Knowledge and practice of handwashing among mothers of under five children in rural coastal South India

Objectives: To study the knowledge and practice of handwashing after critical moments among mothers of under five children and to recommend measures for improvement of handwashing practices based on the study findings Methods: A community based cross-sectional study was undertaken during February 2010 covering 28 villages around coastal South India. The EPI 30-cluster sampling method was used and 1898 mothers of under five children were interviewed about their knowledge and practice regarding handwashing after critical moments. Results: 83.41% mothers stated handwashing was important for prevention of communicable diseases. 77.82% opined that washing hands with only water was sufficient. 38.88% and 24.92% stated handwashing could prevent diarrhoea and ARI respectively. 80.08% mothers thought handwashing was crucial before eating meals; 56.90%, 41.73% and 40.73% respectively felt that it was important to wash hands after defeacation, before preparing food and feeding child. 73.18% mothers washed hands with soap and water after defeacation and 63.91% after cleaning the child who had defeacated. Majority wash their hands with only water before preparing food (71.86%) and feeding the child (67.39%). Mothers with per capita monthly family income of Rs.1001-2000 and more, education of 5-7 standard and above, belonging to a joint family and Christian background had better handwashing practices. However, daily labourer mothers were at highest risk of not washing hands at all critical moments. Conclusion: Knowledge and practice of handwashing is low among rural mothers. Hence there is a need to spread importance of proper and regular handwashing in rural areas through available evidence based BCC strategies and multiple dissemination channels.