Magnitude and Factors Associated with Hygiene Practice Among Primary School Children in Mareko District, Southern Ethiopia: A Cross-Sectional Study

Abstract

Background: Poor school hygiene practice is a major health problem in developing countries, including Ethiopia, and is a leading factor for children's school absenteeism due to hygiene-related illnesses. To our knowledge, little is known about hygiene practice conducted in southern Ethiopia including our study area. Therefore, the objective of this study was to assess magnitude and associated factors of hygiene practice among primary school children in Mareko District. Methods: A school-based cross-sectional study design with multi-stage sampling was conducted from January 15-30, 2018 in Mareko district. Out of 25 second cycle primary schools in the district, eight schools (30%) were recruited with a simple random method. Then, a sample size of 829 students was selected by a simple random method. A selfadministered questionnaire was used to collect data. Data were entered into Epi Info V. 7 and then analyzed in SPSS V. 20. Multivariate logistic regression analysis was used to identify independent factors of hygiene practice. Results: The magnitude of overall good hygiene practice was 252 (30.4%) with 95% CI (27.3-33.5%). Practices of hand washing, latrine utilization, and water handling were found to be 191 (23%), 387 (46.7%), and 238 (28.7%), respectively. In multivariate analysis, factors associated with hygiene practice were found to be knowledge on hand washing (AOR = 5.1, 95% CI 2.86-9.1) and latrine use (AOR = 1.99, 95% CI 1.06-3.75); ever visited model school (AOR = 2.44, 95% CI 1.28-4.64); being 14-18 years old (AOR = 1.42; 95% CI 1.3-1.88); and cleanliness of toilets (AOR = 3.4; 95% CI 1.77-6.55). Conclusion: Overall, good hygiene practice among primary school children in Mareko District was low. Therefore, there should be continuous awareness of good hygiene practice and its impact on health through health education, strengthening and motivation of water, sanitation, and hygiene clubs, and also visits to model primary schools in the district.

Water, Sanitation and Hygiene in Schools in Low- and Middle-Income Countries: A Systematic Review and Implications for the COVID-19 Pandemic

“…Water shortage (intermittent or no water supply) in schools was reported in 62% of papers (n = 40) (see Supplementary Material ). Water consumption was less than 5 L per capita per day in most of the schools assessed in Dessie City (Ethiopia) [ 45 ] and equivalent to 0.6 L per capita per day in schools of Mareko district (Ethiopia) [ 94 ]. To meet their water needs during classes, schoolchildren used to bring water from their own home or from other sources (e.g., buy in the market or fetch water from nearby houses) [ 62 , 63 , 71 , 78 , 80 , 82 , 100 ].…”

“…Twenty percent of the studies (n = 13) entailed location or distance from the water source in schools. Fourteen percent of the studies (n = 9) reported that the water source was located on premises [ 27 , 56 , 57 , 62 , 65 , 77 , 84 , 94 , 99 ]. Distance from the water source varied from within 50 m of the school [ 77 ], more than 30 m from classrooms with some as far as 350 m away [ 102 ], within 1 km of the school [ 66 , 91 ] or more than 1 km away from the school [ 78 , 83 ].…”

“…Unknown sanitation facilities included latrines, pit latrines without further description, ordinary pit latrines with and without cover, traditional pit latrines, toilets, sanplat latrine, pit, pit latrine with cement floor, pit latrine without cement floor and composting latrine. One study informed that all schools had latrine facilities in the compound that were not adequate, however, lacked a definition of what was considered as adequate or inadequate [ 94 ]. In addition to the sanitation facilities, some schools also had urinals, predominantly for boys [ 43 , 44 , 102 ], although also separated urinals for girls, teachers [ 43 ] and shared ones for all students [ 76 ].…”

“…The facilities were often found to be abandoned [ 63 , 71 , 81 ]. Nevertheless, the majority of the students from the schools in Mereb-Leke District [ 46 ], in Dessie City [ 45 ], and Mareko District (Ethiopia) [ 94 ] reported defecating inside the facilities in the schools.…”

“…The facilities and urinals were also without walls [ 95 , 102 ], with holes on the walls [ 95 ] or the walls were built of grass or coconut leaves [ 85 ]. Moreover, students reported queuing for the use of the sanitation facilities in the schools [ 46 , 70 , 77 , 94 ].…”