Rapid Assessment of Indirect Effect of Handwashing Campaign during COVID 19 Risk Communication and Community Engagement on Diarrhoea and Respiratory Illness among Children under Five in Jijiga Town of Somali Region of Ethiopia

Main Article Content

Olusola Oladeji
Abdifatah Elmi Farah
Asli Hassan
Mohamed Ayanle
Yusuf Mohammed Ali
Yusuf Mohammed Ali


Aims: Diarrhoea and pneumonia are serious global public health problems affecting child survival especially in the developing countries. The study aimed to assess the indirect effect of hand washing campaign during COVID risk communication and community engagement on diarrhoea and respiratory infection among children under five.

Study Design: This was both cross sectional survey and retrospective chart review.

Place and Duration of Study: Jijiga Town of Somali Region, Ethiopia between November 2019 and 30th June 2020.

Methodology: Handwashing practices among the households and the reported number of diarrhoea and acute respiratory infection in the District Health Information System (DHIS) database 4 months before and 4 months during COVID 19 risk communication handwashing campaign was assessed and paired t test used to determine the effect of the campaign on diarrhoea and respiratory illness at a significant level of 5%.

Results: 255(44%) of the 580 households had basic hand washing facilities, however 171 (67.1%) of the 255 households with hand washing facilities demonstrated appropriate hand washing techniques. The percentage mean reduction in the number of children under five treated for acute respiratory infection and diarrhoea before and during the campaign was 6.49% and 11.5% though not statistically significant with p value = 0.778 and 0.3952 respectively.

Conclusion: The study reaffirmed the effect of proper hand washing practices on the reduction of episodes of diarrhoea and acute respiratory infection among children which ultimately will contribute to reducing child mortality and shows that COVID interventions and investment could be used to support and strengthen non COVID routine health services.

Handwashing, COVID 19, diarrhoea, acute respiratory infection, risk communication.

Article Details

How to Cite
Oladeji, O., Farah, A. E., Hassan, A., Ayanle, M., Ali, Y. M., & Ali, Y. M. (2020). Rapid Assessment of Indirect Effect of Handwashing Campaign during COVID 19 Risk Communication and Community Engagement on Diarrhoea and Respiratory Illness among Children under Five in Jijiga Town of Somali Region of Ethiopia. Journal of Advances in Medicine and Medical Research, 32(19), 11-19. https://doi.org/10.9734/jammr/2020/v32i1930663
Original Research Article


United Nations Inter-Agency Group for Child Mortality Estimation (UN IGME). Levels and trends in child mortality: Report 2017, estimates developed by the UN inter-agency group for child mortality estimation. United Nations Children’s Fund, New York; 2017.

United Nations Children’s Fund. One is too many: Ending child deaths from pneumonia and diarrhoea. New York: UNICEF; 2016.

Curtis V, Cairncross S. Effect of washing hands with soap on diarrhoea risk in the community: A systematic review. Lancet Infectious Diseases. 2003;3:275-281.

Rabie T, Curtis V. Evidence that handwashing prevents respiratory tract infection: A systematic review. Tropical Medicine and International Health. 2006;11(3):1-10.

World Health Organization (WHO). World Health Report. Geneva: World Health Organization; 2002.

Centers for diseases control and prevention. Handwashing: Clean hands save lives. Available:http/www.cdc.gov/handwashing/ (Accessed on 16th July 2020)

Central Statistical Agency (CSA) [Ethiopia] and ICF. Ethiopia demographic and health survey: Key indicators report. Addis Ababa, Ethiopia and Rockville, Maryland, USA. CSA and ICF; 2016.

Topher Byamukama. Assessing knowledge, attitudes and practice of hand washing with soap among mothers and caregivers of children under five years in Ntungamo District, Uganda Texila. International Journal of Public Health. 2019;7(4).

