Knowledge, Attitude and Practice Enhancements Following Health Education Program among the Harijan Sanitary Workers in the Rajshahi District of Bangladesh.

The Harijan sanitary workers are the most vulnerable group in our society and suffer from several kinds of occupational health problems due to their low level of education, dirty jobs and misunderstanding of occupational health concerns. The purpose of this study was to determine the level of awareness about personal hygiene and occupational health to assess the impact of the occupational health intervention on the Harijan sanitary workers in the Rajshahi district of Bangladesh. A pre-post mixed-methods study was conducted from January to June 2025 in four sweeper colonies of Rajshahi to measure how a culturally adapted health education initiative influenced Harijan sanitary workers' knowledge, attitudes, and practices. Data gathered from 110 participants, along with qualitative inputs from FGDs, KIIs, and in-depth interviews, offered both numerical insights and real-life context. Statistical and thematic analyses using SPSS and NVivo examined shifts in safety habits and skin-related issues, reinforced through cross-validation of findings across multiple qualitative sources. A total of 110 Harijan sanitary workers (52.7% male, 47.3% female) in Rajshahi averaged 6.7 years of service and 6.8 household members, with over 30% lacking formal education and only 6.4% completing secondary school. After the awareness program, pulmonary symptoms showed mixed, non-significant changes and skin disease rates trended downward without statistical significance, while organ pain complaints (back and muscle) significantly declined (χ²=11.64, p = 0.003). Occupational health knowledge scores nearly doubled from 6.8 to 13.2 (94.1% increase, p < 0.001) three months after training. Attitudes toward PPE use and self-care improved by 27.7% (from 27.1 to 34.6, p < 0.001), and adoption of safety practices-glove use, mask wearing, boots, handwashing, and sanitizer-rose substantially (all p < 0.001). Years of service showed no meaningful correlation with gains in knowledge, attitude, or practice, underscoring the importance of structured training regardless of experience. The study revealed that the Harijan sanitary workers of Rajshahi benefited from occupational health interventions that raised their knowledge levels and may influence their health-related behaviours.