Hygiene Facilities Research Articles

Understanding the challenges and gaps in community engagement interventions for COVID-19 prevention strategies in Rohingya refugees: a qualitative study with frontline workers and community representatives.

Rohingya refugees in Bangladesh are vulnerable to infectious diseases such as COVID-19 due to the crowded living conditions with fragile shelters, and limited water, sanitation and hygiene facilities and practices. While risk communication and community engagement (RCCE) is the cornerstone of outbreak control, there is limited evidence available on the effectiveness of the RCCE strategies in this setting. The goal of this study is to evaluate the effectiveness of RCCE strategies and to explore the challenges and community recommendations in relation to COVID-19 preventive measures in the context of Rohingya refugee camps in Bangladesh. It was a qualitative study. Methods used were (a) observation of RCCE intervention by 3 clinical supervisors accompanying 25 Community Health Workers (CHWs) and (b) 5 focus group discussions engaging 60 community representatives. Data were analyzed using a thematic analysis approach, separately for observation and focus group discussions. The study identified a number of good practices of RCCE, including selecting CHWs from the local community, engaging female CHWs, using local dialect, and collaborating with community/religious leaders. Certain good practices need scaling up, such as utilization of multiple communication methods and interpersonal communication skills. Some areas need improvement, such as CHWs being overburdened with multiple tasks, less effort to active listening, repeated delivery of same messages, inadequate linkage to culture, context, and resources, and less effort to empower the community. Engaging the community, five critical themes were identified in relation to poor COVID-19 preventive practices: culture, religion, and language; local context and resources; community trust and interaction with aid workers; communication methods; and gender and social inclusion. Religious misinterpretation, cultural barriers, physical barriers, lack of resources, breach of trust between the community and aid workers, inconsistent/complex messages, lack of gender and social inclusion, and stigmatization are among some key factors. Some key actions were recommended to improve COVID-19 RCCE strategy. We urge the RCCE partners to make use of the findings and recommendations to develop a robust RCCE strategy relevant to local culture and context, responsive to people's concerns and needs, and inclusive of gender, age and social vulnerabilities.

Biologic quality of households' drinking-water in an urban local government area of Oyo State, Southwest, Nigeria

Background: Inadequate access to Water, Sanitation, and Hygiene (WASH) facilities is a global public health issue with several associated illnesses, particularly in developing countries like Nigeria. It is imperative to understand the availabilities of these facilities, to provide baseline data for policy design and implementation. This study assessed access to WASH facilities. It also examined the factors associated with drinking-water contamination by coliform organisms in households within Ogbomoso North Local Government Area, Oyo-State, Nigeria.
 Methods: Cross-sectional design was employed and a two-stage cluster-sampling method was used to recruit eligible respondents from 100 households. Interviewer-administer, semi-structured questionnaire was used to collect data. Chi-square test and binary logistic regression were used for inferential statistics.
 Results: Mean age of respondents was 40.5±16.7years, 81.0% of the households practiced open defecation, and 78.9% of those with toilet facilities used pit latrines. The most common water source was borehole (71.6%); available within 5 minutes walking distance to residence of 68.0% of study participants. Sixty-three percent of the households had high drinking water coliform counts. High drinking-water coliform counts were influenced by the presence or absence of toilets facilities (OR=4.61, CI=1.22-1.68), types of toilets (OR=2.63, CI=3.22-5.34), and water sources (OR=0.12, CI=0.47-0.68).
 Conclusion: Access to good quality water and basic sanitation facilities is sub-optimal in the study setting despite being an urban community. Authors advocate for more vibrant and intentional government efforts at ensuring equitable access to WASH facilities in the Nigerian communities. This is to fast-track the nation's journey towards the actualization of the sustainable development goal (SDG)-6.

