Hand-washing practices at critical times in relation to childhood illnesses and under-nutrition among caregivers in Rongai sub-county, Kenya

Background: Poor food handling creates a pathway for childhood illnesses leading to under-nutrition. Objective: To assess hygiene practices of caregivers of young children at critical points in relation to childhood infections and under-nutrition in Rongai sub-county, Nakuru, Kenya. Methods: A cross-sectional study was conducted among 384 caregivers of children aged 6-23 months. A structured questionnaire was used to assess hygiene practices, history of infections and anthropometric measurements of children to determine z-scores. Results: Majority of caregivers were aware of some critical hand-washing times; before handling food (82.6%), before feeding the child (71%), after handling raw food (60.9%) and garbage (68.7%). Washing hands under running water [AOR=0.078, 95% C.I; (0.008±0.795)], before feeding the child [AOR=0.175 95% C.I; (0.043±0.709)], and after handling garbage [AOR= 0.273 95% C.I; (0.089±.831)] reduced chances of experiencing diarrhoea among children aged 6-11 months. Further, underweight was positively associated (P<0.05) with parasitic infections [AOR=3.123 95% C.I; (1.047±9.317)] and having trouble in breathing [AOR=6.212 95% C.I;(1.596±24.184)]. Conclusion: Adequate hygiene practices among caregivers during critical times were associated with reduced chances of childhood illnesses in children aged 6-11 months. Behaviour change communication and education of caregivers about critical hand washing times during complementary feeding period are needed for improved child nutrition outcomes.