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An investigation of the effects of a hand washing intervention on health outcomes and school absence using a randomised trial in Indian urban communities
Author(s) -
Nicholson Julie A.,
Naeeni Mojgan,
Hoptroff Michael,
Matheson Jane R.,
Roberts Anthony J.,
Taylor David,
Sidibe Myriam,
Weir Anthony J.,
Damle Satyawan G.,
Wright Richard L.
Publication year - 2014
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12254
Subject(s) - medicine , psychological intervention , absenteeism , public health , confidence interval , environmental health , hand washing , health promotion , intervention (counseling) , randomized controlled trial , hygiene , demography , pediatrics , nursing , surgery , psychology , social psychology , pathology , sociology
Objectives To evaluate how an intervention, which combined hand washing promotion aimed at 5‐year‐olds with provision of free soap, affected illnesses among the children and their families and children's school absenteeism. Methods We monitored illnesses, including diarrhoea and acute respiratory infections ( ARI s), school absences and soap consumption for 41 weeks in 70 low‐income communities in Mumbai, India (35 communities per arm). Results Outcomes from 847 intervention households (containing 847 5‐year‐olds and 4863 subjects in total) and 833 control households (containing 833 5‐year‐olds and 4812 subjects) were modelled using negative binomial regression. Intervention group 5‐year‐olds had fewer episodes of diarrhoea (−25%, 95% confidence intervals [ CI ] = −37%, −2%), ARI s (−15%, 95% CI = −30%, −8%), school absences due to illnesses (−27%, 95% CI = −41%, −18%) and eye infections (−46%, 95% CI = −58%, −31%). Further, there were fewer episodes of diarrhoea and ARI s in the intervention group for ‘whole families’ (−31%, 95% CI = −37%, −5%; and −14%, 95% CI = −23%, −6%, respectively), 6‐ to 15‐year‐olds (−30%, 95% CI = −39%, −7%; and −15%, 95% CI = −24%, −6%) and under 5 s (−32%, 95% CI = −41%, −4%; and −20%, 95% CI = −29%, −8%). Conclusions Direct‐contact hand washing interventions aimed at younger school‐aged children can affect the health of the whole family. These may be scalable through public–private partnerships and classroom‐based campaigns. Further work is required to understand the conditions under which health benefits are transferred and the mechanisms for transference.