Husain Farah, Hardy Colleen, Zekele Lemlem, Clatworthy David, Blanton Curtis, Handzel Thomas
Emergency Response and Recovery Branch, Center for Global Health, Division of Global Health Protection, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, MS E-22, Atlanta, GA 30329 USA.
International Rescue Committee, T.K. International P.L.C, Bole Sub-city, Kebele 03/05, House # 162, Addis Ababa, Ethiopia.
Confl Health. 2015 Aug 22;9:26. doi: 10.1186/s13031-015-0053-6. eCollection 2015.
Diarrheal disease is a common cause of morbidity and mortality. Displaced populations are especially vulnerable due to overcrowded camps and limited access to water and sanitation facilities, increasing the risk for outbreaks. Hand washing with soap is effective against disease transmission, and studies suggest access to a convenient hand washing station may be the key to increasing hand washing behavior. This pilot study evaluated the acceptability, durability and use of a novel hand washing bag (HWB) at the household level among Sudanese refugees immediately following an acute emergency.
We distributed one HWB to every household (n = 874) in Adamazin Transit Center in western Ethiopia. The evaluation consisted of baseline and endline surveys, three monthly monitoring visits and focus group discussions (FGDs) over a six month period. FGD data were analyzed using the Risk, Attitudes, Norms, Abilities, and Self-Regulatory model. Survey and monitoring data were analyzed using SPSS. Note: Residents were resettled to Bambasi Refugee Camp during the study period where the endline survey was conducted.
Baseline data suggested water quantity and availability of soap were below SPHERE standards, however participants responded positively to the HWB. At the end of the monitoring period, 73.9 % of the same households retained their original HWBs and 66.7 % of bags had water at the time of the visit. The mean lifespan of the HWB during the monitoring period was 2.73 months. From a new sample of households selected for the endline evaluation, 93.0 % had an original HWB, but only 39.4 % had water in the bag. Endline FGD participants felt the HWB was useful, but reported insufficient soap and hygiene messaging.
The HWB performed well during the early phases of the emergency, however longer term results in this setting are unclear. The low levels of reported use measured by proxy indicators at six months indicated decreasing acceptability over time or a reflection of potential differences between the two sites. It is also unknown whether the HWB influenced hand washing behavior. Study findings were shared with the manufacturer in an effort to improve the bag's acceptability, utility, and durability.
腹泻病是发病和死亡的常见原因。由于营地拥挤以及获得水和卫生设施的机会有限，流离失所人群特别容易受到影响，这增加了疾病暴发的风险。用肥皂洗手可有效预防疾病传播，研究表明，使用方便的洗手设施可能是增加洗手行为的关键。这项试点研究评估了一种新型洗手袋（HWB）在急性紧急情况发生后，在苏丹难民家庭层面的可接受性、耐用性和使用情况。
我们向埃塞俄比亚西部阿达马津中转中心的每户家庭（n = 874）分发了一个洗手袋。评估包括基线和终线调查、为期六个月的每月三次监测访问以及焦点小组讨论（FGD）。使用风险、态度、规范、能力和自我调节模型对焦点小组讨论数据进行分析。使用SPSS对调查和监测数据进行分析。注意：在研究期间，居民被重新安置到班巴西难民营，并在那里进行了终线调查。
基线数据表明，水量和肥皂供应低于《最低标准和资格》标准，然而参与者对洗手袋反应积极。在监测期结束时，73.9%的同一家庭保留了原来的洗手袋，66.7%的袋子在访问时有水。监测期内洗手袋的平均使用寿命为2.73个月。在为终线评估挑选的新家庭样本中，93.0%有原来的洗手袋，但只有39.4%的袋子有水。终线焦点小组讨论参与者认为洗手袋有用，但报告肥皂和卫生宣传不足。
洗手袋在紧急情况的早期阶段表现良好，但在这种情况下的长期结果尚不清楚。六个月时通过替代指标衡量的报告使用率较低，表明随着时间的推移可接受性降低，或者反映了两个地点之间的潜在差异。洗手袋是否影响了洗手行为也不清楚。研究结果已与制造商分享，以努力提高袋子的可接受性、实用性和耐用性。
