Promoting Handwashing and Sanitation Behaviour Change in Low- and Middle-Income Countries: A Mixed-Method Systematic Review

This systematic review shows which promotional approaches are effective in changing handwashing and sanitation behaviour and which implementation factors affect the success or failure of such interventions. The authors find that promotional approaches can be effective in terms of handwashing with soap, latrine use, safe faeces disposal and open defecation. No one specific approach is most effective. However, several promotional elements do induce behaviour change. Different barriers and facilitators that influence implementing promotional approaches should be carefully considered when developing new policy, programming, practice, or research in this area

Guidelines of the International Federation of Red Cross and Red Crescent Societies: an overview and quality appraisal using AGREE II

To appraise the quality of guidelines developed by the International Federation of Red Cross and Red Crescent Societies (IFRC) between 2001 and 2015.status: publishe

A systematic review of the amount of water per person per day needed to prevent morbidity and mortality in (post-)disaster settings

In order to improve the effectiveness and efficiency of humanitarian efforts, minimum standards for humanitarian assistance and key indicators, showing whether a standard has been attained, have been developed. However, many of these standards and indicators are based on a consensus on best practices and experiences in humanitarian response, because relevant evidence on the impact of humanitarian interventions is often lacking.status: publishe

Engaging stakeholders in the development of a mixed method systematic review in the domain of humanitarian aid

Background and objectives: In order to improve handwashing and sanitation practices in low and middle income countries (LMICs), a range of programs to promote behaviour change have been designed. It is not always clear to policy makers which of these approaches is the most effective on learning outcomes, behaviour change and health outcomes, and a mixed methods systematic review (MMSR) was initiated (funded by 3ie/WSSCC). Since this subject is important to policy makers, program developers and end-users, it is very relevant to engage these different stakeholders throughout the different steps of the MMSR, so that context is taken into account as much as possible. We organized discussion groups with a heterogeneous group of stakeholders to develop a theoretical model, as part of the MMSR process, to try and understand how the interventions under study would work out in practice and what the potential mechanisms are that may influence the causal chain developed. Methods: The research team is composed of methodological experts (systematic review, qualitative research) and a topical expert in WASH (Water, Sanitation and Hygiene) behaviour change. In addition to the team members, an Advisory Group was composed by recruiting relevant stakeholders with the following profile: a methodologist (experienced in program implementation in vulnerable populations), WASH experts, a policy maker, end users, and a representative of the donor community. The majority of topical experts and end-users were from LMICs, i.e. Sub-Saharan Africa and South Asia. In order to engage stakeholders in the different steps of the MMSR, we organized discussion groups as part of the mixed methods methodology. Stakeholders were consulted throughout the different steps of the MMSR, via electronic means and through two face-to-face meetings, including one in the preparatory phase (protocol development), and one (future meeting) in the final phase of the project (data interpretation + formulating recommendations based on evidence gathered from the MMSR). Results: The qualitative findings generated from the first face-to-face stakeholder meeting resulted in agreed definitions that are relevant for practice, a refined Theory of Change model sensitive to our target group, and improved research questions and selection criteria. This led to an improved version of the MMSR protocol, , which was initially drafted by researchers with a methodological focus, and now contains greater awareness of the context (http://www.campbellcollaboration.org/lib/project/366/). The second stakeholder meeting aims to translate the findings of the SR into practical implications for policy. Conclusion and discussion: Discussion with the different stakeholders throughout our review process resulted in a review that is more sensitive to the needs of those involved in delivering and financing promotional interventions. Involving stakeholders in the development of the MMSR also created a sense of ownership and stakeholder buy-in, which is important from the point of view of promoting our (future) findings among their network and to facilitate capacity building. Keywords: mixed methods systematic review, stakeholder consultationstatus: publishe

Eerste hulp voor iedereen: eerstehulprichtlijn voor leken

status: publishe

Engaging stakeholders in the conduct of a systematic review of WASH promotion programs on behaviour change

