Hygiene
Dispose of faeces, including children’s faeces, safely, and wash hands after defecation before preparing meals and before feeding children.
It has been estimated that 88% of the diarrhoeal disease burden is attributable to unsafe water supply, sanitation and hygiene, and mostly falls on children in developing countries.
Faecal disposal. Improved sanitation has been associated with a median reduction in all-cause child mortality by 55%, diarrhoea mortality by 65%, and diarrhoea morbidity by 26% (Family and community practices that promote child survival, growth and development: a review of the evidence).
Interventions to improve sanitation should include also hygiene education.
Handwashing. Handwashing practices are often poor.
Although the impact on diarrhoea morbidity varies considerably between studies, there is evidence that interventions successfully promoting handwashing have resulted in significant reductions in diarrhoea incidence, by a median of 33% according to a review (Family and community practices that promote child survival, growth and development: a review of the evidence). The impact has been higher for interventions focussing only on handwashing and no other practice.
Of interest is the use of marketing approaches to involve soap industry in promoting handwashing with soap.
When designing handwashing interventions on a large scale, a number of factors should be taken into consideration, including among others their feasibility and cost, family resources, community involvement and cultural beliefs, and access to water and to cleansing agents.
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