Behavioural determinants of handwashing at critical times among mothers and care givers in Zimbabwe: implications for behaviour change interventions

Figures & data

Table 1. Handwashing doers and non-doers.

Mwenezi (Ward 2, 5, 6, 9 and 12)			Chiredzi (Ward 8, 9, 13, 22 and 25)			Total
Doers	Non-Doers	Total	Doers	Non-Doers	Total	Doers	Non-Doers	Total
22	23	45	23	22	45	45	45	90

Table 2. Perceived self-efficacy.

Determinant	Doers n (%)	Non -Doers n (%)	Difference	Odds Ratio	95% C.I	ERR*	p = 0.05
Do you think based on your knowledge, skills, and resources you can wash your hands at required periods?
Yes	45 (100)	24 (53)	47%				0.000
Possibly	0 (0)	12 (27)	−27%	0.00		0.00	0.000
No	0 (0)	9 (20)	−20%	0.00		0.00	0.001
What makes it easier for you to wash your hands with soap?
For healthy purposes	7 (16)	0 (0)	16%			5.74	0.006
Detergents and knowledge availability	4 (9)	0 (0)	9%			5.39	0.058
Availability of water and detergents	7 (16)	7 (16)	0%	1.00	0.32–3.13	1.00	0.614
Detergents available (soap, ash, sanitizer)	10 (22)	10 (22)	0%	1.00	0.37–2.03	1.00	0.600
Availability of water	5 (11)	8 (18)	−7%	0.58	0.17–1.93	0.64	0.275
Availability of handwashing facilities	1 (2)	10 (22)	−20%	0.08	0.01–0.65	0.10	0.004
Knowledge acquired through training and awareness	7 (16)	3 (7)	9%	2.58	0.62–10.69	2.00	0.157
Water, soap, and knowledge available	1 (2)	0 (0)	2%			5.09	0.500
Fear of contracting COVID-19 and other diseases	3 (7)	0 (0)	7%			5.29	0.121
None	0 (0)	5 (11)	−11%	0.00		0.00	0.028
Set reminders	0 (0)	2 (14)	−4%	0.00		0.00	0.247
What makes it difficult for you to wash your hands with soap?
Detergent’s unavailability (soap, ash, sanitizer)	13 (29)	15 (33)	−4%	0.81	0.33–1.99	0.85	0.410
Unavailability of water and detergents	2 (4)	2 (4)	0%	1.00	0.13–7.43	1.00	0.692
Forgetting to wash hands	5 (11)	6 (13)	−2%	0.81	0.23–2.88	0.84	0.500
None	25 (56)	16 (36)	20%	2.27	0.97–5.29	1.91	0.045
Lack of handwashing facilities	0 (0)	3 (7)	−7%	0.00		0.00	0.121
Unavailability of water	0 (0)	2 (4)	−4%	0.00		0.00	0.247
Lack of knowledge on importance of handwashing	0 (0)	1 (2)	−2%	0.00		0.00	0.500

Notes: *Estimated Relative Risk.

Table 3. Positive and negative consequences.

Determinant	Doers n (%)	Non -Doers n (%)	Difference	Odds Ratio	95% C.I	ERR*	p = 0.05
Advantages of washing your hands with soap
Hygienic purposes	17 (38)	13 (29)	9%	1.49	0.62 – 3.61	1.37	0.251
Prevent disease outbreaks	21 (47)	23 (51)	−4%	0.84	0.37 –1.91 0.98	0.87	0.417
Prevent spread of COVID-19, diarrhoea, and hygienic purposes	5 (11)	1 (2)	9%	5.50	0.62 – 49.11	3.00	0.101
Prevent outbreak of water borne disease such as typhoid and cholera	2 (4)	5 (11)	−7%	0.37	0.07 – 2.03	0.43	0.217
None	0 (0)	2 (4)	−4%	0.00		0.00	0.247
Reduction of medical costs incurred after falling sick	0 (0)	1 (2)	−2%	0.00		0.00	0.500
Disadvantages of washing your hands with soap at recommended times
Skin irritation	4 (9)	4 (9)	0%	1.00	0.23 – 4.27	1.00	0.643
Costly (soap is expensive)	9 (20)	4 (9)	11%	2.56	0.73 – 9.03	2.00	0.115
Tiring	3 (7)	2 (4)	2%	1.54	0.24 – 9.66	1.39	0.500
None	29 (64)	35 (78)	−13%	0.52	0.20 – 1.31	0.60	0.122

