Biswas Debashish, Nizame Fosiul Alam, Sanghvi Tina, Roy Sumitro, Luby Stephen P, Unicomb Leanne E
Program for Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh.
Enteric and Respiratory Infections Program, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
BMC Public Health. 2017 May 5;17(1):390. doi: 10.1186/s12889-017-4316-6.
Diarrhea prevalence increases from around the time that complementary foods are introduced. Improving caregiver's hand hygiene during food preparation could reduce complementary food contamination and enteric pathogen transmission. Washing hands with soap is more common when water and soap are together at a convenient location. We conducted a three-month pilot intervention to evaluate two options for setting up handwashing stations: i) provide a handwashing station, or ii) help the family to make their own from available materials. Additionally, we assessed the feasibility of this intervention to be integrated with a child feeding program.
We conducted the intervention among two groups; 40 households received a free of cost handwashing station and another 40 households were motivated to place their own soap/soapy-water and water vessel near the food preparation and child feeding area. Community health workers encouraged caregivers to wash hands with soap/soapy-water before food preparation and feeding a child. They either assisted study participants to install the study-provided handwashing station at the recommended place or encouraged caregivers to develop their own. Field researchers assessed placement and composition of handwashing stations and the feasibility of integrating handwashing and nutrition messages.
By end of the trial, 39/40 households developed their own handwashing station, comprising a bucket, mug and bar soap/soapy-water of which 60% (6/10) households were observed with a functional and complete handwashing station set. Observed handwashing with soap was detected among 8/10 households from the study-provided handwashing station group and 5/10 among households who had made their own handwashing station. Sixty-seven of the 76 caregivers recalled integrated intervention messages on social and health benefits of infant and young child feeding correctly; and all recalled key handwashing with soap times, before food preparation and feeding a child.
Encouraging households to develop their own handwashing station with soap and water to place at a food preparation/child feeding location is feasible over the short term. In the absence of large-scale provision of handwashing stations, caregivers can be encouraged to create and use their own. Integrating handwashing with soap into a nutrition intervention was feasible and acceptable and should be considered by policy makers.
从开始添加辅食前后起，腹泻患病率就会上升。在准备食物期间改善照料者的手部卫生状况可减少辅食污染和肠道病原体传播。当水和肥皂放置在方便取用的位置时，用肥皂洗手更为常见。我们开展了一项为期三个月的试点干预措施，以评估设立洗手设施的两种方案：i）提供一个洗手设施，或ii）帮助家庭利用现有材料自制洗手设施。此外，我们评估了将该干预措施与儿童喂养计划相结合的可行性。
我们在两组人群中开展了干预措施；40户家庭获得了一个免费的洗手设施，另外40户家庭被鼓励在食物准备和儿童喂养区域附近放置自己的肥皂/肥皂水和盛水容器。社区卫生工作者鼓励照料者在准备食物和喂孩子之前用肥皂/肥皂水洗手。他们要么协助研究参与者将研究提供的洗手设施安装在推荐位置，要么鼓励照料者自制洗手设施。实地研究人员评估了洗手设施的放置和构成情况以及将洗手和营养信息相结合的可行性。
到试验结束时，40户家庭中有39户自制了洗手设施，包括一个水桶、一个杯子和一块肥皂/肥皂水，其中60%（6/10）的家庭拥有一个功能齐全且完整的洗手设施。在研究提供洗手设施组的10户家庭中有8户观察到用肥皂洗手，在自制洗手设施的家庭中有5/10观察到用肥皂洗手。76名照料者中有67名正确回忆起了关于婴幼儿喂养的社会和健康益处的综合干预信息；并且所有人都回忆起了在准备食物和喂孩子之前用肥皂洗手的关键时间点。
鼓励家庭自制带有肥皂和水的洗手设施并放置在食物准备/儿童喂养地点在短期内是可行的。在无法大规模提供洗手设施的情况下，可以鼓励照料者自制并使用他们自己的洗手设施。将用肥皂洗手纳入营养干预措施是可行且可接受的，政策制定者应予以考虑。
