Table 1.
The six steps of child feces management and disposal and associated hygiene behaviors and products
| Disease transmission behaviors | Disease prevention behaviors | Unhygienic tools/place/practice | Hygienic tools/products |
|---|---|---|---|
| Step 1: | |||
| Defecation site | |||
| Feces enter the environment through open defecation | Safe containment of feces through use of an improved latrine or capture in age-appropriate hygienic containment product | Yard, furniture, and paper towels | Reusable or disposable diaper, potty, and latrine |
| Step 2: | |||
| Feces transport | |||
| Feces come into contact with caretaker's hands when moved | No direct contact with caretaker's hands, through use of tools such as shovels, or hygienic capture | Hands, leaves | Feces capture in reusable or disposable diaper, potty |
| Step 3: | |||
| Feces disposal | |||
| Feces left in the environment or disposed of unhygienically | Disposal of feces into an improved latrine or adequate burial or treatment; contaminated disposable materials adequately burned or treated | Buried, garbage thrown in drainage, left in yard | Latrine (direct or from potty, reusable or disposable diaper) |
| Burned or sanitary garbage disposal (disposable diaper) | |||
| Step 4: | |||
| Cleaning tools | |||
| Tools not cleaned or wastewater disposed of in the yard or open environment | Equipment (e.g., potties, shovels, and reusable diapers) cleaned with soap, wastewater disposed of in an improved sanitation facility, and items disinfected through direct exposure to sunlight | In yard, into open drain | In basin, emptied into latrine (ideally using soap), tools/diapers dried in direct sunlight |
| Step 5: | |||
| Cleaning child | |||
| Child not cleaned or wastewater disposed of in the yard or open environment | Child cleaned with soap and wastewater disposed of in an improved sanitation facility | In yard, in basin emptied into yard, into open drain | Over latrine, in basin emptied into latrine |
| Step 6: | |||
| Handwashing with soap | |||
| Caretaker's hands not washed after child bottom washing or any point of contact with child's feces | Caretaker's hands washed with soap after child bottom cleaning and any contact with child's feces before new activity | Not washed at key contact points | With soap after transport, disposal, and child cleaning |