Effects of the level of household access to water, sanitation and hygiene on the nutritional status of children under five, Benin

BackgroundWhether or not the Water, Sanitation and Hygiene (WASH) conditions in which children under five live determine their nutritional status is still under discussion. The work aimed to study the effects of household WASH conditions to which children under five are exposed on their nutritional status in Benin.MethodsThe study utilized a cross-sectional design and consisted of secondary analyses using datasets from the fifth Demographic and Health Survey (DHS-V) conducted in Benin. Stunting, wasting and underweight were the dependent variables. The WASH conditions in which children live were evaluated in the immediate environment, i.e., at the level of their households. After describing the study variables, the relationships between the dependent variables and the exposures were checked using multivariate logistic regression. Data analysis was performed with Stata 15 and took into account the survey’s sampling design.ResultsThe prevalence of stunting, wasting and underweight was 31.15% (95% CI = 29.90-32.42), 4.79% (95% CI = 4.33–5.31) and 15.82% (95% CI = 14.92–16.76), respectively. The stunting odds were 1.35 (95% CI = 1.15–1.59) and 1.27 (95% CI = 1.01–1.59) times higher for children from households with no water and sanitation services, respectively, compared to children living in households with basic water and sanitation services. Children under five from households with no hygiene facilities and using limited hygiene services had 1.31 (95% CI = 1.05–1.63) and 1.35 (95% CI = 1.10–1.67) times the odds of being stunted, respectively, compared to children covered by basic hygiene facilities. There is no evidence of a significant relationship between household access to WASH and wasting in children under five. The odds of being underweight were 1.33 (95% CI = 1.02–1.72) times higher among children under five from households with limited hygiene facilities than among children from households with basic hygiene facilities.ConclusionInterventions to fight malnutrition in children under five should include a WASH dimension.

STATUS OF URBAN HEALTH INFRASTRUCTURE TO COMBAT COVID-19 IN BIRBHUM DISTRICT, WEST BENGAL

The outbreak of Covid-19 was declared a Public Health Emergency of International Concern on 31st January, 2020. Every country can take at national, sub regional and local levels to reorganize essential health services in the pandemic context and maintain a safe access to every citizen. To deal with this catastrophic Corona Virus India is making preparedness with its high urban population density, deficiency in hygiene and sanitation facilities and most crucially insufficient treatment capacity. The first 2000 cases were reported in 56 days. The next 2000 in 15 days and the next 2000 cases in a week. According to the data released by the state health department, West Bengal took just 5 days from June 3 rd to June 7th to register the next 2000 cases. Till Tuesday (9th June) total cases in the state stood at 8985. With increased number of testing and the entry of migrant labourers, there was a sudden spike in the number of cases. The returning migrant workers from the highly infected zones after an unplanned lockdown delivers a major catastrophe at our doorstep. The objective of the study is to focus on the arrangement of health services for this disaster in Birbhum District, West Bengal. According to the direction of the Bengal health department, separate hospitals for Covid-19 patients are to be set up in each district in order to arrange a local set-up before the contamination expands into the community transmission stage.

Nutritional status of tribal and non-tribal adults in rural Bangladesh: A comparative study.

Nutritional status is an important indicator of health status among adults. However, to date, there exists scanty information on the nutritional status of tribal populations of Bangladesh. The aim of the study was to investigate the nutritional status of tribal (T) and non-tribal (NT) adult people living in the rural area of Rajshahi district, Bangladesh. A total of 420 (72 T and 348 NT) households were studied. The samples were selected using multistage stratified sampling with proportional allocation. The nutritional status of adults was measured using body mass index (BMI). Descriptive statistics, t-test, ANOVA and Z-proportional test were utilized for data analysis. The study revealed that 8.3% and 9.2% of T and NT men were suffering from under nutrition respectively, while the corresponding figures in women were 12.5% and 10.1% respectively. Overall, 11.1% and 27.0% men, and 13.9% and 29.3% women T and NT were over-nourished respectively. The rate of over nutrition among T was significantly (p<0.05) higher than NT for both sexes. The mean weight and BMI of the NT men were significantly (p<0.01) higher than T men. The mean weight, height and BMI of NT women were higher (p<0.05) than T women. ANOVA demonstrated that the variation in BMI among education levels of NT men and the variation among occupation for both ethnicities were significant (p<0.01). The variation in BMI among education levels and occupation of T and NT women were significant (p<0.05), moreover ordinal logistic regression model demonstrated that hygienic toilet facilities and father's occupation were predictors of nutritional status. The interaction effects of education and occupation, and education and household monthly income on BMI were significant (p<0.01) for T men and both T and NT women (p<0.05). The prevalence of over-nutrition among NT is higher than T for both sexes. Some socio-economic and demographic factors were found as predictors of malnutrition. At least 12 of the 17 Sustainable Development Goals (SDGs) contain indicators that are highly related to nutrition, our findings can help Bangladesh Government for achieving SDGs by 2030. Appropriate nutritional intervention and awareness programmes can be initiated by the Government to ameliorate the burden of malnutrition among adults in the country.

