ABSTRACT
Despite its simplicity and efficacy, the promotion of hand washing for disease prevention remains a challenge, particularly in resource-limited settings. This article reports on a quasi-experimental school-based study that aimed to improve habitual hand washing. Significant increases in hand washing occurred following improvements in hygiene and sanitation facilities (School A: t = 13.86, p = 0.0052). Smaller increases in hand washing occurred following education (School A: t = 2.63; p = 0.012; School B, no infrastructure improvements: t = 1.66, p = 0.239). Health policy and programming need to pay greater attention to the interplay of the structural, social and individual dimensions of unique contextual environments that influence habitual behaviours.
Disclosure statement
No potential conflict of interest was reported by the authors.
Notes
1. Interactions of Malnutrition & Enteric Infections: Consequences for Child Health and Development was a multi-sited, five-year cohort study of the relationship between malnutrition and enteric disease on childhood development, funded by the Gates Foundation via the National Institutes of Health (http://mal-ed.fnih.org/).