e357 tus was categorized using principal component analysis of household assets. Results: Household residents were observed to wash their hands at most key times (58%11,800 of 20,428) but usually only used water (11,335, 55%). Thirteen percent (213/1692) of persons reported washing both hands with soap/ash before eating, but only 0.4% were observed to do so (0.4%, 29/7006). Again, 53% (891/1692) reported washing both hands with soap/ash after defecation, while 17% (61/349) were observed to do. Moreover, 64% (217/338) from the richest wealth quintile reported washing both hands with soap/ash after defecation compared to 42% (114/338) in the poorest, but in reality, 23% (22/95) and 9% (5/56) respectively from the richest and poorest quintiles were observed practicing. Conclusions: Although handwashing is fairly common in rural Bangladesh, the use of soap is not. Reported handwashing behavior especially with soap or ash overestimates observed rates. Efforts to improve handwashing should focus particularly on the poor who could benefit most from improved rates.
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