IDEAS home Printed from
   My bibliography  Save this article

What causes sustainable changes in hygiene behaviour? A cross-sectional study from Kerala, India


  • Cairncross, Sandy
  • Shordt, Kathleen
  • Zacharia, Suma
  • Govindan, Beena Kumari


This study was designed and the field work carried out by a non-governmental organisation ( NGO) responsible for implementing hygiene promotion. The sustainability of changed hygiene behaviour was studied at various periods up to nine years after the conclusion of a multifaceted hygiene promotion intervention in Kerala, India. Various methods including a questionnaire to assess knowledge, spot observation, demonstration of skills on request, and household pocket voting were used and compared for the measurement of the hygiene outcome. Pocket voting gave the lowest prevalence of good practice, which we infer to be the more accurate. Good handwashing practice was reported by more than half the adults in intervention areas, but

Suggested Citation

  • Cairncross, Sandy & Shordt, Kathleen & Zacharia, Suma & Govindan, Beena Kumari, 2005. "What causes sustainable changes in hygiene behaviour? A cross-sectional study from Kerala, India," Social Science & Medicine, Elsevier, vol. 61(10), pages 2212-2220, November.
  • Handle: RePEc:eee:socmed:v:61:y:2005:i:10:p:2212-2220

    Download full text from publisher

    File URL:
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    1. McCauley, Ann P. & West, Sheila & Lynch, Matthew, 1992. "Household decisions among the Gogo people of Tanzania: Determining the roles of men, women and the community in implementing a trachoma prevention program," Social Science & Medicine, Elsevier, vol. 34(7), pages 817-824, April.
    2. Curtis, Valerie & Kanki, Bernadette & Mertens, Thierry & Traore, Etienne & Diallo, Ibrahim & Tall, François & Cousens, Simon, 1995. "Potties, pits and pipes: Explaining hygiene behaviour in Burkina Faso," Social Science & Medicine, Elsevier, vol. 41(3), pages 383-393, August.
    3. Waterkeyn, Juliet & Cairncross, Sandy, 2005. "Creating demand for sanitation and hygiene through Community Health Clubs: A cost-effective intervention in two districts in Zimbabwe," Social Science & Medicine, Elsevier, vol. 61(9), pages 1958-1970, November.
    Full references (including those not matched with items on IDEAS)


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Jorge M. Agüero & Trinidad Beleche, 2016. "Health Shocks and the Long-Lasting Change in Health Behaviors: Evidence from Mexico," Working papers 2016-26, University of Connecticut, Department of Economics.
    2. Aunger, Robert & Schmidt, Wolf-Peter & Ranpura, Ashish & Coombes, Yolande & Maina, Peninnah Mukiri & Matiko, Carol Nkatha & Curtis, Valerie, 2010. "Three kinds of psychological determinants for hand-washing behaviour in Kenya," Social Science & Medicine, Elsevier, vol. 70(3), pages 383-391, February.
    3. Daniel Bennett & Asjad Naqvi & Wolf‐Peter Schmidt, 2018. "Learning, Hygiene and Traditional Medicine," Economic Journal, Royal Economic Society, vol. 128(612), pages 545-574, July.
    4. Nauges, Céline & Van Den Berg, Caroline, 2009. "Perception of Health Risk and Averting Behavior: An Analysis of Household Water Consumption in Southwest Sri Lanka," TSE Working Papers 09-139, Toulouse School of Economics (TSE).
    5. repec:eee:jhecon:v:54:y:2017:i:c:p:40-55 is not listed on IDEAS
    6. Meredith, Jennifer & Robinson, Jonathan & Walker, Sarah & Wydick, Bruce, 2013. "Keeping the doctor away: Experimental evidence on investment in preventative health products," Journal of Development Economics, Elsevier, vol. 105(C), pages 196-210.
    7. Dammert, Ana C. & Galdo, Jose C. & Galdo, Virgilio, 2014. "Preventing dengue through mobile phones: Evidence from a field experiment in Peru," Journal of Health Economics, Elsevier, vol. 35(C), pages 147-161.
    8. repec:spr:eujhec:v:20:y:2019:i:1:d:10.1007_s10198-017-0950-2 is not listed on IDEAS
    9. McMichael, Celia & Robinson, Priscilla, 2016. "Drivers of sustained hygiene behaviour change: A case study from mid-western Nepal," Social Science & Medicine, Elsevier, vol. 163(C), pages 28-36.
    10. Whittington, Dale & Jeuland, Marc & Barker, Kate & Yuen, Yvonne, 2012. "Setting Priorities, Targeting Subsidies among Water, Sanitation, and Preventive Health Interventions in Developing Countries," World Development, Elsevier, vol. 40(8), pages 1546-1568.
    11. Briscoe, Ciara & Aboud, Frances, 2012. "Behaviour change communication targeting four health behaviours in developing countries: A review of change techniques," Social Science & Medicine, Elsevier, vol. 75(4), pages 612-621.


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:61:y:2005:i:10:p:2212-2220. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.