title: Understanding household behavioral risk factors for diarrheal disease in Dar es Salaam: a photovoice community assessment.
abstract: Whereas Tanzania has seen considerable improvements in water and sanitation infrastructure over the past 20 years, the country still faces high rates of childhood morbidity from diarrheal diseases. This study utilized a qualitative, cross-sectional, modified Photovoice method to capture daily activities of Dar es Salaam mothers. A total of 127 photographs from 13 households were examined, and 13 interviews were conducted with household mothers. The photographs and interviews revealed insufficient hand washing procedures, unsafe disposal of wastewater, uncovered household drinking water containers, a lack of water treatment prior to consumption, and inappropriate toilets for use by small children. The interviews revealed that mothers were aware and knowledgeable of the risks of certain household practices and understood safer alternatives, yet were restricted by the perceived impracticality and financial constraints to make changes. The results draw attention to the real economic and behavioral challenges faced in reducing the spread of disease.
authors.affiliation: Stanford Prevention Research Center, Stanford University School of Medicine, 1070 Arastradero Road, Suite 100, Stanford, CA 94304-1334, USA.
authors.forename: Natalie
authors.initials: N
authors.lastname: Badowski
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Castro
authors.forename: Maggie
authors.initials: M
authors.lastname: Montgomery
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Pickering
authors.forename: Simon
authors.initials: S
authors.lastname: Mamuya
authors.forename: Jennifer
authors.initials: J
authors.lastname: Davis
mesh_terms: D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D003296:Cooking; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000517:prevention & control*; D005260:Female; D006235:Hand Disinfection / Q000379:methods; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012499:Sanitation / Q000592:standards*; D013636:Tanzania; D014038:Toilet Facilities; D014505:Urban Population; D014881:Water Supply / Q000592:standards*; D055815:Young Adult