for explaining spatial heterogeneity and predicting PHDI versus a global model when including six major risk factors. However, some of these predictions mean little. Findings of spatial heterogeneity using GW-RF show the need to consider local factors in approaches to increasing PHDI values. Spatial analysis of PHDI provides valuable information for determining geographic targets for areas whose PHDI values need to be improved.

Ethnicity and access to water, sanitation, and hygiene in Bangladesh: a study using MICS data and policy reviews.

Safe drinking water, sanitation, and hygiene (WASH) are crucial to human health. Reducing inequalities and ensuring universal access to WASH are essential to achieving the agenda of sustainable development. We aimed to measure access to WASH among ethnic minority populations in Bangladesh and understand the situation and factors affecting WASH practices among them. Additionally, we reviewed policy related to WASH to highlight the inequality faced by ethnic minority populations. We utilized data from the multiple indicator cluster survey-2019. We used the chi-square test for bivariate analysis and multilevel mixed-effect logistic regression analyses to identify the effect of ethnicity on WASH in Bangladesh after controlling selected covariates. Furthermore, we systematically reviewed Bangladesh's WASH-related policies and programs. While 98.5% of Bengalis had access to basic drinking water services, the percentage is 60.6% for the ethnic minority population. For improved sanitation facilities not shared with others, the difference between Bengali and ethnic populations was 22.3% (64.6% vs. 42.3%). On the other hand, 75% of the Bengali population had a handwashing facility with water and soap, and 50% of the ethnic population had them. Ethnicity appeared to be a statistically significant predictor of every component of WASH. Compared to Bengali, the ethnic population had 87%, 45%, 31%, and 45% less access to water (aOR = 0.13, p ≤ 0.001), sanitation (aOR = 0.55, p ≤ 0.001), and handwashing (aOR = 0.69, p ≤ 0.05), and WASH facilities aOR = 0.55, p ≤ 0.001), respectively. Among the policies of Bangladesh, only one identified action for WASH rights of ethnic minorities. The government should identify the issues of WASH among ethnic minorities and represent them adequately in policies to achieve the aim of 'leaving none behind' of sustainable development goals.

Assessing the validity of social media in fighting COVID-19 in Africa

The severe outbreak of the COVID-19 pandemic has had a significant impact on global health, the economy, and society as a whole. To this effect, various measures both national and international were taken to respond to the pandemic. Among these measures was the rapid involvement of social media which played a vital role in the context of information dissemination, coordination of medical resources, promotion of public health campaigns, and population management and disease tracing. Besides these facilities put forward by social media, there were some weaknesses like misinformation, lack of guidance, and information leakage. Based on these numerous controversies brought about by social media during the pandemic periods, we aim to examine in this study the socio-economic effect of social media in the fight against Pandemics with particular attention on the case of the COVID-19 outbreak in Africa. Using Driscoll and Kraay's fixed effects and the Lewbel-2SLS estimators on 30 African countries, the results reveal that social media in Africa through the penetration rate of Facebook, Twitter, Instagram, Pinterest, and YouTube contribute significantly in disseminating COVID-19 in Africa. The findings equally reveal the mixed effect of other determinants of COVID-19 in this nexus. While Diabetes prevalence, the proportion of people aged 65 + , and population density contribute to the increased spread of the disease, GDP per capita and Hand Washing facilities instead prove a reducing effect of the disease. Sensitivity analysis reveals that this effect is homogenous for regional considerations of the overall sample. Based on this, appropriate suggestions are made to the various governments regarding the use of social media to prevent pandemics in the future.

Class V Students' Environmental Concern Attitude Through Clean and Healthy Friday Activities

