ArticleFrontiers in public health2026
Changes in household hygiene behaviors and multiple childhood health outcomes following health-behavioral education and health-care facility support: a pre-post intervention study.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: In crisis and displacement settings, disruptions in safe water, sanitation, health service access, and caregiver knowledge often increase children's risk of acute watery diarrhea, malnutrition, and missed preventive care. This study assessed the impact of six months of integrated health-promotion activities at the household level and support for health facilities on changes in household behaviors and child health indicators in crisis contexts. Methods: A pre- and post-intervention study was conducted among 895 households of internally displaced persons (IDPs) and host communities in four Yemeni governorates. The intervention included health-promotion activities at the household level and support for health facilities in the catchment areas of IDPs, including medical supplies, incentives for health workers, and outreach activities for remote areas. The effect size of the intervention was estimated using Generalized Estimating Equations (GEE). Results: Significant improvements were observed in household chlorine use for drinking water treatment (adjusted prevalence ratio (APR) = 1.69; 95% CI: 1.25-2.28), cooking area cleanliness (APR = 1.09; 95% CI: 1.01-1.18), and the proportion of toilets free from visible fecal matter (APR = 1.10; 95% CI: 1.02-1.19). In addition, reductions in acute watery diarrhea (APR = 0.76; 95% CI: 0.60-0.97) and improvements in dietary diversity (APR = 1.83; 95% CI: 1.30-2.58) and vaccination coverage (APR = 1.16; 95% CI: 1.07-1.26) were observed among children. However, no significant improvements were found in the proper disposal of child feces or in the prevalence of acute malnutrition among children. Conclusion: The improvement in certain behavioral factors and child health indicators emphasizes the effectiveness of the integrated community health promotion and health facilities-based interventions. However, the increase in the prevalence of acute malnutrition following the intervention than before highlights the need for continued efforts, combining food security or livelihood initiatives with such projects to address vulnerabilities, particularly among IDPs and host communities.
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