Share research - Behaviour Change

Factors perceived to facilitate or hinder handwashing among primary students: a qualitative assessment of the Mikono Safi intervention schools in NW Tanzania

shareadmin — Mon, 02 Dec 2019 21:16:47 +0000

This paper was published in BMJ Open by Okello et al. (2019). The study used qualitative methods to assess the effects of a multi-modal school-based water, sanitation and hygiene (WASH) intervention on handwashing behaviour among primary students in North Western (NW) Tanzania. Barriers and facilitators to handwashing were explored in the students who participated in the Mikono Safi Trial (Kiswahili for ‘Clean Hands). The intervention increased students' reported capability and motivation to wash their hands with soap at key times, particularly after visiting the toilet. Improvements in students’ handwashing knowledge and skills were reported by both teachers and students, and motivation for handwashing was enhanced by emotional drivers such as disgust, fear and nurture. Newly established handwashing stations improved the physical opportunity to wash hands, although the availability of water and the provision of soap was not always consistent (e.g. due to internal organisational shortcomings or during the dry season). Students and teachers were actively engaged in intervention implementation which created a school community that valued and supported improved hand hygiene.

Download (751.96 KB) Mikono Safi Marni Brennan Tanzania

Policy brief: Changing urban sanitation infrastructure through behaviour change interventions in Lusaka, Zambia

shareadmin — Fri, 01 Nov 2019 13:00:15 +0000

This policy brief details how CIDRZ's San-Dem project used behaviour centred design (BCD) to improve sanitation quality in an informal urban settlement in Lusaka, Zambia. The brief gives recommendations on next steps for scaling up the San-Dem project nationally and globally.

Download (439.41 KB) San-Dem Marni Brennan Zambia

Developing a Contextually Appropriate Integrated Hygiene Intervention to Achieve Sustained Reductions in Diarrheal Diseases

shareadmin — Tue, 17 Sep 2019 09:22:10 +0000

Morse et al. (2019) published this paper in the Sustainability journal. The article discusses formative research carried out to inform the development of an integrated intervention for WASH and food hygiene that aimed to reduce childhood diarrhea in rural Malawi. The researchers explored the personal, social, environmental and psychosocial factors that should be considered in the intervention. A mixed methods approach was used and data was collected from 1079 children between the ages of four to 90 weeks. Four key thematic areas were identified: hand washing with soap; food hygiene; feces management (human and animal); and, water management. The paper also describes the intervention to be delivered and evaluated.

Download (3.64 MB) Integrating WASH and Food Hygiene in Malawi Marni Brennan Malawi

Using a theory-driven creative process to design a peri-urban on-site sanitation quality improvement intervention

shareadmin — Fri, 31 May 2019 15:02:54 +0000

Tidwell et al.’s (2019) paper, published in BMC Public Health, discusses the authors’ experiences of using the Behaviour Centered Design (BCD) framework to design a sanitation quality improvement behaviour change intervention for a peri-urban site in Lusaka, Zambia. The intervention aimed to encourage landlords to improve their toilets by making them more accessible, desirable, hygienic and sustainable. Use of the BCD model resulted in a theory-driven, creative and multi-faceted intervention. This work advances applied behavioural science, will be able to be adapted to improve on-site sanitation in other settings and will contribute to the iterative development of the BCD model.

Download (720.97 KB) San-Dem Marni Brennan Zambia

Effect of a behaviour change intervention on the quality of peri-urban sanitation in Lusaka, Zambia: A randomised controlled trial

shareadmin — Fri, 31 May 2019 15:00:52 +0000

This paper by Tidwell et al. (2019) describes a randomised control trial carried out in Lusaka, Zambia, to determine the effect of a behaviour change intervention to motivate landlords to improve the quality of shared toilets on their plots in a peri-urban setting. The study was published in The Lancet Planetary Health. The intervention was developed using a Behaviour Centred Design approach and involved a series of group meetings designed to motivate sanitation quality improvement as a way to build wealth and reduce on-plot conflict. 1085 landlords were enrolled and no subsidies or materials were provided. Outcomes measured included having a rotational cleaning system (for hygiene), having a solid door on the toilet with an inside lock (for privacy), having an outside lock (for security) and having a sealed toilet (to reduce smell and contamination). Outcomes were measured 1 month before the intervention and 4 months after it ended. The intervention was associated with improvements in all of the outcomes, showing that it is possible to improve the structural quality and cleanliness of shared sanitation through behaviour change interventions and without provision of additional subsidies or materials.

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Assessing peri-urban sanitation quality using a theoretically derived composite measure in Lusaka, Zambia

shareadmin — Thu, 02 Aug 2018 09:45:47 +0000

This paper, published by Tidwell et al. (2018) in The Journal of Water, Sanitation and Hygiene for Development, highlights how a Peri-Urban Healthy Toilet Index (PUHTI) was created for measuring on-site, peri-urban sanitation quality in Lusaka, Zambia. Applying the PUHTI tool showed that while 87% of toilets were classified as ‘improved, but shared,’ there were frequent concerns about doors that could not be locked, dirty user interfaces, unhygienic containment, limited emptyability, and lack of handwashing facilities.

Download (201.64 KB) San-Dem Zambia

Behaviour Change for WASH: Policy Brief

shareadmin — Tue, 26 Jun 2018 15:35:12 +0000

Since 2010, the SHARE Consortium has prioritised behaviour change in WASH interventions, championing the importance of identifying novel and creative approaches to changing behaviours across many countries. This policy brief documents SHARE’s contribution to understanding behaviour change and associated health impacts. It provides recommendations for researchers and intervention implementers, policy makers and funders.

Download (473.23 KB) Choose Soap Integrating WASH and Food Hygiene in Malawi Mikono Safi Safe Start San-Dem SuperAmma Weaning Food Hygiene - Bangladesh Weaning Food Hygiene - Mali Weaning Food Hygiene - Nepal Weaning Food Hygiene - The Gambia Sophie Durrans Bangladesh India Kenya Malawi Mali Nepal Tanzania The Gambia Zambia

Safe Start - Formative Research Brief

shareadmin — Fri, 06 Apr 2018 08:50:32 +0000

This briefing note provides an overview of the formative research conducted for the Safe Start project in Kenya. The brief highlights results from the formative work, and provides key learnings that will inform the main intervention.

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Oral Contact Events and Caregiver Hand Hygiene: Implications for Fecal-Oral Exposure to Enteric Pathogens among Infants 3–9 Months Living in Informal, Peri-Urban Communities in Kisumu, Kenya

shareadmin — Mon, 12 Feb 2018 12:43:07 +0000

Childhood diarrhea is one of the leading causes of morbidity and mortality in children under five in low and middle-income countries, second only to respiratory illness. The mouthing behavior that is common in children exposes them to fecal-orally transmitted pathogens that can result in diarrhea; however, there is a need for further evidence on specific exposure routes. This study describes the frequency and diversity of two important routes of enteric pathogen exposure among infants 3–9 months of age: infant oral contact behavior and caregiver handwashing behavior. The combined implication of data from observing oral contact behavior in children and hand hygiene of caregivers suggests that caregiver hand hygiene prior to feeding events and after cleaning a child are priority interventions.

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San-Dem - Formative Research Brief

shareadmin — Thu, 30 Nov 2017 12:12:09 +0000

This briefing note provides an overview of the formative research conducted for the San-Dem project in Zambia. The brief highlights key results from the formative work, and provides recommendations for the main intervention.

Download (227.76 KB) San-Dem Zambia