The article is a qualitative study evaluating the acceptability and feasibility of a shared soapy water system for handwashing in a low-income urban community in Dhaka, Bangladesh. It explores how a simple handwashing solution—mixing detergent with water in reclaimed bottles—can promote hygiene in communal settings. The study highlights the benefits of the system, including its low cost, ease of use, and effectiveness in encouraging handwashing at key times, such as after defecation. Challenges include reluctance to share the cost and maintain the system. The document emphasizes the role of community health promoters in encouraging behavior change to improve hand hygiene.
Author(s): Sultana, Farhana; Unicomb, Leanne E; Nizame, Fosiul A; Dutta, Notan Chandra; Ram, Pavani K; Luby, Stephen P; Winch, Peter J
Published: 2018
Language: English
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Additional Information
Handwashing with soap at key times is an effective means of reducing pathogen transmission. In a lowincome community in urban Dhaka, we piloted and evaluated the acceptability and feasibility of a shared handwashing intervention. This included promotion by community health promoters of a homemade solution of detergent powder mixed with water and stored in a 1.5-L reclaimed mineral water bottle. Community health promoters encouraged sharing of the recurrent detergent cost among compound members. Of 152 participating compounds, fieldworkers randomly selected 60 for qualitative assessment. Fieldworkers conducted 30 in-depth interviews and five focus group discussions among purposively selected compound members. The reclaimed bottles served as an easily accessible dispenser for the soapy water, which could feasibly be retained next to the toilet and kitchen areas for communal use. Bottles functioned
as a positive reminder for handwashing at recommended key times. Most compounds (45/60, 75%) shared a common soapy water system and its associated costs. There was reluctance to prepare soapy water for shared use in the remaining 25%. Soapy water was an acceptable hand cleaning agent, with the bottle as a feasible dispenser. It was simple in design,
cost-effective, replicable, popular with intervention recipient, and neighboring nonrecipients, and commonly shared among nonrelated households. The need to share expenses and product preparation served as a barrier. Developing a sustainable maintenance system, therefore, is critical to ensuring the public health benefits of handwashing with soap.