Simiyu Sheillah N, Busienei Phylis J, Mbaya Nelson, Baker Kelly K, Dreibelbis Robert, Cumming Oliver
Population Dynamics and Urbanization, African Population and Health Research Center, Nairobi, Kenya.
Data Synergy and Evaluation, African Population and Health Research Center, Nairobi, Kenya.
PLOS Glob Public Health. 2025 Jul 17;5(7):e0004921. doi: 10.1371/journal.pgph.0004921. eCollection 2025.
Handwashing with soap is an effective public health measure against infectious disease and is enabled by availability of handwashing facilities, soap and sufficient water. However, access to handwashing facilities in low-income urban areas is often low, which hinders effective handwashing with soap. We assessed access to basic handwashing facilities and handwashing with soap practices in low-income areas across four cities in Kenya. A cross-sectional survey was conducted and observations made at household level to assess availability of basic handwashing facilities. Respondents demonstrated how they usually washed hands and observations were made on whether hands were washed with soap or not. Multivariable logistic regression models were used to assess determinants of access to basic handwashing facilities and of handwashing with soap across the cities. Results show that most handwashing facilities were basins (77%) and customised containers (4.6%). Less than half of respondents (40%) reported always using soap during handwashing and 59% reported sometimes using soap. Those with secondary education had higher odds of having basic handwashing facilities (Adjusted Odds Ratio (AOR)-1.92, P = 0.02, CI 1.14- 3.24) while those without any compound enclosure had lower odds of having handwashing facilities (AOR = 0.42, P = 0.00, CI 0.28-0.62). Respondents with a handwashing facility (AOR = 69.52, P = 0.00, CI 42.88-112.73) and those with a water point in their compound (AOR 2.4, P = 0.00 CI: 1.43-3.98) had higher odds of handwashing with soap. Across the cities, residents from Mombasa had lower odds of having handwashing facilities (AOR = 0.47, P = 0.01 CI 0.28-0.80) and of handwashing with soap (AOR-0.19; P = 0.00; CI 0.08-0.42) compared to those from Nairobi. These results buttress the important role played by water and the presence of a handwashing facility in promoting handwashing with soap. Interventions in low-income areas should focus on increasing access to conditions such as consistent supply of water to promote adequate and sustained handwashing with soap.
用肥皂洗手是预防传染病的一项有效公共卫生措施，而这一措施的实施需要有洗手设施、肥皂和充足的水。然而，低收入城市地区的洗手设施普及率往往较低，这阻碍了用肥皂有效洗手。我们评估了肯尼亚四个城市低收入地区基本洗手设施的普及情况以及用肥皂洗手的习惯。开展了一项横断面调查，并在家庭层面进行观察，以评估基本洗手设施的可用性。受访者展示了他们通常如何洗手，并观察他们是否用肥皂洗手。使用多变量逻辑回归模型来评估各城市基本洗手设施普及情况和用肥皂洗手习惯的决定因素。结果显示，大多数洗手设施是水盆（77%）和定制容器（4.6%）。不到一半的受访者（40%）表示洗手时总是使用肥皂，59%的受访者表示有时使用肥皂。受过中等教育的人拥有基本洗手设施的几率更高（调整后的优势比（AOR）为1.92，P = 0.02，置信区间1.14 - 3.24），而没有任何院子围墙的人拥有洗手设施的几率较低（AOR = 0.42，P = 0.00，置信区间0.28 - 0.62）。拥有洗手设施的受访者（AOR = 69.52，P = 0.00，置信区间42.88 - 112.73）以及院子里有取水点的受访者（AOR 2.4，P = 0.00，置信区间：1.43 - 3.98）用肥皂洗手的几率更高。在各个城市中，与内罗毕的居民相比，蒙巴萨的居民拥有洗手设施的几率较低（AOR = 0.47，P = 0.01，置信区间0.28 - 0.80），用肥皂洗手的几率也较低（AOR - 0.19；P = 0.00；置信区间0.08 - 0.42）。这些结果支持了水和洗手设施在促进用肥皂洗手方面所起的重要作用。低收入地区的干预措施应侧重于增加获得诸如稳定供水等条件的机会，以促进充分且持续地用肥皂洗手。
