Photo by Bill Wegener on Unsplash
https://rghi.org/wp-content/uploads/2023/09/Photo-by-Bill-Wegener-on-Unsplash--scaled.jpg
1768
2560
inanyevent
https://rghi.org/wp-content/uploads/2021/07/colour-web-logo.png
inanyevent2023-09-14 11:42:442023-09-14 11:44:17Improving hygiene in Africa includes addressing hygiene and sanitation policyRGHI 2022 Fellowship Program
Sitsofe Gbogbo, University of Health and Allied Sciences
Exploring the relationship between menstrual hygiene management and depression among adolescents in Ghana
“Every month, millions of adolescents in sub-Saharan Africa (SSA) go through stress and anxiety because of poor menstrual hygiene. Poor menstrual hygiene (PMH) comes from inadequate basic items including clean water and dignifying environments. Taboos and stigma in some societies make this even worse and possibly puts them at risk of mental health disorders including depression. How PMH may result in depression is unclear. The study I will do will improve upon our understanding of this issue. I will combine behavioral (qualitative) and numerical (quantitative) ways to do this study. I will talk to female adolescents in rural and semi-rural areas in Ghana, parents, teachers and community leaders (13 in all) about the problem. I will understand the behavioral issues better and learn how depression may result from PMH. I will use the information to improve the set of questions I will ask 1175 female high school adolescents in the quantitative study that will follow. I will find out how many adolescent girls face this problem and how it is linked to depression among them. I will ask them the set questions that have been shown to measure the quality of menstrual hygiene and depression. In doing so, I will help to improve the questions that can be used to assess menstrual hygiene in different societies. I will present the findings in different forms and places. It will be used to make the case for improved menstrual hygiene. It will also be used to identify and manage menstruation related depression among adolescent girls in schools in Ghana and other countries. This fellowship will make me stand out among researchers very quickly. It will progress my previous studies in adolescent health as well as get me training and acquire new skills in quantitative data analysis and mental health. By the time I complete this fellowship program in 33 months, I will be a recognized and independent adolescent health researcher who is able to support others.”
Max Eyre, London School of Hygiene & Tropical Medicine
Simplified sewerage to target multiple transmission pathways of environmental and zoonotic diseases in urban communities
“By 2025, over 2 billion people will live in low-income urban communities with inadequate provision of public water, sanitation, and hygiene (WASH) services. These unsanitary conditions favour the transmission of diseases that are transmitted to people from soil and water, or infected rodents or domestic animals. The public health burden of these diseases is expected to increase with continued global urbanisation and extreme weather events caused by climate change. Despite this, little is known about exactly how inadequate WASH leads to high risk for a range of different diseases or how we can prevent human infections through hygiene interventions.
The aim of this project is to examine the mechanisms through which sanitation can improve health by studying three pathogens (Leptospira spp, Toxoplasma gondii and Helicobacter pylori) that are transmitted to people from the environment or animals. First, the project will evaluate how improving sewerage systems impacts their transmission in urban communities in the city of Salvador, Brazil. Second, it will identify where risk for the different diseases is concentrated in the same areas. It aims to provide a better understanding of the different mechanisms by which hygiene interventions prevent disease transmission by studying multiple diseases together and collecting data on several indicators of transmission: human infection, environmental contamination and the presence of rats and other animals. The project will communicate these findings through academic articles, workshops with local policymakers and international researchers, blogposts, and videos and infographics created by the community.
The findings of this project will create new knowledge on the specific role of inadequate WASH in transmission of these diseases. It will also generate evidence to support better-informed decisions on the development and use of sewerage interventions that target a wider range of diseases than has previously been considered.”
Mandikudza Tembo, Biomedical Research and Training Institute
“TAURA”: Participatory Action Research to transform menstrual health and hygiene for women in Zimbabwe
“Menstrual health (MH) is a human rights issue and integral to women’s health and wellbeing; yet it remains a challenge for many, especially in low- and middle-income countries. In Zimbabwe, there is a high unmet need for MH products and support for women, including care for menstrual pain and disorders. If we are to reduce gendered hygiene-related inequalities and related larger health, social and economic impacts, it is important to understand and address the MH-related challenges women face daily.