To improve handwashing and sanitation practices in low and middle income countries (LMICs), a range of programs to promote behaviour change have been designed. It is not always clear to policy makers which of these approaches is the most effective on learning outcomes, behaviour change and health outcomes. Therefore a systematic review was initiated (funded by 3ie/WSSCC/Belgian Red Cross) to know which approaches are the most effective to change handwashing and sanitation behaviour. Since this subject is important to policy makers, program developers and end-users, it is very relevant and important to engage these different stakeholders throughout the different stages of the review, so that context, preferences and requirements of users, are taken into account as much as possible.Stakeholder engagement during our project resulted in: 1. A review that is more sensitive and adapted to the needs of those involved in delivering and financing promotional WASH interventions 2. Sense of ownership and stakeholder buy-in.status: publishe

Evidence-based first aid and prevention guidelines for laypeople in India

Background: Training first medical responders is considered an extremely cost-effective intervention for frequently occurring diseases and injuries in low and middle-income countries. Aims & Objectives: The Belgian Red Cross-Flanders together with the Indian Red Cross Society, aimed to develop evidence-based guidelines to train lay people on how to manage and prevent emergency situations in India. Methods: Evidence-based guidelines were developed adhering to the principles of AGREE II. The reporting of the systematic literature reviews was done according to the PRISMA statements. We identified evidence on the effectiveness of various first aid and preventive procedures from Indian studies and on alternative interventions that have been used by Indian laypeople. The quality of the scientific evidence was determined using the GRADE methodology. Values and preferences from the target group were collected and inputs from a multidisciplinary panel of 12 Indian experts were taken. Result: After developing 77 specific search strategies in PubMed, 10055 references were screened and 90 relevant studies were included as a basis for the recommendations in the guidelines. Examples of effective interventions include rice water for diarrhoea, and gargling to prevent respiratory infections. Conclusion: Evidence-based first aid and prevention guidelines for Indian laypeople were developed. These guidelines will increase the capacity of the Indian Red Cross Society in providing appropriate first aid training and first aid information to the public, and in delivering first aid assistance in case of disasters, disease outbreaks, emergencies, and road accidents in India

A Systematic Review of the Amount of Water per Person per Day Needed to Prevent Morbidity and Mortality in (Post-)Disaster Settings

<div><p>Background</p><p>In order to improve the effectiveness and efficiency of humanitarian efforts, minimum standards for humanitarian assistance and key indicators, showing whether a standard has been attained, have been developed. However, many of these standards and indicators are based on a consensus on best practices and experiences in humanitarian response, because relevant evidence on the impact of humanitarian interventions is often lacking.</p><p>Objectives</p><p>One important example of a standard in humanitarian aid in a disaster setting is “water quantity.” The accompanying indicator states how many litres of water are needed per person per day in a disaster setting. It was our objective to determine the evidence base behind this indicator, in order to improve health outcomes such as morbidity (e.g., diarrhoea) and mortality.</p><p>Methods</p><p>A systematic review was performed searching The Cochrane Library, Medline and Embase. We included studies performed during disasters and in refugee camps that reported a specific water amount and health-related outcomes related to water shortages, including diarrhoea, cholera, and mortality. We used GRADE to determine the quality of evidence.</p><p>Results</p><p>Out of 3,630 articles, 111 references relevant to our question were selected. Based on our selection criteria, we finally retained 6 observational studies, including 1 study that was performed during the disaster and 5 studies in a post-disaster phase. From two studies there is conclusive evidence on the relationship between the amount of water received and diarrhoea or mortality rates in refugee camps. However, overall, these studies do not contain enough data with relevance to a specific amount of water, and the level of evidence is very low.</p><p>Conclusions</p><p>More primary research on water amounts in a disaster setting is necessary, so that the humanitarian sector can further professionalise its water-related standards, indicators and interventions.</p></div