Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Sep 1;13(9):868.
doi: 10.3390/ijerph13090868.

Exploring Determinants of Handwashing with Soap in Indonesia: A Quantitative Analysis

Mitsuaki Hirai  1 , Jay P Graham  2 , Kay D Mattson  3 , Andrea Kelsey  4 , Supriya Mukherji  5 , Aidan A Cronin  6
Affiliations

Exploring Determinants of Handwashing with Soap in Indonesia: A Quantitative Analysis

Mitsuaki Hirai et al. Int J Environ Res Public Health. .

Abstract

Handwashing with soap is recognized as a cost-effective intervention to reduce morbidity and mortality associated with enteric and respiratory infections. This study analyzes rural Indonesian households' hygiene behaviors and attitudes to examine how motivations for handwashing, locations of handwashing space in the household, and handwashing moments are associated with handwashing with soap as potential determinants of the behavior. The analysis was conducted using results from a UNICEF cross-sectional study of 1700 households in six districts across three provinces of Indonesia. A composite measure of handwashing with soap was developed that included self-reported handwashing, a handwashing demonstration, and observed handwashing materials and location of facilities in the home. Prevalence ratios were calculated to analyze associations between handwashing with soap and hypothesized determinants of the behavior. Our results showed that determinants that had a significant association with handwashing with soap included: (1) a desire to smell nice; (2) interpersonal influences; (3) the presence of handwashing places within 10 paces of the kitchen and the toilet; and (4) key handwashing moments when hands felt dirty, including after eating and after cleaning child stools. This study concludes that handwashing with soap may be more effectively promoted through the use of non-health messages.

Keywords: Indonesia; WASH; handwashing; hygiene; open defecation.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest. The Bill & Melinda Gates Foundation had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

Figures

Figure 1
Figure 1
Percentage of respondents who washed hands with soap by education, district, wealth, and access to water and sanitation. Notes:
See this image and copyright information in PMC

References

    1. Curtis V., Cairncross S. Effect of washing hands with soap on diarrhoea risk in the community: A systematic review. Lancet Infect. Dis. 2003;3:275–281. doi: 10.1016/S1473-3099(03)00606-6. - DOI - PubMed
    1. Fewtrell L., Kaufmann R.B., Kay D., Enanoria W., Haller L., Colford J.M. Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: A systematic review and meta-analysis. Lancet Infect. Dis. 2005;5:42–52. doi: 10.1016/S1473-3099(04)01253-8. - DOI - PubMed
    1. Cairncross S., Hunt C., Boisson S., Bostoen K., Curtis V., Fung I.C., Schmidt W.P. Water, sanitation and hygiene for the prevention of diarrhoea. Int. J. Epidemiol. 2010;39:i193–i205. doi: 10.1093/ije/dyq035. - DOI - PMC - PubMed
    1. Luby S.P., Agboatwalla M., Feikin D.R., Painter J., Billhimer W., Altaf A., Hoekstra R.M. Effect of handwashing on child health: A randomised controlled trial. Lancet. 2005;366:225–233. doi: 10.1016/S0140-6736(05)66912-7. - DOI - PubMed
    1. Strunz E.C., Addiss D.G., Stocks M.E., Ogden S., Utzinger J., Freeman M.C. Water, sanitation, hygiene, and soil-transmitted helminth infection: A systematic review and meta-analysis. PLoS Med. 2014;11:868. doi: 10.1371/journal.pmed.1001620. - DOI - PMC - PubMed

MeSH terms