Children under two years of age are at their most vulnerable stage of mental and physical development. Reducing infections and supporting good appetites by promoting hand washing have lifelong benefits.
– The Lancet, 2008
The two leading cause of under-five mortality is diarrhea and pneumonia accounts for more than 30%. The evidence suggests us that hand washing with soap is cost effective yet very impactful intervention. Hand hygiene promotion interventions has potential to interrupt the transmission of diarrhea-causing pathogens. The Handwashing with soap can reduce significantly the incidence of diarrhea and pneumonia (Luby, 2005). Sepsis is other leading cause of children within a month they are born and clean cord care & hand hygiene can prevent sepsis in neonate. Under-nutrition is the other leading cause of child death is often masked by the reported disease. Data says that 45% of all under-five mortality (more than 3.1 million per year) are due to diarrhea and pneumonia. (Horton, 2013). Nevertheless, with recurrent episodes of diarrhea, children become weak and most like to get malnourished as they lose appetite and also don’t get optimum feeding done during this illness & the cycle of illness and malnutrition starts developing (Keene, 2012).
As far as evidences are telling us that handwash is most cost effective intervention and can reduce morbidity due to diarrhea by 44%. India has high number more than 50% of children are malnourished & under-nutrition is quite high in children from 6-24 months. Nevertheless, not only mortality but morbidity due to diarrhea and repeated occurrence in children can lead to severe malnourishment. Even the children?s borne healthy with normal weight nutrition status falls once child reached 6-24 months. This is mainly due to poor Infant & Young Children Feeding (IYCF) practices. Hand wash is vital for IYCF and when hand wash is not practiced by food handlers it can lead to infections, recurrence of diarrhea and loss of weight eventually lead to malnutrition. Early initiation of complementary feeding soon after 6 months is very important but how to feed i.e. proper feeding and hand wash by food handler is important.
Diarrhea is mainly caused by eating infected foods or liquids and person-to-person contact (mainly hand to hand then hand to mouth). Hand washing with soap is one of the most cost effective intervention. Hand wash & hygiene at key occasions specially before eating food and after toilet is important but not easy to practice and this requires behavior change and need to be practiced daily to adopt in routine habit. Children at early age during habit formation or at preschool stage need to taught & also parents need to practice that at household level. Hand wash & hygiene requires sharper behavioral change approach in the community to adopt this behavior and practice it as a daily habit.
Community need to understand the risks associated with unhygienic hand, increases the chances of infections and occurrence of diarrhea which can lead to huge financial loss. There is a strong link between nutrition and hand hygiene. In the study done by (Liu, 2012) certain WASH interventions can significantly reduce morbidity and mortality due to diarrhea which is second leading cause of under five child mortality. In this study it came out clearly Handwashing with Soap is 44% effective, household water treatment about 39%, Sanitation 32%, Water supply 25% and source water treatment 11% (Liu,2012). It would be very important to emphasizes on hand washing interventions in India Nutrition and WASH program. Hand hygiene needs to be integral with all nutrition and health interventions. The need of the hour is to integrate Hand Hygiene in all Nutrition programme and this will certainly result in better Nutritional outcomes in Children. The sustainable Nutrition can be achieved only through integrating Hand hygiene with all nutrition programme in India.
India Manager, Lifebuoy,
Unilever Sustainable Living Plan(USLP)