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Provision of private, piped water and sewerage connections and directly observed handwashing of mothers in a peri‐urban community of Lima, Peru
Author(s) -
Oswald William E.,
Hunter Gabrielle C.,
Kramer Michael R.,
Leontsini Elli,
Cabrera Lilia,
Lescano Andres G.,
Gilman Robert H.
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.12262
Subject(s) - sewerage , sanitation , hygiene , open defecation , environmental health , defecation , water supply , socioeconomics , medicine , latrine , water resource management , geography , environmental engineering , environmental science , surgery , pathology , sociology
Objectives To estimate the association between improved water and sanitation access and handwashing of mothers living in a peri‐urban community of Lima, Peru. Methods We observed 27 mothers directly, before and after installation of private, piped water and sewerage connections in the street just outside their housing plots, and measured changes in the proportion of faecal‐hand contamination and hand‐to‐mouth transmission events with handwashing. Results After provision of water and sewerage connections, mothers were approximately two times more likely to be observed washing their hands within a minute of defecation, compared with when they relied on shared, external water sources and non‐piped excreta disposal ( RR = 2.14, 95% CI = 0.99–4.62). With piped water and sewerage available at housing plots, handwashing with or without soap occurred within a minute after 48% (10/21) of defecation events and within 15 min prior to 8% (11/136) of handling food events. Conclusions Handwashing increased following installation of private, piped water and sewerage connections, but its practice remained infrequent, particularly before food‐related events. Infrastructural interventions should be coupled with efforts to promote hygiene and ensure access to water and soap at multiple on‐plot locations convenient to mothers.