Impact of a Novel, Low-Cost and Sustainable Health Education Program on the Knowledge, Attitudes, and Practices Related to Intestinal Schistosomiasis in School Children in a Hard-to-Reach District of Madagascar

Schistosomiasis control requires multisectoral approaches including praziquantel treatment, access to safe water, sanitation and hygiene, and health education. Community input can help ensure health education programs are culturally appropriate to effectively direct protective behavior change. This study reports on the three-stage development of an education program for Malagasy children, with an impact evaluation on their knowledge, attitudes, and practices (KAP) related to intestinal schistosomiasis. A cross-sectional study took place in 2017 with follow-up in 2018 in the hard-to-reach Marolambo district, Madagascar. A novel schistosomiasis education program (SEP) was designed in collaboration with researchers, stakeholders, and local community and included cartoon books, games, songs, puzzles, and blackboard lessons, costing $10 USD per school. KAP questionnaires were completed by 286 children pre-SEP and 273 children post-SEP in 2017, and by 385 and 337 children pre-SEP and post-SEP, respectively, in 2018. Improvements were observed in responses to all questions between pre- and post-education answers in 2017 (53–77%, P < 0.0001) and 2018 (72–98%, P < 0.0001) and in the pre-education answers between years (53–72%, P < 0.0001). Praziquantel mass drug administration attendance improved, rising from 64% to 91% (P < 0.0001), alongside improved latrine use, from 89% to 96% (P = 0.005). This community-consulted and -engaged SEP resulted in substantial improvements in children’s understanding of schistosomiasis, with improvements in praziquantel uptake and latrine use. Socioculturally tailored education programs can help gain schistosomiasis control. Continued investment in SEP will help promote the future well-being of children through increased participation in control and treatment activities.

Latrine site and its use pattern by Large Indian Civet Viverra zibetha Linnaeus, 1758: record from camera trap

Latrine sites are the places used for urination and defecation, which mostly act as a signaling agent for multiple purposes like territorial marking, confrontation with extruders or potential predators, delivering different inter and intra-communication messages. To understand latrine site visit pattern, a single camera trap was deployed for 91 trap nights at the latrine site of Large Indian Civet during the months of December 2016 and February & March 2017. Latrine site was found under the tree with abundant crown cover and bushes. At least two individuals were found to be using a single latrine site in an irregular manner between 1800 h and 0600 h with higher activity between 1800 h and 2300 h. Our results indicated an irregular latrine site visit pattern, hence similar studies with a robust research design in larger areas are required to understand specific latrine use patterns.

Formative Research to Design a Child-Friendly Latrine in Bangladesh

In low- and middle-income countries, most latrines are not accessible to young children. We explored how to modify existing pit latrines to make them child friendly. We conducted four focus group discussions with mothers to explore barriers to child latrine use. We then enrolled 20 households with a child aged 3–7 years old to test six enabling technologies developed based on the identified barriers. Two to three weeks after installing the selected enabling technologies in each household, researchers conducted 19 in-depth interviews with caregivers to explore the technologies’ acceptance and feasibility. Common barriers included the discomfort of squatting on a large pan, fear of darkness, and fear of a slippery floor. Of the potential solutions, a ring to stabilize the child while squatting in the latrine was preferred by children and was affordable and available. A wooden board with a smaller hole than the usual pan reduced fears of falling and helped eliminate discomfort but was inconvenient to handle and clean. A transparent fiberglass roof tile was affordable, available, increased visibility, and kept the latrine floor dry. In conclusion, the fiberglass roof tile and stability ring were two affordable and locally available technologies that facilitated latrine use by children aged 3–7 years.

Faktor Yang Berhubungan Dengan Penggunaan Jamban Di Desa Sungai Terap Kecamatan Kumpeh Ulu Kabupaten Muaro Jambi

Background: The use of latrines in the village is still unhealthy because of the habits of the people who use pit latrines in the river. The impact of not using latrines is causing diseases, causing odor , and cause pollution. Objectives: The purpose of this study was to to determine the relationship between education, clean water facilities, the role of health workers, the role of community leaders, knowledge of using latrines Research Metodes: This type of research is descriptive analytic with cross sectional approach. The sampling technique used simple random sampling, the sample was all household in the Sungai Terap 90 people. The analysis used the chi-square test. Results: There is no relationship between education and latrine use, the p-value is 0.957. There is a relationship between clean water facilities and the use of latrines, the p-value is 0.000. There is no relationship between the role of health workers and the use of latrines, the p-value is 0.189. There is a relationship between the role of community leaders and the use of latrines, the p-value is 0.000. There is a relationship between knowledge and latrine use. Conclusion: There is no relationship between education and the role of health workers Keywords: latrines, education, clean water facilities, the role of health workers, the role of community leaders, knowledge

How Do Rural Communities Sustain Sanitation Gains? Qualitative Comparative Analyses of Community-Led Approaches in Cambodia and Ghana

Community-led Total Sanitation (CLTS) is a popular intervention for eliminating open defecation in rural communities. Previous research has explored the contextual and programmatic factors that influence CLTS performance. Less is known about the community-level conditions that sustain latrine coverage and use. We hypothesized three categories of community conditions underlying CLTS sustainability: (i) engagement of community leaders, (ii) follow-up intensity, and (iii) support to poor households. We evaluated these among communities in Cambodia and Ghana, and applied fuzzy-set Qualitative Comparative Analysis (fsQCA) to identify combinations of conditions that influenced current latrine coverage and consistent latrine use. In Cambodia, latrine coverage was highest in communities with active commune-level leaders rather than traditional leaders, and with leaders who used casual approaches for promoting latrine construction. Latrine use in Cambodia was less consistent among communities with intense commune engagement, higher pressure from traditional leaders, high follow-up and high financial support. In Ghana, by contrast, active leaders, high follow-up, high pro-poor support, and continued activities post-implementation promoted latrine coverage and consistent use. The different responses to CLTS programming emphasize that rural communities do not have homogenous reactions to CLTS. Accounting for community perceptions and context when designing community-led interventions can foster long-term sustainability beyond short-term achievement.