During this fellowship, I will work across three provinces in Zimbabwe (Harare, Mashonaland East, Bulawayo) and use an innovative participatory action research approach to develop a setting-specific and evidence-based MH resource and training package (an MH Toolkit). This package will improve MH-seeking behaviours, quality of care and the overall wellbeing and quality of life for women in Zimbabwe. I will achieve this through four objectives: i) to investigate the lived experiences of women in Zimbabwe in relation to hygiene and MH; ii) to synthesize findings into an entertaining and educational MH film that brings attention and understanding to the often stigmatized and mystified experiences of menstruation and MH; iii) to understand the gaps in MH-related knowledge and healthcare-seeking behaviour and provision; and iv) to use these findings to co-develop, pilot, and evaluate a comprehensive “Menstrual Health Toolkit” for women and their healthcare providers.
The project is innovative in focusing on women and menstruation across the life-course and on the co-creation of a Menstrual Health Toolkit with women, healthcare providers, and other relevant stakeholders in rural and urban communities across Zimbabwe. It will also be one of the first rigorous research projects on how to practically improve MH and MH-related awareness and care in Southern Africa.”
Fanta Gutema, University of Iowa
Genomic Fingerprinting Enteric and Antimicrobial Resistant Bacteria at Hygiene and One Health Interface for Tracking Disease Transmission in Ethiopia
“Diarrheal diseases and treatment failure due to drug resistance bacteria are common health problems globally. Ethiopia has one of the highest burdens of diarrheal diseases. It is caused mainly by enteric microorganisms. Animal farming within the household environment can contaminate household environmental fomites such as water, soil, and surfaces with animal feces carrying germs. Children living in developing countries are commonly exposed to these agents/bacteria due to widespread contamination of the environment linked with limited access to safe water, sanitation, and hygiene services. In Ethiopia, studies reported occurrence of different bacteria in animals, environments, foods. However, information on which pathways contribute most to transmission of enteric and drug resistant bacteria between animals and children is lacking. This research aims to identify the transmission pathways of common diarrhea causing bacteria namely E. coli, Salmonella, and Listeria monocytogens from animals to infants by performing laboratory analysis of samples collected from cattle, water, soil, infant foods, caregiver’s hands, and infants from selected households having infants and animal in urban and peri-urban neighborhoods of Bishoftu,Ethiopia. The project will also collect information on hygienic practices at household (e.g. during preparation of foods), animal waste management and antimicrobial drug usage. Based on these information, the relationship of enteric and antimicrobial resistant bacteria among the different sources compared and the transmission pathways from animal to infants will be identified. The results of the research will be published in science journals, and more importantly presented to stakeholders including local community in Ethiopia to inform designing effective and feasible community-based interventions to prevent transmission of enteric and drug resistant bacteria from animals to humans in Ethiopia.”
Rehnuma Haque, icddr,b
Child weaning practices and hygiene intervention among mothers in the prevention of foodborne diseases in Bangladesh
“Food contamination is a major cause of childhood diarrhea in low-income areas, especially during the weaning period. Weaning food is a portion of food given to children as complementary foods to breast milk starting at six months and gradually increasing to 24 months.\. The majority of hygiene or child nutrition programs do not adequately address the safety and hygiene of supplemental foods. Weaning foods are typically produced from common household items such as a combination of cereals and legumes etc. Nevertheless, potential hazards of weaning food include microbiological contamination due to poor food hygiene behavior among mothers. The mouth is the typical portal of entry for gastrointestinal pathogens, which are ingested alongside contaminated food and water and cause damage to the gut. Therefore, this research aims to design a food hygiene intervention package, implement it to promote safe food hygiene behavior, and reduce microbiological contamination before serving to children. Interventions of this weaning food hygiene could prevent diarrhea disease among children, which has a high burden in low- and middle-income countries. Furthermore, in resource-poor settings, with high population density, such low-cost interventions can make a substantial difference in the transmission of communicable diseases or even enable proper mobilization of healthcare professionals, nutrition experts, appropriate materials, and governance to improve water sanitation, and hygiene (WaSH) situations. The proposed study will be conducted in that capital city Dhaka, Bangladesh and be split into three phases: formative research, design intervention package, and feasibility trial to look into weaning hygiene habits and contextual interventions to help mothers prevent foodborne illnesses among their children.”
