A handwashing communication intervention in Guatemala

This article outlines the process and results of an education/communication health intervention funded by WHO and carried out in Santa Maria de Jesus, Guatemala, by the Institute of Nutrition of Central America and Panama between 1989 and 1991 to encourage mothers, other carers of children, and children to wash their hands properly and thus to reduce the levels of child diarrhoea which were still high despite the introduction of piped water supplies in the community. The project's method includes: a qualitative assessment of hygiene practices (especially hand washing), beliefs and knowledge about hygiene practices, and communication skills; an ethnographic, communication and behaviour analysis which found that hand washing was not practised because mothers felt it used too much water; the introduction and behaviour trials of the tippy-tap which reduced the amount of water needed for hand washing; the implementation of the communication-intervention action-plan to give information about the construction and correct use of the tippy-tap; and lastly, monitoring and evaluating the impact of this health intervention. The article concludes that by late 1992 the average incidence of diarrhoea among children was lower and that most mothers and children who had been trained, used and maintained the tippy-tap correctly. A step-by-step guide to the construction of a tippy-tap is included.