Evaluation of the Role of School Children in the Promotion of Point-of-Use Water Treatment and Handwashing in Schools and Households—Nyanza Province, Western Kenya, 2007

Abstract

We installed drinking water and handwashing stations in 17 rural schools and trained teachers to promote water treatment and hygiene to pupils. We gave schools flocculent-disinfectant powder and hypochlorite solution for water treatment. We conducted a baseline water handling survey of pupils' parents from 17 schools and tested stored water for chlorine. We trained teachers and students about hygiene, installed water stations, and distributed instructional comic books to students. We conducted follow-up surveys and chlorine testing at 3 and 13 months. From baseline to 3-month follow-up, parental awareness of the flocculent-disinfectant increased (49–91%, P < 0.0001), awareness of hypochlorite remained high (93–92%), and household use of flocculent-disinfectant (1–7%, P < 0.0001) and hypochlorite (6–13%, P < 0.0001) increased, and were maintained after 13 months. Pupil absentee rates decreased after implementation by 26%. This school-based program resulted in pupil-to-parent knowledge transfer and significant increases in household water treatment practices that were sustained over 1 year.

Integrating Water Treatment into Antenatal Care: Impact on Use of Maternal Health Services and Household Water Treatment by Mothers—Rural Uganda, 2013

“…Low demand for and use of sachets has been observed in other studies. [16][17][18][19] ANC and maternity registry data corroborated survey findings by showing that approximately equal numbers of water treatment kits and sachet refills were distributed instead of the programmed four sachet refills per water treatment kit.…”

Impact of a Hygiene Curriculum and the Installation of Simple Handwashing and Drinking Water Stations in Rural Kenyan Primary Schools on Student Health and Hygiene Practices

“…It is not unreasonable to infer that the installation of school handwashing stations and instruction in a learning environment may have led to these outcomes among students. Furthermore, the increase in knowledge observed in this study was similar to other school-based hygiene programs from the same region, 13,15 and the impact on respiratory illness is biologically plausible. A second limitation is that illness outcomes were reported and not clinically confirmed raising the possibility of illness misclassification.…”

“…A similar instance of sustained implementation of a school-based intervention has been shown previously where a school-based safe water pilot was found to persist 10 months after the end of the pilot. 13 This study had several important limitations. First, because the school program was implemented concurrently with a number of other village-level interventions and implementation strategies in the NICHE project, particularly at the household level, it was not possible to determine whether results derived primarily from the school or the community intervention.…”

“…18 Further research into determinants of behavior change could help elucidate reasons for the lack of effect in this and other studies as compared with studies that have shown an impact on caregiver water treatment behavior. 12,13,27 Chlorine present in water 10 (3−14) 11 (7-17) −1 (−6-3) 9 (6-14) 9 (6-18) 0 (−5-4)…”

“…8,9 Primary school programs aimed at preventing diarrhea by installing drinking water and handwashing stations in schools, teaching students about hygiene and water treatment, and instructing them to share these messages with their families have increased hygiene knowledge among students and changed practices of parents. [10][11][12] However, although some studies of these schoolbased programs have found reduced absenteeism among students, [13][14][15][16][17] limited data exist on the direct health impact of these programs.…”