{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T07:21:44Z","timestamp":1780557704793,"version":"3.54.1"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T00:00:00Z","timestamp":1668988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020171","name":"Foreign, Commonwealth and Development Office","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020171","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>People with disabilities and older adults face a high risk of dying from COVID-19. Handwashing with soap and sanitizing surfaces were recommended to disrupt COVID-19 transmission. Yet, in many low-and middle-income countries (LMICs), these populations have inadequate access to water, sanitation and hygiene (WASH) and are not reached by public health campaigns. The Hygiene Behavior Change Coalition (HBCC) was set up to limit the spread of COVID-19 in LMICs. Twenty organizations working across 37 countries were funded to encourage populations to adopt recommended personal hygiene behaviors. This study aims to review the inclusion of disability, aging, and caregiving in HBCC grantee interventions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A COVID-19 Inclusive WASH Checklist, which incorporates core concepts of human rights, was developed to support the inclusion of disability, aging and caregivers in interventions. The Checklist was applied to 137 documents submitted to donors within the HBCC fund to assess inclusion. Eligible grantee programme documents related to HBCC-funded projects were identified between August 2020 and January 2021. Feedback was provided to grantees recommending how to strengthen the inclusion of disability, aging, and caregiving.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Most organizations identified people with disabilities, older adults and caregivers as target groups, but targeted activities to include them were scarce. Where efforts were made, immediate needs rather than rights were addressed. For example, the construction of accessible handwashing facilities featured more prominently than ensuring the participation of these groups. Examples of the coverage of core concepts in interventions included generating data with these groups and developing interventions accordingly. Limitations to inclusion were inconsistent organizational approaches, inability to monitor media campaigns, and inadequate coverage of disability and aging in donor's grant funding mechanisms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>To ensure these populations benefit from efforts, they must be explicitly identified as target groups, with assigned actions that are monitored; efforts must go beyond accessible WASH services to ensure the meaningful participation of these groups. The COVID-19 Inclusive WASH Checklist supports this but requires further testing to assess its appropriateness and effectiveness.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2022.1024850","type":"journal-article","created":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T05:39:28Z","timestamp":1669009168000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["The inclusion of disability and aging in COVID-19 hygiene behavior change interventions across low-and middle-income countries: A review using the COVID-19 Inclusive WASH Checklist"],"prefix":"10.3389","volume":"10","author":[{"given":"Jane","family":"Wilbur","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharika","family":"Ferdous","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine","family":"Wapling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,11,21]]},"reference":[{"key":"B1","unstructured":"2011"},{"key":"B2","unstructured":"2008"},{"key":"B3","unstructured":"2020"},{"key":"B4","unstructured":"2021"},{"key":"B5","unstructured":"2020"},{"key":"B6","unstructured":"2020"},{"key":"B7","unstructured":"Kigoma, Tanzania - August 2020\n            HelpAgeInternational\n          COVID-19 Rapid Needs Assessment of Older People2020"},{"key":"B8","unstructured":"Cambodia - August 2020\n            HelpAgeCambodia\n          COVID-19 Rapid Needs Assessment of Older People2020"},{"key":"B9","unstructured":"Uganda, Adjumani Refugee Settlement - August 2020\n            HelpAgeInternational\n          COVID-19 Rapid Needs Assessment of Older People in Refugee Settlements2020"},{"key":"B10","doi-asserted-by":"publisher","first-page":"104058","DOI":"10.1016\/j.archger.2020.104058","article-title":"Clinical characteristics of older patients infected with COVID-19: a descriptive study","volume":"89","author":"Niu","year":"2020","journal-title":"Arch Gerontol Geriatr."},{"key":"B11","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1038\/s41586-020-2521-4","article-title":"Factors associated with COVID-19-related death using OpenSAFELY","volume":"584","author":"Williamson","year":"2020","journal-title":"Nature."},{"key":"B12","doi-asserted-by":"publisher","first-page":"4348","DOI":"10.3390\/ijerph18084348","article-title":"Health risks and consequences of a COVID-19 infection for people with disabilities: scoping review and descriptive thematic analysis","volume":"18","author":"Kamalakannan","year":"2021","journal-title":"Int J Environ Res Public Health."},{"key":"B13","unstructured":"Public Health England\n            GloverC\n          LondonPublic Health England \u2013 GOV.UKDeaths of People Identified as Having Learning Disabilities with COVID-19 in England in the Spring of 20202020"},{"key":"B14","unstructured":"2022"},{"key":"B15","unstructured":"2020"},{"key":"B16","unstructured":"2020"},{"key":"B17","unstructured":"2020"},{"key":"B18","doi-asserted-by":"publisher","first-page":"79","DOI":"10.12688\/wellcomeopenres.15833.1","article-title":"Disability-inclusive COVID-19 response: what it is, why it is important and what we can learn from the United Kingdom's response","volume":"5","author":"Kuper","year":"2020","journal-title":"Wellcome Open Res"},{"key":"B19","doi-asserted-by":"publisher","first-page":"100109","DOI":"10.1016\/j.lanwpc.2021.100109","article-title":"Water, women and disability: Using mixed-methods to support inclusive wash programme design in Vanuatu","volume":"8","author":"Mactaggart","year":"2021","journal-title":"Lancet Reg Health."},{"key":"B20","doi-asserted-by":"publisher","first-page":"e020077","DOI":"10.1136\/bmjopen-2017-020077","article-title":"Access to water and sanitation among people with disabilities: results from cross-sectional surveys in Bangladesh, Cameroon, India and Malawi","volume":"8","author":"Mactaggart","year":"2018","journal-title":"BMJ Open."},{"key":"B21","doi-asserted-by":"publisher","first-page":"e0155043","DOI":"10.1371\/journal.pone.0155043","article-title":"A qualitative study of barriers to accessing water, sanitation and hygiene for disabled people in Malawi","volume":"11","author":"White","year":"2016","journal-title":"PLoS ONE"},{"key":"B22","doi-asserted-by":"publisher","first-page":"e0223557","DOI":"10.1371\/journal.pone.0223557","article-title":"Are current approaches for measuring access to clean water and sanitation inclusive of people with disabilities? 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