A Qualitative Evaluation of Hand Drying Practices among Kenyans

Abstract

BackgroundRecommended disease prevention behaviors of hand washing, hygienic hand drying, and covering one’s mouth and nose in a hygienic manner when coughing and sneezing appear to be simple behaviors but continue to be a challenge to successfully promote and sustain worldwide. We conducted a qualitative inquiry to better understand current hand drying behaviors associated with activities of daily living, and mouth and nose covering practices, among Kenyans.Methods and FindingsWe conducted 7 focus group discussions; 30 in-depth interviews; 10 structured household observations; and 75 structured observations in public venues in the urban area of Kisumu; rural communities surrounding Kisumu; and a peri-urban area outside Nairobi, Kenya. Using a grounded theory approach, we transcribed and coded the narrative data followed by thematic analysis of the emergent themes. Hand drying, specifically on a clean towel, was not a common practice among our participants. Most women dried their hands on their waist cloth, called a leso, or their clothes whether they were cooking, eating or cleaning the nose of a young child. If men dried their hands, they used their trousers or a handkerchief. Children rarely dried their hands; they usually just wiped them on their clothes, shook them, or left them wet as they continued with their activities. Many people sneezed into their hands and wiped them on their clothes. Men and women used a handkerchief fairly often when they had a runny nose, cold, or the flu. Most people coughed into the air or their hand.ConclusionsDrying hands on dirty clothes, rags and lesos can compromise the benefits of handwashing. Coughing and sneezing in to an open hand can contribute to spread of disease as well. Understanding these practices can inform health promotion activities and campaigns for the prevention and control of diarrheal disease and influenza.

A Cluster Randomized Controlled Evaluation of the Health Impact of a Novel Antimicrobial Hand Towel on the Health of Children Under 2 Years Old in Rural Communities in Nyanza Province, Kenya

“…5 The promotion and use of clean towels for hand drying could improve the effectiveness of handwashing because previous research suggests that, despite promotion of air-drying as a safe hand drying method, the behavior is often not practiced, most likely because it is time consuming and inconvenient. 6 More vigorous promotion of hand towels based on the results of this study would also require promotion of frequent (i.e., at least daily) towel washing and drying to prevent contamination and potential disease transmission.…”

“…5 Furthermore, a qualitative study of hand drying behavior in western Kenya suggested that, despite widespread messaging about the importance of using clean towels or air drying after handwashing, many people tended to use their pants or wraparound skirts for hand drying. 6 In response to the challenge of promoting and sustaining effective handwashing, innovative technologies for improving hand hygiene have been developed that consist of reusable hand towels with antimicrobial properties that are nontoxic and stable over time. Initial laboratory testing of one type of antimicrobial hand towel (Earth-plus ™ ) demonstrated that it could remove microbial contamination from hands.…”

A Cross-Sectional Study of Water, Sanitation, and Hygiene-Related Risk Factors for Soil-Transmitted Helminth Infection in Urban School- and Preschool-Aged Children in Kibera, Nairobi

“…Our results show decreased prevalence of STH infection among children whose caregiver dried his/her hands using a clean towel compared with those who did not dry their hands or dried their hands on clothing or air drying. Further context on hand drying practices in Kibera can be found elsewhere [ 58 ]. Previous research has shown that the benefits of hand drying may be achieved through both the reduction in residual moisture that can act as a conduit for pathogen transfer and encourage bacterial growth and through physical removal of microorganisms through friction [ 56 , 59 – 63 ], while sub-optimal hand drying practices may re-contaminate hands [ 60 ].…”

A Study on the Awareness and Practices of Hand Washing Amongst Mothers of Under-Five Children in the Slums of Guwahati City

“…Similar findings were also observed in studies conducted in India, Kenya. 15,16 Another study finding in Bangladesh 17 observed that appropriate hand washing technique should involve the following procedure of use of both hands, use of an agent, rubbing of hands and rinsing with water and finally drying.…”