Determinants of Handwashing at Critical Times Among Mothers/Caregivers of Children Under-Five Years Old: Panel Data Evidence From Rural Afghanistan

Abstract

Background: Very few studies have used panel data regression models to estimate the determinants of handwashing with water and soap at critical times in a developing country. Objective: To analyse the predictors of handwashing with water and soap at critical times among mother/caregivers of children under-5 years in rural Afghanistan. Method: This study used data from 1208 mothers/caregivers of children under-5 years who were selected and interviewed at baseline and endline in 7 provinces using systematic probability proportional-to-size sampling method. Results: Mother/caregivers with access to handwashing facility with water and soap had 1.20 higher odds of washing hands at 5 critical times. Treatment at public facility, an indirect proxy of health education and having children under 2 years was associated with 1.07 and 1.05 higher odds of washing hands at 5 critical times. Access to handwashing with water and soap, treatment at public facility and children under 2 years were significant and robust to alternative specification of handwashing at least 3 times. Mothers/caregivers who reported contracting infectious diseases in the past 6 months had 1.04- and 1.52-times higher odds of handwashing at 5 critical times and at least 3 times respectively. Conclusion: Access to handwashing facility with water and soap, health education, children under 2 years and occurrence of infectious diseases were the predictors of appropriate handwashing behaviour. Therefore, there is need to improve the availability of handwashing facilities with clean water and soap to promote appropriate handwashing behaviour at critical times. In addition, there is need to promote activities that increase disposable income for households to purchase soap and handwashing facilities. There is need to promote healthcare seeking behaviour for mothers to access medical treatment and health hygiene education at public facilities vital for prevention of infectious diseases.