IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v124y2015icp103-114.html
   My bibliography  Save this article

Changing handwashing behaviour in southern Ethiopia: A longitudinal study on infrastructural and commitment interventions

Author

Listed:
  • Contzen, Nadja
  • Meili, Iara Helena
  • Mosler, Hans-Joachim

Abstract

Improved hand hygiene efficiently prevents the major killers of children under the age of five years in Ethiopia and globally, namely diarrhoeal and respiratory diseases. Effective handwashing interventions are thus in great demand. Evidence- and theory-based interventions, especially when matched to the target population's needs, are expected to perform better than common practice. To test this hypothesis, we selected two interventions drawing on a baseline questionnaire-study that applied the RANAS (Risk, Attitudes, Norms, Abilities, Self-regulation) approach and focused on the primary caregivers of households in four rural, water-scarce kebeles (smallest administrative units of Ethiopia) in southern Ethiopia (N = 462). The two interventions were tested in combination with a standard education intervention in a quasi-experiment, as follows: kebele 1, education intervention, namely an f-diagram exercise, (n = 23); kebele 2, education intervention and public-commitment (n = 122); kebele 3, education intervention and tippy-tap-promotion (i.e. handwashing-station-promotion; n = 150); kebele 4, education intervention, public-commitment and tippy-tap-promotion (n = 113). In kebeles 3 and 4, nearly 100% of the households followed the promotion and invested material and time to construct for themselves a tippy-tap. Three months after intervention termination, the tippy-taps were in use with water and soap being present in up to 83% of the households (kebele 4). Pre-post data analysis on self-reported handwashing revealed that the population-tailored interventions, and especially the tippy-tap-promotion, performed better than the standard education intervention. Tendencies in observed behaviour and a recently developed implicit self-measure pointed to similar results. Changing people's hand hygiene is known to be a challenging task, especially in a water-scarce environment. The present project suggests not only to apply theory and evidence to improve handwashing interventions' effectiveness, but also emphasizes the relevance of tailoring interventions to the target population.