Elizabeth Thomas, Johns Hopkins Bloomberg School of Public Health
Improved backyard poultry management to reduce young children’s exposure to poultry feces
“For rural households in low and middle-income countries, backyard poultry production is an important livelihood strategy. However, poultry ownership can increase young children’s exposure to poultry feces, causing diarrhea and poor growth outcomes. In Bangladesh, most rural households raise poultry, and almost half keep birds inside their household dwelling at night, increasing risk of exposure to poultry feces. We developed a hygiene and poultry management intervention to encourage poultry-raisers to build improved poultry sheds, confine poultry outside of the household dwelling at night, and improve poultry feces management in order to reduce young children’s exposure to poultry feces. We tested this intervention among 79 households in rural Bangladesh; 58% of households built an improved shed. This intervention approach may be an effective behavior change strategy for reducing exposure to poultry feces. However, further evaluation on long-term intervention outcomes and potential to improve human health is needed. This proposed study is a follow-up evaluation of a poultry housing and feces management intervention and aims to provide insights on best practices for WASH interventions to incorporate poultry management as part of their effort to reduce human exposure to animal feces. This study includes three objectives. For objective 1, we will conduct a long-term evaluation of intervention households to assess durability of hygiene behavior change and intervention sustainability. For objective 2, we will measure fecal contamination of the domestic environment and evaluate risk factors for young children’s exposure to poultry feces, which will provide insight on the intervention’s potential to improve human health. For objective 3, we will explore recommendations for the design, content and evaluation of intervention approaches to reduce exposure to poultry feces and optimize the positive contributions of backyard poultry to household health and livelihood.”
RGHI 2022 Grant Program
Matthew Freeman, Emory University - Rollins School of Public Health
Standard reporting guidelines for hygiene and WASH implementation
Tarique Huda, icddr,b
Street food hygiene in low-resource settings: Evidence synthesis
“The outputs from the proposed research activities will contribute to two of the RGHI priority thematic areas:
1) The Relationship Between Hygiene and Health / Disease Outcomes and
2) Hygiene Behaviours and Hygiene Behaviour Change
We propose to conduct a scoping review to synthesize existing evidence. Objective one will give us an in-depth understanding of the determinants of food hygiene behavior among street food vendors in low-resource settings, which can be helpful in developing food hygiene interventions for sustainable behavior change among street food vendors. So objective one will contribute to the theme ‘Hygiene Behaviours and Hygiene Behaviour Change’.
Objectives two and three will provide us with a better understanding of the effect of different food hygiene interventions/approaches for vendors and consumers on safe food handling knowledge, attitudes, practices, and microbiological contamination of street food. As a result, we will gain an understanding of approaches/interventions for safe food hygiene behavior for street food vendors. In addition, we will gain an understanding of the relationship between street food hygiene practices and microbiological contamination of street food. So, Objectives two and three will contribute to RGHI priority themes ‘Hygiene Behaviours and Hygiene Behaviour Change’ and ‘The Relationship Between Hygiene and Health / Disease Outcomes’.”
Patricia Geli, Harvard T.H. Chan School of Public Health (Global Health and Population)
Researching potential topics for RGHI/Harvard jointly developed (collaborative) activities
Alexander Clark, The Behavioural Insights Team
Improving hygiene behaviours among Rohingya refugees in Cox’s Bazar
Thematic area: C. Hygiene Behaviours and Hygiene Behaviour Change
“Cox’s Bazar in Bangladesh has become the world’s largest refugee camp, as hundreds of thousands of Rohingya families fled genocidal violence in Myanmar in 2017. BRAC – the world’s largest NGO – is now also the largest responder to the Rohingya refugee crisis. Building on decades of work to support Rohingya refugees escaping persecution in Myanmar, the BRAC Humanitarian Crisis Management Programme (HCMP) is providing food, shelter, education and, vitally, healthcare to this highly vulnerable population. Healthcare is a crucial component, not least because the COVID-19 pandemic has introduced a new complexity to supporting the Rohingya. In light of this and other public health issues, multiple development agencies, including BRAC, have sought to build public hand washing facilities in the Rohingya refugee camps.
However, research in other similar contexts has issued a stark warning: “Provision of soap and water alone is not sufficient to encourage children to practice handwashing with soap in a humanitarian context”. Although access to soap and water is a vital first step, the problem then becomes behavioural. Encouraging people to make better decisions for themselves is both the mission and the practice of the Behavioural Insights Team (BIT), a global social-purpose consultancy that applies insights from behavioural science to achieve social impact. Our research projects design and test interventions to drive behavioural change.
The proposed research project will aim to increase hand washing with soap among Rohingya refugees in Cox’s Bazar. BIT will work with BRAC’s Social Innovation Lab (SIL) to conduct a 6-month research study that designs an intervention to encourage use of public handwashing stations, and then evaluate impact rigorously through an experimental trial. We will measure impact through observations of real behaviour.
