Mwanza Intervention Trials Unit, Mwanza, Tanzania
National Institute for Medical Research (NIMR), Mwanza Centre, Mwanza, Tanzania.
BMJ Open. 2019 Nov 28;9(11):e030947. doi: 10.1136/bmjopen-2019-030947.
To qualitatively assess the effects of a multi-modal school-based water, sanitation and hygiene (WASH) intervention on handwashing behaviour among primary students in North Western (NW) Tanzania.
The study was a qualitative assessment of barriers and facilitators to handwashing among students attending primary schools participating in the Mikono Safi Trial (Kiswahili for 'Clean Hands), a cluster-randomised trial assessing the impact of a school-based WASH intervention on selected soil transmitted helminth infections. Data collection methods included in-depth interviews with teachers, focus group discussions and friendship pair interviews with students collected between April and October 2018. The Capability-Opportunity-Motivation and Behaviour model was used to inform data collection and analysis.
The study was conducted in four purposively selected intervention schools in three districts of Kagera region, NW Tanzania (Bukoba urban, Bukoba rural and Muleba districts).
Participants comprised 16 purposively selected teachers aged between 23 and 52 years and 100 students aged 7-15 years RESULTS: The Mikono Safi intervention increased students' reported capability and motivation to wash their hands with soap at key times, particularly after visiting the toilet. Improvements in students' handwashing knowledge and skills were reported by both teachers and students, and motivation for handwashing was enhanced by emotional drivers such as disgust, fear and nurture. Newly established handwashing stations improved the physical opportunity to wash hands, although the availability of water and the provision of soap was not always consistent (eg, due to internal organisational shortcomings or during the dry season). Students and teachers were actively engaged in intervention implementation which created a school community that valued and supported improved hand hygiene.
The intervention was successful in improving capability and motivation for handwashing. Handwashing opportunity was also greatly improved, although the supply with water and soap was sometimes interrupted, calling for much stronger multi-sectoral collaboration to improve access to water at schools.
ISRCTN45013173; Pre-results.
定性评估西北（NW）坦桑尼亚一所学校中多模式水、环境卫生和个人卫生（WASH）干预对小学生洗手行为的影响。
本研究是对参加 Mikono Safi 试验（斯瓦希里语为“清洁双手”）的学生洗手行为的障碍和促进因素进行定性评估，该试验是一项评估基于学校的 WASH 干预对选定的土壤传播性蠕虫感染的影响的集群随机试验。数据收集方法包括 2018 年 4 月至 10 月期间对教师进行的深入访谈、对学生进行的焦点小组讨论和友谊对访谈。能力-机会-动机和行为模型用于指导数据收集和分析。
研究在坦桑尼亚西北部 Kagera 地区的四个指定干预学校进行（布科巴市区、布科巴农村区和穆莱巴区）。
参与者包括 16 名年龄在 23 至 52 岁之间的有针对性选择的教师和 100 名年龄在 7 至 15 岁之间的学生。
Mikono Safi 干预措施提高了学生在关键时间用肥皂洗手的报告能力和动机，特别是在上完厕所后。教师和学生都报告了学生洗手知识和技能的提高，洗手的动机受到厌恶、恐惧和养育等情感驱动的增强。新建立的洗手站改善了洗手的实际机会，尽管水的供应和肥皂的供应并不总是一致（例如，由于内部组织缺陷或在旱季）。学生和教师积极参与干预措施的实施，这营造了一个重视和支持改善手部卫生的学校社区。
该干预措施成功地提高了洗手的能力和动机。尽管水和肥皂的供应有时会中断，但洗手的机会也大大提高了，这需要更强大的多部门合作，以改善学校的用水供应。
ISRCTN45013173；预结果。