Suggested Citation

  • Contzen, Nadja & Meili, Iara Helena & Mosler, Hans-Joachim, 2015. "Changing handwashing behaviour in southern Ethiopia: A longitudinal study on infrastructural and commitment interventions," Social Science & Medicine, Elsevier, vol. 124(C), pages 103-114.
    • Handle: RePEc:eee:socmed:v:124:y:2015:i:c:p:103-114
    DOI: 10.1016/j.socscimed.2014.11.006
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953614007291
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2014.11.006?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Aboud, Frances E. & Singla, Daisy R., 2012. "Challenges to changing health behaviours in developing countries: A critical overview," Social Science & Medicine, Elsevier, vol. 75(4), pages 589-594.
    2. Martin Ravallion & Shaohua Chen & Prem Sangraula, 2009. "Dollar a Day Revisited," The World Bank Economic Review, World Bank, vol. 23(2), pages 163-184, June.
    3. Aunger, Robert & Schmidt, Wolf-Peter & Ranpura, Ashish & Coombes, Yolande & Maina, Peninnah Mukiri & Matiko, Carol Nkatha & Curtis, Valerie, 2010. "Three kinds of psychological determinants for hand-washing behaviour in Kenya," Social Science & Medicine, Elsevier, vol. 70(3), pages 383-391, February.
    4. Des Jarlais, D.C. & Lyles, C. & Crepaz, N., 2004. "Improving the Reporting Quality of Nonrandomized Evaluations of Behavioral and Public Health Interventions: The TREND Statement," American Journal of Public Health, American Public Health Association, vol. 94(3), pages 361-366.
    5. Aiello, A.E. & Coulborn, R.M. & Perez, V. & Larson, E.L., 2008. "Effect of hand hygiene on infectious disease risk in the community setting: A meta-analysis," American Journal of Public Health, American Public Health Association, vol. 98(8), pages 1372-1381.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Jurgita Slekiene & Kondwani Chidziwisano & Tracy Morse, 2022. "Does Poor Mental Health Impair the Effectiveness of Complementary Food Hygiene Behavior Change Intervention in Rural Malawi?," IJERPH, MDPI, vol. 19(17), pages 1-12, August.
    2. Anna E. Gamma & Jurgita Slekiene & Hans-Joachim Mosler, 2019. "The Impact of Various Promotional Activities on Ebola Prevention Behaviors and Psychosocial Factors Predicting Ebola Prevention Behaviors in the Gambia Evaluation of Ebola Prevention Promotions," IJERPH, MDPI, vol. 16(11), pages 1-18, June.
    3. Friedrich, Max N.D. & Kappler, Andreas & Mosler, Hans-Joachim, 2018. "Enhancing handwashing frequency and technique of primary caregivers in Harare, Zimbabwe: A cluster-randomized controlled trial using behavioral and microbial outcomes," Social Science & Medicine, Elsevier, vol. 196(C), pages 66-76.
    4. Inauen, Jennifer & Lilje, Jonathan & Mosler, Hans-Joachim, 2020. "Refining hand washing interventions by identifying active ingredients: A cluster-randomized controlled trial in rural Zimbabwe," Social Science & Medicine, Elsevier, vol. 245(C).
    5. YuJung Julia Lee & Tiffany Radcliff, 2021. "Community interactions and sanitation use by the urban poor: Survey evidence from India’s slums," Urban Studies, Urban Studies Journal Limited, vol. 58(4), pages 715-732, March.
    6. Aaron Lawson & Marie Vaganay-Miller, 2019. "The Effectiveness of a Poster Intervention on Hand Hygiene Practice and Compliance When Using Public Restrooms in a University Setting," IJERPH, MDPI, vol. 16(24), pages 1-12, December.
    7. Kondwani Chidziwisano & Elizabeth Tilley & Tracy Morse, 2020. "Self-Reported Versus Observed Measures: Validation of Child Caregiver Food Hygiene Practices in Rural Malawi," IJERPH, MDPI, vol. 17(12), pages 1-14, June.
    8. Monica Nzanga & Mindy Panulo & Tracy Morse & Kondwani Chidziwisano, 2022. "Adherence to Hand Hygiene among Nurses and Clinicians at Chiradzulu District Hospital, Southern Malawi," IJERPH, MDPI, vol. 19(17), pages 1-11, September.
    9. Jonathan Lilje & Hans-Joachim Mosler, 2016. "Continuation of Health Behaviors: Psychosocial Factors Sustaining Drinking Water Chlorination in a Longitudinal Study from Chad," Sustainability, MDPI, vol. 8(11), pages 1-20, November.
    10. Harter, Miriam & Inauen, Jennifer & Mosler, Hans-Joachim, 2020. "How does Community-Led Total Sanitation (CLTS) promote latrine construction, and can it be improved? A cluster-randomized controlled trial in Ghana," Social Science & Medicine, Elsevier, vol. 245(C).
    11. Watson, Julie & Cumming, Oliver & MacDougall, Amy & Czerniewska, Alexandra & Dreibelbis, Robert, 2021. "Effectiveness of behaviour change techniques used in hand hygiene interventions targeting older children – A systematic review," Social Science & Medicine, Elsevier, vol. 281(C).
    12. Robert Dreibelbis & Anne Kroeger & Kamal Hossain & Mohini Venkatesh & Pavani K. Ram, 2016. "Behavior Change without Behavior Change Communication: Nudging Handwashing among Primary School Students in Bangladesh," IJERPH, MDPI, vol. 13(1), pages 1-7, January.
    13. Tracy Morse & Kondwani Chidziwisano & Elizabeth Tilley & Rossanie Malolo & Save Kumwenda & Janelisa Musaya & Sandy Cairncross, 2019. "Developing a Contextually Appropriate Integrated Hygiene Intervention to Achieve Sustained Reductions in Diarrheal Diseases," Sustainability, MDPI, vol. 11(17), pages 1-17, August.
