Natarajan, Gayathri

School of Public Health

MSPH

Bangladesh

Bangladesh - Health Facility Based Delivery of WASH Interventions to Reduce Diarrheal Disease in Bangladesh (CHoBI7)

Household members of diarrhea patients are at a very high risk of developing diarrhea during the 7-day period after their ill family member is admitted to a health facility. This high-risk is thought to come from sharing contaminated drinking water and food, along with poor hand washing practices, leading to the spread of germs in the home. The time patients and their caregivers spend at a health facility for the treatment of severe diarrhea episodes presents the opportunity to deliver WASH interventions when perceived severity of diarrheal disease and perceived benefits of water treatment and handwashing with soap is likely the highest.

In an effort to reduce diarrheal diseases, such as cholera, among household members of diarrhea patients, our team has developed “The Cholera Hospital-Based Intervention for 7 Days” (CHoBI7). The CHoBI7 intervention package includes: (1) chlorine tablets for water treatment during the 7-day high-risk period, a soapy water bottle (prepared with detergent powder and water), a hand washing station, and a sealed water bucket for safe water storage; and (2) a pictorial (“chobi” in Bangla) module delivered by a Health Promoter at the patient’s bedside.

The CHoBI7 intervention was found to significantly reduce symptomatic cholera infections among household members of cholera patients in our recent randomized controlled of this intervention in Dhaka, Bangladesh.  The results of the randomized controlled trial were well-received in the research community and among key stakeholders working in public health sector in Bangladesh. As a result, the objective of our current program funded by USAID is to develop scalable approaches to integrate CHoBI7 into the services provided at health facilities for diarrhea patients and their household members. To achieve this, the CHoBI7 intervention package is being tailored through formative research and engagement of key stakeholders and a second RCT is currently underway. The focus of this placement will be on the monitoring and evaluation of the ongoing RCT as well as tasks related to the synthesis of the formative research collected. 

Global Health PI/Mentor: Christine M. George 

People

Caitlin Kennedy, PhD MPH,BA

Co-Director, MPH concentration in Social and Behavioral Sciences in Public Health; Associate Director, Center for Qualitative...

Stefan Baral, MD MPH,MBA,MSc

Director, Key Populations Program

Yukari C. Manabe, MD

Associate Director of Global Health Research and Innovation

Noreen Hynes, MD MPH

Director, Geographic Medicine Center of the Division of Infectious Diseases

Robert Bollinger Jr., MD MPH

Director, Johns Hopkins Center for Clinical Global Health Education (CCGHE); Associate Director, Johns Hopkins Center for Global...

Joanne Katz, ScD MS,BSc

Associate Chair, Director of Academic Programs
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December 2017

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