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Impact of different promotional channels on handwashing behaviour in an emergency context: Haiti post-earthquake public health promotions and cholera response

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Abstract

Aim

In a disaster context, where risk for diarrhoeal disease is elevated, personal hygiene, i.e. handwashing with soap, is especially relevant. However, to date, the promotion of hygiene in an emergency context has not been adequately addressed in the literature. The aim of the present study is to evaluate the effectiveness of hygiene promotions in post-earthquake Haiti.

Subject and Methods

Cross-sectional data was collected by means of structured interviews in camps and neighbourhoods in which three affiliates of a well-known relief organisation had conducted hygiene promotions. Primary caregivers were targeted. A total sample of 811 was obtained. Data was analysed using multiple linear regression and mediation analysis.

Results

Analysis revealed six promotional channels with positive associations with handwashing behaviour: hygiene radio spots, radio programs with experts answering listener’s questions, material distributions with instructions for use, information from friends or neighbours, hygiene theatres, and community clubs. However, five of the promotional channels were negatively related with handwashing. Respondents who experienced a focus group, stickers, posters and paintings, hygiene songs, special hygiene days and home visits tended to wash their hands less often.

Conclusions

By revealing positive but also negative associations between hygiene promotions and handwashing behaviour, the study underlines the need to apply theory-driven emergency hygiene promotions which are subjected to in-depth evaluation. Only through doing this, is it ensured that effective hygiene promotions are implemented for the most vulnerable people—those affected by a humanitarian disaster.

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Notes

  1. For simplicity, in the following text “handwashing” stands for handwashing with soap.

  2. Water, Sanitation and Hygiene

  3. For simplicity, in the following text food-related handwashing stands for food- and water-related handwashing.

  4. Hygiene songs were not evaluated regarding liking, convincingness, and trustworthiness.

  5. For all one-way ANOVA results, Welch’s F-ratios are reported.

  6. While home visits are rated more favourably, hygiene songs were not evaluated within the interviews. Thus, it is not clear if hygiene songs were rated favourably or unfavourably.

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Acknowledgements

This research was supported by funding from Oxfam America. The authors thank especially Myra Foster, public health specialist Oxfam America, for initiating and continuously supporting and advising the research project.

Conflict of interest

The authors declare that they have no conflict of interest.

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Correspondence to Nadja Contzen.

Appendix

Appendix

Table 7 Linear regression analysis for behavioural factors explaining faeces-related handwashing
Table 8 Mediation results: effects of behavioural factors on faeces-related handwashing
Table 9 Linear regression analysis for behavioural factors explaining food related handwashing
Table 10 Mediation results: effects of behavioural factors on food related handwashing

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Contzen, N., Mosler, HJ. Impact of different promotional channels on handwashing behaviour in an emergency context: Haiti post-earthquake public health promotions and cholera response. J Public Health 21, 559–573 (2013). https://doi.org/10.1007/s10389-013-0577-4

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  • DOI: https://doi.org/10.1007/s10389-013-0577-4

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