This research is motivated by the many cases of environmental pollution and careless waste disposal which can trigger environmental damage. Even though the function of the environment is very important in supporting human life. So, a caring attitude towards the environment must be implemented from an early age. This research aims to describe the environmental care attitudes of students at SD Negeri 1 Bantrung through clean and healthy Friday activities. This type of research uses qualitative research with a case study approach. The case study approach aims to comprehensively reveal the values​​of caring character in clean and healthy Friday activities. Data collection techniques use observation, interviews and documentation obtained by researchers during research implementation. This research was carried out at SD Negeri 1 Bantrung. Based on the results of research, students' environmental care attitudes towards the environment are quite good, students can love the surrounding environment with 5 indicators of environmental care attitudes, 4 of which are appropriate, namely saving electricity and water by using enough, the availability of rubbish bins and hand washing facilities available in the area. . in each class, maintain the cleanliness of the school environment by participating in maintaining the cleanliness of the environment, providing bathrooms and sufficient clean water for all school residents. A caring attitude towards the environment is instilled at the educational level through the routine implementation of clean and healthy Friday activities. Clean and healthy Friday activities have a positive impact on caring attitudes towards the environment.

Solid health care waste management practice in Ethiopia, a convergent mixed method study

IntroductionHealthcare waste is any waste generated by healthcare facilities that is considered potentially hazardous to health. Solid healthcare waste is categorized into infectious and non-infectious wastes. Infectious waste is material suspected of containing pathogens and potentially causing disease. Non-infectious waste includes wastes that have not been in contact with infectious agents, hazardous chemicals, or radioactive substances, similar to household waste, i.e. plastic, papers and leftover foods.This study aimed to investigate solid healthcare waste management practices and develop guidelines to improve solid healthcare waste management practices in Ethiopia. The setting was all health facilities found in Hossaena town.MethodA mixed-method study design was used. For the qualitative phase of this study, eight FGDs were conducted from 4 government health facilities, one FGD from each private health facility (which is 37 in number), and forty-five FGDs were conducted. Four FGDs were executed with cleaners; another four were only health care providers because using homogeneous groups promotes discussion. The remaining 37 FGDs in private health facilities were mixed from health professionals and cleaners because of the number of workers in the private facilities. For the quantitative phase, all health facilities and health facility workers who have direct contact with healthcare waste management practice participated in this study. Both qualitative and quantitative study participants were taken from the health facilities found in Hossaena town.ResultSeventeen (3.1%) health facility workers have hand washing facilities. Three hundred ninety-two (72.6%) of the participants agree on the availability of one or more personal protective equipment (PPE) in the facility ‘‘the reason for the absence of some of the PPEs, like boots and goggles, and the shortage of disposable gloves owes to cost inflation from time to time and sometimes absent from the market’’. The observational finding shows that colour-coded waste bins are available in 23 (9.6%) rooms. 90% of the sharp containers were reusable, and 100% of the waste storage bins were plastic buckets that were easily cleanable. In 40 (97.56%) health facilities, infectious wastes were collected daily from the waste generation areas to the final disposal points. Two hundred seventy-one (50.2%) of the respondents were satisfied or agreed that satisfactory procedures are available in case of an accident. Only 220 (40.8%) respondents were vaccinated for the Hepatitis B virus.ConclusionHand washing facilities, personal protective equipment and preventive vaccinations are not readily available for health workers. Solid waste segregation practices are poor and showed that solid waste management practices (SWMP) are below the acceptable level.

The Relationship of Handwashing Behaviour with Soap and Incidence of Diarrhea Among Students at Elementary School 04 Rantau Utara

&lt;p&gt;&lt;em&gt;Diarrhea can be defined as a condition where a person experiences an increased frequency of defecation, which results in liquid or non-solid faeces. Washing hands with soap is&lt;/em&gt;&lt;em&gt; a fundamental and essential technique for preventing and controlling the spread of infectious diseases&lt;/em&gt;&lt;em&gt;. Hands are one of the main routes for bacteria to enter and infect the body&lt;/em&gt;&lt;em&gt;. &lt;/em&gt;&lt;em&gt;Diarrhea is one of the factors causing death, so there must be prevention of diarrhea incidents. This study aimed to analyze the relationship between hand washing behavior using soap and the incidence of diarrhea.This research includes quantitative research analysis using a cross-sectional design. Research activities were conducted at State Elementary School 04 Rantau Utara from February to March 2024. The population studied in this research were all students from Elementary School 268 Negeri 04 Rantau Utara.&lt;/em&gt; &lt;em&gt;The sampling technique used was random sampling, which resulted in a research sample of 71 people.&lt;/em&gt; &lt;em&gt;The variables examined in this research include hand washing behavior using soap and the incidence of diarrhea.. Data was collected through questionnaires. Data analysis carried out included univariate and bivariate analysis using the Chi-Square test using SPSS version 24 software.&lt;/em&gt; &lt;em&gt;Based on the analysis results, a p-value of 0.000 &lt;/em&gt;&lt;em&gt;&amp;lt;&lt;/em&gt;&lt;em&gt;0.05. This shows that there is a statistically significant relationship between handwashing behaviour using soap and the incidence of diarrhea. This is due to a lack of good and correct hand washing with soap, which causes diarrhoea. Many still need to understand the basic techniques for washing hands with soap properly. Having hand washing facilities and infrastructure will make it easier for children to wash their hands properly so that they can effectively break the chain of bacteria.&lt;/em&gt;&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Keywords: School Children, Diarrhea, Adequate Facilities, Hand Washing Behavior&lt;/em&gt;&lt;/strong&gt;&lt;/p&gt;

Assessment of water, sanitation and hand hygiene practices in rural households of Tamil Nadu: A cross-sectional study.

Water is a basic human right essential to all for sustainable development. Sanitation is one of the determinants of quality of life and the human development index. Drinking unsafe water impairs health through illnesses such as diarrhoea, and untreated excreta contaminates ground waters and surface waters used for drinking, bathing and household purposes. To assess the existing facilities and practices related to drinking water, sanitation, and hygiene among household members in the rural population of Tamil Nadu and to assess whether accessibility and availability of safe drinking water and adequate sanitation under sustainable development goal 6 is being achieved in the rural population of Tamil Nadu. This community-based cross-sectional study was carried out among 200 households in the rural field practice area of the Medical College and Hospital, Thiruvallur district, Tamil Nadu. The participants were interviewed using a predesigned semi-structured questionnaire on their existing water, sanitation, and hand washing facilities and practices. Our study observed that 71.5% of households had piped water supply into their dwellings, 82% were using sanitary latrines and 28% had closed drainage for draining wastewater. Twenty-eight percent were using soap and water for hand-washing before food, and 82.5% were doing hand-washing with soap after using the toilet. In our study, the association between sanitary practices and education, occupation and socioeconomic status was statistically significant. Our study emphasized the need for strengthening health education and behaviour change communication regarding sanitation and hand hygiene practices.

Water, Sanitation and Hygiene practices in areas affected by Cyclone Idai in Zimbabwe

ABSTRACT This study aimed to investigate the association between Cyclone Idai and the Water, Sanitation and Hygiene (WASH) practices in Chimanimani and Chipinge districts in Zimbabwe. The WASH parameters assessed included the main water source, the type of toilet in the household, the number of households sharing a toilet and the presence of a handwashing facility for use after using the toilet. The highest proportion of households that were mostly affected used piped water, while those not affected mainly used community boreholes (42.9%), protected wells (24.2%) and surface water (18.7%). Most households that were relocated to camps (70%) used the pit latrine with slabs, while most of the households that were not affected (41.8%) used the bush as their toilet facility. Only households relocated to camps shared toilets. Only the most affected and resettled population groups (in camps) had better access to improved WASH infrastructure. However, the sharing of toilets was high and the use of handwashing facilities was low in all settlement types. There was a significant association between the severity of Cyclone Idai and the main water source, adequacy of drinking water, sharing of toilets and the ability to purify drinking water.

Rapid Scale-Up of Screening for Early Detection of Sudan Virus Disease (SVD) in Healthcare Facilities (HCFs) during the 2022 Outbreak in Uganda