The devastating effect of cyclone Freddy amidst the deadliest cholera outbreak in Malawi: a double burden for an already weak healthcare system-short communication.

Cholera outbreaks cause significant disease burden, especially in developing countries. While the disease is largely eliminated in developed countries, it still remains a huge burden to Sub-Saharan Africa. Lack of access to clean water, hygiene and sanitation facilities remains a huge risk factor for disease transmission and persistence. These outbreaks in Africa are usually associated with high case fatality rates. While many risk factors exist for the spread of the disease, climate change poses a huge challenge to the fight and spread of the disease. Most countries in southern Africa including Malawi and Mozambique have been experiencing the direct and indirect impact of climate change. Climate change can affect the epidemiological dynamics of multiple infectious agents, including vector-borne, water-borne, and food-borne pathogens. The aftermaths effects of flooding and droughts can largely be felt in seasonality changes in the spread of Cholera. Having an in-depth understanding of multiple factors that influence the patterns of spread of climate change related diseases combined with robust surveillance systems could help detect environmental changes in high-risk areas and result in early public health interventions that can alleviate potential outbreaks.

Exploring associations between household environmental factors and handwashing with essential agents in sub-Saharan Africa.

3 billion people lack proper home hand hygiene facilities globally. Of these, 1.4 billion (18%) lack soap or water, while 1.6 billion (22%) have neither. This analysis explores the link between living conditions and the use of essential agents in sub-Saharan Africa. This secondary data analysis examines potential associations between the domiciliary environment and the use of essential agents in sub-Saharan Africa. Eighteen demographic and health surveys were used to analyze the association between household environmental factors and handwashing with essential agents. STATA version 16 was used to analyze data from 203,311 households across weighted samples. Using a multivariable multilevel mixed effect logistic regression analysis, it was possible to determine how each independent factor affected the outcome while taking the data clustering into account. The adjusted odds ratio and its associated 95% confidence interval were used to assess the independent factors' statistical significance. Only one in three households 34.84%, practiced handwashing with essential agents, with the highest prevalence in Angola (70.2%) and the lowest in Malawi (6.5%). Educational status [aOR = 1.77; 95%(CI = 1.68-1.86)], female headship[aOR = 1.09; 95%(CI = 1.06-1.2)], household wealth[aOR = 4.08; 95%(CI = 3.84-4.33)], not sharing toilets with other homes[aOR = 1.13; 95%(CI = 1.10-1.17)], having a fixed place for hand washing[aOR = 1.49; 95%(CI = 1.45-1.54)], not having regular access to water [aOR = 0.09; 95%(CI = 0.095-0.10)]and being a rural resident [aOR = 0.85; 95%(CI = 0.82-0.88)] were associated with handwashing. sub-Saharan nations are failing to demonstrate advancements in handwashing practices. There are still a lot of homes without access to basic infrastructure for handwashing and household water sources. For essential agent adoption programs to be successful in an environment with limited resources, Water, Sanitation, and Hygiene measures must be implemented. Furthermore, it is critical to include contextual factors from the current study as well as socio-cultural and psychological characteristics that dissuade people from using essential agents in intervention strategies.

Effects of Welfare Facilities (Amenities for Well-Being) on the Satisfaction of Civil Engineers in Construction Industry

ABSTRACT The construction industry plays an important role in the upliftment of a country’s economy. Thus, the satisfaction of workers in the construction industry is of prime importance, since it is believed that satisfied working staff will be more efficient and effective. Therefore, it becomes crucial to understand the factors that may influence the satisfaction of the workforce. Among these factors, recently, welfare facilities have received much attention. In this study, welfare facilities such as health, hygiene, eating, drinking, resting, safety, and transportation play a vital role in the satisfaction of workers in the construction industry. Furthermore, a questionnaire survey was used to collect data from 203 civil engineers in Balochistan, Pakistan. The data was analyzed using Partial Least Squares-Structural Equation Modelling (PLS-SEM). Consequently, the empirical findings indicated that providing welfare facilities have a significant positive impact on the satisfaction of workers. Additionally, the results indicate that among the facilities, transportation and hygiene facilities are the major requirements of civil engineers. Hence, it can be concluded from the findings that organizations that are involved in construction projects, wish to increase the satisfaction of workers and success rate, they should focus on providing welfare facilities to their employees.

