Resources / Review: Domestic Hygiene and Diarrhoea – Pinpointing the Problem

Summary

Improving domestic hygiene practices is potentially one of the most effective means of reducing the global burden of diarrhoeal diseases in children. However, encouraging behaviour change is a complex and uncertain business. If hygiene promotion is to succeed, it needs to identify and target only those few hygiene practices which are the major source of risk in any setting. Using biological reasoning, the authors hypothesize that any behaviours which prevent stools from getting into the domestic arena, the child’s main habitat, are likely to have a greater impact on health than those practices which prevent pathogens in the environment from being ingested. Epidemiological evidence for the effect of primary and secondary barrier behaviours suggest that it supports this conclusion. In the absence of local evidence to the contrary, hygiene promotion programmes should give priority to the safe disposal of faecal material and the adequate washing of hands after contact with adult and child stools.