Diarrhoea and hygiene : what people know, believe and do in a West African town

The document begins with a demographic description of Bobo-Dioulasso and then details its domestic water sources, public standpipes, communal taps, unprotected hand-dug wells, and sanitation facilities, mainly dry pit latrines. A list of research methods used to pinpoint the problem focuses on two practices likely to put children at risk of diarrhoea. One is the disposal of child stools on the ground or in the open, rather than in a latrine, and the second is the failure by child caretakers to wash their hands with soap after cleaning the child. An analysis of hygiene practices concludes that they do not use soap because they have never acquired the habit, or because it has never been suggested to them as a good idea and also that mothers do not link poor hygiene to child diarrhoea. A chart analysing ten distinct types of illnesses with accompanying diarrhoea shows that according to mothers hardly any of them are caused by poor hygiene. The conclusion drawn is that hygiene projects have failed to communicate effectively with mothers because they do not use concepts mothers recognize and that promoting better hygiene as socially acceptable behaviour may be more effective than promoting it as a means of preventing disease. When mothers tried the safe disposal of stools and handwashing with soap, they found these practices acceptable. An investigation of the ways in which people communicate in Bobo suggests that the best methods for promoting the new hygiene practices would be through neighbourhood sanitation commissions, women's groups, clinics, primary schools, local radio and theatre.