Students' attitudes toward Water, Sanitation, and Hygiene (WASH) are influenced by socio-economic conditions, cultural perceptions, and resource availability. Urban students typically access better WASH facilities and education than rural peers. Cultural norms and community involvement play crucial roles in promoting positive hygiene practices and improving health outcomes, especially in Tanzania. The study examined WASH attitudes among students in rural and urban Iringa, Tanzania, highlighting socio-economic influences on these perspectives. This study assessed WASH attitudes among primary and secondary students in rural (Kilolo, Mufindi) and urban (Iringa Municipality) schools in Iringa, Tanzania, from July 4 to 25, 2024. A quantitative analytical cross-sectional design was employed, including 1,536 students randomly selected from 64 schools. Data were collected using structured questionnaires and analyzed by Statistical Package for Social Sciences (SPSS), utilizing descriptive statistics, P-values for associations, and multinomial logistic regression to identify predictors associated with attitudes among students. Rural students have a mean attitude score of 86.38%, slightly higher than urban students at 85.42%. The overall mean attitude score for both groups is 85.90%. It is noteworthy that both rural and urban settings demonstrate a high level of attitude. An independent samples t-test reveals a significant difference (t = -2.067, p = 0.039). In rural areas, 82.4% of students have a high attitude compared to 79.8% in urban areas. Key predictors of WASH attitudes include level of study and type of school, where primary and public-school students revealed significantly higher moderate attitudes, all with (p < 0.05). Rural students exhibit more positive WASH attitudes than urban peers, indicating the need for targeted educational programs and resources to address disparities in various settings highlighted attitude gaps.
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