Journal
CLINICAL INFECTIOUS DISEASES
Volume 61, Issue -, Pages S703-S709Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/civ845
Keywords
water, sanitation and hygiene; intervention design research; formative research; stunting; environmental enteric dysfunction
Categories
Funding
- Bill & Melinda Gates Foundation [OPP1021542]
- Department for International Development, UK
- Wellcome Trust, UK [093768/Z/10/Z]
- Swiss Agency for Development and Cooperation
- US National Institutes of Health [2R01HD060338-06]
- European Union
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We sought to develop a water, sanitation, and hygiene (WASH) intervention to minimize fecal-oral transmission among children aged 0-18 months in the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial. We undertook 4 phases of formative research, comprising in-depth interviews, focus group discussions, behavior trials, and a combination of observations and microbiological sampling methods. The resulting WASH intervention comprises material inputs and behavior change communication to promote stool disposal, handwashing with soap, water treatment, protected exploratory play, and hygienic infant feeding. Nurture and disgust were found to be key motivators, and are used as emotional triggers. The concept of a safe play space for young children was particularly novel, and families were eager to implement this after learning about the risks of unprotected exploratory play. An iterative process of formative research was essential to create a sequenced and integrated longitudinal intervention for a SHINE household as it expects (during pregnancy) and then cares for a new child.
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