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Sanitation & Hygiene In Basic Schools In Ghana. The Links Between Sanitation in Schools and in Households BY JOAN AWUNYO-AKABA. PRESENTATION OUTLINE. Brief Background Problem Statement Study Objectives Research Methodology Intervention Process Recommendations Conclusions .

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sanitation hygiene in basic schools in ghana

Sanitation & Hygiene In Basic Schools In Ghana

The Links Between Sanitation in Schools and in Households



presentation outline
  • Brief Background
  • Problem Statement
  • Study Objectives
  • Research Methodology
  • Intervention Process
  • Recommendations
  • Conclusions
brief background
  • Thesis assessed S&H facilities in basic schools.
  • Focused on latrines, urinals, & potable water use behaviours in schools.
  • Examined factors that promote or constrain the sustainability of S&H practices in basic schools in Ghana.
brief background cont
Brief Background (cont)
  • Study - In the Ga West District/ Greater Accra Region, with a high rural profile (60%) (GSS, 2005).
  • Basic schools in the study area are representative of over 60% of such in the rural communities makng up the Ghanaian population (GPRS, 2003).
problem statement
  • Poor school sanitation and hygiene is a major problem in developing countries (IRC,2001).
  • General deplorable state of latrines & urinals, lack of HW facilities, inadequate and poor storage of drinking water & inappropriate refuse disposal in schools .
problem statement cont
Problem Statement (CONT)
  • Huge investments made to improve schools S&H situation through CWSA have not brought about desired sustainable results.
  • In Ghana, 31% of schoolchildren lack access to safe drinking water, whilst 78% do not have access to good sanitation. This may contribute to poor hygiene behaviour among schoolchildren (UNICEF, 2003).
study objectives
  • Explore & describe factors affecting sustainability of SSHE in basic schools in Ga West District - GRTAR
  • Provide information for determining factors that may promote or constrain the sustainability of school S & H practices.
specific objectives
Specific Objectives
  • Describe pupils’ perception of good S&H in school
  • Examined nature and methods of teaching hygiene behaviours
  • Examined extent to which facilities for implementing and maintaining SSHE are made available to schoolchildren
specific objectives cont
Specific Objectives (cont.)
  • Assessed children’s use of S & H facilities provided at school & determine why & when the facilities are used.
  • Examined systems that schools have in place for ensuring continued desirable hygiene behaviours in school children
research approach design
Research Approach & Design
  • Cross-sectional descriptive study
  • Used varied methodological approaches for data gathering
  • Different study populations to assess & describe factors that may constrain or promote the sustainability of S &H practices in basic schools.
research approach design cont
Research Approach & Design(cont.)
  • This study is anthropological in its

orientation as it tries to understand the S&H concepts and behaviours of schoolchildren and the experience of school authorities.

sample data collection
  • 10 schools (31%) with CWSA school latrine facility randomly selected out of the universe of 32 schools.
  • 246 randomly selected respondents from upper primary 4, 5 & 6; JSS forms 1 & 2 surveyed.
  • 4 FGD sessions - 52 discussants of male & female students from same class levels
  • In-depth interviews held with Head Teachers & SHC (20 respondents).
  • Observational checklist used to assess S&H facilities
  • Children’s Perception & Expectations

- Difficulty to demonstrate

understanding of good S&H concept

- Forgot about latrine and water use


- Environmental cleanliness only


- Latrine and urinal facilities – Clean not too


  • Roles Children Play

- Performed ALL S&H functions

- Guided by S&H prefects mainly.