Crucially, because SIL have already received funding and begun their work on encouraging hygiene behaviour change in Cox’s Bazar, this research study will be highly cost-efficient. BRAC has already built hand washing stations with which BIT is very familiar based on our previous collaboration in Bangladesh to encourage hand washing. BIT will be able to augment SIL’s planned work, and conduct an additional, high-quality study concurrently.
The refugee population in the Cox’s Bazar camps is now over a million: yet this is less than 5% of the total refugee population globally. This research study has the potential to make a valuable contribution to the hygiene science literature generally, through quantifying behaviour change impacts, and the literature around refugee camp hygiene specifically.”
RGHI 2021 Fellowship Program
Ian Ross, London School of Hygiene & Tropical Medicine
Improving the economic evaluation of handwashing interventions
“Budgets are always limited, and there are always competing options for use of resources. We do not know enough about which handwashing interventions comprise the best use of funds. We do not even know enough about how much hygiene interventions cost, or the role of scale in average cost. This makes it harder for governments and implementers to plan. The aim of this project is to improve the economic evidence base regarding handwashing interventions. It has three components. First, it will estimate the costs of two programmes implemented by World Vision. Second, it will compare the costs and benefits of those interventions, so we know which strategy a more efficient use of resources. Third, it will develop a set of questions to measure ‘hygiene-related quality of life’ meaning the things that people find most important about having good hygiene. The project will produce academic articles, but also a suite of guidance and tools for implementers to be able to practically use the methods developed. The project will support better-informed decisions about which hygiene promotion strategies to choose. It will also help implementers and governments calculate the costs of scaling up handwashing interventions. Finally it will help researchers and implementers measure how much people’s lives have improved as a result of hygiene programmes.”
Sheillah Simiyu, African Population and Health Research Center
Assessing the effectiveness of compound-led initiatives on hygiene practices and maintenance of handwashing facilities in low income settings in Kenya.
“Many African countries, including Kenya, have large numbers of their urban residents living in low income settlements, that often lack basic services water, sanitation and hygiene, that are critical in preventing diseases. When water and sanitation services are available, they are often shared with several other households. Whereas it is expected that handwashing facilities are available at the household level, this is not the case in low income settlements, thereby limiting handwashing with soap at key moments. This study aims to understand hand hygiene behaviours in low income settlements, to design appropriate hand hygiene facilities that are managed by community members, and assess the effectiveness of these facilities in increasing handwashing practices. This work will be done in three phases, with the first phase aimed at identifying the key hygiene practices in the settlements. This information will enable the design of appropriate handwashing facilities with compound members in the second phase, and later evaluate their effectiveness in increasing handwashing practices in the third phase. The study will be conducted in three sites in Kenya, to provide a comparison of hygiene practices in a capital city, a medium sized city, and a rapidly growing secondary city. Outputs from this
study will provide information on determinants of hygiene practices in low income settlements, and how communities can be empowered to influence their hygiene practices. This data will provide evidence relevant to policy makers and practitioners, and will inform global goals such as the sustainable development goals.”
Julie Hennegan, Burnet Institute
Measuring unmet menstrual health and hygiene needs and their impacts on health and education
“An estimated two billion people currently experience a menstrual cycle. There is recognition globally that unmet menstrual needs result in harms to women’s and girls’ physical and mental health, education, and gender equality. Longterm, my work aims to support the implementation of evidence-based programmes and policies to improve menstrual health and hygiene. Stigma and silence around menstruation have meant we have limited evidence to understand menstrual needs and inform effective support strategies. Moreover, we lack the data and evidence to build a strong case for investing in menstrual health and hygiene. Through the RGHI Fellowship I will address significant evidence gaps. First, I will advance our ability to measure menstrual health and hygiene needs. In 2020, I developed a comprehensive tool to assess menstrual hygiene: The Menstrual Practice Needs Scale (MPNS). This measure provides a way for respondents to report whether they had what they needed to manage menstruation during their last period (for example, sufficient materials to absorb blood or spaces to change and wash materials). I developed the tool in Uganda, but it is now being used in many countries around the world. Through the fellowship I will test the performance of the measure in different populations. I will use information from these assessments to develop a shorter version of the scale so that it can be administered quickly to support research and practice. Second, I will provide missing evidence testing the impact of unmet menstrual health and hygiene needs in adolescence on broader health and education outcomes. By following a group of adolescent girls over time, I will capture changes in their menstrual needs to inform effective interventions. I will also be able to calculate the extent to which their menstrual health and hygiene experiences impact their psychological wellbeing and schooling.”
