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The Impact of a School-Based Water, Sanitation and Hygiene Intervention on Knowledge, Practices, and Diarrhoea Rates in the Philippines

Author

Listed:
  • Hassan Vally

    (Department of Public Health, La Trobe University, Melbourne 3086, Australia)

  • Celia McMichael

    (School of Geography, The University of Melbourne, Melbourne 3053, Australia)

  • Claire Doherty

    (Department of Public Health, La Trobe University, Melbourne 3086, Australia)

  • Xia Li

    (Department of Mathematics and Statistics, La Trobe University, Melbourne 3086, Australia)

  • Gilbert Guevarra

    (Australian Red Cross, Manila 1515, Philippines)

  • Paola Tobias

    (Philippine Red Cross, Manila 1515, Philippines)

Abstract

A school-based water, sanitation, and hygiene (WASH) intervention in the Philippines was evaluated. Students and households from four schools that received the WASH intervention (intervention schools) were compared with four schools that had not (comparison schools). Knowledge of critical handwashing times was high across all schools, but higher in intervention schools. Students reported higher rates of handwashing after toilet use (92% vs. 87%; RR = 1.06; p = 0.003) and handwashing with soap (83% vs. 60%; RR = 1.4; p < 0.001) in intervention versus comparison schools. In intervention schools, 89% of students were directly observed to handwash after toilet use versus 31% in comparison schools (RR = 2.84; p < 0.0001). Observed differences in handwashing with soap after toilet use were particularly marked (65% vs. 10%; RR = 6.5; p < 0.0001). Reported use of school toilets to defecate (as opposed to use of toilet elsewhere or open defecation) was higher among intervention versus comparison schools (90% vs. 63%; RR = 1.4; p < 0.001). Multilevel modelling indicated that students from intervention schools reported a 10-fold reduction in odds ( p < 0.001) of school absence due to diarrhoea. In addition to school-based findings, self-reported handwashing at critical times was found to be higher among household members of students from intervention schools. This school-based WASH program appeared to increase knowledge and hygiene behaviours of school students, reduce absences due to diarrhoea, and increase handwashing at critical times among household members.

Suggested Citation

  • Hassan Vally & Celia McMichael & Claire Doherty & Xia Li & Gilbert Guevarra & Paola Tobias, 2019. "The Impact of a School-Based Water, Sanitation and Hygiene Intervention on Knowledge, Practices, and Diarrhoea Rates in the Philippines," IJERPH, MDPI, vol. 16(21), pages 1-14, October.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:21:p:4056-:d:279279
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    References listed on IDEAS

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    1. Dreibelbis, R. & Freeman, M.C. & Greene, L.E. & Saboori, S. & Rheingans, R., 2014. "The impact of school water, sanitation, and hygiene interventions on the health of younger siblings of pupils: A cluster-randomized trial in Kenya," American Journal of Public Health, American Public Health Association, vol. 104(1), pages 91-97.
    2. Celia McMichael, 2019. "Water, Sanitation and Hygiene (WASH) in Schools in Low-Income Countries: A Review of Evidence of Impact," IJERPH, MDPI, vol. 16(3), pages 1-21, January.
    3. Christian Jasper & Thanh-Tam Le & Jamie Bartram, 2012. "Water and Sanitation in Schools: A Systematic Review of the Health and Educational Outcomes," IJERPH, MDPI, vol. 9(8), pages 1-16, August.
    4. Robert Dreibelbis & Anne Kroeger & Kamal Hossain & Mohini Venkatesh & Pavani K. Ram, 2016. "Behavior Change without Behavior Change Communication: Nudging Handwashing among Primary School Students in Bangladesh," IJERPH, MDPI, vol. 13(1), pages 1-7, January.
    5. Emily Oster & Rebecca Thornton, 2009. "Menstruation and Education in Nepal," NBER Working Papers 14853, National Bureau of Economic Research, Inc.
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    Cited by:

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