Implementation of culturally sensitive and informed health education as a part of the 'wash approach' to controlling soil-transmitted helminth infections in the rural village of Bati Kelo, east Shewa Zone, Adama Wereda, Ethiopia

Abstract

Problem Statement: A lack of population-specific approaches and interventions exist with regards to soil-transmitted helminth control measures, thus resulting in significantly reduced effectiveness and lasting impact. Purpose: The purpose of this clinical project was to develop and implement a culturally sensitive and informed health education program to address the health practices of a rural high risk population as a method for controlling soil-transmitted helminth infections. Methods: A culturally sensitive and informed health education program, utilizing the holistic method of the 'WASH Approach,' was implemented in the community of Bati Kelo, East Shewa Zone, Adama Wereda, Ethiopia. The project intervention consisted of three key components: 1) developing a culturally competent and population-specific KAP survey, 2) developing culturally competent health education material for the project population, and 3) conducting the KAP survey and health education sessions in a culturally competent manner. A convenience sample of 234 individuals was collected from the community. The project data were based on self-reported responses to the KAP survey. Ten key health behavior questions were utilized to evaluate the project: two on latrine usage, three on clean water usage, three on hand washing, and two on wearing shoes. Eighty-one surveys qualified for final inclusion. Data were analyzed using SPSS version 2.4. Descriptive statistics were utilized for the evaluation of the entire project. McNemar's test was used to analyze the differences between pre and post intervention (survey) results involving dichotomous variables. Wilcoxon's signed-rank test was used to analyze the differences between pre and post intervention (survey) results involving paired ordinal data. Findings: Positive health behavior/practice change was demonstrated post-intervention in the areas of 'latrine use,' 'clean water (treating water),' and 'handwashing;' however, it was not shown in the area of 'wearing shoes.' Conclusions: The overall findings of this clinical project were consistent with prior research studies, which found the WASH approach impactful on STH infection prevention measures (health behavior practices). A gap in the literature regarding 'cultural competence' in health education as a part of the WASH approach and STH control measures still exists. Much more inquiry and work still remains to be done.