title: Promotion of sanitation and hygiene in a rural area of South India: A community-based study.
abstract: BACKGROUND
  Globally, billions of people do not have access to improved sanitation and many defecate in the open air. Poor hand washing practices and limited access to sanitation facilities perpetuate the transmission of disease-causing germs. The objectives of the study were to find out the level of knowledge, attitudes, and practices (KAPs) on sanitary latrine, footwear, and hand washing among rural people and to assess the improvement in KAP after health education intervention.
  
  
  METHODS
  A health education intervention study was conducted from November 2012 to January 2014 in a rural area of Kuppam, Andhra Pradesh, South India among the people aged 15 years and above. The individuals were selected by multistage random sampling and interviewed using a structured questionnaire. After a baseline KAP assessment, intervention activities were conducted twice. The intervention activities were group level talks and discussions, free soap distribution, and display of posters at anganwadi centers. Post-KAP was assessed twice, and the significance of difference was found by using McNemar's test.
  
  
  RESULTS
  After the intervention, there was a significant improvement in the overall KAPs among the subjects in post test-1 and post test-2 (P1< 0.0001,P2< 0.0001), respectively.
  
  
  CONCLUSIONS
  Health education as an intervention has significantly increased KAP more than 30%. Hence, it is imperative that education interventions are needed to bring or sustain positive change.
authors.affiliation: Department of Community Medicine, Viswabharathi Medical College, Kurnool, Andhra Pradesh, India.
authors.forename: Nagapraveen
authors.initials: N
authors.lastname: Veerapu
authors.affiliation: Department of Community Medicine, PES Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh, India.
authors.forename: P
authors.initials: P
authors.lastname: Subramaniyan
authors.affiliation: Department of Community Medicine, PES Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh, India.
authors.forename: B A
authors.initials: BA
authors.lastname: Praveenkumar
authors.affiliation: Department of Community Medicine, PES Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh, India.
authors.forename: G
authors.initials: G
authors.lastname: Arun
keywords: Attitudes and practices; disease; footwear; hand washing; health education; knowledge; sanitary latrine