Formative Research for the Development of the CHoBI7 Cholera Rapid Response Program for Cholera Hotspots in Bangladesh

Fatema Zohura, Elizabeth D. Thomas, Jahed Masud, Md Sazzadul Islam Bhuyian, Tahmina Parvin, Shirajum Monira, Abu S. G. Faruque, Munirul Alam and Christine Marie George ()
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Fatema Zohura: Research, Training and Management International, Dhaka 1216, Bangladesh
Elizabeth D. Thomas: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
Jahed Masud: Research, Training and Management International, Dhaka 1216, Bangladesh
Md Sazzadul Islam Bhuyian: Research, Training and Management International, Dhaka 1216, Bangladesh
Tahmina Parvin: Research, Training and Management International, Dhaka 1216, Bangladesh
Shirajum Monira: International Centre for Diarrhoeal Disease Research, icddr,b, Dhaka 1212, Bangladesh
Abu S. G. Faruque: International Centre for Diarrhoeal Disease Research, icddr,b, Dhaka 1212, Bangladesh
Munirul Alam: International Centre for Diarrhoeal Disease Research, icddr,b, Dhaka 1212, Bangladesh
Christine Marie George: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA

IJERPH, 2022, vol. 19, issue 20, 1-14

Abstract: Cholera is a severe form of acute watery diarrhea that if left untreated can result in death. Globally, there are 2.9 million cholera cases annually. Individuals living in close proximity to cholera cases are at a higher risk for developing cholera compared to the general population. Targeted water, sanitation, and hygiene (WASH) interventions have the potential to reduce cholera transmission in cholera hotspots around cholera cases. The objective of this study was to expand the scope of the Cholera-Hospital-Based-Intervention-for-7-Days (CHoBI7) program, focused on cholera patient households, for delivery in cholera hotspots in urban slums in Dhaka, Bangladesh. Thirty-one semi-structured interviews were conducted in cholera hotspots around cholera patients, and three intervention planning workshops were conducted to inform modifications needed to the CHoBI7 program. After exploratory interviews, a two-phase, iterative pilot study was conducted for 9 months to test the developed CHoBI7 Cholera Rapid Response program among 180 participants to further inform modifications to intervention content and delivery. Findings from pilot participant interviews highlighted the need to adapt intervention content for delivery at the compound—rather than household—level, given an environment with multiple households sharing a water source, toilets, and kitchen facilities. This was addressed by conducting a “ring session” for intervention delivery in cholera hotspots for households to discuss how to improve their shared facilities together and encourage a compound-level commitment to promoted WASH behaviors and placement of soapy water bottles in shared spaces. Based on the low number of soapy water bottles observed in communal spaces during the first iteration of the pilot, we also added context-specific examples using the narratives of families in mobile messages to encourage WASH behavioral recommendations. Formative research identified important considerations for the modifications needed to tailor the CHoBI7 program for delivery in cholera hotspots in urban Bangladesh.

Keywords: mHealth; behavior change; cholera and diarrhea; handwashing with soap; water treatment; WASH; Bangladesh (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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