Background: The Uganda Ministry of Health (MoH) and implementing partners instituted an infection prevention and control (IPC) response strategy during the Uganda SVD outbreak in 2022 that involved rapid enhancement of screening capacity at HCFs. Rapid scale-up of screening for infectious diseases, such as SVD, is critical for early identification and triage of suspected or confirmed cases in HCFs. We describe the rapid deployment of a multimodal IPC strategy implemented in response to the SVD outbreak and the resulting impact on screening measures at HCFs. Methods: We implemented a multimodal IPC strategy in HCFs from five high risk districts to improve screening practices from November 2022–January 2023. The strategy included training health workers (HCWs) identified as IPC mentors; establishing screening areas; and providing screening supplies and communication materials. The three-day training utilized an MoH standardized training package with didactic and practice sessions. The mentors then cascaded screening information and skills to other HCWs through onsite trainings and mentorships and established screening areas. Baseline and endline (3 months after baseline) cross-sectional assessments were conducted using the MoH IPC Assessment Tool adapted from the WHO Ebola IPC Scorecard. The five main screening parameters assessed included presence of ≥ 1 meter distance between screener and the person screened, availability of a functional handwashing facility and infrared thermometer, correct record of each person’s temperature, and appropriate referral process for those suspected of having SVD to holding areas. IPC capacity was measured through the summation of each of these parameter results and calculated as an overall percentage. IBM SPSS Statistics 20 software was used for data analysis and a paired t-test done to determine any significant findings between mean scores (percentage) at baseline and endpoint. Results: A total of 296 IPC mentors were trained, screening information was cascaded to 3,899 HCWs, and screening areas were established in 1,135 HCFs. Based on the screening results from the MoH IPC assessment tool, capacity improved from 44% (SD=37) at baseline to 67% (SD=34) at endpoint. Screening capacity improved from baseline to endpoint among level II and public HCFs from 33% (SD=35) to 60% (SD=35) (p &lt; 0 .05) and from 54% (SD=38) to 76% (SD=31) (p &lt; 0 .05), respectively. Conclusion: Rapid implementation of a multimodal IPC strategy was successful in enhancing screening capacity across Uganda’s HCFs during a SVD response, which is critical for early identification of infected patients to interrupt transmission. This multimodal approach should be recommended for future response actions.

Individual and household risk factors for Ebola disease among household contacts in Mubende and Kassanda districts, Uganda, 2022

BackgroundIn 2022, an Ebola disease outbreak caused by Sudan virus (SUDV) occurred in Uganda, primarily affecting Mubende and Kassanda districts. We determined risk factors for SUDV infection among household members (HHM) of cases.MethodsWe conducted a case-control and retrospective cohort study in January 2023. Cases were RT-PCR-confirmed SUDV infection in residents of Mubende or Kassanda districts during the outbreak. Case-households housed a symptomatic, primary case-patient for ≥ 24 h and had ≥ 1 secondary case-patient with onset < 2 weeks after their last exposure to the primary case-patient. Control households housed a case-patient and other HHM but no secondary cases. A risk factor questionnaire was administered to the primary case-patient or another adult who lived at home while the primary case-patient was ill. We conducted a retrospective cohort study among case-household members and categorized their interactions with primary case-patients during their illnesses as none, minimal, indirect, and direct contact. We conducted logistic regression to explore associations between exposures and case-household status, and Poisson regression to identify risk factors for SUDV infection among HHM.ResultsCase- and control-households had similar median sizes. Among 19 case-households and 51 control households, primary case-patient death (adjusted odds ratio [ORadj] = 7.6, 95% CI 1.4–41) and ≥ 2 household bedrooms (ORadj=0.19, 95% CI 0.056–0.71) were associated with case-household status. In the cohort of 76 case-HHM, 44 (58%) were tested for SUDV < 2 weeks from their last contact with the primary case-patient; 29 (38%) were positive. Being aged ≥ 18 years (adjusted risk ratio [aRRadj] = 1.9, 95%CI: 1.01–3.7) and having direct or indirect contact with the primary case-patient (aRRadj=3.2, 95%CI: 1.1–9.7) compared to minimal or no contact increased risk of Sudan virus disease (SVD). Access to a handwashing facility decreased risk (aRRadj=0.52, 95%CI: 0.31–0.88).ConclusionDirect contact, particularly providing nursing care for and sharing sleeping space with SVD patients, increased infection risk among HHM. Risk assessments during contact tracing may provide evidence to justify closer monitoring of some HHM. Health messaging should highlight the risk of sharing sleeping spaces and providing nursing care for persons with Ebola disease symptoms and emphasize hand hygiene to aid early case identification and reduce transmission.

