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Hand Hygiene Intervention Strategies to Reduce Diarrhoea and Respiratory Infections among Schoolchildren in Developing Countries: A Systematic Review

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  • Balwani Chingatichifwe Mbakaya

    (School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, SAR, China)

  • Paul H. Lee

    (World Health Organization Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, SAR, China)

  • Regina L. T. Lee

    (World Health Organization Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, SAR, China)

Abstract

Effective and appropriate hand-washing practice for schoolchildren is important in preventing infectious diseases such as diarrhoea, which is the second most common cause of death among school-age children in sub-Saharan Africa. The objective of the review was to identify hand hygiene intervention strategies to reduce infectious diseases such as diarrhoea and respiratory tract infections among schoolchildren aged 6–12 years in developing countries. Published research articles were searched from databases covering a period from as far back as the creation of the databases to November 2015. Eight randomized controlled trials (RCT/CRCT) from developing countries met the inclusion criteria. The Jadad Scale for appraising RCT/CRCT studies revealed methodological challenges in most studies, such that 75% (6/8) were rated as low-quality articles. The review found that hand hygiene can reduce the incidence of diarrhoea and respiratory conditions. Three hand hygiene intervention strategies utilized were training, funding and policy, with training and funding implemented more commonly than policy. These strategies were not only used in isolation but also in combination, and they qualified as multi-level interventions. Factors that influenced hand washing were contextual, psychosocial and technological. Findings can inform school health workers in categorizing and prioritizing activities into viable strategies when implementing multi-level hand-washing interventions. This review also adds to the existing evidence that multi-level hand-washing interventions can reduce the incidence of diarrhoea, respiratory infections, and school absenteeism. Further evidence-based studies are needed with improved methodological rigour in developing countries, to inform policy in this area.

Suggested Citation

  • Balwani Chingatichifwe Mbakaya & Paul H. Lee & Regina L. T. Lee, 2017. "Hand Hygiene Intervention Strategies to Reduce Diarrhoea and Respiratory Infections among Schoolchildren in Developing Countries: A Systematic Review," IJERPH, MDPI, vol. 14(4), pages 1-14, April.
    • Handle: RePEc:gam:jijerp:v:14:y:2017:i:4:p:371-:d:94777
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    References listed on IDEAS

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    1. Dreibelbis, R. & Freeman, M.C. & Greene, L.E. & Saboori, S. & Rheingans, R., 2014. "The impact of school water, sanitation, and hygiene interventions on the health of younger siblings of pupils: A cluster-randomized trial in Kenya," American Journal of Public Health, American Public Health Association, vol. 104(1), pages 91-97.
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    2. Angela Mathee & Jocelyn Moyes & Thulisa Mkhencele & Jackie Kleynhans & Brigitte Language & Stuart Piketh & Elias Moroe & Floidy Wafawanaka & Neil Martinson & Meredith McMorrow & Stefano Tempia & Kathl, 2021. "Housing Quality in a Rural and an Urban Settlement in South Africa," IJERPH, MDPI, vol. 18(5), pages 1-17, February.
    3. Emily Ying Yang Chan & Kimberley Hor Yee Tong & Caroline Dubois & Kiara Mc Donnell & Jean H. Kim & Kevin Kei Ching Hung & Kin On Kwok, 2021. "Narrative Review of Primary Preventive Interventions against Water-Borne Diseases: Scientific Evidence of Health-EDRM in Contexts with Inadequate Safe Drinking Water," IJERPH, MDPI, vol. 18(23), pages 1-20, November.
    4. Supa Pengpid & Karl Peltzer, 2020. "Trends of Alcohol Use, Dietary Behaviour, Interpersonal Violence, Mental Health, Oral and Hand Hygiene Behaviour among Adolescents in Lebanon: Cross-Sectional National School Surveys from 2005, 2011 a," IJERPH, MDPI, vol. 17(19), pages 1-14, September.
    5. Lorna Kwai Ping Suen & Janet Pui Lee Cheung, 2020. "Effectiveness of “Hand Hygiene Fun Month” for Kindergarten Children: A Pilot Quasi-Experimental Study," IJERPH, MDPI, vol. 17(19), pages 1-15, October.
    6. Khalid M. Khan & Rishika Chakraborty & Stephen Brown & Rasheda Sultana & Alec Colon & Devinder Toor & Pooja Upreti & Banalata Sen, 2021. "Association between Handwashing Behavior and Infectious Diseases among Low-Income Community Children in Urban New Delhi, India: A Cross-Sectional Study," IJERPH, MDPI, vol. 18(23), pages 1-14, November.
    7. Berik Toleubekov & Zhanerke Bolatova & Martin Stafström, 2022. "Assessing Access to WASH in Urban Schools during COVID-19 in Kazakhstan: Case Study of Central Kazakhstan," IJERPH, MDPI, vol. 19(11), pages 1-12, May.
    8. Yu-E Cha & Yuan-Zheng Fu & Wei Yao, 2021. "Knowledge, Practice of Personal Hygiene, School Sanitation, and Risk Factors of Contracting Diarrhea among Rural Students from Five Western Provinces in China," IJERPH, MDPI, vol. 18(18), pages 1-14, September.

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