Hygiene Practices During Food Preparation in Rural Bangladesh: Opportunities to Improve the Impact of Handwashing Interventions

Abstract

Abstract. This study explored the steps of food preparation, related handwashing opportunities, current practices, and community perceptions regarding foods at high-risk of contamination such as mashed foods and salads. In three rural Bangladeshi villages, we collected qualitative and observational data. Food preparation was a complex and multistep process. Food preparation was interrupted by tasks that could contaminate the preparers' hands, after which they continued food preparation without washing hands. Community members typically ate hand-mixed, uncooked mashed food and salad as accompaniments to curry and rice at meals. Hand-mixed dried foods were mostly consumed as a snack. Observers recorded handwashing during preparation of these foods. Among 24 observed caregivers, of 85 opportunities to wash hands with soap during food preparation, washing hands with soap occurred twice, both times after cutting fish, whereas washing hands with water alone was common. A simple and feasible approach is promotion of handwashing with soap upon entering and re-entering the food preparation area, and ensuring that everything needed for handwashing should be within easy reach.

Quantitative assessment of fecal contamination in multiple environmental sample types in urban communities in Dhaka, Bangladesh using SaniPath microbial approach

“…The CDC estimates that nearly half of all food-borne illnesses in the United States [57] are caused by contaminated fresh produce and that more than 30% of gastroenteritis cases in low-and middle-income countries are linked to food borne transmission [58]. Risk factors for food contamination in the low-and middle-income settings are different than high-income countries because cooked food is more common and is usually freshly prepared in households [29,59]. The causes of the fecal contamination detected on the produce in this study are not known and may be due to poor agricultural practices by farmers (e.g.…”

“…Observational studies in rural Bangladesh identified that produce washing practices during salad preparation (uncooked and mashed cucumber, tomato etc.) within low-income neighborhoods were inadequate, and salads were often contaminated due to poor hygiene practices [29,60].…”

“…For produce, the fieldworkers visited the local produce market in each neighborhood and sampled fresh produce that people commonly consumed raw or uncooked such as salad or garnish. Salads are typically prepared with bare hands and consist of raw vegetables like tomatoes, cucumbers, carrots, lettuce, coriander, onion, and green chili [29]. For this study, we collected samples of tomatoes, cucumbers, and coriander leaves, which are common salad ingredients found in Dhaka food markets.…”

Effectiveness of a large‐scale handwashing promotion intervention on handwashing behaviour in Dhaka, Bangladesh

“…Even when only the right hand was used by the food preparer, the hand would be contaminated due to other interrupting events (toileting, adding cow dung fuel to the fire, etc.) which may not be followed by handwashing before going back to food preparation . If washing both hands is required in order for an observed behaviour to be considered as handwashing, the prevalence of handwashing with water would be reduced to 6.9%, and prevalence of handwashing with soap would be reduced to 2.1%.…”

Community finance and promotion of Managed Aquifer Recharge systems affect uptake and sustainability as a potable water source in southwest coastal Bangladesh: A qualitative study

“…Our key informants included the key personnel from the Dhaka University team who are responsible to oversee the MAR implementation in the field. IDI interview and FGD sample sizes were determined from data saturation attainment in previous water, sanitation and hygiene qualitative studies [21][22][23]. [24].…”