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AJPH First Look, published online ahead of print Nov 13, 2008
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January 2009, Vol 99, No. 1 | American Journal of Public Health 94-101
© 2009 American Public Health Association
DOI: 10.2105/AJPH.2007.129759

RESEARCH AND PRACTICE

Hand Washing Among School Children in Bogotá, Colombia

Catalina Lopez-Quintero, MD, MPH, Paul Freeman, DrPH, MHP, MPH and Yehuda Neumark, PhD, MPH

Catalina Lopez-Quintero and Yehuda Neumark are with the Hebrew University, Hadassah, Israel, and the Braun School of Public Health & Community Medicine, Jerusalem, Israel. Paul Freeman is an independent international health consultant based in Seattle, WA.

Correspondence: Requests for reprints should be sent to Yehuda Neumark, PhD, Braun School of Public Health & Community Medicine, Hebrew University, Hadassah, PO Box 12272, Jerusalem, Israel (e-mail: yehudan{at}ekmd.huji.ac.il).

Objectives. We assessed hand-washing behaviors and intentions among school children in Bogotá, Colombia, to help identify and overcome barriers to proper hygiene practices.

Methods. Data on hand-washing behavior and intentions and individual and contextual factors were collected from 2042 sixth- through eighth-grade students in 25 schools in Bogotá via anonymous questionnaires. A member of the school administration or teaching staff completed a questionnaire about the school environment. Site inspections of bathroom facilities were conducted.

Results. Only 33.6% of the sample reported always or very often washing hands with soap and clean water before eating and after using the toilet. About 7% of students reported regular access to soap and clean water at school. A high level of perceived control was the strongest predictor of positive hand-washing intentions (adjusted odds ratio [AOR] = 6.0; 95% confidence interval [CI] = 4.8, 7.5). Students with proper hand-washing behavior were less likely to report previous-month gastrointestinal symptoms (OR = 0.8; 95% CI = 0.6, 0.9) or previous-year school absenteeism (OR = 0.7; 95% CI = 0.6, 0.9).

Conclusions. Scarcity of adequate facilities in most schools in Bogotá prevents children from adopting proper hygienic behavior and thwarts health promotion efforts. The current renovation program of public schools in Bogotá provides a unique opportunity to meet the challenges of providing a supportive environment for adoption of healthy behaviors.






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