In the Lake Zone of Tanzania, Behavioral Determinants Are Associated with Hygiene but Not Sanitation Practice

Understanding why individuals do or do not adopt optimal water, sanitation, and hygiene (WASH) practices is critical to designing successful behavior change interventions. However, policy makers and program implementers often fail to obtain the context-specific information on behavioral determinants of WASH practices. This two-stage, randomized survey among 5000 female primary caregivers in the Lake Zone of Tanzania assessed associations between behavioral determinants and a range of hygiene and sanitation practices. Behavioral determinants of hygiene were almost always significantly associated with cleaning one’s own hands after cleaning the baby’s bottom and being able to show at least one place where family members wash their hands. In regression models, those who knew when to wash their own hands (OR = 1.8, 95% CI: 1.5, 2.1) and their child’s hands (OR = 1.5, 95% CI: 1.3, 1.7) and mothers who thought that their female friends washed their hands after cleaning the baby’s bottom (OR = 5.5, 95% CI: 4.5, 6.7) were significantly more likely to frequently clean their own hands after cleaning the baby’s bottom. This research suggests that in the Lake Zone of Tanzania, numerous determinants are associated with hygiene practices. Identifying context-specific determinants of WASH behaviors is the first step toward developing effective interventions.