Promoting Clean Hands Among Uganda's Children: A School-Based Intervention Using Tippy-Taps

Open Access
Zhang, Ce
Area of Honors:
Elective Area of Honors - Civic and Community of Engagement
Bachelor of Science
Document Type:
Thesis Supervisors:
  • Dr Stephen Matthews, Thesis Supervisor
  • Jeremy Cohen, Honors Advisor
  • public scholarship
  • handwashing
  • Uganda
  • diarrheal disease
  • child health
  • public health
This thesis describes a student-founded public scholarship project designed to promote child health in resource-limited contexts. In response to the global burden of diarrheal disease, we constructed a low-cost handwashing promotion program, specifically designed to induce positive handwashing behavior change in schoolchildren. The scholarship component of the project is focused on testing the efficacy of our tippy-tap handwashing program in promoting handwashing rates and reducing the number of self-reported stomach pain episodes in elementary schoolchildren in rural Eastern Uganda. The thesis describes the student contribution and motivation behind this project from inception to its conclusion, and provides suggestions that may enable university students to become more motivated and successful in conducting public scholarship projects in the future. The field research component (September 2010-January 2011) was a collaboration with volunteers from the Uganda Village Project. Pre and post intervention surveys were fielded in eight schools (398 students, ages 7-13). Four intervention schools were given tippy-taps, soap, and educational materials while four control schools initially received only educational materials. After one month, intervention schools reported large increases in handwashing rates, soap usage, and a reduction in the absence of stomach pain episodes compared to control schools. After receiving the intervention, control schools attained similar handwashing and stomach pain rates. The school-based tippy-tap handwashing program improved handwashing rates and has the potential to reduce the incidence of infectious diarrheal disease for children residing in resource-limited contexts. Future research goals include modification of our educational program, direct handwashing observation, focus group analysis, and the design of objective trials to measure the impact of washing hands on diarrhea.