Water Source and Distance is Associated with Hygiene Behaviors in Karamoja, Uganda

We investigated the relationship between distance to improved water sources and hygiene practices Karamoja Uganda. We conducted semi‐structured interviews and household observations among mothers of children under 24 months (n=56) from seven villages during the rainy season, when seasonal stream use is common. Distance to water source was estimated using a GPS monitor and total water use was estimated per‐capita by the volume of water containers used divided by the total household members. Households with a water source closer than 300 meters had significantly greater daily hand washing frequency among mothers (4.6 vs 3.6, p=.038) but not among children (3.00 versus 2.89, p=0.33). When the closest water source was a borehole compared to a stream, the daily frequency of hand washing was higher among children (3.4 vs 2.8 times, p .023) but not among mothers (4.2 vs 4.8, p=0.60). The mean per capita water use was 10.9L (SE 1.1), and 82.1% of households consumed less than 20L per person. Larger households did not account for greater water needs: households with more than 5 children had the same total water usage as households with fewer than 5 children (64.8L vs 64.1L, p=0.53). Findings suggest that children in large families may be vulnerable to poor hygiene practices owing to a lack of sufficient water for increased family size. Increasing access to boreholes may improve child hand‐washing frequency in this remote region.