Prevalence and factors associated with engaging in poor hand hygiene practices among adult carers of children under five years in Mbale district: a cross-sectional study

Background While proper hand hygiene practices can reduce the risk of contracting hygiene-related diseases among children under five years of age (< 5 years old), poor hand hygiene practices continue to exist in the community. We determined the prevalence and factors associated with engaging in poor hand hygiene practices among adult carers of < 5-year-old children to inform the design of tailor-made interventions to improve hand hygiene practices in this population. Methods This was a cross-sectional study. Quantitative data were collected in March 2023 from 320 adult carers of under-five year-old children. Structured questionnaires were utilized to capture data on socio-demographic characteristics, household characteristics, knowledge of hand hygiene, and COVID-19 prevention practices. A carer was considered to have engaged in poor hand hygiene practice if he/she washed hands at five or less out of ten listed critical junctures. We conducted multivariable logistic regression to identify independent factors associated with poor hand hygiene practices. Factors with a p-value less than 0.05 were statistically significant to the primary outcome. Results Of the 320 carers, 275 (85%) were females. Slightly more than one-third (38.4%, n = 123) of the carers were aged 25–34 years while 55.6% (n = 178) had primary education. Twenty-eight percent (n = 88) of the carers engaged in poor hand hygiene practices. Having post-primary education (adjusted odds ratio [AOR] = 0.5; 95% Confidence Interval [95%CI]: 0.2, 0.9) and receiving information that hand hygiene protects against COVID-19 (AOR = 0.2; 95% CI: 0.04,0.8) were inversely associated with engaging in poor hand hygiene practices while receiving hand hygiene information from village health teams [VHT] (AOR = 3.0; 95% CI: 1.6, 9.8), and having inadequate soap or sanitiser at the place reserved for hand washing (AOR = 8.8; 95% CI: 1.7, 45.5) were positively associated with engaging in poor hand hygiene practices. Conclusion Nearly three out of ten adult carers of under-five year-old children engaged in poor hand hygiene practices largely driven by receipt of hand hygiene information from VHT coupled with inadequate hand-washing materials. These findings suggest a need for target-specific hygiene-related interventions to increase the proportion of carers who engage in proper hand hygiene practices in Mbale district.