Hand washing practice in ASEH Project Area: a study for impact monitoring : paper presented at the South Asia Hygiene Practitioners Workshop, Dhaka, Bangladesh, 1 to 4 February 2010

The study examined the status and benefits of hand washing with cleaning agents at five critical times. This study (2008) was the third part of a longitudinal study, of a project in rural and urban areas of Bangladesh, with an earlier baseline (2004) and mid-term impact study (2007). It was designed using an iterative Cluster Sampling Technique. The study revealed that knowledge about critical hand washing times increased significantly in both rural and urban areas at all of five critical times of hand washing, except two critical times related to children in rural. Again, 27% and 63% respondents in rural and urban areas respectively have knowledge about all of five critical times. Hand washing at these critical times increased in rural and urban areas, with the exception of feeding young children in rural. It is worth mentioning that 27% people in rural and 32% people in urban areas reported washing their hands properly at all of five critical times. These results, however, critically depended on time period of project implementation and geographical contexts. Incidence of diseases, duration of sickness and workdays lost for waterborne diseases decreased from baseline. Nonetheless, people who did not wash their hands properly are affected more by waterborne diseases. Data from respondents showed that medical expenditures were reduced by 64% in rural and 73% in urban areas, implying a significant increase in disposable income. The project has significant positive impacts, e.g., reducing waterborne diseases, decreasing lost workdays, increasing disposable income, and decreasing medical expenditure due to proper hand washing practice with appropriate cleaning agents.