Handwashing with Soap in Mali: Using data to create a Public Private Partnership

Diarrhea is a serious health concern in Mali as it is the third most common reason for doctor's visits among children. Handwashing with soap can reduce diarrhea incidence. The Ministry of Health in Mali carried out a survey to examine handwashing behavior. Survey objectives were: to estimate levels of handwashing by mothers and/or child caretakers and of pupils in primary schools; to know the motivation of the target groups to adopt handwashing; to identify difficulties and constraints which block adoption; to identify private sector soap producers; to evaluate behavior and practices of users of toilets in schools and restaurants; to formulate solutions for promotion of handwashing with soap. The survey was a socio-anthropological study to obtain data and qualitative information. It was carried out in 2006 in households, primary schools, restaurants and public toilets in Koulikoro, Mopti, Gao and the District of Bamako. Observation grids and questionnaires were used. Results: Only 15% of households used soap for handwashing; among mothers and child caretakers 45,4% washed only one hand with water (no soap) after cleaning the anal area of children; in schools, 68% of pupils did not wash their hands after leaving the toilet and 75% of the pupils who do wash their hands do not use soap. In restaurants 34% of customers wash their hands before eating and 82% of customers who wash hands do not use soap. From a cultural point of view several reasons were given for non-use of soap - the reduction of “good fortune” was the most significant reason given. In addition, lack of money to pay for soap by certain households was cited, the shortage of water (only 42% have access to potable water in Mali), and the absence of hand washing stations in schools. The MOH with partners developed a National Action plan for handwashing with soap within the framework of a private public partnership. The first National day of handwashing with soap occurred in 2007. The following year Mali celebrated the Global Handwashing Day. This day is centered on improving knowledge levels and behavior and on encouraging the partnership between the soap producers in Mali and the MOH.