Water, Sanitation, Hygiene

Pavani Kalluri Ram, an associate professor in the Department of Epidemiology and Environmental Health, is leading studies to evaluate hand washing behavior change programs promote handwashing with soap to improve water, sanitation, and hygiene in communities in Kenya, South Sudan, Democratic Republic of Congo, Bangladesh, and Nepal.

Photo by Kelly B. Kamm

Kenya perinatal handwashing study

Pavani Kalluri Ram, MD

Location: Meru County, Kenya
Department: Epidemiology and Environmental Health

This study will test the feasibility, acceptability, and impact of a program promoting hand washing with soap to pregnant women in Meru County, Kenya. The program will utilize antenatal health care providers and community health volunteers to promote the program to women using an interactive, storytelling approach and addressing individual barriers to hand washing at key times to interrupt pathogen transmission to the neonate. The Maternal handwashing study is funded by Save the Children.

Soapy water handwashing stations school- A pilot study in Kisumu, Kenya

Pavani Kalluri Ram, MD

Location: Kisumu, Kenya
Department: Epidemiology and Environmental Health

This study will assess the feasibility and effectiveness of a redesigned handwashing system when coupled with a handwashing behavioral intervention in peri-urban primary schools in Kisumu, Kenya. Using a cluster-randomized trial approach that incorporates a stepped wedge design, the study seeks to understand usage and maintenance practices related to handwashing stations in primary schools in comparison to existing handwashing practices. The Soapy water handwashing station study was funded by USAID.

Waterless hand sanitizer for diarrhea prevention in a humanitarian emergency

Pavani Kalluri Ram, MD

Location: South Sudan, Democratic Republic of the Congo
Department: Epidemiology and Environmental Health

In collaboration with colleagues from CDC, Dr. Ram's team conducted key informant interviews with experts and practitioners in water, sanitation and hygiene in humanitarian emergencies to understand the current state of handwashing promotion efforts. Subsequently, they assessed the knowledge, attitudes and practice of handwashing with soap in an on going humanitarian emergency in South Sudan using more rigorous methods of evaluation. In the near future, they will identify barriers and facilitators of hand hygiene promotion among populations affected by humanitarian emergencies in internally displaced persons camps in the Democratic Republic of the Congo.  They will also evaluate effects of interventions employing visual cues, nudges, and emotion-based motivators on the behavior of displaced persons.

Waterless hand cleansing with Chlorhexidine: a novel approach to prevent neonatal deaths

Pavani Kalluri Ram, MD

Location: Mirzapur, Bangladesh
Department: Epidemiology and Environmental Health

In a randomized controlled trial, Dr. Ram’s team is evaluating the impact of promoting waterless hand cleansing with chlorhexidine on the hand cleansing behavior of mothers and others during the peripartum / neonatal periods.

Measuring the benefits of water quality, sanitation, and handwashing interventions for improving health and development

Pavani Kalluri Ram, MD

Location: Bangladesh & Kenya
Department: Epidemiology and Environmental Health

Dr. Ram’s team provides technical expertise in measurement of handwashing behavior and development of handwashing interventions for this comprehensive study on the benefits of water quality, sanitation, and handwashing interventions for improving child health and development.

Monitoring and evaluation of UNICEF handwashing behavior change programs

Pavani Kalluri Ram, MD

Location: Kenya and Nepal
Department: Epidemiology and Environmental Health

To develop robust monitoring and evaluation plans, and to collect the necessary data to evaluate UNICEF-supported handwashing promotion programs in Kenya and Nepal. Hand washing has been shown to reduce diarrhea and pneumonia, the two leading causes of death in young children. The work will fill significant gaps in the understanding of whether or not large-scale hand washing promotion programs succeed in changing the behavior of individuals, and whether this change in behavior is sufficient to improve health in low- and middle-income countries.