243538 Improved Water, Sanitation, and Hygiene Practices in Childcare Centers in Rural Malawi

Wednesday, November 2, 2011

Shannon Senefeld , Catholic Relief Services, Baltimore, MD
Antonia Powell , Catholic Relief Services, Baltimore, MD
Paul Clayton Perrin, MPH , Department of International Health, Johns Hopkins University School of Public Health, Baltimore, MD
Diarrhea is the second highest cause of global mortality of children under five, responsible for nearly one in five childhood deaths. Outcomes are estimated to be worse for children with HIV. CRS, with WHO, USAID, and local partners, developed a pilot project in a rural high-prevalence region of Malawi to improve WSH practices at community-based childcare centres (CBCCs). The pilot collected pre and post-test data on WSH knowledge, attitudes and practices (KAP) of community caregivers at twelve purposively sampled CBCCs, each with four caregivers serving an average of 70 children, ages 2-5. WSH interventions were implemented within the communities, with an assessment conducted after one year to examine changes in KAP within CBCCs. There were significant improvements in WSH practices at the CBCCs over the one-year period including: 1.) 100% increase in caregivers who reported treating the water at the facility; 2.) 100% increase in caregivers who reported drawing water in a safe manner; 3.) Observed hand washing facilities increased by 60%; 4.) The number of facilities with latrines increased by 17%; 5.) The number of latrines with visible fecal matter declined by 34%; and 6.) In the communities surrounding the CBCCs, household members with reported diarrhea during the previous two weeks declined from 26.3% to 15%. Small, do-able actions, combined with complementary interventions to improve access to basic services resulted in substantial WSH improvements in HIV-affected communities' childcare centres. Replication of these actions may be an option to decrease diarrhea and morbidity in children from high HIV prevalence communities.

Learning Areas:
Diversity and culture
Public health or related research

Learning Objectives:
Describe how an intervention in Malawi resulted in substantial water and sanitation improvements in childcare centers. Discuss potential avenues for replication of results through similar intervention activities.

Keywords: Children, HIV Interventions

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I oversaw this research project.
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.