title: Hand washing behavior and associated factors in Vietnam based on the Multiple Indicator Cluster Survey, 2010-2011.
abstract: BACKGROUND
  Handwashing is a cost-effective way of preventing communicable diseases such as respiratory and food-borne illnesses. However, handwashing rates are low in developing countries. Target 7C of the seventh Millennium Development Goals was to increase by half the proportion of people with sustainable access to safe drinking water and basic sanitation by 2015. Studies have found that better access to improved water sources and sanitation is associated with higher rates of handwashing.
  
  
  OBJECTIVE
  Our goal was to describe handwashing behaviour and identify the associated factors in Vietnamese households.
  
  
  METHODS
  Data from 12,000 households participating in the Vietnam Multiple Indicator Cluster Survey 2011 were used. The survey used a multistage sampling method to randomly select 100 clusters and 20 households per cluster. Self-administered questionnaires were used to collect data from a household representative. Demographic variables, the presence of a specific place for handwashing, soap and water, access to improved sanitation, and access to improved water sources were tested for association with handwashing behaviour in logistic regression.
  
  
  RESULTS
  Almost 98% of households had a specific place for handwashing, and 85% had cleansing materials and water at such a place. The prevalence of handwashing in the sample was almost 85%. Educational level, ethnicity of the household head, and household wealth were factors associated with handwashing practice (p<0.05). Those having access to an improved sanitation facility were more likely to practise handwashing [odds ratio (OR)=1.69, 95% confidence interval (CI): 1.37-2.09, p<0.001], as were those with access to improved water sources (OR=1.74, 95% CI: 1.37-2.21, p<0.001).
  
  
  CONCLUSIONS
  Households with low education, low wealth, belonging to ethnic minorities, and with low access to improved sanitation facilities and water sources should be targeted for interventions implementing handwashing practice. In addition, the availability of soap and water at handwashing sites should be increased and practical teaching programs should be deployed in order to increase handwashing rates.
authors.affiliation: Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam; kiengiato@gmail.com.
authors.forename: Kien Gia
authors.initials: KG
authors.lastname: To
authors.affiliation: JW LEE Center for Global Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.|Department of Family Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; docmohw@snu.ac.kr.
authors.forename: Jong-Koo
authors.initials: JK
authors.lastname: Lee
authors.affiliation: JW LEE Center for Global Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.|Department of Family Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: You-Seon
authors.initials: YS
authors.lastname: Nam
authors.affiliation: Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.
authors.forename: Oanh Thi Hoang
authors.initials: OT
authors.lastname: Trinh
authors.affiliation: Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.
authors.forename: Dung
authors.initials: D
authors.lastname: Van Do
mesh_terms: D003967:Diarrhea / Q000517:prevention & control; D005006:Ethnicity; D005191:Family Characteristics; D006235:Hand Disinfection; D063373:Hand Hygiene / Q000706:statistics & numerical data; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D011634:Public Health; D012499:Sanitation / Q000592:standards*; D012915:Soaps; D011795:Surveys and Questionnaires; D014744:Vietnam; D014881:Water Supply
chemical_list: D012915:Soaps
keywords: Vietnam; communicable disease control; community survey; hand hygiene; hand washing; public health practice