    14. Kim Dockx & Hans Van Remoortel & Emmy De Buck & Charlotte Schelstraete & An Vanderheyden & Tiene Lievens & John Thomas Kinyagu & Simon Mamuya & Philippe Vandekerckhove, 2019. "Effect of Contextualized Versus Non-Contextualized Interventions for Improving Hand Washing, Sanitation, and Health in Rural Tanzania: Study Design of a Cluster Randomized Controlled Trial," IJERPH, MDPI, vol. 16(14), pages 1-12, July.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Langford, Rebecca & Panter-Brick, Catherine, 2013. "A health equity critique of social marketing: Where interventions have impact but insufficient reach," Social Science & Medicine, Elsevier, vol. 83(C), pages 133-141.
    2. McMichael, Celia & Robinson, Priscilla, 2016. "Drivers of sustained hygiene behaviour change: A case study from mid-western Nepal," Social Science & Medicine, Elsevier, vol. 163(C), pages 28-36.
    3. Calvin Blackwell & Daniela Goya-Tocchetto & Zach Sturman, 2018. "Nudges in the restroom: How hand-washing can be impacted by environmental cues," Journal of Behavioral Economics for Policy, Society for the Advancement of Behavioral Economics (SABE), vol. 2(2), pages 41-47, September.
    4. Rieckmann, Johannes, 2015. "Determinants of drinking water treatment and hygiene habits in provincial towns in Yemen," VfS Annual Conference 2015 (Muenster): Economic Development - Theory and Policy 113183, Verein für Socialpolitik / German Economic Association.
    5. Mike Waugh & David Lagakos & Doug Gollin, 2011. "The Agricultural Productivity Gap in Developing Countries," 2011 Meeting Papers 1397, Society for Economic Dynamics.
    6. Ivanic, Maros & Martin, Will & Zaman, Hassan, 2012. "Estimating the Short-Run Poverty Impacts of the 2010–11 Surge in Food Prices," World Development, Elsevier, vol. 40(11), pages 2302-2317.
    7. Chen, Shaohua & Ravallion, Martin, 2021. "Reconciling the conflicting narratives on poverty in China," Journal of Development Economics, Elsevier, vol. 153(C).
    8. Imai, Katsushi S. & Gaiha, Raghav & Thapa, Ganesh & Annim, Samuel Kobina, 2012. "Microfinance and Poverty—A Macro Perspective," World Development, Elsevier, vol. 40(8), pages 1675-1689.
    9. Falconnier, Gatien N. & Descheemaeker, Katrien & Traore, Bouba & Bayoko, Arouna & Giller, Ken E., 2018. "Agricultural intensification and policy interventions: Exploring plausible futures for smallholder farmers in Southern Mali," Land Use Policy, Elsevier, vol. 70(C), pages 623-634.
    10. Giuseppe La Torre & Remigio Bova & Rosario Andrea Cocchiara & Cristina Sestili & Anna Tagliaferri & Simona Maggiacomo & Camilla Foschi & William Zomparelli & Maria Vittoria Manai & David Shaholli & Va, 2023. "What Are the Determinants of the Quality of Systematic Reviews in the International Journals of Occupational Medicine? A Methodological Study Review of Published Literature," IJERPH, MDPI, vol. 20(2), pages 1-12, January.
    11. Stephanie L. Martin & Jennifer K. Arney & Lisa M. Mueller & Edward Kumakech & Fiona Walugembe & Emmanuel Mugisha, 2013. "Using Formative Research to Design a Behavior Change Strategy to Increase the Use of Improved Cookstoves in Peri-Urban Kampala, Uganda," IJERPH, MDPI, vol. 10(12), pages 1-19, December.
    12. Penelope Love & Jillian Whelan & Colin Bell & Jane McCracken, 2019. "Measuring Rural Food Environments for Local Action in Australia: A Systematic Critical Synthesis Review," IJERPH, MDPI, vol. 16(13), pages 1-21, July.
    13. Paul Montgomery & Caitlin R Ryus & Catherine S Dolan & Sue Dopson & Linda M Scott, 2012. "Sanitary Pad Interventions for Girls' Education in Ghana: A Pilot Study," PLOS ONE, Public Library of Science, vol. 7(10), pages 1-7, October.
    14. Jennifer Trudeau & Anna-Maria Aksan & William F. Vásquez, 2018. "Water system unreliability and diarrhea incidence among children in Guatemala," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 63(2), pages 241-250, March.
    15. Wai Quin Ng & Jane Neill, 2006. "Evidence for early oral feeding of patients after elective open colorectal surgery: a literature review," Journal of Clinical Nursing, John Wiley & Sons, vol. 15(6), pages 696-709, June.
    16. Martin Ravallion, 2012. "Why Don't We See Poverty Convergence?," American Economic Review, American Economic Association, vol. 102(1), pages 504-523, February.
    17. Fosu, Augustin Kwasi, 2017. "Growth, inequality, and poverty reduction in developing countries: Recent global evidence," Research in Economics, Elsevier, vol. 71(2), pages 306-336.
    18. Brun, Martín & Colacce, Maira, 2019. "Medición de la pobreza monetaria en el Uruguay: conceptos, metodologías, evolución y alternativas," Estudios y Perspectivas – Oficina de la CEPAL en Montevideo 44415, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL).
    19. Antonio Jesús Ramos-Morcillo & Francisco José Moreno-Martínez & Ana María Hernández Susarte & César Hueso-Montoro & María Ruzafa-Martínez, 2019. "Social Determinants of Health, the Family, and Children’s Personal Hygiene: A Comparative Study," IJERPH, MDPI, vol. 16(23), pages 1-15, November.
    20. Christos Nicolaides & Demetris Avraam & Luis Cueto‐Felgueroso & Marta C. González & Ruben Juanes, 2020. "Hand‐Hygiene Mitigation Strategies Against Global Disease Spreading through the Air Transportation Network," Risk Analysis, John Wiley & Sons, vol. 40(4), pages 723-740, April.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:124:y:2015:i:c:p:103-114. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.