The Effect of Public Handwashing Stations on Health Behaviour and Outcomes During COVID-19

In line with the overall goals of HBCC for reducing the transmission of COVID-19 via rapid response interventions to raise awareness and enacting long-term behaviour change regarding people's personal and environmental hygiene habits, BRAC has taken an adaptive approach under the Hygiene and Behaviour Change Collation (HBCC) platform. The aim of this project is to systematically change the behaviour of people across communities in Bangladesh via interventions such as setting up handwashing stations and broadcasting behaviourally-informed messages to nudge people to adopt healthier prevention and response practices.

To achieve the overall goals of the project and positively impact the lives of over 10 million people in communities across Bangladesh, BRAC primarily chose 20 sub-districts from 3 divisions (out of a total of 8 divisions) for implementing the interventions, namely Dhaka, Mymensingh and Khulna. The prime activity is to install 1,000 handwashing stations across these sub-districts to increase the access of communities to handwashing facilities. The BRAC handwashing stations have been designed to enhance both availability and inclusiveness, fitted with foot-operated pedals for dispensing water and liquid soap, to reduce contact with sink surfaces and thereby reduce probability of transmission from the device surface. They have been fitted with posters, promoting handwashing with proper technique, and have also been designed to allow hand-washers to maintain social distance while using the devices.

In addition to these handwashing stations, there are other supports available in the intervention areas i.e. in-person demonstration, hygiene meetings, and soap distribution. After the economy opened up in Bangladesh after a long lockdown, the community engagement activities in the form of in-person communication and forum discussions, to motivate people to uptake safe hygiene behaviours including but not limited to regular handwashing. In these demonstrations and meetings, the participants are motivated to adopt recommended hygiene behaviours such as handwashing with soap, mask usage and disposal, sneezing etiquette, social distancing, etc. Along with the BRAC staff, the WASH entrepreneurs who are members of the local community whom BRAC traditionally supports with free training in entrepreneurship and market development to improve the communities' access and knowledge of hygiene products. The HBCC project empowers them with responsibilities to disseminate the messages of the recommended behaviours and distribute the soap in the communities across the intervention areas, especially the poorest of the poor community and the participants who attend the meetings regularly.

Primary Outcomes (end points)

The main outcome variables of interest in this study are: