The effect of hand hygiene intervention on the knowledge and skills level of school children: A Literature Review

ABSTRACT Background: Hand washing is an alternative, effective and inexpensive method that can be used to prevent infectious diseases. Washing hands with soap can improve children's health. The purpose of this study was to determine the effect of hand hygiene intervention on the level of knowledge and skills of elementary school students. The method used to conduct this research is a critical review, namely by reviewing articles from databases such as Google Scholar, Pubmed, Direct, Medline. The search keywords used were: quantitative studies on delivery, intervention, hand hygiene, skills, children, and primary school. The selected articles are articles that meet the standard writing criteria, which were published between 2017-2021, both in English and Indonesian. Based on these evaluation criteria, 20 (twenty) studies were obtained. From the results of a literature search, several studies on the use of intervention strategies to provide hand hygiene health education found that although there were other intervention strategies to improve hand hygiene, there were significant differences in both knowledge and skills after being given the intervention. Keywords: hand hygiene intervention, knowledge, skills

COVID-19 Hand Hygiene Intervention - PREPRINT

Objective: We aimed to test the efficacy of a theory-based intervention to promote the avoidance of touching one’s face with unwashed hands to reduce the spread of COVID-19. Methods: We tested effects of an intervention employing imagery, persuasive communication, and planning techniques in two pre-registered studies adopting randomized controlled designs in samples of Australian (N=254; Study 1) and US (N=245; Study 2) residents. Participants were randomly assigned to theory-based intervention or education-only conditions (Study 1), or to theory-based intervention, education-only, and no-intervention control conditions (Study 2). The intervention was delivered online and participants completed measures of behavior and theory-based social cognition constructs pre-intervention and one-week post-intervention. Results: Mixed-model ANOVAs revealed a significant increase in avoidance of touching the face with unwashed hands from pre-intervention to follow-up irrespective of intervention condition in both studies, but no significant condition effects. Exploratory analyses revealed significant effects of the theory-based intervention on behavior at follow-up in individuals with low pre-intervention risk perceptions in Study 2. Conclusions: Results indicate high adoption of avoiding touching one’s face with unwashed hands, with behavior increasing over time independent of the intervention. Future research should confirm risk perceptions as a moderator of the effect theory-based interventions on infection-prevention behaviors.

Practices of hygiene among primary school children in a selected semi urban area of Bangladesh

This descriptive type of cross sectional study was conducted to assess the practice of hygiene among primary school children in a selected semi urban area of Bangladesh. This study was conducted among 150 respondents who were selected purposively at Shafipur Model High School in Kaliyakoir thana of Shafipur upazilla, Gazipur in Bangladesh and a semi-structured questionnaire was used to collect data by face-to-face interview. In this study, majority of the respondents 89 (59.33%) were within the age group of 08-10 years. About respondents 88 (58.67%) were girls and 62 (41.33%) were boys. Among the respondents 54 (36%) were students of class III, 48 (32%) were students of class IV and 48 (32%) were students of class V. About 121 (80.66%) respondents gathered knowledge of hand hygiene from their parents. Regarding hand washing, 137 (91.33%) respondents washed their hands before meal. All the respondents washed their hands with soap after coming from toilet. Almost everyone 145 (96.67%) regularly cut their fingernails. Maximum respondents 119 (79.33%) used tap water and 31 (20.67%) used deep tube well water for drinking. Almost all of them 148 (98.66%) covered their water container. Maximum respondents 148 (98.67%) took bath regularly. Most of the respondents 148 (98.67%) used sanitary latrine. Maximum respondents 131 (87.33%) kept garbage in covered dustbin. Information from this study will serve as baseline data for future school-based hygiene intervention programs in semi-urban area of Bangladesh.

The Lived Experiences of Community Health Workers Serving in a Large-Scale Water, Sanitation, and Hygiene Intervention Trial in Rural Bangladesh

Community health workers (CHWs) are key to implementing community-based health interventions and quality can be enhanced by better understanding their lived experiences. The WASH Benefits, Bangladesh trial engaged 540 female CHWs to promote varying health intervention packages. We report on factors influencing their lived experiences during the trial, to aid future recruitment, training and retention of CHWs. Nine focus groups and 18 in-depth interviews were conducted with CHWs. Focus groups and interviews were transcribed and thematic content analysis performed to summarize the results. All CHWs described experiencing positive working conditions and many benefits both socially and financially; these contributed to their retention and job satisfaction. Their honorarium was commonly applied towards their children’s education and invested for income generation. CHWs gained self-confidence as women, to move unaccompanied in the community and speak in public. They earned respect from the community and their family members who helped them manage their family obligations during work and were viewed as a resource for advice on health and social issues. Many participated in family decision-making from which they were previously excluded. Health programs should foster a positive experience among their CHWs to aid the recruitment, retention and development of this important human resource.

Social outcomes of a community-based water, sanitation and hygiene intervention

Social benefits of water, sanitation and hygiene (WASH) interventions are less documented compared to health benefits such as the reduction of diarrheal diseases. Although most decisions in WASH investments are based on potential health outcomes, interventions may also lead to social benefits, such as income generation, increased school enrollment, improved levels of dignity, self-esteem and civic pride, which can have a significant value both personally and to the wider community. This qualitative case study was used to assess the perceived social outcomes of purposively selected stakeholders from a WASH intervention study in Malawi. In-depth Interviews (n = 10), focus group discussions (n = 4) and key informants interviews (n = 10) were conducted with caregivers (male and female), community leaders, traditional leaders and community coordinators. Thematic analysis identified eight social outcomes: formation and strengthening of relationships (n = 32), becoming role models to community members (n = 23), women empowerment (n = 20), time-saving (n = 17), change of status (n = 12), receiving awards (n = 12), reduced medical costs (n = 11) and obtaining new skills (n = 7). Social capital among caregivers was also found to be high. No negative outcomes from the intervention were reported. WASH interventions have multiple, important, but difficult to quantify social benefits which should be measured, reported and considered in WASH investment decision-making.

An evaluation of water, sanitation, and hygiene status and household assets and their associations with soil-transmitted helminthiasis and reported diarrhea in Nueva Santa Rosa, Guatemala

Soil-transmitted helminth (STH) infections and diarrheal illness affect billions of people yearly. We conducted a cross-sectional survey in Nueva Santa Rosa, Guatemala to identify factors associated with STH infections and diarrhea using univariable and multivariable logistic regression models. On multivariable analyses, we found associations between STH infections and two factors: school-aged children (odds ratio (OR) vs. adults: 2.35, 95% CI 1.10–4.99) and household drinking water supply classified as ‘other improved’ (OR vs. ‘improved’: 7.00, CI 1.22–40.14). Finished floors in the household vs. natural floors were highly protective (OR 0.16, CI 0.05–0.50) for STH infection. In crowded households (>2.5 people/bedroom), observing water present at handwashing stations was also protective (OR 0.32, CI 0.11–0.98). When adjusted for drying hands, diarrhea was associated with preschool-age children (OR vs. adults: 3.33, CI 1.83–6.04), spending >10 min per round trip collecting water (OR 1.90, CI 1.02–3.56), and having a handwashing station ≤10 m near a sanitation facility (OR 3.69, CI 1.33–10.21). Our study indicates that familiar WASH interventions, such as increasing drinking water quantity and water at handwashing stations in crowded homes, coupled with a hygiene intervention like finished flooring may hold promise for STH and diarrhea control programs.