Giorgia Gon, London School of Hygiene & Tropical Medicine
HY-NORM-Changing HYgiene social NORMsat key times in the life-course: what works and how?
“Social norms are an important way through which hygiene behaviours can be changed, and they shape for example the practice ofopen defecation. In this example, there is a societal expectation that people will not defecate in public spaces and should not do it. Public shaming or other forms of punishment are used to enforce this expectation. Social norms are thus a very effective way of changing behaviour because once they are established they are self-sustaining. Currently our knowledge on how to exploit social norms to change hygiene behaviour is scarce. In particular, we do know how best utilise them under different circumstances. During this fellowship, I will measure social norms within three existing studies of hygiene behaviours: surface hygiene during birth in healthcare facilities (in Cambodia), food hygiene when starting to give solids to babies in the home (in Bangladesh), and menstrual hygiene of adolescent schoolgirls (in Uganda). These studies are each testing interventions which can exploit social norms to bring about change in the respective hygiene behaviours, but none of them have currently planned to do this. My fellowship will seize this opportunity and will deliver on three objectives: firstly, to understand if each of these interventions have created or strengthened social norms; second, to identify factors explaining whether some sub-groups of people have stronger social norms than others; thirdly, to assess whether an intervention focusing on social norms could be effective in changing hygiene behaviour. The findings of my work will not only create new knowledge on the role of social norms as agents of change but also show the potential for this pathway to bring lasting benefits to hygiene-related health.”
RGHI 2021 Grant Program
Siyan Yi, Saw Swee Hock School of Public Health, National University of Singapore
Developing and piloting infection prevention and control intervention to reduce the incidence of hospital-acquired infection in Cambodia and Lao PDR
“Hospital-acquired infections (HAI) or “nosocomial” infections, which occur in patients under medical care, do not receive much public health attention, particularly that of policymakers in low- and middle-income countries (LMICs), unless there is an epidemic. The current pandemic—coronavirus disease 2019 (COVID-19)—is a case in point. It has provided healthcare providers and policymakers with clear and practical lessons learned about the effectiveness of enhanced infection prevention and control (IPC) in reducing HAI incidence. Several recent retrospective studies have shown that enhanced IPC at hospitals during the pandemic has reduced HAI incidence. Generally, the prevalence of nosocomial infections in LMICs is higher than that in high-income countries. Therefore, the economic burden of the endemic HAI in LMICs is higher than that in high-income countries. HAI prevention and control programs are critical as the infections pose threats to both patients and healthcare providers. There is a growing body of evidence of the effectiveness of IPC interventions in reducing HAI prevalence. Nevertheless, which interventions work effectively in which LMICs is an important research question. On top of that, available resources on IPC introduced by the World Health Organization (WHO) provide direction for LMICs to effectively implement IPC programs at national and facility levels. The resources include guidelines on core components of IPC programs at the national and acute health-facility level and IPC framework at the facility level.
Against the backdrop of HAI and IPC in LMICs mentioned above, our team at the Saw Swee Hock School of Public Health has partnered with a pool of experts from the institutes in LMICs, including the University of Health Sciences (UHS) in Cambodia and the Lao Institute of Tropical and Public Health Institute (TPHI) in Lao People’s Democratic Republic (Lao PDR) to tackle IPC and HAI in the two LMICs. We seek consideration from Reckitt Global Hygiene Institute over our joint grant application with a total budget of USD 299,912 over two years. The proposal comprises three research components, namely:
- Gap analysis of IPC implementation and practices among healthcare workers at national, provincial, and district health facilities to identify IPC intervention components;
- Development of IPC intervention based on gap analysis and model interventions selected based on screening exercise of studies in the most recent systematic review of IPC interventions to reduce the incidence of HAI in LMICs; and
- Pilot and assessment of the feasibility and acceptability of the IPC intervention developed in component 2 in Cambodia and Lao PDR.
The above three components and objectives will help us arrive at the ultimate goal of developing a promising IPC intervention to reduce HAI prevalence in Cambodia, Lao PDR, and other LMICs.
Cambodia and Lao PDR have been selected for this proposal because the two countries share similar healthcare systems and lag behind their neighboring countries, namely Thailand and Vietnam, in HAI research and IPC infrastructures. Lessons learned from these countries could be piloted in other LMICs, given their development level. More importantly, this proposed study will bring together a consortium of research-oriented institutes in Cambodia and Lao PDR. Strengthening and sustaining research networks and building research capacity in LMICs through learning-by-doing along the proposed project’s course is part of the Reckitt Global Hygiene Institute’s goal and priorities. The team has also anticipated that there will be several outcomes at the end of the research project.
