Exploring handwashing knowledge and practice among lactating mothers in Kathmandu's slum communities, Nepal

ABSTRACT Hand hygiene is an evolving public health issue in low-income countries such as Nepal. Poor water, sanitation, and hygiene infrastructure and practices lead to high morbidity in children under five. This study focuses on handwashing practices and disease occurrence among breastfeeding mothers in two slum settlements in Kathmandu along the Bishnumati River: Samakhusi and Tangkesower. A cross-sectional study using a semi-structured questionnaire was conducted with 127 breastfeeding mothers having at least one child. Both univariate and bivariate analyses were conducted using SPSS version 25. In the bivariate analysis, p < 0.05 was considered statistically significant. The majority of lactating mothers demonstrated good knowledge and appropriate practices in handwashing; many (81.1%) had good handwashing practices. Significant associations were found between maternal education level and childhood illness (p < 0.001); the prevalence of illness among children whose mothers had only basic education was 26% higher than children who had mothers with secondary education. Family income and handwashing practice were also significantly associated with child health (p < 0.01). Notably, 73.2% of children had experienced diarrhoea in the past 6 months. Strengthening maternal hand-hygiene education programmes, particularly for lactating mothers, and improving WASH infrastructure are necessary, as well as promoting affordable handwashing solutions in urban slums.