Developing a contextually appropriate integrated hygiene intervention to achieve sustained reductions in diarrheal diseases

Tracy Morse, Kondwani Chidziwisano, Elizabeth Tilley, Rossanie Malolo, Save Kumwenda, Janelisa Musaya, Sandy Cairncross

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Abstract

Diarrheal disease in under-five children remains high in Sub-Saharan Africa; primarily attributed to environmental pathogen exposure through poorly managed water, sanitation, and hygiene (WASH) pathways, including foods. This formative study in rural Malawi used a theoretical base to determine the personal, social, environmental, and psychosocial factors that are to be considered in the development of an integrated intervention for WASH and food hygiene. Using a mixed methods approach, a stakeholder analysis was followed by data collection pertaining to 1079 children between the ages of four to 90 weeks: observations (n = 79); assessment of risks, attitudes, norms and self-regulation (RANAS) model (n = 323); structured questionnaires (n = 1000); focus group discussions (n = 9); and, in-depth interviews (n = 9) (PACTR201703002084166). We identified four thematic areas for the diarrheal disease intervention: hand washing with soap; food hygiene; feces management (human and animal); and, water management. The contextual issues included: the high level of knowledge on good hygiene practices not reflected in observed habits; inclusion of all family members incorporating primary caregivers (female) and financial controllers (male); and, endemic poverty as a significant barrier to hygiene infrastructure and consumable availability. The psychosocial factors identified for intervention development included social norms, abilities, and self-regulation. The resulting eight-month context specific intervention to be evaluated is described.
Original languageEnglish
Article number4656
Number of pages17
JournalSustainability
Volume11
Issue number17
DOIs
Publication statusPublished - 27 Aug 2019

Fingerprint

diarrheal disease
hygiene
Sanitation
Disease
sanitation
Soaps (detergents)
psychosocial factors
Water management
Pathogens
food
self-regulation
Washing
Water
Animals
social development
Availability
feces
water management
water
poverty

Keywords

  • WASH
  • food hygiene
  • complementary foods
  • RANAS
  • Malawi

Cite this

Morse, Tracy ; Chidziwisano, Kondwani ; Tilley, Elizabeth ; Malolo, Rossanie ; Kumwenda, Save ; Musaya, Janelisa ; Cairncross, Sandy. / Developing a contextually appropriate integrated hygiene intervention to achieve sustained reductions in diarrheal diseases. In: Sustainability. 2019 ; Vol. 11, No. 17.
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Developing a contextually appropriate integrated hygiene intervention to achieve sustained reductions in diarrheal diseases. / Morse, Tracy; Chidziwisano, Kondwani; Tilley, Elizabeth ; Malolo, Rossanie ; Kumwenda, Save; Musaya, Janelisa ; Cairncross, Sandy.

In: Sustainability, Vol. 11, No. 17, 4656, 27.08.2019.

Research output: Contribution to journalArticle

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AU - Chidziwisano, Kondwani

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AU - Musaya, Janelisa

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