Manikganj

Diarrhea is a leading cause of death in children under five worldwide, with poor handwashing and water treatment practices contributing to the disease. This research evaluates a scalable version of the Cholera Hospital-Based Intervention for 7 Days (CHoBI7), which aims to improve water, sanitation, and hygiene (WASH) behaviors to reduce diarrheal diseases in both rural and urban settings. Previous trials showed CHoBI7 effectively reduced symptomatic cholera infections, diarrheal disease, and stunting in young children, while improving handwashing behavior and water quality over 12 months. The study compares a standard government recommendation on oral rehydration solution (ORS) and educational flyers with the CHoBI7 Scale-Up Program. The CHoBI7 program involves health promoters delivering a handwashing, water treatment, and safe storage module to diarrhea patients and their families in health facilities. This includes video testimonials and demonstrations on making homemade handwashing stations. The program is reinforced by weekly voice, interactive voice response, and text messages over three months from a local hospital doctor. The intervention also provides a soapy water bottle and chlorine tablets, encouraging households to build handwashing stations themselves. Participants are assessed on handwashing rates at stool and food-related events and the number of homemade handwashing stations after three months. Researchers monitor behavior changes, water quality, and diarrheal disease reduction. The study involves enrolling diarrhea patients who meet specific household and contact criteria and requires follow-up for at least three months to evaluate the intervention's impact on health and hygiene practices.