Diarrhoeal diseases are among the leading causes of child mortality and morbidity in Nepal. The possible reasons as to why Nepali children continue suffering from enteric diseases including diarrhoea may be the significant lack of basic determinants for better health, such as access to safe water, proper hygiene practices and basic sanitation services. Tackling Diarrhoeal diseases requires a comprehensive package of protective, preventive and curative interventions. The main purpose of this formative research was to understand current hygiene practices and their determinants, and to prioritize key hygiene behaviours for addressing through the routine immunization programme.
The study design was descriptive cross-sectional exploratory formative research using qualitative and quantitative methods. In total, 303 mothers were included in the study from the four districts (Bardiya, Jajarkot, Myagdi and Nawalparasi) representing various ethnic groups and educational backgrounds. From each district (considering stratification) at least two Village Development Committees (VDCs)1 and one municipality2 were randomly-selected for the study. All health institutions, Immunisation (EPI) clinics/sessions, FCHVs and health staff from these VDCs/municipalities were also identified as participants.
The study highlights the water and sanitation status along with the key hygiene behaviors of mothers and the possibility of integrating the hygiene promotion activities into routine immunization. Despite the frequent diarrheal diseases outbreaks throughout the country, efforts in improving the WASH status are not adequate and the hygiene behaviors of the mothers are still below optimal level. It was noted that physical barriers like shortage of gas/firewood as well as attitudinal barriers like baby’s preference of cold milk, hinder to maintain optimum level of food hygiene. There is a positive indication that the community is being aware of diarrheal diseases, its causes and treatment. However, it was observed that some children below five year of age were suffering from diarrhea. The study helps in generalizing the prevailing hygiene behaviors of mothers in respect to their child‟s health and possibility of integration of hygiene promotion activities in routine immunization.