Peer-reviewed article
Changes in household hygiene behaviors and multiple childhood health outcomes following health-behavioral education and health-care facility support: a pre-post intervention study.
Mansour Abdu Al-Taj, Ashwaq Abdulrahman Al-Taj ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study evaluated a six-month integrated health promotion and facility support intervention in four Yemeni governorates with internally displaced persons and host communities. The intervention improved several household hygiene behaviors including water chlorination and toilet cleanliness, and reduced acute watery diarrhea in children while improving vaccination coverage and dietary diversity. However, acute malnutrition did not improve and the authors note that food security efforts are needed alongside health promotion activities.
Key points
- Household chlorine use for water treatment increased by 69% following the intervention
- Acute watery diarrhea in children was reduced by 24%
- Dietary diversity among children improved by 83%
- Vaccination coverage increased by 16%
- Acute malnutrition did not improve and actually increased, highlighting the need for integrated food security interventions
Limitations
The study used a pre-post design without a comparison group, making it difficult to attribute changes definitively to the intervention rather than other contextual factors. The study took place during a crisis in Yemen, which may limit generalizability to other settings.
Abstract
BACKGROUND: In crisis and displacement settings, disruptions in safe water, sanitation, health service access, and caregiver knowledge often increase children's risk of acute watery diarrhea, malnutrition, and missed preventive care. This study assessed the impact of six months of integrated health-promotion activities at the household level and support for health facilities on changes in household behaviors and child health indicators in crisis contexts. METHODS: A pre- and post-intervention study was conducted among 895 households of internally displaced persons (IDPs) and host communities in four Yemeni governorates. The intervention included health-promotion activities at the household level and support for health facilities in the catchment areas of IDPs, including medical supplies, incentives for health workers, and outreach activities for remote areas. The effect size of the intervention was estimated using Generalized Estimating Equations (GEE). RESULTS: Significant improvements were observed in household chlorine use for drinking water treatment (adjusted prevalence ratio (APR) = 1.69; 95% CI: 1.25-2.28), cooking area cleanliness (APR = 1.09; 95% CI: 1.01-1.18), and the proportion of toilets free from visible fecal matter (APR = 1.10; 95% CI: 1.02-1.19). In addition, reductions in acute watery diarrhea (APR = 0.76; 95% CI: 0.60-0.97) and improvements in dietary diversity (APR = 1.83; 95% CI: 1.30-2.58) and vaccination coverage (APR = 1.16; 95% CI: 1.07-1.26) were observed among children. However, no significant improvements were found in the proper disposal of child feces or in the prevalence of acute malnutrition among children. CONCLUSION: The improvement in certain behavioral factors and child health indicators emphasizes the effectiveness of the integrated community health promotion and health facilities-based interventions. However, the increase in the prevalence of acute malnutrition following the intervention than before highlights the need for continued efforts, combining food security or livelihood initiatives with such projects to address vulnerabilities, particularly among IDPs and host communities.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Six months of integrated health-promotion activities at the household level and support for health-care facilities, including medical supplies, health worker incentives, and outreach to remote areas.
- Population
- 895 households of internally displaced persons and host communities in four Yemeni governorates
Key finding
Household chlorine use for drinking water treatment increased significantly (APR = 1.69; 95% CI: 1.25-2.28)
Al-Taj et al. · PubMed (US National Library of Medicine) · 8 Jul 2026