Handwashing indicators were strongly influenced by socio-economic status and so would not be an independent measure of handwashing behaviour. Handwashing promotion efforts in urban Dhaka that include specific efforts to provide handwashing facilities inside the house are more likely to improve handwashing behaviour than interventions that ignore this component. This is the conclusion of an early article in Tropical medicine & international health by Luby and Halder [1]. The authors explored the relationship of easy to collect handwashing indicators with socioeconomic status and reported respiratory disease among children below 5 years of age.

Of 6970 households, 92% had a bar of body soap, 41% had a place with water to wash hands inside the house, and 40% had soap present at the most convenient place to wash hands. Handwashing indicators were more common among households with higher socioeconomic status. Within each wealth quintile a place to wash hands within the household was strongly associated with the presence of soap at the handwashing location (odds ratios 13-70). In general estimated equation models that controlled for socioeconomic status, the presence of a place inside the house with water to wash hands was the only handwashing indicator significantly associated with a child in the household who reported cough or difficulty breathing in the preceding 7 days (adjusted odds ratio 0.95, 95% confidence interval 0.93-0.98, P < 0.001).

[1] Luby, S.P. and Halder, A.K. (2008). Associations among handwashing indicators, wealth, and symptoms of childhood respiratory illness in urban Bangladesh. Tropical medicine & international health. Online early article.

Related news: Hygiene: handwashing reduces diarrhoea by 30 per cent, Source Weekly, 29 Feb 2008

Related web site: Heal in Your Hands

Contact: Steve Luby, International Centre for Diarrhoeal Disease Research, Bangladesh, sluby@icddrb.org

Tags: hygiene promotion, urban wash