Gizaw Zemichael, Addisu Ayenew
Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Parasitology, School of Biomedical Science, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Environ Health Insights. 2020 Jan 31;14:1178630220903100. doi: 10.1177/1178630220903100. eCollection 2020.
Water, Sanitation, and Hygiene (WASH) promotion is a viable solution to prevent enteric infections. It focuses on hygiene education, where a number of theoretical models have emerged which attempt to guide behavior change interventions. This study was, therefore, conducted to evaluate the effectiveness WASH education program on households' WASH performance in rural Dembiya, northwest Ethiopia.
An uncontrolled before-and-after intervention study was conducted. Baseline and endline surveys were done among 225 and 302 randomly selected households with under-5 children, respectively, using a structured questionnaire and observational checklists. Percent point change was used to see the effect of the intervention. Pearson χ and Fisher exact tests were used to test for statistically significant percentage point changes on the basis of < .05.
Access to adequate sanitation was significantly improved from 43.1% at the baseline to 50.7% at the endline ( < .05). Access to protected water sources was high at the baseline (73.8%) and remained high (81.1%) at the endline ( < .05). Significant proportion of households (58.3%) practiced good drinking water handling at the endline compared with the baseline (6.7%) ( < .001). Practice of home-based water treatment was improved at the endline (47%) compared with the baseline (7.6%) ( < .001). The general hygienic condition of children was significantly improved at the end of the intervention compared with the conditions before the intervention ( < .05). At the end of the intervention, mothers' hand washing practice was improved to 68.2% from 24.4% at the baseline ( < .001). Moreover, 52.4% and 69.5% of the households at the baseline and endline, respectively, had good food safety practice ( < .05).
The proportion of households who practiced water safety, basic sanitation, good personal hygiene, and basic food safety measures significantly increased at the endline. This significant increment clearly showed that our WASH interventions were effective to improve households' WASH performance in rural Dembiya. The local health office need, therefore, strengthens the WASH education program.
促进水、环境卫生和个人卫生（WASH）是预防肠道感染的可行解决方案。它侧重于健康教育，已经出现了一些理论模型来指导行为改变干预措施。因此，本研究旨在评估WASH教育项目对埃塞俄比亚西北部登比耶农村家庭WASH表现的有效性。
进行了一项非对照的前后干预研究。分别使用结构化问卷和观察清单，对225户和302户随机抽取的有5岁以下儿童的家庭进行了基线调查和终期调查。用百分点变化来观察干预效果。使用Pearson χ检验和Fisher精确检验，以检验基于α<0.05的具有统计学意义的百分点变化。
获得充足卫生设施的比例从基线时的43.1%显著提高到终期时的50.7%（P<0.05）。获得受保护水源的比例在基线时较高（73.8%），在终期时仍然很高（81.1%）（P<0.05）。与基线时（6.7%）相比，终期时有很大比例的家庭（58.3%）采取了良好的饮用水处理措施（P<0.001）。与基线时（7.6%）相比，终期时家庭水处理的做法有所改善（47%）（P<0.001）。与干预前的情况相比，干预结束时儿童的总体卫生状况有显著改善（P<0.05）。干预结束时，母亲的洗手习惯从基线时的24.4%提高到了68.2%（P<0.001）。此外，基线时和终期时分别有52.4%和69.5%的家庭采取了良好的食品安全措施（P<0.05）。
在终期时，采取水安全、基本环境卫生、良好个人卫生和基本食品安全措施的家庭比例显著增加。这一显著增加清楚地表明，我们的WASH干预措施有效地改善了登比耶农村家庭的WASH表现。因此，当地卫生办公室需要加强WASH教育项目。
