DESIGNING EDUCATIONAL MESSAGES TO IMPROVE WEANING FOOD HYGIENE PRACTICES OF FAMILIES LIVING IN POVERTY

This paper describes a methodology to design feasible interventions to improve weaning food hygiene practices of families living in extreme poverty. Educational messages to promote specific behavioural changes were defined and tested by utilizing a combination of ethnographic, su rvey and observational methods, and integrating viewpoints and suggest ions of mothers and caretakers into the decision-making process. This new approach culminated in a household trial in which five groups, eac h of 15 non-practising mothers, were invited to adopt defined behaviou rs (handwashing before and after defined events, boiling water for rec onstituting powdered milk, feeding gruel by spoon rather than bottlefe eding, not storing gruels and milks, and all four together). All initi ated the advocated behaviours and most (53-80%) sustained the new beha viours and practised them every time during a one-month period. Of the four advocated behaviours, spoon-feeding was the most difficult to ad opt wholly. The methodology was developed in response to the high prio rity given to reducing weaning food contamination for diarrhoeal disea se control, and the lack of any existing methodology for defining appr opriate educational interventions in resource-poor regions. This appro ach, with its combination of qualitative and quantitative methods and community focus, is recommended for future studies to design hygiene a nd other health education interventions in developing countries. (C) 1 997 Elsevier Science Ltd.