The expected project’s outcomes include:
- A report of gap analysis of the practice of IPC among healthcare workers and their behavior-related factors influencing their adherence to IPC guidelines in Cambodia and Lao PDR;
- A report of selected IPC interventions using extracted IPC intervention studies from the most recent systematic review on IPC intervention in LMICs;
- A report of how an IPC intervention is developed and validated by the national technical working groups using a national validating workshop; and
- A report of the pilot study of the IPC intervention and the intervention’s feasibility and acceptability assessment to reduce HAI in LMICs.
Dissemination workshops will also be organized to share knowledge, experience, and findings with policymakers, academia, and various relevant stakeholders in Cambodia and Lao PDR. The study’s findings will be presented at national, regional, and international forums and published in international peer-reviewed journals.”
Kai Chen, Yale School of Public Health
Associations Between Extreme Precipitation, Floods, or Drought and Childhood Diarrhea in Low-and Middle-Income Countries
“In the absence of improvements in hygiene, climate change is expected to increase the incidence of diarrheal disease, a leading cause of childhood mortality and morbidity. Diarrhea is estimated to account for approximately 0.5 million deaths annually in children under age five, with most of the burden concentrated in areas with poor hygiene such as sub-Saharan Africa and South Asia. Even a small increase in diarrhea risk can result in a substantial increase in global burden of disease. However, our understanding of the burden of childhood diarrhea attributable to climate change has been hampered by the scarcity and inconsistency of empirical evidence on the relationship between extreme precipitation, floods, or droughts and diarrhea, especially in low- and middle-income countries (LMICs). It also remains unclear whether water, sanitation, and hygiene (WaSH) practices could modify these associations, a critical knowledge gap in reducing the diarrheal disease burden under climate change. Using Demographic and Health Surveys (DHS) data covering 51 LMICs in sub-Saharan Africa, South and Southeast Asia, Latin America, and the Caribbean, we aim to apply statistical modeling to estimate the relationship between extreme precipitation, floods, or drought and risk of childhood diarrhea, and to evaluate whether these effects are modified by WaSH practices. We will further collect geo-referenced data from the Multiple Indicator Cluster Surveys (MICS) in a sensitivity analysis. Our proposed research directly addresses the topic “Impact of climate change, urbanization, travel and other natural and artificial changes on pathogen survival and transmission, and on human microbiome,” which is under the first RGHI Area of Interest – “The role of hygiene in the epidemiology and transmission of specific pathogens and disease.” The proposed research will further our understanding of the potential impacts of climate change on diarrheal disease in LMICs and will help prioritize adaptation measures such as improved structural and individual-level hygiene practices.”
Donna Spiegelman, Yale School of Public Health
Using Implementation Science Methods to Assess Impacts of Respiratory Hygiene and Safe Return to Work Protocols (STRW) in the COVID-19 Era
“COVID-19 was officially declared a pandemic by the World Health Organization on March 11, 2020,and the global burden of infection with SARS-CoV-2 is high in terms of mortality, morbidity, burden on health systems, and adverse economic impacts. COVID-19 has impacted workplaces around the world, and as a precaution, most companies and institutions, including Yale, shifted to virtual work when possible, requiring employees to work from home. The City of New Haven, home to Yale University, has a population of 130,250 people, of whom 26.5% were below the poverty line prior to the COVID-19 pandemic [9]. Yale University, which employs approximately 14,000 faculty and staff, is the largest private employer in New Haven [10]. After more than 2 months of virtual operations in March-May 2020, Yale implemented plans to transition 3000 highly restricted access personnel back into their workspaces on June 1, 2020, as part of a Phase 1 reopening and an additional 6000 restricted access personnel on July 20, 2020, as Phase 2. As of February 15, 2021, Yale moved to Phase 3, allowing the remaining ~6000 less restricted operations personnel back on campus. In initiating the phased return to work, Yale developed and released a regularly updated protocol to minimize the risk of exposure to the virus. A large systems-level roll out of behavior change such as this may face formidable challenges to successful implementation, and a rigorous protocol evaluation plan is needed. This implementation research study will place Yale at the cutting edge of institutions implementing safe back to work plans, while also developing generalizable methods that can be utilized for environmental hygiene studies in the future. Our overall aim is to use rigorous implementation science methodology to evaluate and improve the rollout of the Phase 3 safe return to work protocols (SRTW) for Yale employees. We will employ a hybrid Type 3 study design and, following Proctor’s Implementation Outcomes Framework, we will evaluate thefidelity of implementation of the protocol; assess itsacceptability, adoption, appropriateness, and feasibility; and evaluate the effectiveness of the protocol in regard to COVID-19-related health outcomes: antibody test results, self-reported symptoms, and days lost from work. In addition, we will obtain data investigating potential improvements to SRTW for future adoption and evaluation. We will achieve these goals through an innovative multi-disciplinary collaboration across multiple schools at Yalethat combines cutting-edge environmental hygiene measurement methodologies and machine learning approaches with state of the art implementation science research strategies. Through a longitudinal study design, at least 6000 Yale employees, a large proportion of whom are of Black/African American and Hispanic/Latino races/ethnicities, will be followed for one year.”