Impact of Water, Sanitation and Hygiene Poverty on Child Health in Pakistan: Evidence from Micro Data

Attainment of SDGs by Pakistan and emphasis on hygiene and sanitation during and after COVID-19 pandemic signifies importance of current study which analyzes the effect of conditions of water, sanitation and hygiene facilities at household level on child health. This study uses household data from PSLM Survey 2018-2019. Results of zero-inflated poisson regression reveal that a one-unit increase in household water poverty significantly increases expected log outcome of the number of children with diarrhoea. One-unit increase in sanitation poverty increases expected log of number of children with diarrhoea significantly by 1.462. A one-unit increase in household multidimensional hygiene poverty of the household insignificantly increases the expected log of number of children under age five with diarrhea. Rural households have more children affected from diarrhea when household is multidimensional water, sanitation and hygiene poor compared to urban households. There is a significantly high impact on child health in Balochistan and Sindh if water, sanitation, and hygiene poverty increases by one unit with households in KP as reference group. Household characteristics like type of wall, floor, and roof significantly determine the expected change in the log number of children suffering from diarrhea in a water-poor, sanitation poor and hygiene poor household in Pakistan. The study recommends targeted and stern policy formulation along with the effective implementation of existing policies to attain the associated sustainable development goals.

Determinants of Menstrual Hygiene Among Adolescent School Girls in Indonesia.

The aim of this study was to determine the prevalence of menstrual hygiene management (MHM) and its associated factors among adolescent girls in Tangerang District, Indonesia. This study was a cross-sectional study of 409 female students aged 12-15 years old from 3 junior high schools selected using multistage sampling. The data were collected through a self-reported questionnaire both online and offline that was administered from April to May 2022. Bivariate and multivariable analysis using binary logistic regression were performed to determine the factors and predictors between sociodemographic characteristics, menstruation variables, knowledge, attitude, enabling environment, and the practice on MHM. Our study revealed a prevalence of good MHM practices among 52.3% of students, as well as moderate knowledge (48.9%) and neutral attitudes (70.4%). With regard to water, sanitation, and hygiene (WASH) facilities at school, most girls reported access to hand washing soap, a hook, a mirror, and a covered bin, but at home, the least available facilities were a mirror and a covered bin. Significant predictors of healthy MHM practices were having reached grade 8 (AOR = 1.80, 95% CI = 1.10-2.95), having ever received information about menstruation at school (AOR = 1.95, 95% CI = 1.19-3.18), having a positive attitude (AOR = 4.21, 95% CI = 1.78-9.96), having access to a private home toilet (AOR = 2.71, 95% CI = 1.36-5.42), and having a home toilet with a covered bin (AOR = 2.15, 95% CI = 1.38-3.37). The girls in this study showed a high prevalence of good MHM practices, but access to WASH facilities at school and at home was still a challenge. Positive attitude was the most significant factor associated with good MHM among female students. Therefore, we suggest establishing menstruation-focused education related to attitudes, particularly sociocultural norms, myths, and misconceptions and WASH facilities provided at home.

Evaluating Implementation Status of the National Guidelines for Covid-19 Hygiene and Sanitation in Primary Schools of Marsabit County, Kenya

