A pilot pre-post trial with and without subsidy to promote safe backyard poultry-raising practices to prevent exposure to poultry and poultry feces in rural Bangladesh

BackgroundBackyard poultry-raising is common in rural Bangladeshi households. Raising poultry contributes to fecal contamination of the domestic environment, increasing childrens exposure to enteric pathogens, including Campylobacter, which has been associated with child stunting. ObjectiveTo investigate the effectiveness of a behavior change communication and counseling intervention to encourage households to confine poultry outside of the household dwelling in a shed at night and improve poultry feces management. MethodsWe conducted a two-arm pre-post pilot study. Households in both arms received the behavior change communication and counseling intervention. Households in the subsidy arm also received ~23 USD for the construction of a poultry shed for nighttime housing. We administered a household survey and spot-check before and after intervention implementation among 37 subsidy and 42 non-subsidy households. ResultsAt endline, 58% of all households had a poultry shed (87% of subsidy and 33% of non-subsidy households) and the percentage of households confining all poultry outside the house the previous night was significantly higher at endline (33%) compared to baseline (2.5%) (prevalence difference [PD]: 30 percentage points [pp]; 95% CI: [19, 41]). Additionally, more households had no visible poultry feces piles inside the house compared to baseline (PD: 26pp 95% CI: [12, 41]), but there were no significant differences in the number of poultry feces piles in the courtyard or veranda. DiscussionOur intervention effectively encouraged households to confine poultry outside of household dwellings at night and to maintain an indoor living space free of poultry feces. Households were willing and able to construct a shed even without a subsidy. Households that received a subsidy were more likely to construct a shed. Future studies should assess if housing all poultry outside the household dwelling reduces childrens exposure to poultry feces enough to mitigate health risks associated with poultry ownership.