Robert Dreibelbis, London School of Hygiene & Tropical Medicine
Improving Hygiene in Guardian Waiting Shelters and Communities in Malawi: an intervention development and feasibility study
“Guardian Waiting Shelters (GWS) are temporary residential homes at healthcare facilities that
provide dormitory type accommodations for caregivers (parents, relatives, carers) whose relatives
have been admitted to hospitals. GWS have limited environmental services, variable infection
prevention and control protocols, and are overcrowded – creating significant risk for communicable
disease transmission. These risks are particularly pronounced within the context of COVID-19, which
has resulted in high rates of hospitalisation – increasing the use of GWS while COVID-19
transmission dynamics create high risk of transmission among GWS residents and increase the risk of
transmission to the home and community.
In the first wave of the COVID-19 pandemic, the GWS at Queen Elizabeth Central Hospital (QECH) in
Blantyre, Malawi was identified as one of these high risks, yet unsupported areas. Between April and
September 2020 (1st peak of COVID-19), the WASHTED Centre (University of Malawi – The
Polytechnic) and University of Strathclyde worked hand in hand with the Ministry of Health and
Chira Fund to develop a bespoke programme for the GWS. This programme included a daily hygiene
education programme focussed on transmission reduction through hand washing, mask wearing,
physical distancing, and maintaining behaviours whilst at the GWS and when returning home. While
preliminary and informal data suggest the GWS intervention has been well received, a
comprehensive research initiative is required to inform the adaption, implementation, and
evaluation of these novel interventions to promote hygienic behaviours. Furthermore, this will
inform future programme and policy level interventions at the national and district level.
The proposed research will address two key areas: how to maintain adequate infection prevention
and control standards within GWS and how to utilise the GWS intervention to improve hygiene
behaviours after returning from the health care facilities to the home environment – a particularly
critical window for preventing and reducing the risk of infectious disease.”
Katie Greenland, London School of Hygiene & Tropical Medicine
Face washing methods to eliminate trachoma (FAME)
rachoma, a Neglected Tropical Disease (NTD), is the commonest infectious cause of blindness globally, affecting some of the world’s poorest communities(1).Trachoma eliminationrequires implementation of the WHO-endorsed SAFE strategy: Surgery for trichiasis; Antibiotics to treat infection; Facial cleanliness and Environmental improvementto reduce transmission.Improving the evidence base for the “F”component of the SAFE strategy for trachoma elimination is highlighted as a critical action to reach 2030 targets in the WHO NTD Roadmap 2021–2030 (2); the proposed research directly addresses that critical action. Our identified RGHI priority area is the role of hygiene in the epidemiology and transmission of specific pathogens and disease.We will conduct a study to assess the effectiveness of different face cleansing protocols at removing Ct bacteria and oculo-nasalsecretionsfrom the faces of children with active trachoma. We will also assess how long it takes for Ctto build up again on children’s faces after they are washed.The study will be carried out in one woreda(district) in Oromia, Ethiopiawith high trachomatous inflammation—follicular(TF) prevalence. A total of 300 participantswill be selected purposively following a two-stage screening process. Children aged 2-5 years with ocular Ctinfection determined by rapid test will be eligible to participate in the study. Once parental consent has been obtained, we will i) take a conjunctival swab to test for Ctinfection, ii) swab each child’s face and hands for Ctand iii) assess facial cleanliness using both qualitative and quantitative metrics. Recruited children will be randomised into two equal groups: face washing with water only or face washing with water and soap. Following face washing, each child’s face and hands will be swabbed again for Ct. Swabbing will be repeated at regular intervals up to 8 hours post-protocol.The following week, half of the children in each group will be randomised to one of two face wiping protocols and the study will be repeated. There is currently a lot of international momentum to better understand the “F” component of the SAFE strategy to improve both resource allocation and intervention effectiveness. This study is the first of its kind to explore whether and how face washing can remove Ct from children’s faces.This study will have the opportunity to directly improve trachoma elimination.The proposed study leverages collaborations formed during the Stronger-SAFE trialand builds on published pilot work conducted in Ethiopia in 2018 (3).We have received local ethical approval for this study and are readyto move this research forwards. The applicants are well-positioned to disseminate findings widely in Ethiopia and at the World Health Organization, as well as to the international trachoma community via symposia and conferences. Findings will also be published in Open Access peer-reviewed journals.