- Gender roles assessment - boys did less

findings cont
Findings (cont)


  • Varied methods of delivery, & aspects of hygiene behaviours taught.
  • Non-uniformity of SSHE prog. content
  • Lack of S&H learning materials and models
  • Lacked well-structured S&H Progm
  • Deficient knowledge of teachers on concept of S&H
  • Chn-High knowledge level (92.6%) of hand-washing behaviour at critical times
findings cont1
Findings (cont)

Sanitary Facilities, Usage & Maintenance

  • Latrines (67.7% usage- 5.5% x3)
  • Urinals (40% Nil; 99% Usage)
  • Classroom Dustbins (90% Nil;)
  • Anal Cleansing(50%’T’ Roll; 30% leaves etc)
  • Materials and sanitary cleaning materials

(20% Nil). – Various levels of maintenance

findings cont2
Findings (cont)

Hygiene Facilities

  • Safe Drinking Water(82.8% access, 41.4%shortages; 21.3% -pure H2O)
  • Hand Washing (40% Nil; 88.4%yes to HWng soap & water)
  • Soap (76.3%)
findings cont3
Findings (cont)

Good Practices Identified

  • Commitment and co-operation
  • Chn- Involvement & active participtn
  • Monitoring & support supervision of chn by HT &SHC
  • Maintenance of sch S&H facilities.
findings cont4
Findings (cont)

Poor Performers of SSHE

  • Teacherslacked ability to review, assess, and direct programme
  • Heavy teaching workload
  • Inadequate resources for S&H facilities & activities
  • Lack of co-operation & support frm peers to S&H prefects
  • Latrines are not user friendly – difficult to clean.
findings cont5
Findings (cont.)

System for SSHE Assessment

  • No system for M &E
  • Lacked clearly defined indicators
  • Inability to assess SSHE prog impact
  • Impact on children
intervention process models
  • Way forward for Establishing Systems for SSHE and Identifying Indicators for Strengthening Programme & Measuring Impact

- 1- Sanitation and Hygiene Behaviours Acquisition Process Model

- 2- The Child’s Sanitation and Hygiene Behaviour Impact Process Model

-3-Sanitation and Hygiene Behaviour Sustainability Model

fig 1 sanitation and hygiene behaviours acquisition process model
Fig. 1 –Sanitation and Hygiene Behaviours Acquisition Process Model

Child’s Behaviour Capacity, Adoption, Change and Behaviour Setting

Home/School Environment Provides Opportunity and Facilities for Cues & Triggers for Linking Theory with Practical Action

Provides - Knowledge and skills that lead to Behaviour Capacity

Provides -

Observational Learning through Social Interactions

  • Reinforcements
  • Direct
  • Vicarious
  • Reinforces Child’s behaviour selection
  • Mastering Learning through skills Acquisition
fig 2 the child s sanitation and hygiene behaviour impact process model




Fig. 2 - The Child’s Sanitation and Hygiene Behaviour Impact Process Model
  • b) Community: Resources;
  • Empowerment, & Competences of Key Players- to Guide & Develop Child’s
  • Primary Socialization Process – Social Order e.g.
    • Household Roles
      • Cleaning
      • Caring for younger siblings
  • Etc.


Acquisition of Behaviour Capacity and Adoption

a) Social Networks and Social Support

To School SSHE Program Focus on training children as Future Parents

  • e) Individual Coping
  • Resources - Developed by Child
  • Problems Solving Abilities
  • Child Undergoes
  • Mental Development:
    • Eager to learn new concepts
  • See Environmental Care and
  • Their Role As Important
  • Takes Care of own health
  • Health of Others
  • c) Health Behaviours Preventive Health Practices – Build Child’s capacity at School for its acquisition through -
  • Developmental Socialization Process -
  • Child → Change Agent
    • Within Family
  • Stimulus To Community Development
  • d) Physical Mental & Social Health Development
    • Active Participant in Developmental Process

Fig. 3 - Sanitation and Hygiene Behaviour Sustainability Model

2) Involvement of Community leadership:

- Build Community Capacity


Multiple Levels of Influence

Pool of Committee Stake Holders

Influential and Supportive of School Environment

4) Advocators for Effective

SSHE Interventions: To

Government /District Assembly, NGO, CSO

Mass Communications


SHEP Policy Change


Promotion of Developmental Socialization

Sustained Sanitation and Hygiene behaviour

Ability & opportunity to link Sanitation & Hygiene theory with practice.

