Evaluation of facial cleanliness and environmental improvement activities: Lessons learned from Malawi, Tanzania, and Uganda

• Published in: PLoS neglected tropical diseases Vol. 15; no. 11; p. e0009962
• Main Authors: Sanders, Angelia M, Dixon, Ruth, Stuck, Logan, Kelly, Michaela, Woods, Geordie, Muheki, Edridah M, Baayenda, Gilbert, Masika, Michael, Kafanikhale, Holystone, Mwingira, Upendo, Wohlgemuth, Leah
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01-11-2021; Public Library of Science (PLoS)
• Subjects: Antibiotics; Biology and Life Sciences; Blindness; Chlamydia; Chlamydia trachomatis - physiology; Cleanliness; Data collection; Distribution; Environmental Monitoring; Ethics; Evaluation; Face; Face - microbiology; Feces; Funding; Hand Disinfection; Health aspects; Health promotion; Health Promotion - methods; Humans; Hygiene; Infections; Malawi - epidemiology; Medicine and Health Sciences; People and Places; Polls & surveys; Prevention; Program Evaluation; Risk factors; Sample size; Sanitation; Schools; Social Sciences; Survey design; Surveying; Surveys; Tanzania - epidemiology; Trachoma; Trachoma - epidemiology; Trachoma - prevention & control; Tropical diseases; Uganda - epidemiology; Visual impairment; Malawi; Uganda; Tanzania; Africa
• ISSN: 1935-2735; 1935-2727; 1935-2735
• DOI: 10.1371/journal.pntd.0009962

The World Health Organization promotes the SAFE (Surgery, Antibiotics, Facial cleanliness, and Environmental improvements) strategy for trachoma control and prevention. The F&E components of the strategy focus on promotion of healthy hygiene and sanitation behaviors. In order to monitor F&E activities implemented across villages and schools in Malawi, Tanzania, and Uganda, an F&E Monitoring and Evaluation (FEME) framework was developed to track quarterly program outputs and to provide the basis for a pre and post evaluation of the activities. Results showed an increase in knowledge at the school and household levels, and in some cases, an increase in presence of hand/face washing stations. However, this did not always result in a change in trachoma prevention behaviors such as facial cleanliness or keeping compounds free of human feces. The results highlight that the F&E programs were effective in increasing awareness of trachoma prevention but not able to translate that knowledge into changes in behavior during the time between pre and post-surveys. This study also indicates the potential to improve the data collection and survey design and notes that the period of intervention was not long enough to measure significant changes.