Handwashing among caregivers of young children in a protracted and complex refugee and immigration context

Introduction: Protracted refugee situations create complex contexts that present significant health risks for young children. Effective hand hygiene practices by caregivers can reduce respiratory infections and diarrhoeal disease, the two largest contributors to mortality among children between 1 month and 5 years of age. This study documented handwashing patterns and access to water, sanitation and hygiene (WASH) infrastructure among caregivers of young children living along the Thai-Myanmar border, one of the world's most protracted and complex refugee and immigration contexts. It also examined the association between handwashing and socio-demographic variables and captured participants' explanations for when and how hands are washed. The study broadened the scope of previous research by also including the large number of caregivers living outside formal camps. Methods: = 9). Results: Fewer than half the caregivers reported routinely washing their hands before preparing meals or after using the latrine/toilet. Fewer than one-in-five routinely used soap in these situations. Interviewees explained that handwashing was only necessary when a substance could be felt or seen, in which case wiping with a cloth or a rinsing with water were sufficient to clean hands. However, their explanations also suggested some potential avenues for culturally appropriate and feasible interventions to improve hand hygiene. Conclusion: The results confirmed previous research on the multi-dimensional barriers to good hand hygiene in protracted refugee situations and other low-resource settings. Additional investment to overcome shortages in the infrastructure necessary to support good hand hygiene and creative means of drawing on and developing human capital will be necessary to realize the potential hand hygiene holds for reducing ill-health and mortality among young children living in these contexts

Diarrhea · Diarrhoeal disease · Environmental health · Geography · Hand washing · Hygiene · Immigration · Latrine · Psychological intervention · Qualitative research · Refugee · Sanitation · Thematic analysis · Child Nutrition and Water Access · Medicine · Migration, Health and Trauma · Nursing · Pediatric health and respiratory diseases · Gerontology

• Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health

  Open Access•Katherine R Paulson, Katherine Paulson et al.•The Lancet•2021

  Incluir item

• Investing in the foundation of sustainable development

  Open Access•L M Richter, Bernadette Daelmans et al.•The Lancet•2017

  Incluir item

• Global, regional, and national causes of under-5 mortality in 2000–19

  Open Access•Jodi Perin, Jamie Perin et al.•The Lancet Child & Adolescent…•2022

  Incluir item

• Effectiveness of interventions to improve drinking water, sanitation, and handwashing with soap on risk of diarrhoeal disease in children in low-income and middle-income settings

  Open Access•Jennyfer Wolf, Sydney Hubbard et al.•The Lancet•2022

  Incluir item

• Effect of a behaviour-change intervention on handwashing with soap in India (SuperAmma)

  Open Access•Adam Biran, Wolf‐peter Schmidt et al.•The Lancet Global Health•2014

  Incluir item

• Planned, motivated and habitual hygiene behaviour

  Open Access•Val Curtis, V A Curtis et al.•Health Education Research•2009

  Incluir item

• Nurturing care

  Open Access•Pia R Britto, Stephen J Lye et al.•The Lancet•2017

  Incluir item

• Beyond frequency

  Open Access•Bas Verplanken•British Journal of Social…•2006

  Incluir item

• The Integrated Behavioural Model for Water, Sanitation, and Hygiene

  Open Access•Robert Dreibelbis, Peter J Winch et al.•BMC Public Health•2013

  Incluir item

• Consolidated criteria for reporting qualitative research (Coreq)

  A Jaure, A Tong et al.•International Journal for Quality…•2007

  Incluir item

• Early childhood development coming of age

  Open Access•Maureen M Black, Susan P Walker et al.•The Lancet•2017

  Incluir item

• Sociocultural Determinants to Adoption of Safe Water, Sanitation, and Hygiene Practices in Nyakach, Kisumu County, Kenya

  Open Access•Job Wasonga, Mark Okowa et al.•Journal of Anthropology•2016

  Incluir item

• Infectious disease risk communication and engagement using puppetry and related approaches for improving handwashing with soap in an informal settlement of Nairobi

  Open Access•Rebecca Richardson, Andrew Collins•International Journal of Disaster…•2023

  Incluir item

• Human resources for health

  Open Access•Sharon Y Y Low, Sharon Low et al.•Global Health Action•2014

  Incluir item

• Measles outbreaks in displaced populations

  Open Access•Isidore Koffi Kouadio, Taro Kamigaki et al.•BMC International Health and…•2010

  Incluir item

• Soap is not enough

  Open Access•Raina M Phillips, Jelena Vujcic et al.•Conflict and Health•2015

  Incluir item

• Innovative strategies for providing menstruation-supportive water, sanitation and hygiene (Wash) facilities

  Open Access•Margaret L Schmitt, Olivia R Wood et al.•Conflict and Health•2021

  Incluir item

• Hand Hygiene during the Early Neonatal Period

  Open Access•Yolisa Nalule, Hilary Buxton et al.•International Journal of…•2021

  Incluir item

• Screening for Intestinal Parasitic Infections Among Myanmar Migrant Workers in Thai Food Industry

  Open Access•Surang Nuchprayoon, Vivornpun Sanprasert et al.•Journal of Immigrant and Minority…•2008

  Incluir item

• Social and geographic inequalities in water, sanitation and hygiene access in 21 refugee camps and settlements in Bangladesh, Kenya, Uganda, South Sudan, and Zimbabwe

  Open Access•Alhelí Calderon-Villarreal, Ryan Schweitzer et al.•International Journal for Equity…•2022

  Incluir item

• Epidemiological investigation on hand hygiene knowledge and behaviour

  Open Access•Lorna Kwai Ping Suen, Zoe Y Y So et al.•BMC Public Health•2019

  Incluir item

• Barriers to and motivators of handwashing behavior among mothers of neonates in rural Bangladesh

  Open Access•Parveen, Shahana Parveen et al.•BMC Public Health•2018

  Incluir item

• The context and practice of handwashing among new mothers in Serang, Indonesia

  Open Access•Katie Greenland, Endang Iradati et al.•BMC Public Health•2013

  Incluir item

• Determinants of food preparation and hygiene practices among caregivers of children under two in Western Kenya

  Open Access•Emily Awino Ogutu, Anna Ellis et al.•BMC Public Health•2022

  Incluir item

• The 1951 Refugee Convention and Non-Signatory States

  Open Access•Maja Janmyr•International Journal of Refugee…•2021

  Incluir item

• A mixed methods systematic review of studies examining the relationship between housing and health for people from refugee and asylum seeking backgrounds

  Open Access•Anna Ziersch, Clemence Due•Social Science & Medicine•2018

  Incluir item

• Gender Differences in Violence and Other Human Rights Abuses Among Migrant Workers on the Thailand–Myanmar Border

  Open Access•Sarah R Meyer, Warren C Robinson et al.•Violence Against Women•2018

  Incluir item

• Estimating wealth effects without expenditure data—or tears

  Open Access•Deon Filmer, Lant Pritchett et al.•Demography•2001

  Incluir item

• Using thematic analysis in psychology

  Open Access•Braun, Virginia Braun et al.•Qualitative Research in Psychology•2006

  Incluir item

• Three kinds of psychological determinants for hand-washing behaviour in Kenya

  Open Access•Robert Aunger, Wolf‐peter Schmidt et al.•Social Science & Medicine•2010

  Incluir item

• Household ecology and out-migration among ethnic Karen along the Thai-Myanmar border

  Open Access•Daniel M Parker, James W Wood et al.•Demographic Research•2014

  Incluir item