News Room
Photo by Bill Wegener on Unsplash
https://rghi.org/wp-content/uploads/2023/09/Photo-by-Bill-Wegener-on-Unsplash--scaled.jpg
1768
2560
inanyevent
https://rghi.org/wp-content/uploads/2021/07/colour-web-logo.png
inanyevent2023-09-14 11:42:442023-09-14 11:44:17Improving hygiene in Africa includes addressing hygiene and sanitation policy
https://rghi.org/wp-content/uploads/2022/11/iStock-1202033073.jpg
1414
2121
inanyevent
https://rghi.org/wp-content/uploads/2021/07/colour-web-logo.png
inanyevent2023-07-05 15:19:362023-07-05 15:35:57CLEAN Briefing Paper identifies research priorities for healthcare cleaning in resource-limited settings
https://rghi.org/wp-content/uploads/2023/05/WHO.jpg
484
474
inanyevent
https://rghi.org/wp-content/uploads/2021/07/colour-web-logo.png
inanyevent2023-05-18 11:12:342023-05-18 11:12:35Hygiene experts urge global health community to wake up to the value of hygiene ahead of World Health Assembly
https://rghi.org/wp-content/uploads/2022/11/thumbnail_nathan-dumlao-x7Lyx8Yyvug-unsplash.jpg
1280
853
inanyevent
https://rghi.org/wp-content/uploads/2021/07/colour-web-logo.png
inanyevent2023-05-05 13:13:122023-05-18 13:14:25Healthcare professionals aren’t equipped to practise good hand hygiene, experts say on World Hand Hygiene Day
https://rghi.org/wp-content/uploads/2022/11/thumbnail_iStock-490400030.jpg
810
1280
inanyevent
https://rghi.org/wp-content/uploads/2021/07/colour-web-logo.png
inanyevent2023-04-28 09:07:402023-04-28 09:08:03Handwashing during ‘normal times’ can reduce burden of respiratory disease
https://rghi.org/wp-content/uploads/2022/05/Dr-Hennegan.jpg
210
210
inanyevent
https://rghi.org/wp-content/uploads/2021/07/colour-web-logo.png
inanyevent2023-04-25 10:09:562023-07-14 17:26:24Young Australians are taking up reusable menstrual hygiene products, but their needs aren’t being met
https://rghi.org/wp-content/uploads/2022/11/thumbnail_nathan-dumlao-x7Lyx8Yyvug-unsplash-1.jpg
1280
853
inanyevent
https://rghi.org/wp-content/uploads/2021/07/colour-web-logo.png
inanyevent2023-04-13 10:46:382023-07-14 17:26:41New Ebola-like virus brings the value of ‘hygiene’ in terms of prevention back to the fore
https://rghi.org/wp-content/uploads/2023/04/RGHI_Assets_logo1-scaled.jpg
2560
2560
inanyevent
https://rghi.org/wp-content/uploads/2021/07/colour-web-logo.png
inanyevent2023-04-05 15:30:032023-07-14 17:27:09RGHI hosts ICA Grant information session and Q&A
https://rghi.org/wp-content/uploads/2022/11/thumbnail_iStock-600999260.jpg
853
1280
inanyevent
https://rghi.org/wp-content/uploads/2021/07/colour-web-logo.png
inanyevent2023-03-23 10:39:002023-04-13 10:44:38Health for all remains a pipedream without hygieneRGHI is committed to enabling and accelerating a portfolio of hygiene science to improve public health through better outcomes and behaviours. Our Grant and Fellowship programs are a key part of this mission, and we are incredibly proud of the significant research that has already been published thanks to RGHI funding.