title: Water treatment and handwashing behaviors among non-pregnant friends and relatives of participants in an antenatal hygiene promotion program in Malawi.
abstract: Access to safe drinking water and improved hygiene are essential for preventing diarrheal diseases. To integrate hygiene improvement with antenatal care, free hygiene kits (water storage containers, water treatment solution, soap) and educational messages were distributed to pregnant women at antenatal clinics in Malawi. We assessed water treatment and hygiene practices of 275 non-pregnant friends and relatives of the hygiene kit recipients at baseline and follow-up nine months later to measure program impact on non-participants in the same communities. At follow-up, friends and relatives who did not receive kits or education were more likely than at baseline to purchase and use water treatment solution (25% versus 1%; P < 0.0001) and demonstrate correct handwashing practices (60% versus 18%; P < 0.0001). This antenatal clinic-based program resulted in improved water treatment and hygiene behaviors among non-pregnant friends and relatives living in the same communities as hygiene kit recipients, suggesting that program benefits extended beyond direct beneficiaries.
authors.affiliation: Division of Foodborne, Waterborne, and Environmental Diseases, and Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. elizabeth.russo@gmail.com
authors.forename: Elizabeth T
authors.initials: ET
authors.lastname: Russo
authors.forename: Anandi
authors.initials: A
authors.lastname: Sheth
authors.forename: Manoj
authors.initials: M
authors.lastname: Menon
authors.forename: Kathleen
authors.initials: K
authors.lastname: Wannemuehler
authors.forename: Merri
authors.initials: M
authors.lastname: Weinger
authors.forename: Amose C
authors.initials: AC
authors.lastname: Kudzala
authors.forename: Blessius
authors.initials: B
authors.lastname: Tauzie
authors.forename: Humphreys D
authors.initials: HD
authors.lastname: Masuku
authors.forename: Tapona E
authors.initials: TE
authors.lastname: Msowoya
authors.forename: Robert
authors.initials: R
authors.lastname: Quick
mesh_terms: D003247:Conservation of Natural Resources; D003967:Diarrhea / Q000517:prevention & control*; D060766:Drinking Water / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006235:Hand Disinfection / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D006920:Hygiene; D008295:Malawi; D011247:Pregnancy; D012915:Soaps / Q000378:metabolism; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
chemical_list: D060766:Drinking Water; D012915:Soaps