Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Ranas Ltd, Zurich, Switzerland.
BMC Public Health. 2024 Mar 28;24(1):912. doi: 10.1186/s12889-024-18396-y.
Within South Africa, many low-income communities lack reliable waste management services. Within these contexts, absorbent hygiene product (AHP) waste, including nappies (diapers), are not recycled, and are often dumped, ending up in watercourses and polluting the local environment. The structural barriers to collection which have been well explored, however the behavioural determinants of safe disposal for AHPs remains poorly understood. The purpose of this study is to determine the psycho-social factors driving AHP disposal behaviour for caregivers, while identifying potential underlying mechanisms (such as mental health), which may be influencing disposal behaviour, with the intention of informing a future, contextually appropriate and sustainable, collection system.
The cross-sectional study was conducted within three low-income communities located within eThekwini Municipality (Durban), South Africa. The study included a pre-study and a quantitative survey of 452 caregivers, utilising the RANAS approach of behaviour change. The quantitative questionnaire was based on the RANAS model to measure psycho-social factors underlying sanitary disposal of AHPs. Mental health was assessed using the Self-Reporting Questionnaire (SRQ-20). Statistical analysis involved regressing psycho-social factors onto disposal behaviour and exploring their interaction with mental health through a moderation model.
Our findings suggest that one third of caregivers do not dispose of nappies sanitarily, despite intent (86.9%). Regression analysis revealed ten psycho-social factors which significantly predict the desired behavioural outcome, the sanitary disposal of AHPs. Caregivers with poor mental health were less likely to dispose of AHP sanitarily, which reflects previous research linking poor mental health and the impairment of health-related daily activities, particularly within vulnerable groups. Specifically, several psycho-social factors underlying were moderated by poor mental health, the prevalence of sanitary disposal of AHPs depended on mental condition of caregiver.
Our findings confirmed the link between poor mental health and unsanitary AHPs disposal. This is especially relevant because poor mental health is common within South Africa. Addressing mental health problems within these communities is an essential step to providing sustainable waste management services. The findings informed an intervention strategy to implement a future collection system for these communities, and similar low-income or informal contexts within South Africa.
在南非，许多低收入社区缺乏可靠的废物管理服务。在这些情况下，吸收性卫生用品（AHP）废物，包括尿布（纸尿裤），没有被回收，而是被倾倒，最终进入水道并污染当地环境。虽然已经充分研究了收集过程中的结构障碍，但对于 AHPs 的安全处理的行为决定因素仍知之甚少。这项研究的目的是确定照顾者处理 AHP 行为的心理社会因素，同时确定可能影响处理行为的潜在潜在机制（例如心理健康），以期为未来提供一个背景适当和可持续的收集系统提供信息。
这项横断面研究在南非 eThekwini 市（德班）的三个低收入社区内进行。该研究包括预研究和对 452 名照顾者的定量调查，使用 RANAS 行为改变方法。定量问卷基于 RANAS 模型，用于测量 AHPs 卫生处理的心理社会因素。使用自我报告问卷（SRQ-20）评估心理健康。统计分析涉及将心理社会因素回归到处理行为上，并通过调节模型探索它们与心理健康的相互作用。
我们的研究结果表明，尽管有意愿（86.9%），但三分之一的照顾者并没有将尿布卫生处理。回归分析显示，十个心理社会因素可显著预测 AHP 卫生处理的理想行为结果。心理健康状况较差的照顾者不太可能将 AHP 卫生处理，这反映了先前的研究将心理健康状况较差与健康相关的日常活动受损联系起来，尤其是在弱势群体中。具体来说，几个心理社会因素受到心理健康状况差的调节，AHPs 卫生处理的流行取决于照顾者的精神状态。
我们的研究结果证实了心理健康状况不佳与不卫生的 AHP 处理之间的联系。这尤其重要，因为南非的心理健康状况很普遍。在这些社区中解决心理健康问题是提供可持续废物管理服务的重要步骤。研究结果为实施未来针对这些社区的收集系统以及南非类似的低收入或非正式社区提供了干预策略。