Globally, erupting in late 2019 in China, COVID-19 pandemic became a monumental public health policy problem and threat to humanity of our time. As of June 13, 2021, the pandemic affected close to 176 million people and caused over 3.8 million deaths and disrupted global economies leading to loss of jobs and livelihoods. From a public health perspective, African countries like Kenya, need greater investments in water, sanitation and hygiene (WASH) interventions as the first line of defence to effectively mitigate against the pandemic. The objective of this study was to identify and assess the level and status of hygiene and sanitation implementation of COVID-19 national guidelines in four schools in three sub counties of Marsabit County in northern Kenya. COVID-19The study adopted a cross sectional design and mixed method in data collection. In addition, review of secondary literature both quantitative and qualitative data were collected during October to December 2022. Data was collected through administering questionnaires targeting 284 respondents, key informant interviews and focused group discussions with selected opinion leaders. Quantitative data was analysed using SPSS ver25 and univariate and bivariate statistical techniques were applied. Descriptive analysis using thematic technique was used to analyse qualitative data. The study findings observed that the current school based intervention for COVID-19 prevention included wearing of face masks (86%), practicing social distance (65%), hand washing with water (52%), and using alcohol based hand sanitizers (64%). It also revealed key factors influencing covid19 interventions: barriers to uptake included: lack of enforcement (84.2%), shortage of WASH facilities (78.9%), lack of funds (76.8%), lack of trained staff (70.4%), inadequate facilities (88.7%), lack of awareness (50.0%), poor attitude and ignorance (76.4%), accessibility (37.3%), cultural and religious factors (70.1%).This study concludes that while knowledge of transmission and prevention were found to be high; access to many of the essential support systems and WASH facilities remain a major challenge in the schools in Marsabit. These challenges were also identified from the findings of qualitative study. The study advances key recommendations notably: promotion of school-based training and sensitization of teachers and workers; increased financial support for provision of hygiene and sanitation facilities and preventive support supplies; expansion of community sensitization using radio, television, mass media and school drama clubs; and finally, enhanced financial and budgetary support from national and county governments, donors, and non-governmental organizations to implement robust WASH interventions especially in schools in the Arid and Semi-Arid regions of Kenya.

'Development and psychometric evaluation of the safety feeling scale in adult patients at hospital: Exploratory sequential mixed method'.

This study aimed to develop and examine psychometric properties of the safety feeling scale (SFS) in adult patients to assess their sense of safety during a hospital stay. Mixed methods design. A SQUIRE checklist was used. This is a study with two phases of scale development and evaluation of the psychometric properties of the scale. In the first phase, the concept of 'safety feeling' was analysed using a hybrid model. Thus, a systematic review and then a qualitative study with hospitalized patients (n = 31) were conducted by conventional content analysis. In the psychometric phase, factorial validity, reliability, feasibility, and responsiveness of the scale were evaluated by different tests in various samples. After integrating the results of the systematic review and qualitative study, a scale item pool with 84 items was developed. In the psychometric phase, 12 items with four factors were specified; 'effective care,' 'confidence in the healthcare team,' 'emotional enrichment' and 'hygienic facilities,' explaining 51% of the total variance of the scale. They were confirmed by confirmatory factor analysis. Internal consistency and stability of the scale were satisfactory. Feasibility and responsiveness were also acceptable.

Advances in paper based isothermal nucleic acid amplification tests for water-related infectious diseases

Water-associated or water-related infectious disease outbreaks are caused by pathogens such as bacteria, viruses, and protozoa, which can be transmitted through contaminated water sources, poor sanitation practices, or insect vectors. Low- and middle-income countries bear the major burden of these infections due to inadequate hygiene and subpar laboratory facilities, making it challenging to monitor and detect infections in a timely manner. However, even developed countries are not immune to these diseases, as inadequate wastewater management and contaminated drinking water supplies can also contribute to disease outbreaks. Nucleic acid amplification tests have proven to be effective for early disease intervention and surveillance of both new and existing diseases. In recent years, paper-based diagnostic devices have made significant progress and become an essential tool in detecting and managing water-associated infectious diseases. In this review, we have highlighted the importance of paper and its variants as a diagnostic tool and discussed the properties, designs, modifications, and various paper-based device formats developed and used for detecting water-associated pathogens.

