title: Observed practices and perceived advantages of different hand cleansing agents in rural Bangladesh: ash, soil, and soap.
abstract: Bangladeshi communities have historically used ash and soil as handwashing agents. A structured observation study and qualitative interviews on the use of ash/soil and soap as handwashing agents were conducted in rural Bangladesh to help develop a handwashing promotion intervention. The observations were conducted among 1,000 randomly selected households from 36 districts. Fieldworkers observed people using ash/soil to wash their hand(s) on 13% of occasions after defecation and on 10% after cleaning a child's anus. This compares with 19% of people who used soap after defecation and 27% after cleaning a child who defecated. Using ash/soil or soap was rarely (< 1%) observed at other times recommended for handwashing. The qualitative study enrolled 24 households from three observation villages, where high usage of ash/soil for handwashing was detected. Most informants reported that ash/soil was used only for handwashing after fecal contact, and that ash/soil could clean hands as effectively as soap.
authors: icddr,b, Dhaka, Bangladesh; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Stanford University, Stanford, California fosiul@icddrb.org fosiul05@gmail.com.
authors: Fosiul A
authors: FA
authors: Nizame
authors: icddr,b, Dhaka, Bangladesh; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Stanford University, Stanford, California.
authors: Sharifa
authors: S
authors: Nasreen
authors: icddr,b, Dhaka, Bangladesh; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Stanford University, Stanford, California.
authors: Amal K
authors: AK
authors: Halder
authors: icddr,b, Dhaka, Bangladesh; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Stanford University, Stanford, California.
authors: Shaila
authors: S
authors: Arman
authors: icddr,b, Dhaka, Bangladesh; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Stanford University, Stanford, California.
authors: Peter J
authors: PJ
authors: Winch
authors: icddr,b, Dhaka, Bangladesh; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Stanford University, Stanford, California.
authors: Leanne
authors: L
authors: Unicomb
authors: icddr,b, Dhaka, Bangladesh; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Stanford University, Stanford, California.
authors: Stephen P
authors: SP
authors: Luby
mesh_terms: D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D003672:Defecation; D003902:Detergents; D004522:Educational Status; D005260:Female; D006235:Hand Disinfection / Q000379:methods*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D012424:Rural Population / Q000706:statistics & numerical data*; D012915:Soaps; D012987:Soil; D055815:Young Adult
chemical_list: D003902:Detergents; D012915:Soaps; D012987:Soil