206773 When Knowledge Fails: Hygiene in Rural Honduras

Tuesday, November 10, 2009

Pamela Bravo Alcantara , The Pan American Health Organization, North West, DC
Shannon Young, MPH , Office of the Associate Director for Program, Centers for Disease Control and Prevention, Atlanta, GA
Mateyo Bonham , The School of Public Health and Health Services, The George Washintton University, North West, DC

Childhood diarrhea is a leading cause of morbidity and mortality in Honduras. Poor hygiene practices are one of the main risk factors for diarrheal transmission: 47% of mothers with children younger than five years old do not dispose of feces safely, while 57% of households in rural communities do not treat their water. Little research has been conducted in rural areas regarding hygiene behavior, beliefs and motivations.


Over the course of two months in 2008, we conducted formative research using focus groups, in-depth interviews and participant observations. The study assessed hygiene practices among women aged 19-59 years who cared for children aged five and under in San Antonio de la Libertad, a sparsely populated rural community in Central Honduras.


Despite the presence of soap in households (93%), mothers did not use it when washing their hands. Mothers were aware of the causes of water contamination and the effects of diarrhea. Hygiene behavior, however, did not match this knowledge. The study found the motivation of mothers to appear clean, attractive, wealthy, and responsible drove hygiene behavior.


These findings emphasize that hygiene promotion interventions should not rely solely on the public health and/or biomedical approaches. Rather, a hygiene behavior change program will succeed or fail depending on the understanding of the social and consumer motivations of the target population (e.g. mothers). This research suggests a successful hygiene behavior change campaign should incorporate a social marketing approach that retains its consumer focus and a sound understanding of user motivations.

Learning Objectives:
Discuss how knowledge vs. cultural beliefs, attitudes and motivations affects hygiene behavior. Explain the importance of "consumer motivation" in the design of a hygiene behavior change program.

Keywords: Behavioral Research, Diarrhea

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted the behavioral study related to hygiene practices. Additionally,I was a former member of the Ministry of Health, Peru, working for 4 years in health promotion/communication studies and programs
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.