SOCIOECONOMIC INEQUALITIES, WATER, SANITATION, HYGIENE AND DIARRHEAL DISEASE AMONG CHILDREN UNDER FIVE YEARS IN INDONESIA

Background: Diarrheal diseases are still a serious digestive tract infection in Indonesia. The geographical areas with lower socioeconomic inequalities and water, sanitation and hygiene (WASH) contribute to incline diarrheal disease among children under 5 years old. Purpose: This study aimed to map the distribution of diarrheal diseases among children under 5 years old and identify areas with higher risk in socioeconomic status and WASH. Methods: This study used secondary spatial data repository from Indonesia Demographic Health Survey 2017. This study used ecological approach to provide visual geographic distribution of diarrheal diseases among children under 5 years old, as well as to identify the risk based on the socioeconomic inequalities and WASH. The map production was performed by GIS software. Results: We found that provinces with higher percentage of diarrheal diseases in children also had higher percentage of population with the lowest socioeconomic status. Additionally, the provinces which had higher unimproved drinking water sources, unimproved sanitation facility, and limited handwashing facility, had the higher percentage of diarrheal disease among children under 5 years. Conclusion: The percentage of the lowest socioeconomic status and unimproved WASH might contribute to incline the percentage of diarrheal disease among children under 5 years. The government needs to consider the geographical area to decrease the diarrheal diseases among children under 5 years.

Water, sanitation, and hygiene factors associated with nutrition status among children under five years in Ewaso Narok Wetland, Laikipia County, Kenya

Background: Wetlands are known to harbor disease-causing bacteria, posing health risks that can be mitigated through improved water, sanitation, and hygiene (WASH) practices. This study aimed to understand the factors affecting nutritional status and its connection to WASH-related diseases among children under five in Ewaso Narok Wetland, Laikipia County. Methods: Using a mixed-method approach, qualitative and quantitative data were collected. Simple random method was used to identify the respondents. Results: Findings revealed that 36% of households surveyed had children with nutritional edema, with mean age, weight, and height at 21 months, 11 kilograms, and 73 centimeters respectively. Using WHO standards, a significant proportion of children were found to be undernourished at 45.3% and stunted at 41.3%. Socio-demographic factors like caregiver education level and marital status were identified as influential on the nutrition status. While 51% of households had unimproved water sources, 86% had access to toilet facilities, predominantly traditional pit latrines. 67% of the respondents were located near a wetland with a proximity ranging from 1km to 5km. Disease prevalence among children included diarrhea (46%), typhoid-related fevers (22%), and malaria (12%), with edema significantly associated with WASH diseases. Conclusions: Factors such as feces disposal, wetland proximity, protective gear use, handwashing, and toilet facilities were linked to child nutrition. Recommendations include implementing WASH programs, improving water and sanitation access, promoting hygiene practices, ensuring safe feces disposal, using protective gear in wetlands, and advocating for improved toilet facilities. Further research is warranted to assess intervention effectiveness and explore additional influencing factors.

Training and tool supply to enhance food safety behaviors among ready-to-eat chicken vendors in informal markets in Ouagadougou, Burkina Faso: A randomized-controlled trial

In Burkina Faso, street food vendors are key in ensuring food safety in urban markets, particularly within the poultry value chain. The sale of high-risk ready-to-eat chicken by these vendors poses substantial health hazards, emphasizing the urgency for capacity-building to enhance food safety practices. This study evaluated the effect of a participatory interactive three-day training program coupled with tool supply on self-reported and observed behavior, and knowledge, attitudes, and cognitions of vendors of ready-to-eat chicken meat in Ouagadougou's informal markets. A two-armed RCT was conducted, including pre- and post-training vendor surveys, along with direct outlet observations. Total sample size comprised 162 vendors, with 72 in the treatment group and 90 in the control group. Self-reported behavior - measured on a five-point scale - significantly improved in the treatment group including higher frequency of mask wearing (1.8 ± 0.8 vs 2.5 ± 1.2, p < 0.001) and inspecting nail hygiene (4.3 ± 0.8 vs. 4.7 ± 0.6, p < 0.001). Treatment outlets improved on securing adequate evisceration platforms (1.3 ± 0.6 vs. 1.0 ± 0.5, p = 0.054), regular carcass water renewal (61.8% vs. 36.4%, p = 0.038), and handwashing during carcass management (1.1 ± 0.5 vs. 0.9 ± 0.3, p = 0.008). Better adherence to handwashing (1.1 ± 0.4 vs. 0.9 ± 0.3, p = 0.051), fork use (58.9% vs. 41.8%, p = 0.029), proper handwashing facilities (38.4% vs. 20.9%, p = 0.014), and waste management (64.4% vs. 37.8%, p < 0.001) were observed in treatment outlets. Trained vendors scored significantly higher than controls on knowledge (effect size 0.75, p < 0.001). Vendors rated the perceived usefulness and perceived ease of use, trust in materials/tools - measured on a five-point scale - as high, and perceived mean increased daily profits (21,242 FCFA) and number of customers (8.3) following training. In conclusion, training combined with a tool package proved effective in fostering significant food safety behavior changes, underscoring its substantial impact beyond just knowledge enhancement. For lasting behavior changes, ongoing training and support, an enabling environment, and strong incentives that prioritize vendor food safety behaviors in informal markets are crucial.

