Handwashing and Hygiene interventions

Introduction: Worker behavior of handwashing with soap in the informal sector has rarely not been studied in Indonesia. This study was conducted to determine factors related to the quality of handwashing performed by workers in the formal and informal sectors in Indonesia. Methods: The research used secondary data from Indonesia Basic Health Research. The research design was cross-sectional, and a total sample included was 421,404 workers at the productive age of 15-64 years across 34 provinces in Indonesia. The data collected included age, gender, marital status, education, place of residence, occupation, and handwashing practice. The determinants were identified using binary logistic regression. Results and Discussion: Results showed that 1.9% of workers did not wash their hands, and 35.0% only washed their hands with water; most of them worked in the informal sector (77.5%). Regarding the characteristics of workers, age (OR=1.17; 95% CI: 1.14–1.21), gender (OR=1.23; 95% CI: 0.93–0.99), education (OR=2.07; 95% CI: 2.01–2.14), and formal workplace (OR=1.43; 95% CI: 1.40-1.46) were mostly related to the quality of handwashing. Conclusion: The government is expected to formulate a structured policy in educating the workers, especially for male, young (15-24 years), low educated, and informal workers, about good handwashing. This study recommends that the government should use the current research findings to target proper population for the policy implementation.

A B S T R A C T Safe environmental conditions and the availability of standard precaution items are important to prevent and treat infection in health care facilities (HCFs) and to achieve Sustainable Development Goal (SDG) targets for health and water, sanitation, and hygiene. Baseline coverage estimates for HCFs have yet to be formed for the SDGs; and there is little evidence describing inequalities in coverage. To address this, we produced the first coverage estimates of environmental conditions and standard precaution items in HCFs in low-and middle-income countries (LMICs); and explored factors associated with low coverage. Data from monitoring reports and peer-reviewed literature were systematically compiled; and information on conditions, service levels, and inequalities tabulated. We used logistic regression to identify factors associated with low coverage. Data for 21 indicators of environmental conditions and standard precaution items were compiled from 78 LMICs which were representative of 129,557 HCFs. 50% of HCFs lack piped water, 33% lack improved sanitation, 39% lack handwashing soap, 39% lack adequate infectious waste disposal, 73% lack sterilization equipment, and 59% lack reliable energy services. Using nationally representative data from six countries, 2% of HCFs provide all four of water, sanitation, hygiene, and waste management services. Statistically significant inequalities in coverage exist between HCFs by: urban-rural setting, managing authority, facility type, and sub-national administrative unit. We identified important, previously undocumented inequalities and environmental health challenges faced by HCFs in LMICs. The information and analyses provide evidence for those engaged in improving HCF conditions to develop evidence-based policies and efficient programs, enhance service delivery systems, and make better use of available resources.

This paper generally examines the level of knowledge and practice of hand washing with soap (HWWS) among basic school
pupils and the existing challenges. The study employed structured questionnaires, interviews and spot observations to obtain
relevant information from 162 pupils and 20 head teachers from 20 primary schools in Ofankor, in the Ga East Municipality,
Ghana. The pupils comprising of equal proportion of boys and girls were purposively selected from the lower and upper
primary grades. Most pupils (87%) reported being educated on HWWS but 73% reported actually practicing HWWS after
visiting the toilet. Protection from illnesses was generally mentioned (60%) as the major importance of HWWS. Apparently,
pupils who claimed to be educated on HWWS are more likely to wash their hands after visiting the toilet and before eating as
compared to those who have not been educated (χ2= 4.17; p < 0.05). Younger pupils (lower primary) are reportedly more likely
to wash their hands after visiting the toilet and before eating as compared to older pupils (upper primary) (χ2 = 13.40; p < 0.05).
Conversely, no statistically significant association (χ2 = 2.96; p > 0.05) was found between gender and these two critical
moments for HWWS. Although pupils have good knowledge of HWWS, hand washing stations in the schools are not only substandard
but also inadequate and soap provision is infrequent. The best practices to ensure effective implementation of hand
hygiene programme in schools are discussed in detail in the paper.

We present Haksh-E, a social robot for promoting good hand hygiene among children. This robot can supply valuable objective data to stakeholders and the UN to monitor progress on targets for UN SDGs 3 and 6. We discuss the design parameters of Haksh-E and a pilot study conducted with 10 children between the ages 6-11 years hailing from rural and urban locations in Southern India. The children provide insights on their perception and acceptance of our robot prototype over various dimensions including likeability, perceived intelligence, anthropomorphism, trustworthiness, age, and gender. Our results suggest that Haksh-E has the potential to be used in educational and children-centered spaces to promote handwashing behavior change.

To contain the SARS-CoV-2 infection rate, health authorities have encouraged the population to enhance protective behaviors such as physical distancing and handwashing. Behavioral sciences emphasize the role of sociocognitive determinants to explain health behaviors, while largely ignoring emotional factors. In a large online study (N > 4000), we investigated the role of sociodemographic, cognitive, emotional, and social factors that can facilitate or hinder handwashing and limitation of social contacts. Data were collected from March 18 until April 19, 2020, which corresponds to the spring lockdown and the first peak of the pandemic in Belgium. Logistic regressions showed that sociodemographic factors (gender, age, level of education) and the dimensions of the Theory of Planned Behavior (intentions, attitudes, perceived behavioral control and subjective norms) had a strong impact on health behaviors, but that emotional factors explained an additional part of the variance. Being more attentive/determined and frightened/anxious, along with scoring higher on health anxiety were related to a higher frequency of handwashing. In contrast, being enthusiastic/happy was related to lower adherence to limiting social contacts. Our results suggest that the type of predictors and the direction of associations depend on the type of health behavior considered. The role of specific emotional factors in addition to more classical predictors is discussed. The study offers new perspectives regarding the factors that are associated with the adherence to behaviors recommended to adopt when faced with a pandemic.