Changes in access to household handwashing facility and hygiene practice in Kanyama peri-urban, Zambia - a repeated cross-sectional study.

Hand hygiene is an essential behaviour that significantly enhances public health, especially in resource-limited settings with inadequate water supply and sanitation services. However, hand hygiene practices and access to facilities remain a challenge. We aimed to assess handwashing facilities and practice of hand hygiene in a peri-urban community of Zambia - Southern Africa. A repeated cross-sectional survey was conducted in Lusaka in 2018 and 2022 on 318households for both surveys. Data were collected using a Water Sanitation and Hygiene (WASH) questionnaire and checklist on household and handwashing facility characteristics, participants' sociodemographic characteristics and methods of hand hygiene practice. Descriptive analysis, chi-square and logistic regression tests were used to analyse the data. Households without handwashing facilities increased by 20%, while those with handwashing facilities with soap and water reduced from 14% to 0%. Using soap and water was higher in 2018 than 2022 ( ≤ 0.05). The chances of handwashing with soap and water were reduced in males, those over 40 years old, married/living with a partner, and employed. The study revealed a decline in access to handwashing facilities and hygiene practices, indicating the need for strategies to enhance hand hygiene in peri-urban areas and individuals of all demographics.