POTTIES, PITS AND PIPES - EXPLAINING HYGIENE BEHAVIOR IN BURKINA-FASO

Stool disposal practices have been shown to be associated with childho od diarrhoea. However, efforts to promote improved hygiene behaviour a re hampered by a lack of understanding of what determines those behavi ours. Data from 2793 household interviews with mothers of children fro m the town of Bobo-Dioulasso in Burkina Faso were analyzed to examine what differentiated mothers who reported using safer stool disposal pr actices from those who did not. Three 'outcomes' were considered: wher e the child was reported to defaecate; where the mother reported dispo sing of the child stools; and whether excreta were observed in the com pound. Regression models were developed to identify those factors with the strongest independent associations with the outcomes. There was a consistent association between the source of water and the outcomes. Mothers with access to a tap in the yard reported using safe hygiene p ractices three times more often than mothers using wells outside the c ompound and twice as often as mothers who used public standpipes or we lls within the yard. The source of water showed a similar pattern of a ssociation with observations of faecal matter in the environment. Impr oved sources of water may contribute to safer stool hygiene by reducin g the time spent on water collection or by encouraging mothers to conf orm to higher standards of hygiene. Other factors which played a role in predicting the hygiene behaviour of mothers were the husbands' occu pation, the number of health education sessions that she had attended, her zone of residence and family ownership of certain valuable object s. These factors are likely to be related and to be, to some extent, p roxies for the real determinants of her behaviour. A model of the cult ural, psycho-social and infrastructural proximate determinants of hygi ene behaviour is proposed. Data from focus group discussions suggested that the main purpose of hygienic behaviour is to conform to existing norms of social etiquette. Trials of interventions based on changing such norms are needed to test whether this is an effective means of pr omoting of safer hygiene practices.