Handwashing Products

Robert Dreibelbis Assistant Professor University of Oklahoma February 11, 2014

Handwashing Products
The physical tools necessary to enable effective handwashing with soap
Handwashing hardware Enabling technologies Frugal technologies

Handwashing with Soap

IBM-WASH Framework
Technology Factors Demographics Socio-economics
Household division of labor Access to markets Climate and geography

Habits Self-efficacy, knowledge Norms, shame Shared values, collective efficacy Cultural Identity

Contextual Factors Ease of use

Psychosocial Factors

Cost, value, convenience Access and sharing Collective ownership Manufacturing and distribution

Dreibelbis et al. BMC Public Health 2013, 13:1015

Contextual

Psychosocial

Technological

Societal / Structural

Community Household Individual Habitual

Contextual

Psychosocial

Technological

Social Ecological Model

Societal / Structural

Community Household Individual Habitual

Health Belief Model RANAS Model

Who can wash hands with soap?

Percentages of households with soap anywhere in the dwelling

(courtesy of Swapna Kumar, U of Buffalo) 100 90 80 70 60 50 42 22
South Asia
East Asia/Pacific

99 89 75

96

99

95

88

51

40
30 20 10 0
Africa CEE/CIS

Countries with lower per capita GDP have households with lower soap availability
(courtesy of Swapna Kumar, U of Buffalo)
100 90 80 70

Percentage of households with soap anywhere in the household

60
50 40 30 20 10 0

1000

2000 3000 4000 Per capita GDP during year of survey

5000

6000

Percentage of households with observed place for handwashing, soap and water
(courtesy of Swapna Kumar, U of Buffalo)
Africa South Asia CEE/CIS East Asia/ 98 Pacific

100 90 80 70 60 50 40 30 20 10 0

78
48

83

87

85

29
0 0

34

35 38

34

9 11 12

Soap: A Space for Innovation

Soap: A Space for Innovation

Soapy Water
Sanitizers
Photo: KRS Hulland

Soap: A Space for Innovation

Shared and or communal technologies can discourage behavior change / habit formation
Loss / theft from multiple users Disgust or negative reaction to shared soap, bottles, etc.

Sanitizers

Soapy Water

Can we provide functional technologies that limit theft AND contact?

Photos: KRS Hulland

Soap: A Space for Innovation

Shared and or communal technologies can discourage behavior change / habit formation
Loss / theft from multiple users Disgust or negative reaction to shared soap, bottles, etc.

Can we provide functional technologies that limit theft AND contact?

http://www.nathaliestaempfli.com/

Handwashing Station as Cue

Placement matters:
Near toilet reminded participants to wash hands after defecation Too far removed to be useful for cooking and eating

From a cue to a habit?

Novelty decreases over time Becomes part of the stable environment, habitual activity

Photo: KRS Hulland

Handwashing Station as Determinant

Handwashing products
The physical tools necessary to enable effective handwashing with soap
The physical tools that promote effective handwashing with soap and foster positive habit formation

Photo: KRS Hulland

Handwashing Technologies: Incremental Improvement

Across the WASH sector:
Movement away from binary indicators (improved vs. unimproved) Recognition of the role of incremental improvements, locally manageable

Is there a Hygiene Ladder?

Sources: JMP 2010; WSP Introduction to Self Supply