Notes: * Estimated Relative Risk.

Table 4. Perceived social norms.

Determinant	Doers n (%)	Non -Doers n (%)	Difference	Odds Ratio	95% C.I	ERR*	p = 0.05
Do most people you know approve this practice
Yes	36 (80)	27 (60)	20%	2.67	1.04 – 6.85	2.25	0.032
Possibly	6 (13)	8 (18)	−4%	0.71	0.23 – 2.25	0.76	0.382
No	3 (7)	10 (22)	−16%	0.25	0.06 – 0.98	0.30	0.034
People that approve this practice
Village Health Worker (VHW)	22 (49)	13 (29)	20%	2.35	0.99 – 5.62	1.95	0.041
Family member	11 (24)	8 (18)	7%	1.50	0.54 – 4.16	1.37	0.303
Ministry of health, NGOS, Community, social media	10 (22)	17 (38)	−16%	0.47	0.19 – 1.19	0.54	0.083
None	2 (4)	7 (16)	−11%	0.25	0.05 – 1.29	0.30	0.079
People that disapprove this practice
Community	5 (11)	6 (13)	−2%	0.81	0.23 – 2.88	0.84	0.500
Those without knowledge	3 (7)	0 (0)	7%			5.29	0.121
None	35 (78)	34 (76)	2%	1.13	0.43 – 3.01	1.11	0.500
Family member	2 (4)	5 (11)	−7%	0.37	0.07 – 2.03	0.43	0.217

Notes: * Estimated Relative Risk.

Table 5. Access and Reminders.

Determinant	Doers n (%)	Non -Doers n (%)	Difference	Odds Ratio	95% C.I	ERR*	p = 0.05
Difficulties in having soap to wash your hands
Very difficult	0 (0)	8 (18)	−18%	0.00		0.00	0.003
Somewhat difficult	27 (60)	20 (44)	16%	1.88	0.81 – 4.33	1.65	0.103
Not difficult at all	18 (40)	16 (36)	4%	1.21	0.51 – 2.84	1.16	0.414
Difficulty to remember to wash your hands with soap
Very difficult	0 (0)	4 (9)	−9%	0.00		0.00	0.058
Somewhat difficult	13 (29)	19 (42)	−13%	0.56	0.23 – 1.33	0.62	0.135
Not difficult at all	32 (71)	22 (49)	22%	2.57	1.08 – 6.14	2.15	0.026

Notes: * Estimated Relative Risk.

Table 6. Risk.

Determinant	Doers n (%)	Non -Doers n (%)	Difference	Odds Ratio	95% C.I	ERR*	p = 0.05
Likelihood your child has diarrhoea in the next 3 months?
Very likely
Somewhat likely	9 (20)	16 (36)	−16%	0.45	0.17 – 1.17	0.52	0.079
Not likely at all	34 (76)	24 (53)	22%	2.70	1.10 – 6.63	2.26	0.023
Likelihood your child will have diarrhoea if you wash your hands with soap at appropriate times (action efficacy)?
Very likely	1 (2)	4 (9)	−7%	0.23	0.02 – 2.17	0.28	0.180
Somewhat likely	5 (11)	13 (29)	−18%	0.31	0.10 – 0.95	0.37	0.032
Not likely at all	39 (87)	28 (62)	24%	3.95	1.38 – 11.27	3.19	0.007

Notes: * Estimated Relative Risk.