Comparing the Performance of Indicators of Hand-Washing Practices in Rural Indian Households

OBJECTIVE To compare the results obtained from 26 proxy indicators of domestic hand-washing practices with those obtained from direct, 'structured' observation of hand-washing in a sample of 387 households and to assess the potential of these indicators for use in the evaluation of hygiene...

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Main Authors:	Biran, A., Rabie, T., Schmidt, W., Juvekar, S., Hirve, S., Curtis, V.
Format:	Journal Article
Language:	EN
Published:	2012
Online Access:	http://hdl.handle.net/10986/5193

id	okr-10986-5193
recordtype	oai_dc
spelling	okr-10986-51932021-04-23T14:02:21Z Comparing the Performance of Indicators of Hand-Washing Practices in Rural Indian Households Biran, A. Rabie, T. Schmidt, W. Juvekar, S. Hirve, S. Curtis, V. OBJECTIVE To compare the results obtained from 26 proxy indicators of domestic hand-washing practices with those obtained from direct, 'structured' observation of hand-washing in a sample of 387 households and to assess the potential of these indicators for use in the evaluation of hygiene promotion campaigns. METHODS Fieldwork in rural India between February 2005 and April 2006. Household-level data on hand-washing practices and the availability of soap and water were collected by structured observation, questionnaire survey, pocket voting, hand-wash demonstration and environmental check. Between them these techniques produced 27 binary indicators of hand-washing practices, each of which was used to classify households as 'hand-washing' or 'non-hand-washing. To assess the extent to which household classification based on each of 26 proxy indicators concurred with classification based on observation, we used the kappa statistic. The prevalence of households defined as 'hand-washing' according to each indicator was compared statistically with the prevalence according to structured observations by testing for a significant difference between two proportions. RESULTS Agreement between all the proxy indicators and the observation data was poor and all but two of the indicators produced estimates of hand-washing prevalence that were significantly different from that resulting from observation. CONCLUSION Although some interventions may be able to use proxy indicators as a guide to the magnitude and direction of their impact, these indicators do not provide an accurate guide to the actual practice or prevalence of hand-washing. Structured observation remains the best indicator of those tested. 2012-03-30T07:31:44Z 2012-03-30T07:31:44Z 2008 Journal Article Tropical Medicine & International Health 1360-2276 http://hdl.handle.net/10986/5193 EN http://creativecommons.org/licenses/by-nc-nd/3.0/igo World Bank Journal Article India
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	EN
geographic_facet	India
relation	http://creativecommons.org/licenses/by-nc-nd/3.0/igo
description	OBJECTIVE To compare the results obtained from 26 proxy indicators of domestic hand-washing practices with those obtained from direct, 'structured' observation of hand-washing in a sample of 387 households and to assess the potential of these indicators for use in the evaluation of hygiene promotion campaigns. METHODS Fieldwork in rural India between February 2005 and April 2006. Household-level data on hand-washing practices and the availability of soap and water were collected by structured observation, questionnaire survey, pocket voting, hand-wash demonstration and environmental check. Between them these techniques produced 27 binary indicators of hand-washing practices, each of which was used to classify households as 'hand-washing' or 'non-hand-washing. To assess the extent to which household classification based on each of 26 proxy indicators concurred with classification based on observation, we used the kappa statistic. The prevalence of households defined as 'hand-washing' according to each indicator was compared statistically with the prevalence according to structured observations by testing for a significant difference between two proportions. RESULTS Agreement between all the proxy indicators and the observation data was poor and all but two of the indicators produced estimates of hand-washing prevalence that were significantly different from that resulting from observation. CONCLUSION Although some interventions may be able to use proxy indicators as a guide to the magnitude and direction of their impact, these indicators do not provide an accurate guide to the actual practice or prevalence of hand-washing. Structured observation remains the best indicator of those tested.
format	Journal Article
author	Biran, A. Rabie, T. Schmidt, W. Juvekar, S. Hirve, S. Curtis, V.
spellingShingle	Biran, A. Rabie, T. Schmidt, W. Juvekar, S. Hirve, S. Curtis, V. Comparing the Performance of Indicators of Hand-Washing Practices in Rural Indian Households
author_facet	Biran, A. Rabie, T. Schmidt, W. Juvekar, S. Hirve, S. Curtis, V.
author_sort	Biran, A.
title	Comparing the Performance of Indicators of Hand-Washing Practices in Rural Indian Households
title_short	Comparing the Performance of Indicators of Hand-Washing Practices in Rural Indian Households
title_full	Comparing the Performance of Indicators of Hand-Washing Practices in Rural Indian Households
title_fullStr	Comparing the Performance of Indicators of Hand-Washing Practices in Rural Indian Households
title_full_unstemmed	Comparing the Performance of Indicators of Hand-Washing Practices in Rural Indian Households
title_sort	comparing the performance of indicators of hand-washing practices in rural indian households
publishDate	2012
url	http://hdl.handle.net/10986/5193
_version_	1764394270068834304

Comparing the Performance of Indicators of Hand-Washing Practices in Rural Indian Households

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