在马拉维实施社区主导的整体卫生:对卫生和卫生干预的过程评估
Mindy Panulo1,2, Kondwani Chidziwisano3, Clara MacLeod4
1Centre for Water, Sanitation, Health and Appropriate Technology Development (WASHTED), Malawi University of Business and Applied Sciences, Blantyre, Malawi.
社区主导的整体卫生 (CLTS) 计划可以减少露天排便. 加强干预忠诚度和家庭参与是马拉维有效的卫生和卫生行为改变的关键.
科学领域:
- 公共卫生 公共卫生
- 环境健康 环境健康
- 行为科学 行为科学
背景情况:
- 社区主导的整体卫生 (CLTS) 旨在通过改善卫生和卫生行为来结束露天排便.
- 关于CLTS实施如何在低收入和中等收入国家推动行为改变的证据有限.
研究的目的:
- 评估马拉维的CLTS干预措施的实施忠实性,覆盖范围,剂量,适应和影响机制.
- 评估干预暴露与卫生设施可用性之间的关联.
主要方法:
- 回溯混合方法过程评价 (2022年1月 - 2023年2月).
- 包括1,151个家庭调查,36个深度访谈和28个焦点小组讨论.
- 后勤回归分析了干预暴露和结果之间的关联.
主要成果:
- 观察到可变的实施忠实度,在培训交付方面忠实度低,但在家庭参与方面忠实度高.
- 干预范围低于最佳,其特点是家庭接触有限,对卫生运动的回忆不足.
- 综合社区和家庭活动暴露显著增加了所所有权 (OR=1.63) 和洗手设施的存在 (OR=1.39).
结论:
- 为了实现可持续性和影响力,CLTS计划需要提高干预忠实度和家庭参与度.
- 建议整合负担得起的,适应气候变化的卫生设施.
- 未来的CLTS战略应集中于加强社区和家庭层面的干预.
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