Manikganj

Diarrhea is a leading cause of death in children under five worldwide, and poor handwashing and water treatment habits increase the risk of diarrheal disease. This research aims to develop and test a scalable version of the Cholera Hospital-Based Intervention for 7 Days CHoBI7 program, which was previously shown to reduce cholera infections and improve hygiene behaviors in households. The study focuses on delivering this program in rural health facilities and evaluating its impact on water, sanitation, and hygiene WASH behaviors and diarrheal disease reduction through a randomized controlled trial. Participants will be assigned to one of two groups a standard recommendation group receiving government advice on oral rehydration solution and a flyer on water treatment and handwashing, or the CHoBI7 Scale-Up Program group. The CHoBI7 group receives in-person education from health promoters on handwashing, water treatment, and safe water storage, including video testimonials and demonstrations to build homemade handwashing stations. This is reinforced by weekly voice and text messages for three months to encourage sustained behavior change. During the study, participants will be monitored over three months with assessments of handwashing frequency at key times, the number of homemade handwashing stations constructed, and water quality measures such as chlorine concentration and bacterial contamination. Researchers will also evaluate the number of diarrheal cases and psychosocial factors related to WASH behaviors. The study aims to assess the feasibility and effectiveness of delivering this modified intervention in district hospitals and health complexes to improve health outcomes in rural and urban Bangladesh.