Evidence of Households' Water, Sanitation, and Hygiene (WASH) Performance Improvement Following a WASH Education Program in Rural Dembiya, Northwest Ethiopia

Background: Water, Sanitation, and Hygiene (WASH) promotion is a viable solution to prevent enteric infections. It focuses on hygiene education, where a number of theoretical models have emerged which attempt to guide behavior change interventions. This study was, therefore, conducted to evaluate the effectiveness WASH education program on households' WASH performance in rural Dembiya, northwest Ethiopia. Method: An uncontrolled before-and-after intervention study was conducted. Baseline and endline surveys were done among 225 and 302 randomly selected households with under-5 children, respectively, using a structured questionnaire and observational checklists. Percent point change was used to see the effect of the intervention. Pearson chi(2) and Fisher exact tests were used to test for statistically significant percentage point changes on the basis of P < .05. Result: Access to adequate sanitation was significantly improved from 43.1% at the baseline to 50.7% at the endline (P < .05). Access to protected water sources was high at the baseline (73.8%) and remained high (81.1%) at the endline (P < .05). Significant proportion of households (58.3%) practiced good drinking water handling at the endline compared with the baseline (6.7%) (P < .001). Practice of home-based water treatment was improved at the endline (47%) compared with the baseline (7.6%) (P < .001). The general hygienic condition of children was significantly improved at the end of the intervention compared with the conditions before the intervention (P < .05). At the end of the intervention, mothers' hand washing practice was improved to 68.2% from 24.4% at the baseline (P < .001). Moreover, 52.4% and 69.5% of the households at the baseline and endline, respectively, had good food safety practice (P < .05). Conclusion: The proportion of households who practiced water safety, basic sanitation, good personal hygiene, and basic food safety measures significantly increased at the endline. This significant increment clearly showed that our WASH interventions were effective to improve households' WASH performance in rural Dembiya. The local health office need, therefore, strengthens the WASH education program.