Testing a participatory strategy to change hygiene behaviour: face washing in central Tanzania

A participatory strategy to increase face washing was designed and tested in central Tanzania. Changing children's face-washing behaviour is postulated to be important in preventing the transmission of eye disease, particularly blinding trachoma. The strategy used non-formal adult education techniques at neighbourhood level meetings to build a community consensus to keep children's faces clean for the prevention of eye disease. Men, women, schoolchildren, traditional healers and village social groups participated in the intervention. The strategy was evaluated by observing changes in numbers of clean faces of a sample of preschool children in the village. Clean faces increased from 9% to 33% over the course of a year. Factors which were related to sustained change in children's clean faces included distance to water, age of the child, and presence of a corrugated metal roof. Owning cattle was associated with lack of sustainable change in this population.