MEASURING THE EFFECT OF A HYGIENE BEHAVIOR INTERVENTION BY INDICATORSOF BEHAVIOR AND DIARRHEAL DISEASE

A social marketing approach used both qualitative and quantitative met hods to develop a hygiene behaviour intervention in rural north-east T hailand. Behaviours were preselected from a previous study and the int ervention was designed to promote hand washing, especially before feed ing a baby, cooking, eating, and after defaecation or cleaning a baby' s bottom, and dish washing immediately after eating. A bacteriological indicator (enumerating faecal streptococci using a finger impression technique) was developed to measure changes in hand washing behaviour and observation (spot checks) of dirty dishes to indicate dish washing practice. There was a significant improvement in both behaviours and a significant reduction in diarrhoeal disease as a result of the inter vention. Furthermore, both indicators were retrospectively found to be positively related to diarrhoeal disease incidence. However, receivin g and being able to recall the intervention messages was not necessari ly sufficient to ensure behaviour change, as some adults found it diff icult to change old habits. Villages showing the greatest improvement tended to have a stronger sense of community than others and to have m ore people actively involved in the intervention.