Situational analysis on hand washing practices among primary school children in Kisumu, Wajir and Kajiado counties Simon Kimani Kenya Medical Training College

Research Team

Simon Kimani (P.I) Prof Mohammed Karama Dr John Kariuki: Bernard Gitau: Erick Machuki: Tobias Omufwuoko: Hellen Gitau Viola Kipkemoi Francis Kariuki KMTC KEMRI MOH KMTC MOH MOH KEMRI KMTC KMTC

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Introduction

The total primary school enrolment in Kenya stands at 10,182, 500 which is approximately a quarter of the country’s population (KNBS, 2013).

 There is need to support Water Sanitation and Hygiene in primary schools through capacity building and provision of infrastructure.  Primary school children spend most of their day time in schools hence the need for healthy and conducive learning environment  88% of diarrhoeal disease among children is attributed to unsafe drinking water, inadequate sanitation and poor hygiene (UNICEF, 2014).

Problem statement

 diarrhea is the second most common cause of mortality and morbidity in the country with a case fatality of up to 21 percent.

 There is Inadequate provision of water for drinking and hand washing in communities and schools in the study area  Inadequate provision of sanitation facilities in schools in the study area (s).

 Past studies have observed low translation of knowledge on hand washing to practice.

Justification

 Need to employ inexpensive means to eliminate diarrhoea diseases among school going children in the study areas  Need to provide innovative and customizable hand washing technologies in primary schools within the study areas  Need to establish the role of school health club in promoting Water sanitation and hygiene in primary schools

Objectives

 To assess the level of knowledge on hand washing among primary school going children in Kajiado, Wajir and Kisumu counties  To assess hand washing practices among primary school going children in Kajiado, wajir and Kisumu  To establish the adequacy of sanitation infrastructure in primary schools in Kajiado, wajir and Kisumu

Methodology

 This is part of a larger quasi-experimental study  Three Primary schools were selected randomly from each of the three counties- Kajiado, Kisumu and Wajir  Five hundred students from each county were randomly sampled from the upper and lower primary classes.

 Data from the lower classes was collected using an interview schedule while self administered questionnaires were used to collect data from the upper classes

LEVEL OF EDUCATION COUNTY Upper primary KAJIADO KISUMU WAJIR TOTAL 466 (93.2%) 299 (59.8%) 456 (91.2%) 274 male 192 female 129 male 170 female 172 male 1221 (81.4%) 284 female 575 male 646 female Lower primary 34 (6.8%) 201 (40.2%) 44 (8.8%) 279 (18.6%) 15 male 19 female 103 male 98 female 27 male 17 female 145 male 134 female

Study Findings: Level of knowledge on hand washing

Study findings: Hand Washing Practices

 91.9 % of the pupils in the three study areas reported that they had received information on the importance of hand-washing.  Pupils in the three study areas washed hands at the 4 critical times: 85% after defecation, 77.1 % before eating food, 55 % before preparing food and 46.9% after changing the baby nappy  Sources of information on hand washing reported were media 27%, SHC 54%, champion teachers 47%, friends/guardians 41% and religious centres 13%

Study Findings: Adequacy of sanitation infrastructure

 Among the pupils interviewed 84.9% reported that there were hand-washing facilities within the school. Of these facilities only 41.9% were close to the latrine, 12.1% close to classrooms, 78.1% within the school compound and 30.3% within the dining area.  27.3% of the respondents reported that soap was available at hand-washing facilities within the school compound whereas 64.0% of the respondents reported that soap was not available.

Study Findings: Adequacy of sanitation infrastructure

Study findings: Role of School Health Club in school sanitation

   Five of the ten schools involved in the study had a functional school health club (SHC).

There was a significant association between the presence of a SHC and hand washing practices in schools, χ 2 (1, N=1425)=8.177 P<0.05 Students in schools with a SHC were more likely to wash hands after defecation (48.4%); before eating food (43.8%); after changing nappy (24.4%) and before preparing food (30.7%) as compared to those in schools that did not have a health club; after defecation (38.6%), before eating food (34.1%), after changing baby nappy (22.6%) and before preparing food (24.6%)

Cont: Role of School Health Club in school sanitation

 There was a significant association between the presence of an active school health club and presence of hand washing facilities close to latrines, χ 2 (1, N=1443) =59.8, P<0.05  60.6% Of the schools with an established SHC had installed hand washing facilities close to latrines as compared to 39.4% of the schools without a functional SHC

Conclusion

 There is need to provide user friendly sanitation infrastructure in primary schools  There is still need for provision of wholesome and portable water in primary schools  There is still need for provision of sustainable soap in primary schools  There is need for strengthening of the school health club as this will generally improve wash uptake in primary school

Recommendations

    The government and immediate communities in the four counties need to provide user friendly sanitation infrastructure in the schools School stakeholders should jointly come up with suitable innovations to foster hand washing in primary schools Schools should provide adequate soap and water for hand washing There is need for strengthening of the school health club as this will generally improve wash uptake in primary school