title: Acceptability and use of portable drinking water and hand washing stations in health care facilities and their impact on patient hygiene practices, Western kenya.
abstract: Many health care facilities (HCF) in developing countries lack access to reliable hand washing stations and safe drinking water. To address this problem, we installed portable, low-cost hand washing stations (HWS) and drinking water stations (DWS), and trained healthcare workers (HCW) on hand hygiene, safe drinking water, and patient education techniques at 200 rural HCFs lacking a reliable water supply in western Kenya. We performed a survey at baseline and a follow-up evaluation at 15 months to assess the impact of the intervention at a random sample of 40 HCFs and 391 households nearest to these HCFs. From baseline to follow-up, there was a statistically significant increase in the percentage of dispensaries with access to HWSs with soap (42% vs. 77%, p<0.01) and access to safe drinking water (6% vs. 55%, p<0.01). Female heads of household in the HCF catchment area exhibited statistically significant increases from baseline to follow-up in the ability to state target times for hand washing (10% vs. 35%, p<0.01), perform all four hand washing steps correctly (32% vs. 43%, p = 0.01), and report treatment of stored drinking water using any method (73% vs. 92%, p<0.01); the percentage of households with detectable free residual chlorine in stored drinking water did not change (6%, vs. 8%, p = 0.14). The installation of low-cost, low-maintenance, locally-available, portable hand washing and drinking water stations in rural HCFs without access to 24-hour piped water helped assure that health workers had a place to wash their hands and provide safe drinking water. This HCF intervention may have also contributed to the improvement of hand hygiene and reported safe drinking water behaviors among households nearest to HCFs.
authors.affiliation: Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
authors.forename: Sarah D
authors.initials: SD
authors.lastname: Bennett
authors.affiliation: Safe Water and AIDS Project, Kisumu, Nyanza Province, Kenya.
authors.forename: Ronald
authors.initials: R
authors.lastname: Otieno
authors.affiliation: Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Ayers
authors.affiliation: Safe Water and AIDS Project, Kisumu, Nyanza Province, Kenya.
authors.forename: Aloyce
authors.initials: A
authors.lastname: Odhiambo
authors.affiliation: Safe Water and AIDS Project, Kisumu, Nyanza Province, Kenya.
authors.forename: Sitnah H
authors.initials: SH
authors.lastname: Faith
authors.affiliation: Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
authors.forename: Robert
authors.initials: R
authors.lastname: Quick
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D002648:Child; D002675:Child, Preschool; D060766:Drinking Water; D005191:Family Characteristics; D005260:Female; D063373:Hand Hygiene; D006268:Health Facilities; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D007223:Infant; D007630:Kenya; D008297:Male; D062486:Public Health Surveillance; D055815:Young Adult
chemical_list: D060766:Drinking Water