Danquah LO. Measuring hand washing behaviour: Methodological and validity issues. Paper Presented at the South Asia Hygiene Practitioners Workshop, Dhaka, Bangladesh; 2010. Available:https://www.ircwash.org/resources/measuring-hand-washing-behaviour-methodological-and-validity-issues-paper-presented-south

UNICEF, WHO. Progress on household drinking water, sanitation and hygiene 2000-2017. Special focus on inequalities. New York: United Nations Children’s Fund (UNICEF) and World Health Organization (WHO); 2019.

Wolf J, Johnston R, Freeman MC, Ram PK, Slaymaker T, Laurenz E. Handwashing with soap after potential fecal contact: Global, regional and country estimates. International Journal of Epidemiology. 2019;1204–1218. DOI: 10.1093/ije/dyy253

Nsele N, McKerrow H. A study of self-reported handwashing practices of caregivers in relation to acute respiratory infections and gastroenteritis in infants in a peri-urban community in KwaZulu-Natal Province, South Africa S. Afr J Child Health. 2019;13(1):23-26. DOI: 10.7196/SAJCH.2019.v13i1.1532

Matthew C. Freeman, Meredith E. Stocks, Oliver Cumming, Aurelie Jeandron, Julian P. T. Higgins. Systematic review. Hygiene and health: Systematic review of handwashing practices worldwide and update of health effects. Tropical Medicine and International Health. 2014;19(8):906–916.

Ejemot RI, Ehiri JE, Meremikwu MM, Critchley JA. Hand washing for preventing diarrhoea. Cochrane Database of Systematic Reviews. 2008;1.

Art. No.: CD004265. DOI: 10.1002/14651858.CD004265.pub

Fewtrell L, Kaufmann RB, Kay D, Enanoria W, Haller L, Colford JM Jr. Water, sanitation and hygiene interventions to reduce diarrhoea in less developed countries: A systematic review and meta-analysis. Lancet Infectious Diseases. 2005;5(1):42–52.

Curtis V, Cairncross S. Effect of washing hands with soap on diarrhoea risk in the community: A systematic review. Lancet Infectious Diseases. 2003;3(5):275–81.

Fewtrell L, Colford JM. Water, sanitation and hygiene: Interventions and diarrhoea: A systematic review and meta-analysis [Report No 34960]. Washington DC: The International Bank for Reconstruction and Development/The World Bank; 2004. Available:https://documents.worldbank.org/en/publication/documentsreports/documentdetail/916941468167378489/water-sanitation-and-hygiene-interventions-and-diarrhoea

Abdiwahab H, Abera K, Janvier G. Hand washing with soap and WASH educational intervention reduces under-five childhood diarrhoea incidence in Jigjiga District, Eastern Ethiopia: A community-based cluster randomized controlled trial. Preventive Medicine Reports. 2017;6:361–368.

Luby SP, Halder AK, Huda T, Unicomb L, Johnston RB. The effect of handwashing at recommended times with water alone and with soap on child diarrhoea in rural Bangladesh: An observational study. PLoS Med. 2011;8(6):e1001052. Available:https://doi.org/10.1371/journal.pmed.1001052

Aiello AE, Coulborn RM, Perez V, Larson EL. Effect of hand hygiene on infectious disease risk in the community setting: A meta-analysis. American Journal of Public Health. 2008;98:1372–1381.

Ram PV, DiVita MA, Khatun-e-Jannat K, Islam M, Krytus K, et al. Impact of intensive handwashing promotion on secondary household influenza-like illness in Rural Bangladesh: Findings from a randomized controlled trial. PLoS One. 2015;10(6):e0125200. DOI: 10.1371/journal.pone.0125200

Kamm KB, Feikin DR, Bigogo GM, Aol G, Shah MM. Associations between presence of handwashing stations and soap in the home and diarrhoea and respiratory illness, in children less than five years old in Rural Western Kenya. Tropical Medicine and International Health. 2014;19(4):398–406. DOI: 10.1111/tmi.12263

Biran A, Rabie T, Schmidt W, Juvekar S, Hirve S, Curtis V. Comparing the performance of indicators of handwashing practices in Rural Indian households. Tropical Medicine & International Health. 2008;13:278–285.