Volume 81, Issue 1, January–February 2015, Pages 107–108
Consortium of Universities for Global Health: Poster Abstracts from the 6th Annual CUGH ConferenceConsortium of Universities for Global Health: Mobilizing Resesarch for Global Health
Sesame street in the tea estates: A multi-media intervention to improve sanitation and hygiene among Bangladesh's most vulnerable youth
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Children growing up in Bangladesh's Sylhet Division are some of the world's most vulnerable youth. While this region is home to over 150 lush tea estates, workers and their families living in the area's densely-populated slums lack basic resources, such as clean water and latrines. Diarrhea remains a leading cause of childhood morbidity and mortality. In Spring 2014, Sesame Workshop and its local production team Sisimpur developed a multi-media intervention to improve health and hygiene knowledge, attitudes and behaviors among children and parents living in Sylhet. A research study was conducted to examine the most effective way to deliver these health communication messages.
A twelve week intervention occurred in Bhurbhuria, Bhararura, and Satgaon (similar communities within the Sylhet Division). Two approaches were created. The “me” approach framed messages and activities as personal, such that engaging in hygiene and sanitation behaviors would result in stronger and healthier individuals (delivered in Bhurbhuria). The “we” approach addressed hygiene and sanitation behaviors as community and social endeavors (Bhararura). Participants from Satgaon served as a control. Immediately before and after the intervention, 240 children (ages 3 to 8 years) and one of their parents completed one-on-one interviews. Active consent was used and the University of Maryland's IRB evaluated and approved the study protocols and instruments.
The interventions resulted in improvements in terms of hygiene and sanitation. Those receiving the “me” approach had stronger and statistically significant gains compared to those receiving the “we” approach for: Reported latrine use (based on child reports); “all of the time” hand-washing after defecation (parent reports); better understanding of tippy taps (parent reports); awareness of Sisimpur characters (child reports); and identifying behaviors depicted in the intervention materials (child reports). In contrast, members of the “we” approach did better than “me” approach for: Favorable attitudes of sanitation and hygiene behaviors (child reports); using an improved ventilated pit latrine at home (child reports); wearing shoes “all the time” (child reports); and using a tippy tap (child reports).
The Sisimpur interventions led to positive changes in hygiene and sanitation knowledge, attitudes and behaviors; multi-media approaches improved latrine use, shoe-wearing and hand-washing among young children from Sylhet. Because gains occurred with both approaches, the “we” approach was better as most participants felt the interventions' goals were to improve health and behaviors of all children in the community. While there were challenges and it is unknown how long the interventions’ impact will last, this work suggests that a hygiene and sanitation intervention can lead to improved outcomes with an extremely vulnerable population.
This research was supported by the Bill & Melinda Gates Foundation.
01SEDH005Copyright © 2015 Published by Elsevier Inc