The dangers of dirt : household hygiene and health

V. Curtis

    Research output: Thesisexternal PhD, WU


    <p>Encouraging changes in hygiene practices are potentially one of the mosteffective means of reducing the global impact of diarrhoeal diseases, whichkill an estimated 3.3 million children a year. However, efforts to improve hygiene in the developing world have met with limited success. Some of thereasons behind this include:</p><UL><LI>the complexity of the subject of hygiene<LI>the problem of how to identify and target only a few specific household risk practices<LI>the difficulty of measuring hygiene behaviour accurately<LI>the lack of available methods for understanding what hygiene means to people<LI>the lack of strategic thinking in planning interventions.</UL><p>This thesis presents the results from nine years work on these problems from the town of Bobo-Dioulasso, Burkina Faso and elsewhere. The first chapter addresses the subject of hygiene in general and suggests that it has dual origins; in the need for individual and social order, and also in the need to avoid disease. The second chapter evaluates the specific hygiene practices most likely to put health at risk. The literature on thesubject suggests that practices which can reduce the faecal contamination of the household environment, such as safe stool disposal and hand-washing with soap after contact with stools, are likely to be of greatest protective value. The problem of the measurement of hygiene behaviour is addressed in chapters four to six, which conclude that structured observations are probably the most valid and practical tool available orrecording hygiene practices.</p><p>The thesis then goes on to address the question of how hygiene was understood by mothers in Bobo-Dioulasso, and concludes that mothers saw little connection between hygiene and diarrhoeal diseases, but that hygiene was very important to them as a positive social value. In the final chapters the lessons learned from the work in Bobo are fitted into a framework that can be used to design hygiene promotion programmes in the future. This employs a variety of qualitative and quantitative methods to carry out a systematic programme of formative research that combines what people know, do and want, with the available scientific knowledge. The results provide a rational basis for the design of hygiene promotion programmes. A trial of the effectiveness of this new approach to hygiene promotion is currently underway in Burkina Faso.</p>
    Original languageEnglish
    QualificationDoctor of Philosophy
    Awarding Institution
    • Niehof, A., Promotor
    • Mertens, T.E., Promotor, External person
    Award date28 Sep 1998
    Place of PublicationS.l.
    Print ISBNs9789054858980
    Publication statusPublished - 1998


    • hygiene
    • public health
    • households
    • burkina faso


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