02893nas a2200397   4500000000100000008004100001653000900042653001300051653002200064653003900086653001800125653001300143653001300156653002400169653001400193100001400207700001400221700002000235700001500255700001400270700001300284700001200297700001600309700001500325700001400340700001400354700001500368700001400383700001700397245016000414856008800574300001300662490000700675520179900682022001402481       2016                            d10aWASH10aTrachoma10aRural communities10aNeglected tropical diseases (NTDs)10aInterventions10aEye care10aEthiopia10aBehavioural changes10aAttitudes1 aAiemjoy K1 aStoller N1 aGebresillasie S1 aShiferaw A1 aTadesse Z1 aSewnet T1 aAyele B1 aChanyalew M1 aCallahan K1 aStewart A1 aEmerson P1 aLietman TM1 aKeenan JD1 aOldenburg CE00a'If an eye is washed properly, it means it would see clearly': A mixed methods study of face washing knowledge, attitudes, and behaviors in rural Ethiopia.  uhttp://journals.plos.org/plosntds/article/asset?id=10.1371/journal.pntd.0005099.PDF  ae00050990 v103 a<p><strong>BACKGROUND: </strong>Face cleanliness is a core component of the SAFE (Surgery, Antibiotics, Facial cleanliness, and Environmental improvements) strategy for trachoma control. Understanding knowledge, attitudes, and behaviors related to face washing may be helpful for designing effective interventions for improving facial cleanliness.</p>

<p><strong>METHODS: </strong>In April 2014, a mixed methods study including focus groups and a quantitative cross-sectional study was conducted in the East Gojjam zone of the Amhara region of Ethiopia. Participants were asked about face washing practices, motivations for face washing, use of soap (which may reduce bacterial load), and fly control strategies.</p>

<p><strong>RESULTS: </strong>Overall, both knowledge and reported practice of face washing was high. Participants reported they knew that washing their own face and their children's faces daily was important for hygiene and infection control. Although participants reported high knowledge of the importance of soap for face washing, quantitative data revealed strong variations by community in the use of soap for face washing, ranging from 4.4% to 82.2% of households reporting using soap for face washing. Cost and forgetfulness were cited as barriers to the use of soap for face washing. Keeping flies from landing on children was a commonly cited motivator for regular face washing, as was trachoma prevention.</p>

<p><strong>CONCLUSIONS: </strong>Interventions aiming to improve facial cleanliness for trachoma prevention should focus on habit formation (to address forgetfulness) and address barriers to the use of soap, such as reducing cost. Interventions that focus solely on improving knowledge may not be effective for changing face-washing behaviors.</p>
  a1935-2735