A LONGITUDINAL-STUDY OF THE IMPACT OF BEHAVIORAL-CHANGE INTERVENTION ON CLEANLINESS, DIARRHEAL MORBIDITY AND GROWTH OF CHILDREN IN RURAL BANGLADESH

A community-based intervention was developed through direct participat ion of the target population in assessment and iterative trials to imp rove hygiene practices and to reduce childhood diarrhoea in lowland ru ral Bangladesh. A total of 185 (98%) households with children ages 0-1 8 months in five contiguous villages were targeted for the interventi ons. A comparison site was selected for a detailed observational study and for use as a control for the intervention. About 97% of all house holds with children ages 0-18 months were enrolled for study at the co ntrol site. Children in this age group were targeted because at this d evelopmental stage they were most vulnerable to diarrhoeal morbidity a nd malnutrition (related to unhygienic practices). The intervention wa s implemented with the assistance of village leaders through a ''Clean Life'' campaign by local project workers and volunteer mothers who we re chosen from the target households. The intervention activities star ted in January 1986 and lasted for 7 months. Higher adoption rates of the intervention were associated with better cleanliness status, which was related to lower diarrhoea and malnutrition rates in the interven tion site. The results of between-site longitudinal analyses showed th at after the intervention, the intervention site had substantially hig her cleanliness scores, lower diarrhoeal morbidity, and better growth status compared to those of the control site, with differences increas ing over time. The findings suggest that this type of community-based intervention can be very beneficial in modifying hygiene behaviours an d lowering childhood diarrhoea and malnutrition.