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Effect of Community Handwashing Campaigns on Handwashing Station Use among Residents of Informal Settlements in Nigeria

Abstract

Handwashing is an important public health practice for preventing the transmission of infectious diseases and maintaining community hygiene. Residents of informal settlements in Nigeria may experience challenges in maintaining regular handwashing practices because of inadequate water supply, limited availability of handwashing stations, overcrowding, poor sanitation infrastructure, financial constraints, and limited access to hygiene information. Community handwashing campaigns provide an opportunity to increase awareness of the importance of hand hygiene, promote appropriate handwashing techniques, and encourage residents to use available handwashing stations at critical times. Against this background, this study investigates the effect of community handwashing campaigns on handwashing station use among residents of informal settlements in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Social Ecological Model. The Health Belief Model explains how residents' perceptions of susceptibility to hygiene-related infections, perceived severity, perceived benefits of handwashing, perceived barriers, self-efficacy, and cues to action may influence handwashing station use. Social Cognitive Theory emphasizes observational learning, behavioural modelling, self-efficacy, reinforcement, social support, and community influence in shaping handwashing behaviours. The Social Ecological Model emphasizes the influence of individual, household, community, environmental, infrastructural, and socioeconomic factors on hand hygiene practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how community handwashing campaigns may influence handwashing station use among residents of informal settlements in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise adults aged 18 years and above residing in selected informal settlements across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, informal settlements, residential clusters, households, and eligible residents. Community handwashing campaigns will be assessed using indicators such as exposure to campaign activities, frequency and duration of campaigns, campaign messages, demonstrations of proper handwashing techniques, information on critical handwashing times, availability and location of handwashing stations, information on soap and water use, disease-prevention messages, community mobilization, household participation, and reinforcement or follow-up activities. Handwashing station use will be assessed using indicators such as frequency of using available handwashing stations, use before eating or preparing food, use after toilet use, use after cleaning children, use after contact with waste or potentially contaminated materials, use of soap and water, appropriate handwashing technique, regular maintenance of household handwashing stations, and observed availability or use of handwashing facilities where direct observation is feasible. Data will be collected using structured questionnaires, standardized hand-hygiene assessment tools, household and community observation checklists, campaign records, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize residents' demographic and socioeconomic characteristics, household water and sanitation conditions, exposure to handwashing campaigns, availability of handwashing stations, and handwashing practices. Inferential statistical techniques, including chi-square tests, paired and independent t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of community handwashing campaigns on handwashing station use. Where a quasi-experimental design is adopted, handwashing station-use scores or observed utilization rates before and after the campaign may be compared with those of a comparison community to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that community handwashing campaigns have a significant positive effect on handwashing station use among residents of informal settlements in Nigeria. Residents exposed to structured, practical, culturally appropriate, and sustained handwashing campaigns are expected to demonstrate greater use of available handwashing stations than residents without comparable exposure. Campaigns may improve residents' understanding of critical handwashing times, proper handwashing techniques, the importance of using soap and water, and the role of hand hygiene in preventing infectious diseases. Demonstrations and community mobilization activities may strengthen residents' confidence and motivation to use handwashing facilities consistently. Campaigns may also encourage households and community leaders to support the placement, maintenance, and regular use of handwashing stations. However, inadequate water supply, lack of soap, poor station maintenance, overcrowding, limited household resources, inconvenient station locations, and weak sanitation infrastructure may reduce the effectiveness of campaigns alone. The study therefore expects accessible, practical, community-driven, and sustained handwashing campaigns, supported by reliable water supplies, soap availability, functional handwashing stations, and appropriate sanitation infrastructure, to contribute significantly to improved handwashing station use among residents of informal settlements in Nigeria. The study is expected to contribute to the literature on handwashing campaigns, hand hygiene, handwashing station use, informal settlements, WASH, environmental health, infectious disease prevention, community health education, sanitation, health promotion, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, Federal Ministry of Water Resources and Sanitation, state ministries of health and water resources, local government authorities, environmental health officers, community health workers, non-governmental organizations, community leaders, development partners, and policymakers regarding strategies for improving hand hygiene in underserved communities. The study will also provide evidence-based recommendations for strengthening community handwashing campaigns, increasing access to functional handwashing stations, improving water and soap availability, promoting community participation in station maintenance, strengthening WASH education, and developing sustainable community-based interventions that improve handwashing station use among residents of informal settlements across Nigeria.

Keywords: Community handwashing campaigns, handwashing station use, informal settlements, hand hygiene, WASH, sanitation, infectious disease prevention, community health education, environmental health, health promotion, Nigeria, public health.