Training intervention to improve hygiene practices in Islamic boarding school in Yogyakarta, Indonesia: A mixed-method study.

Vita Widyasari,Adi Utarini,Yayi Suryo Prabandari,Andrew Soundy

doi:10.1371/journal.pone.0233267

Vita Widyasari, Adi Utarini + Show 2 more

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https://doi.org/10.1371/journal.pone.0233267

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Abstract

The primary objective of this study was to determine the effect of a training intervention in overall improvement in students' (santris) knowledge, behavior, and outcome. A mixed-methods exploratory sequential design was applied. First, qualitative data were collected from three focus group discussions with 20 supervisors and one in-depth interview with school principal to explore current hygiene practices. The information was then used to develop training intervention using either video, poster, and leaflet. To measure the effect, a stepped wedge cluster design with pre- and post-test analyses was conducted. A total of 452 junior high school santris in one Islamic boarding school were non-randomly allocated to either three intervention groups. Outcome measures were knowledge, personal behavior, and room hygiene. Codes and categories were produced in the qualitative analysis, while paired t-tests and Wilcoxon rank tests test were used in the quantitative analysis. The qualitative study identified poor practices on personal and room hygiene among the santris and proposed a training intervention. Overall, there was a significant increase in knowledge and personal behavior after the intervention (7.22 ± 1.34 pre-intervention to 7.70 ± 0.74 post-intervention and 9.75 ± 2.98 pre-intervention to 12.16 ± 2.12 post-intervention, respectively, p < 0.001). Room hygiene was significantly improved among boys and those who received leaflets. Having developed a specific training materials, school-based hygiene training intervention improved knowledge and personal behavior. Its effect on room hygiene particularly for female santris needs further strengthening of the intervention in this Islamic boarding school setting.

Highlights

Hygiene is a basic need of every human being
There was a significant increase in knowledge and personal behavior after the intervention (7.22 ± 1.34 pre-intervention to 7.70 ± 0.74 post-intervention and 9.75 ± 2.98 pre-intervention to 12.16 ± 2.12 post-intervention, respectively, p < 0.001)
Based on the preliminary study that was conducted by first author in January 2016 at Mawar Islamic Boarding School [6], we found that hygiene facilities and personal hygiene were generally poor, such as shown by poor garbage system, santri’s behavior of rarely changed their clothes and eat by hand without washing hands, and so forth

Summary

Introduction

Hygiene is a basic need of every human being. Despite great achievements during the millennium development goals (MDGs) era, more efforts must be undertaken and sustained to improve hygiene practices. Sanitation, and hygiene are still considered important priorities globally, and these basic human needs are clearly stated in one of the targets of the sustainable development goals (SDGs). Goal 6 articulates the aims of achieving access to adequate and equitable sanitation and hygiene for all and putting an end to open defecation, paying special attention to the needs of women, girls, and those in vulnerable situations. Despite substantial recent progress in access to a clean water supply and sanitation services in Indonesia, MDGs targets have not been achieved. The primary objective of this study was to determine the effect of a training intervention in overall improvement in students’ (santris) knowledge, behavior, and outcome

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