Promoting clean hands among children in Uganda: A school-based intervention using ‘tippy-taps’.

This paper summarizes the design and preliminary findings from a comprehensive, child-led tippy-tap handwashing promotion program implemented in rural schools in Nakigo, Iganga District, Uganda. The handwashing program contains three components, handwashing education, construction of tippy-taps and provision of soap. The education component is centered on instructional lessons about the benefits, proper technique and critical times when handwashing should take place. This includes poster presentations, a handwashing song, distribution of flyers and discussions with students about handwashing with soap. The proportion of students reporting always or often washing their hands at school increased from 3.5% at baseline to 100.0% at follow-up. The proportion of students always washing their hands after using the toilet increased from5.5%to 65.0% in the intervention schools washing hands after using the toilet among students in the control schools increased from 3.6% to 79.3%. Use of soap in the intervention schools increased from 13.5% to 84.5% with even higher proportions reported at control schools at Time 3. These findings provide evidence that a tippy-tap promotion program can potentially serve as a successful, low-cost model for handwashing initiatives in remote, rural and low-resource school settings.