title: Teaching minority children hygiene: investigating hygiene education in kindergartens and homes of ethnic minority children in northern Vietnam.
abstract: OBJECTIVE
  Ethnic minority children in Vietnam experience high levels of hygiene- and sanitation-related diseases. Improving hygiene for minority children is therefore vital for improving child health. The study objective was to investigate how kindergarten and home environments influence the learning of hygiene of pre-school ethnic minority children in rural Vietnam.
  
  
  METHODS
  Eight months of ethnographic field studies were conducted among four ethnic minority groups living in highland and lowland communities in northern Vietnam. Data included participant observation in four kindergartens and 20 homes of pre-school children, together with 67 semi-structured interviews with caregivers and five kindergarten staff. Thematic analysis was applied and concepts of social learning provided inputs to the analysis.
  
  
  RESULTS
  This study showed that poor living conditions with lack of basic sanitation infrastructures were important barriers for the implementation of safe home child hygiene. Furthermore, the everyday life of highland villages, with parents working away from the households resulted in little daily adult supervision of safe child hygiene practices. While kindergartens were identified as potentially important institutions for improving child hygiene education, essential and well-functioning hygiene infrastructures were lacking. Also, hygiene teaching relied on theoretical and non-practice-based learning styles, which did not facilitate hygiene behaviour change in small children. Minority children were further disadvantaged as teaching was only provided in non-minority language.
  
  
  CONCLUSIONS
  Kindergartens can be important institutions for the promotion of safe hygiene practices among children, but they must invest in the maintenance of hygiene and sanitation infrastructures and adopt a strong practice-based teaching approach in daily work and in teacher's education. To support highland minority children in particular, teaching styles must take local living conditions and caregiver structures into account and teach in local languages. Creating stronger links between home and institutional learning environments can be vital to support disadvantaged highland families in improving child health.
authors.affiliation: a Department of International Health, Immunology and Microbiology , University of Copenhagen , Copenhagen , Denmark.
authors.forename: Thilde
authors.initials: T
authors.lastname: Rheinländer
authors.forename: Helle
authors.initials: H
authors.lastname: Samuelsen
authors.forename: Anders
authors.initials: A
authors.lastname: Dalsgaard
authors.forename: Flemming
authors.initials: F
authors.lastname: Konradsen
mesh_terms: D002675:Child, Preschool; D005006:Ethnicity; D005260:Female; D006266:Health Education; D006801:Humans; D006920:Hygiene / Q000193:education*; D007223:Infant; D007407:Interviews as Topic; D008297:Male; D008913:Minority Groups; D012424:Rural Population; D014744:Vietnam
keywords: Vietnam; children; ethnic minorities; health education; qualitative research; social capital