PEMBERIAN EDUKASI KESEHATAN TENTANG PENCEGAHAN DIARE PADA BALITA

Diarrhea is still the second leading cause of death in children under five years old. Less than 80% of diarrhea-related deaths occur in the first 2 years of life. In Indonesia, the morbidity and mortality rates are still high. Recurrent diarrhea in children can cause nutritional deficiencies, dehydration and cause death. The high incidence of diarrhea in children is caused by many factors, including poor sanitation, poor hygiene facilities, poor personal hygiene, such as not washing hands before, after eating and after defecating. Diarrhea in toddlers occurs because of the problem of lack of family knowledge and lack of health or cultural information. Hand washing and proper feeding is one of the efforts to prevent and risk the transmission of diarrheal diseases. The community service program carried out aims to increase public knowledge and understanding about diarrhea and its prevention efforts through hand washing. Knowledge about the prevention and management of diarrhea is important for parents to control the incidence of diarrhea in children. The method of implementation is through outreach activities to the community, especially mothers of children under five about diarrheal disease and some of its prevention efforts. Health promotion is one way to increase knowledge to prevent diarrhea and to help prevent diarrhea from causing complications or death. This activity involves mothers who have toddlers in the Dasan Kolo neighborhood. With 30 participants. The results of the activity showed that there was an increase in participants' knowledge about how to prevent diarrhea in toddlers.

Assessment of WASH infrastructure in schools in Central Sulawesi, Indonesia using structured observations and principal interviews

Abstract Adequate water, sanitation, and hygiene (WASH) facilities in schools are vital, especially for girls. This study addresses a gap in assessing the adequacy of WASH facilities' repair at schools affected by natural hazards. Central Sulawesi was used as a case study where principal interviews were conducted at 26 schools, and structured observations were made at 18 schools, 3 years after the earthquake in September 2018. Ten of 26 principals reported no damage to the toilets from the events of September 2018. Among those who did, a third felt that the fixes insufficiently met basic needs and that they did not deliver WASH services as well as they used to. Not all WASH inadequacy stemmed from the earthquake. Structured observations revealed that most toilets lacked soap, open water reserves were placed next to non-flush latrines, posing a high potential for vector-breeding, and there were inadequate facilities for menstrual hygiene management, including no bins. Recommendations include ensuring a supply of soap, adding lids to water storage containers, and providing sanitary napkins and lidded bins. Observations suggested that private schools provided a better level of WASH service than state schools, and schools in more hazardous zones did not take longer to recover.

Rewards, risks and responsible deployment of artificial intelligence in water systems

Artificial intelligence (AI) is increasingly proposed to address deficiencies across water systems, which currently leave about 25% of the global population without clean water, about 50% without sanitation services and about 30% without hygiene facilities. AI is poised to enhance supply insights, catchment management and emergency response, improve treatment plant and distribution network design, operation and maintenance, and advance service availability, demand management and water justice. However, proliferation of this nascent technology could trigger serious and unexpected problems, including system-wide compromise owing to design errors, malfunction and cyberattacks as well as exposures to cascading socio-ecological, water–energy–food nexus and coupled critical infrastructure failures. In response, we make three recommendations for safe and responsible deployment of AI across potable water supply and sewage disposal systems: address gaps in foundational infrastructure and digital literacy; establish institutional, software and hardware mechanisms for trustworthy AI; and prioritize applications based on our proposed systematic benefit and risk assessment framework. In this Perspective, the authors survey potential water-system-wide benefits of AI applications from catchments to end-users and then highlight potential systemic barriers, direct risks and exposures to cascading failures, which may prove catastrophic for communities. In response, they make three recommendations for safe and responsible deployment of AI across potable water supply and sewage disposal systems.

Radiographers’ knowledge, attitude and adherence to standard COVID-19 precautions and the policy implications: a national cross-sectional study in Nigeria

Background We investigated the knowledge of COVID-19 pathogenesis and prevention, attitude, and adherence to safe clinical practices among radiographers during the pandemic and made some informed policy recommendations. Materials and methods The study was an online cross-sectional survey. The questionnaire captured data on respondents’ demographics, knowledge of COVID-19, attitudes, practices, and standard precaution adherence during the pandemic. Data were analysed using descriptive statistics, Pearson’s correlation and one-way ANOVA tests. Results Of the 255 respondents, 17.3% were actively involved in the management of COVID-19 cases. Participants had high scores regarding their knowledge of COVID-19 pathology (82.46 ± 8.67%), prevention (93.43 ± 7.11%) and attitude (74.11 ± 11.61%), but low compliance to safety precautions (56.08 ± 18.56%). Knowledge about COVID-19 prevention strategies differed significantly across educational qualifications, F(3, 251) = 4.62, p = .004. Similarly, levels of compliance with safety precautions differed across educational qualification (F[3, 251] = 4.53, p = .004) and years-in-practice (F[4, 250] = 4.17, p = .003). Conclusion Participants’ adherence to standard COVID-19 precautions was low. The level of professional qualification influenced participants’ knowledge and safe practices during the pandemic. Upgrading the aseptic techniques and amenities in practice settings and broadening the infectious diseases modules in the entry-level and continuous professional education may improve radiographers’ response to COVID-19 and future pandemics. Key messages Radiographers whose qualifications were lower than a bachelor’s degree had significantly less knowledge of COVID-19 prevention. Generally, radiographers had a positive attitude towards safe practices during the pandemic, but inadequate education, standard operational guidelines and resources affected their level of adherence. Apart from the shortage of personal protective equipment, poor infrastructural design and inadequate hygienic facilities such as handwashing stations, running water and non-contact hand sanitizer dispensers hampered adherence to COVID-19 precautions in low-resource settings.

