EFFECTIVENESS OF COMMUNITY-BASED HEALTH EDUCATION ON IMPROVING HAND HYGIENE PRACTICES

Abstract

Background: Hand hygiene is a cost-effective and proven measure to prevent the spread of communicable diseases. Despite robust evidence of its benefits, community-level compliance remains suboptimal in many low- and middle-income settings, including Pakistan. Structured, community-based health education has the potential to improve hygiene practices through culturally relevant and interactive approaches.

Objective: To evaluate the effectiveness of a structured community-based health education intervention in improving hand hygiene practices and reducing communicable disease incidence in urban Pakistani populations.

Methods: A randomized controlled trial was conducted over six months in three private hospitals in Lahore, Faisalabad, and Islamabad. A total of 400 adults were randomized into intervention and control groups (1:1 allocation). The intervention group received structured, interactive health education sessions incorporating demonstrations, visual materials, and group discussions; the control group received routine health advice. Primary outcome was hand hygiene compliance, assessed through direct observation using a WHO-adapted checklist. Secondary outcomes included the incidence of gastrointestinal and respiratory infections, recorded via weekly telephone surveys and verified with clinic records. Data were analyzed using independent t-tests, chi-square tests, and repeated-measures ANOVA for normally distributed data.

Results: Baseline characteristics and outcome measures were comparable between groups. At six months, mean compliance increased from 58.2% to 81.3% in the intervention group versus 57.9% to 61.2% in the control group (p<0.001). Gastrointestinal infections occurred in 9.0% of the intervention group versus 21.0% of the control group (p<0.01), while respiratory infections occurred in 12.5% versus 27.5% respectively (p<0.01).

Conclusion: Structured community-based health education significantly improved hand hygiene compliance and reduced communicable disease incidence. Such interventions could be integrated into public health strategies to promote sustainable hygiene behavior change.