Determinants of Hand-washing with Soap: Evidence from Primary Schools in Bangladesh Pubblico
Erhard, Loida Clara (2011)
Published
Abstract
Determinants for Hand-washing with Soap: Evidence from Primary Schools in Bangladesh
Background: More than 8.1 million children died before their
fifth birthday in 2009, mostly
from preventable and treatable causes. These child deaths are
concentrated in low-income
countries, with 34% of all deaths occurring in South Asia. Although
Bangladesh has made
considerable improvements in child health, many of these health
problems persist. Research
studies have shown strong evidence that hand washing with soap may
greatly reduce the
incidence of diarrheal disease and respiratory infection. However,
there is little data on current
hygiene practices in primary schools or the state of sanitation
facilities in Bangladesh.
Objective: The specific objective of the study is to better
understand and measure the current
rate of hand washing with soap after latrine use in primary school
children in Bangladesh.
Additionally, this study aims to determine the physical and
psychological constraints that affect
students' hand washing behaviors.
Methods: Data from fifty participating schools were collected
using quantitative methods.
Water, sanitation and hygiene facilities of each school were
assessed with a physical survey.
Hygiene behavior after latrine use was measured by structured
observations. Finally, four
students and the head master from each school were surveyed to
gather information on barriers
to access of WASH facilities
Results: Overall, the assessment of school facilities found
access to water to be adequate in most
schools with 40 out of 50 schools possessing a water source on
school property. Soap for hand
washing was not found to be as easily available; approximately 50%
of schools had soap for
hand washing. Hand washing with soap was rarely practiced: 21% of
629 students observed
after latrine use washed both hands with soap. Survey results from
students and head masters
illustrated the need for increased funding for soap and maintenance
of sanitation facilities.
Discussion: Inconsistent availability of soap and water are
major barriers for hand washing with
soap with primary school children. Recommendations of increased
funding, engagement of the
community, and continued education in school hygiene programs can
help address those issues.
Further research is needed to fully understand the motivations for
hand washing with soap
among primary school children in Bangladesh.
Table of Contents
Table of Contents Chapter 1: Introduction
1.1 Background...1
1.2 Significance...3
1.3 Study objectives...6
Chapter 2: Literature Review
2.1 School WASH
Programs...7
2.1.1 School WASH Hardware Components...8
2.1.2 School Hygiene Education Components...10
2.2 Behavior Change...15
2.3 Measuring Hygiene Behaviors...17
2.4 Current School WASH Programs...21
Chapter 3: Methods
3.1 Study Site & Population...25
3.2 Sampling Methods...28
3.3 Study Procedures...29
3.4 Instrument Design...30
3.5 Data Collection...31
3.6 Ethics...35
3.7 Data Quality Control...36
3.8 Data Organization...36
3.9 Data Analysis...36
Chapter 4: Results
4.1 Study Population...38
4.2 Spot Check of Water Facilities...44
4.3 Observed Hand-washing Behavior...45
4.4 Spot Check of Latrine Facilities...50
4.5 Barriers to WASH Facilities...52
4.6 Motivation of School Headmaster...55
4.7 Student Reported Hygiene Behaviors...57
4.8 School Hygiene Program Improvement...58
4.9 Program Indicators of Practicing Hand-washing...59
Chapter 5: Discussion
5.1 General Discussion of Findings...62
5.2 Study Limitations...68
5.3 Conclusion & Recommendations...69
References....77
Appendix...83
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