Factors affecting hand hygiene practice during the COVID-19 pandemic in the Zimbabwean population: a qualitative study

BackgroundPracticing hand hygiene is recommended as one of the key preventive measures for reducing the transmission of COVID-19 and other infectious agents. However, it is often not practiced frequently enough or correctly by the public. We aimed to identify barriers to and facilitators of hand hygiene in the Zimbabwean population during the COVID-19 pandemic.MethodsA qualitative study was conducted with a purposive sample of health workers, village health workers, church leaders, traditional healers, teachers, youth leaders and the general population selected from ten districts across the country from September to October 2022. Semistructured interviews were conducted with 3 key informant interviews per site. In addition, one homogenous focus group discussion was also conducted per site using a focus group discussion guide. The data were recorded on audiotapes, transcribed verbatim, and translated into English. All the analyses were performed manually using thematic analysis.ResultsTwo themes were identified as facilitators of hand hygiene. These include individual factors (knowledge of hand hygiene practices and how they are performed) and access-related factors (access to hand washing infrastructure, soap, and sanitizers). Among the barriers to hand hygiene, four themes were identified: individual factors (knowledge gaps in proper hand washing, lack of conviction about hand hygiene, and habitual behaviour), access-related factors (lack of access to hand washing infrastructure, soap, and sanitizers), safety concerns (concern about the side effects of sanitizers), and sociocultural and religious factors (social customs, cultural beliefs, values, and religious practices).ConclusionDuring public health emergencies, there is a need for people to access uninterrupted, on-premises water supplies to promote compliance with hand hygiene. The provision of clean water and hand washing facilities is critical for vulnerable communities to afford them the opportunity to improve quality of life and facilitate resilience in the event of future pandemics. Community engagement is important for identifying vulnerability factors to provide appropriate mitigatory measures.

Handwashing Practices among Public Primary School Students in East Dembiya District, Ethiopia.

Poor water sanitation and hygiene is a public health problem in developing and underdeveloped countries, including Ethiopia, and remains an important public health issue among primary school students. Students have been repeatedly exposed to various communicable diseases associated with water sanitation and hygiene. The objective of this study was to assess predictors of handwashing practice among second-cycle public primary school students in East Dembiya District, northwestern Ethiopia, 2022. A cross-sectional study was conducted among 752 second-cycle primary school students. Data were gathered through face-to-face interviews using a structured interviewer-administered questionnaire and observational checklists adopted and modified from different sources of literature. The data were checked further by visualizing and computing rates with the SPSS version 26 statistical software. Multivariable logistic regression was used to identify predictors. The prevalence of washing practices among second-cycle primary school students was 57.6% (95% CI 53.90-61.10). Residency (urban) (adjusted odds ratio [aOR] = 2.17, 95% CI: 1.30-2.87), access to media (aOR = 1.66, 95% CI: 1.11-2.49), hygiene and sanitation club membership (aOR = 1.88, 95% CI: 1.26-2.80), good knowledge about handwashing (aOR = 3.93, 95% CI: 2.34-6.60), and a positive attitude toward handwashing (aOR = 3.63, 95% CI: 2.01-5.584) were predictors of handwashing practice among second-cycle primary school students. This study showed that handwashing practice among primary school students was low. Availing handwashing facilities, better media access, formation of a hygiene and sanitation club in the school, celebration of "Handwashing Day" with students, and leading behavior change communication are all important for improving students' handwashing practice.