Community Support for Religious Tourism

In recent years, tourism has increased significantly, especially in developing countries, due to the development of infrastructures like good roads, well-connected airports, and hygienic accommodation facilities. However, the host community's attitude is critical for a tourism destination's strategic growth, development, and sustainability. As such, this study analyses attitudes and perceptions of the local community in Thrissur, a famous cultural destination in Kerala, India. Structural Equation Modelling (SEM) was adopted to develop a model for perceived tourism support with community attachment and overall quality of life. This model uses seven constructs: temple place image, economic benefits, social benefits, physical benefits, community attachment, overall quality of life, and perceived tourism support with forty-four attributes. The result indicates that Temple place image, socioeconomic and physical benefits, community attachment, and overall quality of life are predominant determiners for perceived tourism support of the local community.

Analisis Fasilitas Cuci Tangan Pasar Tradisional di Kecamatan Klungkung pada Masa Pandemi COVID-19

Background: Hand washing facilities are one of the facilities that must be provided in public facilities such as markets to prevent the spread of the COVID-19 virus. The use of public hand hygiene facilities is required before passing through entrances and locations that are easily accessible in crowded areas so that people and traders can easily wash their hands during the COVID-19 pandemic. Purpose:To find out the description of traditional market hand washing facilities in Klungkung District during the COVID-19 pandemic. Method: The research design used in this study is a descriptive study with a cross-sectional approach which was carried out on April 30 - May 1, 2021. The population in this study were all hand washing facilities at traditional markets in Klungkung District. The sampling technique used is non-probability sampling. Data collection tools used in the form of observation sheets. Data analysis using univariate analysis. Results:The results showed that most of the traditional market hand washing facilities were in sufficient condition as many as 4 markets (57.1%) and were in good condition as many as 3 schools (42.9%). Conclusion: It is recommended to all market managers to continue to pay attention to the availability of components of hand washing facilities complete with clean conditions to prevent the chain of disease transmission during the COVID-19 pandemic.

HAND HYGIENE AUDIT TO STUDY ADHERENCE TO HAND HYGIENE IN A TERTIARY CARE HOSPITAL

Introduction:Hands are the main pathways of germ transmission during health care. Regular monitoring of adherence to Hand hygiene is very important to prevent hospital acquired infections. Direct observation method for WHOs 5 moments of hand hygiene is still the gold standard to provide qualitative &amp; quantitative information about when and why failures in hand hygiene occur. Material &amp; Methods:A Prospective observational study was conducted from September 2022 to January 2023. Adherence to Hand hygiene was observed in 33 areas of a tertiary hospital. A total of 500 Health care workers are included in the study. Each area was observed for 5 days in a month for 1 hour. Hand hygiene complete adherence rate &amp; partial adherence rate was calculated &amp; analysed .Compliance to WHO moments of hand hygiene was also observed. Results: Hand hygiene complete adherence rate(HHCAR) was 52%, Hand hygiene partial adherence rate( HHPAR )was 30.5% &amp; non adherence rate was 17.5%. Adherence to WHO moments 1 &amp; 5 was 30.2 &amp; 33.6%. Adherence to moments 2,3,4 was 40.7%, 45.6% &amp; 42.9% respectively. Conclusion:Despite adequate hand hygiene facilities, Hand Hygiene compliance remains low in student nurses and interns.Regular training programmes on Hand hygiene in hospitals should focus on WHO moments 1 &amp; 5 in particular.