The London School of Hygiene and Tropical Medicine

(Type 2) Research: WRA089

Research Focus: Changing Hygiene Around Maternal Priorities 

Location: Cambodia 

Partner CSOs: WaterAid 


March 2022


The London School of Hygiene and Tropical Medicine, together with WaterAid and the National Institute of Public Health of the Ministry of Health, has recently completed their 3.5 year research project in Cambodia, focused on designing and testing a novel intervention to improve handwashing in healthcare facilities and homes in Kampong Chhnang Province. A very big thank you to the whole research team, led by Robert Dreibelbis, for the delivery of this significant research project. This research will continue into a second phase, led by WaterAid together with LSHTM and NIPH, called CHAMP Plus.  

Key Research Questions:

Can a hygiene intervention delivered through existing health care facilities:

  1. Improve hygiene behaviours – specific hand hygiene - that influence maternal and neonatal infection during labour, delivery, and post-natal care?
  2. Improve maternal satisfaction with health care services?
  3. Improve the hygiene of maternal and neonatal care practices in the home environment?
  4. Empower women to ensure quality, hygienic care in facilities and home?


Research Description: 

Changing Hygiene around Maternal Priorities (CHAMP) will follow the innovative Behaviour Centred Design approach.  We will systematically document current hygiene practices, motives and environments at both health care facilities and in the home paying special attention to understand existing gender norms and roles. 

The population will consist of one referral hospital and its network of 10 affiliated primary health care facilities (HCF) in Kampong Chhnang Province, Cambodia.  WaterAid Cambodia has previously, in partnership with the Royal Government of Cambodia’s Ministry of Health, worked to improve hygiene and sanitation infrastructure and systems in these facilities.

This information will then inform the rapid prototyping and iterative improvement of a multimodal behaviour-change intervention delivered through existing health care facilities to improve hygiene behaviours along the continuum of care, for mothers and neonates, while improving women’s control of their own health.

A before-and-after evaluation will assess the effect of the final intervention on maternal and infant hygiene practices.

“WaterAid, with the Ministry of Health and partners, has been working to transform health care through better water, sanitation and hygiene during childbirth. While improving water and sanitation services has been successful in several health centres, changing hygiene behaviour remains a challenge. Through this research, we will test new approaches to improving handwashing behaviour during labor, delivery, and the immediate after birth while addressing the inequitable care burden placed on new mothers.”

- WaterAid

London School of Hygiene and Tropical Medicine logo


Project Updates

Photo: WaterAid

Contact Us