EVIDENCE LINKING HANDWASHING TO IMPROVED CHILD FEEDING OUTCOME | 20th International Congress of Nutrition , Granada, Spain, September 15–20, 2013
L. Unicomb1, F. Nizame1, D. Biswas1, P. Ghosh1, S. Roy2, T. Sanghvi2, S. Luby 1,3 1International Centre For Diarrhoeal Disease Research, Bangladesh, 2 Alive and Thrive, Bangladesh, 3 Infectious Diseases and Geographic Medicine, Center for Innovation and Global Health Stanford University, Stanford, USA
Background and objectives: Handwashing with soap can prevent childhood infections; reduced infections and improved complementary feeding can reduce malnutrition. We describe formative research to link handwashing with soap to complementary feeding and an intervention trial.
Methods: A formative study on perceptions, practices, barriers and motivators, among households across three districts in Bangladesh, with a child 6-23 months of age given complementary food included video data collection, motivational exercises, indepth interviews, and focus group discussions. An intervention trial of an integrated handwashing and complementary feeding included qualitative studies and baseline-endline surveys among up to 450 households.
Results: Distant location of soap and water from the child feeding place was a common barrier to handwashing with soap before child feeding; commonly water only was used. Limited knowledge of the link between handwashing with soap around food events and childhood disease prevention was detected. Facilities that brought soap and water together, located near the kitchen was a motivator and reminder for handwashing with soap. By the trial end, 65% of participants were observed washing hands with soap at key times, 75% reported that they intended to adopt and continue, 83% followed complementary feeding recommendations, the main motivators being child health and convenience. Trial target handwashing practice was associated with intervention component exposure, handwashing facility near the kitchen and perceived link between disease and handwashing. Acceptable complementary feeding was associated with wealth, older child age and intervention component exposure.
Conclusions: The integrated handwashing and improved complementary feeding intervention was acceptable and feasible. Handwashing facilities location increase convenience and facilitate handwashing. Increasing knowledge on complementary feeding and links between handwashing and disease prevention were incorporated into a national media campaign to motivate behavior change.
