- The control of waterborne diseases requires a safe water source of a high quality and with enough water for the practice of general water hygiene, which will ensure that the water stays safe.
- The control of water-washed diseases depends on easy access to large quantities of water and the motivation to use more water for personal hygiene, whereas the quality of the water used is less important.
- The control of vector-related water-borne diseases depends on improved environmental hygiene and decreased exposure to the vector.
- The control of water-based diseases depends on elimination of contact with the infected water source.
The availability of water is essential for water hygiene and naturally, an easy accessible water source facilitates the practice. But to ensure that water hygiene is practiced daily the water source must be reliable both in quantity and quality through out the year. Problems of poor water quality or low quantity discourage improved hygienic behaviors. E.g., in areas with corrosion problems community members often prefer to use the traditional water sources, as the brownish-yellow colour and the taste of the improved water source are less attractive. An improved water source can be contaminated if poorly maintained. The motivation of the community to maintain and protect their water source is, therefore, of critical importance to ensure a sustainable reduction in not only water borne diseases, but also to prevent an increase in the incidence of water-related vector-borne diseases, due to breeding of mosquitoes in stagnant water around the water source. As all water-borne and faecal-disposal-related diseases, as well as some water-based diseases, depend on infecting agents from human excreta, the provision and hygienic use of adequate sanitation are crucial for their control. Finally proper refuse disposal is important for the control of some faecal-oral and vector-related water-borne diseases, as it prevents the breeding of insects.
Planning and implementation of hygiene education: The Community outreach by district staff is the essence of hygiene education, as an effective interaction with community leaders and members is important to ensure community participation for hygiene education. To facilitate the development of a functional, sustainable system for planing, management and evaluation of a hygiene programme at community level, there is a need to strengthen the capacity of the district personnel trained in environmental health and community development. They should be trained in teaching methodologies (how to design and deliver messages) and learn to plan, manage and evaluate hygiene education as an integrated part of comprehensive Primary Health Care. Supervision and follow-up enhance motivation and quality at all levels. Here, intra-and inter-sectoral coordination is important to ensure cost-effective management and avoid duplication of efforts.
Water-borne diseases transmitted by water. Water is a passive transporter for the infective agent, e.g., diarrhoea, dysentery, typhoid, giardiasis, cholera. Water-washed diseases due to lack of water or insufficient use of water for personal or domestic hygiene, e.g., trachoma. Water-related vector-borne diseases transmitted by insects breeding or biting in relation to water, e.g., malaria, onchocerciasis. Water-based diseases caused by infecting agents spread by contact with or ingestion of water. An essential part of the life cycle of the infecting agent takes place in an aquatic animal, e.g., schistosomiasis and Guinea worm. Faecal-disposal-related diseases transmitted due to faecal contamination of soil. Human infection is either through direct penetration of the intact human skin (e.g., hookworms) or through ingestion, either with an intermediate host (e.g., tapeworm) or without (e.g., roundworm).
When educating at the community level, the messages should be as simple as possible, ocally adapted and with the use of appropriate methods of adult learning. It is the aim of hygiene education that the community should understand how human behavior and environmental factors influence health. Through increased knowledge and awareness the community should be motivated to; take better care of their water source and practice better water hygiene when collecting and storing water, use more water for hygienic purposes, avoid traditional water sources, enhance the hygienic use of sanitation facilities, dispose refuse and waste water properly and improve housing. Hygiene education will, if successful, improve the personal and environmental hygiene within the entire community. Hygiene education should aim to actively involve the entire community, but it is important to identify target groups and develop specific plans of action, on how to reach them. An important target group is women , as they play a significant role in rural family life and have a prominent role in improving the hygiene within the family. Children, as the future generation, caretakers of younger siblings and water collectors, are an other important target group. Children can be reached through their daily caretakers and, if in school, school teachers.
School teachers should be trained to promote hygiene education, particularly in primary schools. Further to reinforce the practice of better hygienic behaviors, all schools should have, and encourage the use off hygienic latrines with hand-washing facilities close by. Drinking water should be safely stored and refuse properly disposed. Finally hygiene education should also be an integrated part of the training of all personnel involved in the water and sanitation programme; the extension worker, the drilling crew, the pump mechanic, the caretaker and the driver. They all have a unique chance to teach hygiene education when in the communities.
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