伊拉克库尔德地区两个难民营中境内流离失所妇女的洗手行为决定因素。
The determinants of handwashing behaviour among internally displaced women in two camps in the Kurdistan Region of Iraq.
机构信息
Kurdistan Board of Medical Specialties (KBMS), Erbil, Kurdistan, Iraq.
Department of Community Medicine, Hawler Medical University, Erbil, Kurdistan, Iraq.
出版信息
PLoS One. 2020 May 8;15(5):e0231694. doi: 10.1371/journal.pone.0231694. eCollection 2020.
BACKGROUND
Diarrhoea is one of the most common causes of mortality and morbidity among populations displaced due to conflict. Handwashing with soap has the potential to halve the burden of diarrhoeal diseases in crisis contexts. This study aimed to identify which determinants drive handwashing behaviour in post-conflict, displacement camps.
METHODS
This study was conducted in two camps for internally displaced people in the Kurdistan Region of Iraq. A Barrier Analysis questionnaire was used for assessing the determinants of hand washing behaviour. Participants were screened and classified as either 'doers' (those who wash their hands with soap at critical times) or 'non-doers' (those who do not wash their hands with soap at critical times). Forty-five doers and non-doers were randomly selected from each camp and asked about behavioural determinants. The Barrier Analysis standard tabulation sheet was used for the analysis.
RESULTS
No differences were observed between doers and non-doers in relation to self-efficacy, action efficacy, the difficulties and benefits of handwashing, and levels of access to soap and water. In the first of the two camps, non-doers found it harder to remember to wash their hands (P = 0.045), had lower perceived vulnerability to diarrhoea (P = 0.037), lower perceived severity of diarrhoea (P = 0.020) and were aware of 'policies' which supported handwashing with soap (P = 0.037). In the second camp non-doers had lower perceived vulnerability to diarrhoea (P = 0.017).
CONCLUSIONS
In these camp settings handwashing behaviour, and the factors that determine it, was relatively homogenous because of the homogeneity of the settings and the socio-demographics of population. Handwashing programmes should seek to improve the convenience and quality of handwashing facilities, create cues to trigger handwashing behaviour and increase perceived risk. We identify several ways to improve the validity of the Barrier Analysis method such as using it in combination with other more holistic qualitative tools and revising the statistical analysis.
背景
腹泻是因冲突而流离失所人群中导致死亡和发病的最常见原因之一。用肥皂洗手有潜力将危机环境中腹泻病的负担减少一半。本研究旨在确定哪些决定因素在冲突后流离失所者营地中推动洗手行为。
方法
本研究在伊拉克库尔德斯坦地区的两个境内流离失所者营地进行。使用障碍分析问卷评估洗手行为的决定因素。对参与者进行筛查并分类为“执行者”（在关键时刻用肥皂洗手的人）或“非执行者”（在关键时刻不用肥皂洗手的人）。从每个营地中随机选择 45 名执行者和非执行者，询问其行为决定因素。使用障碍分析标准制表页进行分析。
结果
在自我效能感、行动效能感、洗手的困难和益处以及获得肥皂和水的程度方面，执行者和非执行者之间没有差异。在第一个营地中，非执行者发现更难记住洗手（P=0.045），对腹泻的易感性较低（P=0.037），对腹泻的严重程度感知较低（P=0.020），并且意识到支持用肥皂洗手的“政策”（P=0.037）。在第二个营地中，非执行者对腹泻的易感性较低（P=0.017）。
结论
在这些营地环境中，由于环境和人口的社会人口统计学特征的同质性，洗手行为及其决定因素相对单一。洗手计划应旨在改善洗手设施的便利性和质量，创造触发洗手行为的提示，并增加感知风险。我们确定了几种改进障碍分析方法有效性的方法，例如将其与其他更全面的定性工具结合使用并修改统计分析。
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