School-based hand washing using the ‘tippy-tap’ intervention in basic public schools Ghana: A Pre- and Post- Descriptive study in the Volta Region

Margaret Kweku,John Owusu Gyapong,Hubert Amu,Emmanuel Manu,Fortress Yayra Aku,Martin Adjuik,Elvis Enowbeyang Tarkang,Martin Amogre Ayanore,Clement Narh,Joyce Komesuor

doi:10.3396/ijic.v16i4.027.20

Margaret Kweku, John Owusu Gyapong + Show 8 more

Open Access

https://doi.org/10.3396/ijic.v16i4.027.20

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Abstract

We examined the availability and utilisation of hand washing facilities in public basic schools in the Volta Region before and after a ‘tippy-tap’ intervention project by the United Nations Children’s Fund (UNICEF), Ghana in 2017. This descriptive study involved 29 Primary and Junior High Schools from 6 districts in the Volta Region. A total of 316 and 346 pupils respectively, aged 9–20 years were interviewed in the baseline and end line surveys. Descriptive and inferential statistics were used in estimating outcomes of interest. We found that the availability of hand washing stations increased from 61.1% in the baseline survey to 97.7% in the end line survey. Hand washing after defecation also improved from 68.7% during baseline to 82.7% in the end line survey. Among pupils who washed their hands after urinating, there was an increase from 13.6% in the baseline to 30.6% in the end line survey. While 77.2% of the pupils washed their hands before eating in the baseline survey, this decreased to 74.3% in the end line survey. Pupils in the end line survey were also three times more likely to practise hand washing compared to the base line. We conclude that the tippy-tap intervention improved hand washing practices of pupils. The tippy-tap project could be replicated by UNICEF Ghana in other regions of the country. In the Volta Region, however, there is a clear need for more installation and management of tippy-taps in schools. The schools should also intensify education on hand washing.

Highlights

IntroductionIncreasing equity in access to and use of safe water and sanitation facilities as well as improved hygiene practices will reduce child mortality, improve health and education outcomes, as well as contribute to the reduction of poverty and overall achievement of Sustainable Development Goal (SDG) 6 targets of achieving universal and equitable access to adequate water, sanitation, and hygiene by the year 2030.1 Water sanitation and hygiene (WASH) in schools does promote hygiene and increase access to quality education, and supports national and local interventions to establish equitably sustainable access to safe water and basic sanitation services in schools.[1]Poor WASH is the main cause of faecally-transmitted infections (FTIs), including cholera and other diarrhoeal diseases, which remain the second leading cause of morbidity and mortality among children under-five[2] and the leading cause of death in subSaharan Africa.[3,4] Hand-washing with soap (HWS) falls under the third pillar of WASH and is the single most important means of preventing the spread of infections.[5]
In the base line survey, 50.6% of the pupils were in primary school and this remained fairly the same (51.2%) in the end line survey
We realised that hand washing stations increased from 61.1% in the base line survey to 97.7% in the end line survey

Summary

Introduction

Increasing equity in access to and use of safe water and sanitation facilities as well as improved hygiene practices will reduce child mortality, improve health and education outcomes, as well as contribute to the reduction of poverty and overall achievement of Sustainable Development Goal (SDG) 6 targets of achieving universal and equitable access to adequate water, sanitation, and hygiene by the year 2030.1 Water sanitation and hygiene (WASH) in schools does promote hygiene and increase access to quality education, and supports national and local interventions to establish equitably sustainable access to safe water and basic sanitation services in schools.[1]Poor WASH is the main cause of faecally-transmitted infections (FTIs), including cholera and other diarrhoeal diseases, which remain the second leading cause of morbidity and mortality among children under-five[2] and the leading cause of death in subSaharan Africa.[3,4] Hand-washing with soap (HWS) falls under the third pillar of WASH and is the single most important means of preventing the spread of infections.[5]. HWS has proven to be an effective mechanism in averting the transmission of faeco-oral and other infectious diseases in school children,[8,9,10,11,12,13,14,15,16] the practice in developing countries including Ghana is very low. A 2015 school-based study conducted in the Mion District for instance found that 85% of schools had no hand-washing facility mounted on their premises and that only 30% of the schools had a functional water point close to the school premises.[17] To forestall this situation, there is an ongoing campaign to boost awareness of the importance of having designated places for hand washing with running water and soap; Ghana’s Public-Private Partnership (PPP) for HWS.[17,18,19] and efficiently implemented hand washing in schools programme will lead to healthier pupils who will positively influence hygiene practices in their homes and the wider community, change their current hygiene behaviour and continue better hygiene practices in the future

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