IT MIGHT SEEM like a trivial thing, but handwashing can be hugely important to health .

Diarrhoea, for example, and respiratory infections are the two biggest causes of child death globally, but handwashing with soap could substantially reduce the risk of children contracting them.

But in some parts of the world, the prevalence of handwashing is quite low.

A study was done in the Chittoor district in southern Andhra Pradesh in India in 2012 to see if there was a way to encourage children to wash their hands more,

The secret to increasing handwashing, it showed, was ‘SuperMum’.

SuperAmma

The SuperMum handwashing campaign (known as SuperAmma) showed for the first time that using emotional motivators, such as feelings of disgust and nurture, rather than health messages, can result in long-lasting improvements in people’s handwashing behaviour.

This means it could in turn help to reduce the risk of infectious diseases.

The SuperMum campaign was analysed in the Lancet Global Health journal, and shows that six months after the campaign was rolled out in 14 villages in rural India, rates of handwashing with soap increased by 31 per cent, compared to communities without the programme, and were sustained for 12 months.

Dr Val Curtis, from the London School of Hygiene & Tropical Medicine explained:

Every year, diarrhoea kills around 800000 children under five years old. Handwashing with soap could prevent perhaps a third of these deaths.Handwashing campaigns usually try to educate people with health messages about germs and diseases, but so far efforts to change handwashing behaviour on a large scale have had little success.

The intervention targeted ‘emotional drivers’ found to be effective in bringing about behaviour change:

• disgust (the desire to avoid and remove contamination)
• nurture (the desire for a happy, thriving child)
• status (the desire to have greater access to resources than others),
• affiliation (the desire to fit in).

Findings

As part of the SuperAmma intervention, promoters put on community and school events, including public pledging ceremonies during which women promised to wash their hands at key occasions and to help ensure their children did the same.

They measured observed rates of handwashing with soap at key moments (like after toilet, before food handling, or after cleaning a child) in a random sample of 25 households in each village at the start of the study and at three subsequent visits (six weeks, six months, and one year after the intervention).

• At the start, handwashing with soap was rare in both the intervention and control groups (one per cent vs two per cent).
• After six weeks, handwashing was more common in the intervention group (19 per cent vs 4 per cent), and after six months, compliance in the intervention group had increased to 37 per cent compared with six per cent in the control group.
• One year after the campaign, and after the control villages had received a shortened version of the intervention, rates of handwashing with soap were the same in both groups (29 per cent).

Study co-author Katie Greenland, from The London School of Hygiene & Tropical Medicine:

The SuperAmma campaign appears to be successful because it engages people at a strong emotional level, not just an intellectual level, and that’s why the behavioural change was long-lasting.

She said that given the results, perhaps public health practitioners “should consider behaviour change campaigns designed along the lines of our approach”.

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