Assessing the environmental context of hand washing among school children in Limpopo, South Africa

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.

KEYWORDS:

• Hand washing
• waterborne disease
• hygiene and sanitation
• quasi-experimental design
• South Africa

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/).

Additional information

Funding

This work was funded by the National Science Foundation Research Experience for Undergraduates program [award number EEC 1156999], and by the Fogarty International Center of the NIH [award number D43 TW009259].