Impact of different promotional channels on handwashing behaviour in an emergency context: Haiti post-earthquake public health promotions and cholera response

摘要

Aim: In a disaster context, where risk for diarrhoeal disease is elevated, personal hygiene, i.e. handwashing with soap, is especially relevant. However, to date, the promotion of hygiene in an emergency context has not been adequately addressed in the literature. The aim of the present study is to evaluate the effectiveness of hygiene promotions in post-earthquake Haiti. Subject and Methods: Cross-sectional data was collected by means of structured interviews in camps and neighbourhoods in which three affiliates of a well-known relief organisation had conducted hygiene promotions. Primary caregivers were targeted. A total sample of 811 was obtained. Data was analysed using multiple linear regression and mediation analysis. Results: Analysis revealed six promotional channels with positive associations with handwashing behaviour: hygiene radio spots, radio programs with experts answering listener's questions, material distributions with instructions for use, information from friends or neighbours, hygiene theatres, and community clubs. However, five of the promotional channels were negatively related with handwashing. Respondents who experienced a focus group, stickers, posters and paintings, hygiene songs, special hygiene days and home visits tended to wash their hands less often. Conclusions: By revealing positive but also negative associations between hygiene promotions and handwashing behaviour, the study underlines the need to apply theory-driven emergency hygiene promotions which are subjected to in-depth evaluation. Only through doing this, is it ensured that effective hygiene promotions are implemented for the most vulnerable people - those affected by a humanitarian disaster.