Acquisition of Behaviour capacity & Adoptions

5 Conducive School Environment

Full Complement of School Structures & Sanitation & Hygiene cues /triggers

Well structured Sanitation and Hygiene Educational Programme

Clearly targeted specific Sanitation and Hygiene behaviour for change.

Capacity development of teachers

Active media involvement for sustained Advocacy for School SSHE programme

Employment of Trained Sanitation and Hygiene Labourers /Workers

3) Community ownership and control of Schools Environment

- Keen oversight of school Management & Environment

- Ensures schools have adequate Sanitation & Hygiene facilities always

- Community education to promote Sanitation and Hygiene facilities at home to conform to that of the schools’

way forward
Way Forward
  • The Intervention Models have identified factors likely to determine behaviour change
  • Provide indicators for monitoring and evaluating the SSHE impact.
  • Guide to determine the extent to which changes in behaviour are sustained over time.
  • 1) Improving SSHE Programme
  • 2) Guide for SHEP Policy Document Finalization
  • 3) Further Research
1 improving sshe programme short term
1) Improving SSHE Programme- Short Term
  • Short-term i.e., 1-3 years
  • Develop concept of good S&H in schoolsStrategies:

- Broaden S&H scope of Sch Chn

- Expose chn to S&H options,

- Exchange visits, tours / excursions

improving sshe prog cont
Improving SSHE Prog (cont)

- Use proposed models- Trng, Prog Imp & M&E

- Equally involve both boys and girls in S&H activities

- collective development of hygiene behaviour capacity, adoption, and change.

improving sshe prog cont1
Improving SSHE Prog (cont)
  • Enhance nature & methods of teaching hygiene behaviours in school

- 1st - Assess knowledge & skills of teachers on SSHE.

- 2nd - Identify or design appropriate & cost-effective S&H trng materials & models

-Review & develop IEC materials.

improving sshe prog cont2
Improving SSHE Prog (cont)
  • 3rd - Promote innovative & appropriate methods of teaching S&H

– Adapt & Usebehaviour change

communication models

  • Reduce teaching workload by teaching S&H during the holiday period.
2 guide for shep policy document finalization
2) Guide for SHEP Policy Document Finalization
  • Need for common goal, vision, mission, and objectives
  • Give prominence SSHE Programme; & Have
  • Support supervision strategies
  • Indicators for implementation, M&E & impact assessment.
  • Maintenance, supply & replacement systems
  • Incorporate hygiene promotional intervention packages of inter-related actions
  • Take cognizance of recent international targets and recommendations
  • Ensure programme uniformity for all schools
3 further research
3) Further Research
  • What policies for construction of school buildings and their facilities?
  • Who plans or designs schools &Who approves?
  • Why are structures commissioned without S&H facilities?
  • Effects of children congregating without S&H facilities?
  • Any standards for school S&H facilities?
  • Who ensures adherence to all the above?

“We see the active participation of

children: children actively involved In

decision-making at all levels and in

planning, implementing, Monitoring, and

evaluating all matters affecting the rights of the child”.

[A World Fit For Children: The Children’s Statement, UN General Assembly, May, 2002]


“Schools bring little influence to bear on a child’s achievement that is independent of his background and general social context”

  • [James Coleman, 1964]
  • Strengthen the social networks and social support (fig. 4). To become catalyst to strengthen community involvement in promoting healthy homes and schools’ S&H environments.
  • Undoubtedly, children who are socialized with the ability and opportunity to link sanitation and hygiene theory with practice both at school and in the home would be raised.
  • Then, Links Between Sanitation at Schools and in Households – WOULD BE MADE
food for thought

“The child of today carries national

and international responsibilities

for the world of tomorrow by ensuring

that he will do all he can to make it a

better place than he met it. Yet the

child is helpless”.

  • [Treading a Way to the Future; First Decade of GNCC (1979-1989)]