Water, Sanitation, and Hygiene (WASH) Education in Isolated Coastal Villages of Madagascar
Keywords:
WASH education, coastal Madagascar, waterborne disease prevention, community health behavior change, open defecation free, sanitation governanceAbstract
Persistent deficits in water, sanitation, and hygiene (WASH) infrastructure and knowledge across the isolated coastal villages of Madagascar generate a chronic burden of waterborne disease, childhood malnutrition, and preventable mortality that disproportionately afflicts communities already marginalized by geographic remoteness, extreme poverty, and the diminishing coastal livelihoods driven by climate-induced marine ecosystem degradation. This community-based participatory action research (CBPAR) study examined the effectiveness of a structured WASH education and behavior change communication program implemented across five isolated coastal village clusters in the districts of Morondava, Toliara Sud, Mahajanga Pesisir, Manakara, and Vangaindrano over an 11-month intervention cycle (February 2024–December 2024). Engaging 160 community participants—comprising household caregivers, community health volunteers, schoolteachers, local health post workers, and village council members—the program delivered safe water treatment and storage education, handwashing behavioral activation, open-defecation-free community triggering, and menstrual hygiene management modules. Mixed-methods evaluation revealed statistically significant improvements across six WASH knowledge and practice indicators (mean Cohen’s d = 0.91, p < .001) and documented autonomous community-led WASH governance activity in 88% of participating village clusters at program conclusion.
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