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Table 3 Key factors related to intervention components as organized by IBM-WASH

From: Formative research to scale up a handwashing with soap and water treatment intervention for household members of diarrhea patients in health facilities in Dhaka, Bangladesh (CHoBI7 program)

 Contextual factorsPsychosocial factorsTechnology factors
StructuralGovernment of Bangladesh mandated tendering process for procurement of goods (e.g. chlorine tablets, enabling technologies, etc.).
Government of Bangladesh policy that hygiene is the responsibility of the individual.
Government stakeholder interest in, and prioritization of, a health facility-based WASH intervention.Past use of chlorine tablets by Bangladesh government during cholera outbreaks or high-disease-risk events (e.g. floods).
Pharmaceutical company development and provision of an affordable, locally-available chlorine tablet.
Plastics company development and provision of an affordable, locally-available handwashing station and safe water storage bucket.
Government subsidization of laundry detergent.
Health Facility/ CommunityAccess to/Condition of latrines, basin, potable water, stove use/fuel in the compound or community.
Access to/Condition of latrines, basin, potable water in public/private health facilities.
Access to markets and market goods (e.g. soap or detergent).
Public/private health facility resources and regulations.
Informal providers as initial point of treatment.
Prevalence and expectation of promoted behaviors within the local and larger community.Position of cue cards to increase visibility of key messages for neighbors of enrolled households.
HouseholdAccess to/Condition of, basin, potable water, stove use/fuel in the household.
Responsibility for water collection, treatment, and storage.
Responsibility for children under five years of age.
Available space in home for handwashing station and safe water storage bucket.
Household size.
Desire to develop and maintain a safe and hygienic household environment.Modelling handwashing station use for children to reduce non-use or misuse..
IndividualWealth, education, gender, livelihood of primary taker of children under five and primary decision-maker.
Age of children in household.
Awareness of diarrheal disease transmission within the household/compound, and high perceived susceptibility of disease.
High perceived benefits of adopting protective water, sanitation, and hygiene behaviors.
Disgust reaction in response to the information that diarrheal disease can be a result of consuming water or food contaminated with feces.
Response efficacy that practice of recommended WASH behaviors will reduce risk of diarrheal disease.
Dislike of taste/smell of chlorine-treated water during.
High perceived convenience of handwashing station, soapy water bottle, safe water storage bucket, and chlorine tablets compared to other options.
Strengths/weaknesses of enabling technologies for users (e.g. size).
HabitualEnvironment allows for habit formation and limits habit disruptions.Existing water collection, treatment and storage practices.
Existing hand hygiene practices.
Ease of routine use of handwashing station and safe water storage bucket.
Visible handwashing station, safe water storage bucket, and cue cards to serve as cues to action.