The Influence of Environmental Sanitation on Stunting

Introduction: According to Pekanbaru City Health Department in 2019, there were 17.,67% of toddlers in Pekanbaru with poor nutritional status. Poor sanitation can trigger the emergence of infectious diseases that can reduce nutritional absorption in toddlers throughout the digestive process, resulting in stunting. The aim of this study was to analyze environmental sanitation influences on stunting. Methods: This research used case control study design. The case and control groups each received 30 samples. Independent variables include water source for sanitation, condition of latrines, condition of hand washing facilities with soap, condition of waste water drainage channels, management of household waste, type and condition of floors, presence of vectors and disease carrier animals, drinking water quality from biological conditions. The dependent variable was stunting. All data were collected using questionnaires that were asked directly to participants. Data analysis was performed by using the chi-square and multiple logistic regression tests. Results and Discussion: Water sources for sanitation, availability and condition of latrines, drinking water quality from biological terms influences on stunting (p-value &lt;0.,05). Multivariate tests show that, the drinking water quality from biological terms and water sources for sanitation had a probability value of 21% to cause stunting. Conclusion: The dominant factor influences on stunting is the drinking water quality in biological terms and water sources for sanitation.

A qualitative assessment of cleaning and hand hygiene practices at shelters serving people experiencing homelessness during the COVID-19 pandemic, Atlanta, GA – May-June, 2020

BackgroundCleaning practices and hand hygiene are important behaviors to prevent and control the spread of infectious disease, especially in congregate settings. This project explored hygiene- and cleaning-related experiences in shelters serving people experiencing homelessness (PEH) during May–June 2020 of the COVID-19 pandemic.MethodsWe conducted qualitative, in-depth interviews by phone with 22 staff from six shelters in Atlanta, Georgia. The interview guide included questions about cleaning routines, cleaning barriers and facilitators, cleaning promotion, hand hygiene promotion, and hand hygiene barriers and facilitators. We analyzed interview transcripts using thematic analysis.ResultsMultiple individuals, such as shelter individuals (clients), volunteers, and staff, played a role in shelter cleaning. Staff reported engaging in frequent hand hygiene and cleaning practices. Barriers to cleaning included staffing shortages and access to cleaning supplies. Staff reported barriers (e.g., differing perceptions of cleanliness) for clients who were often involved in cleaning activities. Barriers to hand hygiene included limited time to wash hands, forgetting, and inconvenient handwashing facilities. Specific guidance about when and how to clean, and what supplies to use, were requested.ConclusionDuring the early months of the COVID-19 pandemic, shelters serving PEH in the Atlanta-metro area needed resources and support to ensure sufficient staffing and supplies for cleaning activities. As part of future pandemic planning and outbreak prevention efforts, shelters serving PEH could benefit from specific guidance and training materials on cleaning and hand hygiene practices.

Overview of Water Sanitation and Hygiene in School (WinS) Urban Areas, Indonesia

Objective: Indonesia is a developing country that still has water, sanitation and hygiene (WASH) problems. Only 16% of education units have access to all basic services such as water, sanitation and hygiene and as many as 43.5 million Indonesian children do not have access to basic drinking water, basic sanitation and hygiene at school. This can have an impact on increasing disease transmission in children at school. This study aimed to analyse the coverage of school WASH in Bekasi City so as to identify the constraints and problems of WASH in schools. Methodology: This type of research used a cross sectional design approach. The samples of this study were 30 schools in Bekasi City. The indicator data measured consists of 3, namely sanitation, hygiene and air. Results: The results of this study indicate that school WASH in Bekasi is good, this can be seen from the availability of WASH facilities in schools such as the availability of drinking water, easy access, waste management facilities, the availability of hand washing facilities and the existence of toilets that have been widely separated between men and women. Suggestions: The role of stakeholders and school sanitation programme holders is very important in the implementation of school WASH.