title: Long-term impact of integration of household water treatment and hygiene promotion with antenatal services on maternal water treatment and hygiene practices in Malawi.
abstract: A clinic-based program to integrate antenatal services with distribution of hygiene kits including safe water storage containers, water treatment solution (brand name WaterGuard), soap, and hygiene education, was implemented in Malawi in 2007 and evaluated in 2010. We surveyed 389 participants at baseline in 2007, and found and surveyed 232 (60%) participants to assess water treatment, test stored drinking water for residual chlorine (an objective measure of treatment), and observe handwashing technique at follow-up in 2010. Program participants were more likely to know correct water treatment procedures (67% versus 36%; P < 0.0001), treat drinking water with WaterGuard (24% versus 2%; P < 0.0001), purchase and use WaterGuard (21% versus 1%; P < 0.001), and demonstrate correct handwashing technique (50% versus 21%; P < 0.001) at the three-year follow-up survey than at baseline. This antenatal-clinic-based program may have contributed to sustained water treatment and proper handwashing technique among program participants.
authors.affiliation: Epidemic Intelligence Service, and Division of Foodborne, Bacterial, and Mycotic Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. anagha.loharikar@gmail.com
authors.forename: Anagha
authors.initials: A
authors.lastname: Loharikar
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Russo
authors.forename: Anandi
authors.initials: A
authors.lastname: Sheth
authors.forename: Manoj
authors.initials: M
authors.lastname: Menon
authors.forename: Amose
authors.initials: A
authors.lastname: Kudzala
authors.forename: Blessius
authors.initials: B
authors.lastname: Tauzie
authors.forename: Humphreys D
authors.initials: HD
authors.lastname: Masuku
authors.forename: Tracy
authors.initials: T
authors.lastname: Ayers
authors.forename: Robert M
authors.initials: RM
authors.lastname: Hoekstra
authors.forename: Robert
authors.initials: R
authors.lastname: Quick
mesh_terms: D000293:Adolescent; D000328:Adult; D002713:Chlorine / Q000378:metabolism; D003430:Cross-Sectional Studies; D003625:Data Collection; D005191:Family Characteristics; D005260:Female; D005500:Follow-Up Studies; D006235:Hand Disinfection / Q000379:methods; D006293:Health Promotion; D006801:Humans; D006920:Hygiene / Q000592:standards*; D008295:Malawi; D008875:Middle Aged; D011247:Pregnancy; D012915:Soaps / Q000378:metabolism; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D018508:Water Purification / Q000379:methods*; D055815:Young Adult
chemical_list: D012915:Soaps; D002713:Chlorine