Multi-Sectoral Participatory Design of a BabyWASH Playspace for Rural Ethiopian Households

Area of Science:

• Global Health
• Pediatric Health
• Environmental Health

Background:

• Current water, sanitation, and hygiene (WASH) interventions inadequately improve domestic hygiene for infant health.
• Existing interventions often overlook age-specific behaviors that elevate infection risks in infants.
• Direct fecal-oral transmission is a significant pathway for infant infections in domestic settings.

Purpose of the Study:

• To detail the design, development, and testing of a household playspace (HPS) for rural Ethiopian households.
• To assess the acceptability and feasibility of an HPS intervention in low-income, rural settings.
• To provide a framework for developing similar material-based interventions using participatory design.

Main Methods:

• A multi-sectoral, multistep participatory process including focus group discussions (FGD) and user-centered design workshops.
• Collaboration with local manufacturers and implementation of Trials by Improved Practices (TIPs) for prototype refinement.
• Testing through FGD, TIPs, and a subsequent randomized controlled feasibility trial in Ethiopian households.

Main Results:

• The household playspace (HPS) intervention was found to be acceptable and feasible in rural Ethiopian households.
• The participatory development process led to a refined HPS prototype.
• The study highlights the potential of HPS to reduce fecal-oral transmission, especially where livestock increase exposure risk.

Conclusions:

• A household playspace (HPS) is a viable and acceptable intervention for improving infant health in resource-limited settings.
• Participatory design is crucial for developing effective and contextually appropriate health interventions.
• Future interventions should consider age-specific behaviors and environmental factors like livestock presence to mitigate infection risks.