Hygiene Facilities Research Articles

Knowledge, attitude and practice regarding sexual and reproductive health rights among married adolescents in urban slums of Bangladesh: A cross-sectional survey

Background: Adolescents, especially married adolescents living within urban slum communities, encounter significant difficulties in obtaining and exercising their sexual and reproductive health rights (SRHR). This study aimed to determine the knowledge, attitude, and practice of SRHR and its associated factors among married adolescents living in urban slums. Methods: A cross-sectional survey of 500 married adolescent girls living in slums in Dhaka and Gazipur, Bangladesh, was conducted in the icddr,b Health and Demography Surveillance System areas. We interviewed them using a pretested questionnaire to assess their knowledge, attitude, and practice of SRHR. Data on their sociodemographic variables, such as household asset items and age and education, were collected. Principal component analysis was used to create wealth indices. Results: Knowledge of self-care during menstruation and the oral contraceptive pill was almost universal, though knowledge of condoms, abortion, danger signs of pregnancy and sexually transmitted infections was low. They (70%) agreed that young people should have access to menstruation-related hygiene facilities, contraception and sex education, though there was less agreement regarding abortion being a woman’s right. The use of antenatal care and institutional-level delivery was also low. Age, years of schooling and prior pregnancy were positively associated with their knowledge levels. Important attitudinal and practice variations were noted between regions, Gazipur being the most disadvantaged. Conclusion: There are important gaps in knowledge and practice in SRH service-seeking in this slum population. Heterogeneity in the slum population must be recognised to design services that reach the most disadvantaged group.

Water, Sanitation, Hygiene Facilities and Economic Well‐Being: A Multilevel and Spatial Analysis in Punjab, Pakistan

Water, Sanitation, Hygiene Facilities and Economic Well‐Being: A Multilevel and Spatial Analysis in Punjab, Pakistan

Food handling practices and sanitary conditions of charitable food assistance programs in eThekwini District, KwaZulu-Natal, South Africa

Unsafe food handling practices by food handlers have dire health and financial implications worldwide. Each year, approximately 600 million people, or about 1 in 10 people, are said to become ill from eating contaminated food, and 420,000 people inadvertently die. According to the 2019 World Bank report on the economic burden of foodborne diseases, the annual cost of treating foodborne illnesses is estimated to be US$ 15 billion, and the total productivity loss caused by foodborne diseases in low- and middle-income countries is estimated to be US$ 95.2 billion annually. The purpose of this study was to assess the food handling practices and sanitary conditions of the charitable food assistance programs (CFAPs) in the eThekwini District of KwaZulu-Natal, South Africa. A descriptive cross-sectional study was conducted among 196 CFAPs in eight study settings across five municipal planning regions (MPRs) of the eThekwini District between January 2021 and May 2021. Data were collected using a standardized 37-item observational checklist and analysed through Stata Statistical Software (TX: StataCorp. 2021 LLC.: Release 17. College Station). Compliance levels were calculated using the compliance score (C-score), whereby 0.0–0.20 (0–20%), 0.21–0.40 (21–40%), 0.41–0.60 (41–60%), 0.61–0.80 (61–80%), and 0.81–1.00 (81–100%) were determined as very poor, poor, average, good, and very good, respectively. Statistically significant associations were declared at p < 0.05. Compliance with food hygiene, storage, and packaging was very poor (C-score = 0.003), as were personal hygiene and staff facilities (C-score = 0.147), as well as product information/labelling (C-score = 0.003). Similarly, waste management and pest control systems (C-score = 0.203), compliance with health and hygiene education/training (C-score = 0.335), as well as use and maintenance of transport (C-score = 0.333), all scored ‘poor’. Only the design of premises and facilities had an average compliance score (C-score = 0.43). Given CFAPs’ role in mitigating the impact of poverty, their strict compliance with hygiene protocols is of utmost importance. Systems for identifying and correcting common noncompliance in CFAPs are required.

WASH recommendations for improving disaster preparedness and recovery in schools in Indonesia

Access to functional and clean toilets which maintain privacy and dignity and support girls’ Menstrual hygiene management (MHM) plays a crucial role to getting girls back to school post-disaster. This could also help in managing feelings of shame and disgust experienced when using toilets in schools in post disaster settings. In this paper, we report on our assessment of water, sanitation and hygiene (WASH) facilities in schools three-years post the 2018 multi-hazard event in Indonesia. We used a mixed-methods approach using visual observations, interviews with school principals, surveys with schoolgirls and focus group discussions with schoolgirls and teachers to understand the lived experiences of students using toilets at school. Our results highlight that across schools descriptive and injunctive social norms were supportive of littering, inadequate toilet facilities for girls to manage their menstruation and bullying and antisocial behaviour by opening toilet doors while the facilities were occupied. Based on these results, we developed two types of interventions, physical and behavioural, piloted in three schools to increase WASH and MHM awareness and the safety of sanitation facilities. Our interventions showed that approaches for WASH interventions in schools can only be designed if we understand the local barriers to carrying out interventions that integrate maintenance plans. We provide recommendations to support practitioners in mitigating risk and improving circumstances for girls in schools in Indonesia, which have the potential to address SDG 4 on inclusive and equitable education and SDG 5 on gender equality and girls’ empowerment.

EXPLORING THE ASSOCIATION BETWEEN HOUSEHOLD SANITATION AND WOMEN’S MENSTRUAL HYGIENE MANAGEMENT IN RURAL ODISHA, INDIA

IntroductionAccess to water, sanitation, and hygiene (WASH) facilities has been globally recognized as a critical need, especially for women and girls to ensure their menstrual hygiene. This study aimed to investigate the association between household sanitation and women’s menstrual management experience in Odisha, India. MethodsA cross-sectional study was conducted in Balasore district of Odisha state in India among 694 rural women and girls aged 15-45 years selected using a multi-stage sampling method. The Performance Monitoring and Accountability (PMA) 2020 questionnaire was used for data collection. Multivariate logistic regression analysis was carried out using SPSS version 25. ResultsMore than two-third (68.4%) of rural families used improved sanitary facilities. Around 30% of households have been using an unimproved sanitary facility, which means the practice of open defecation is still prevalent in rural areas. About 40.6% of women and girls reported using clothes as their primary menstrual hygiene material. Further, women and girls with improved sanitation facilities (aOR = 1.56, 95% CI: 1.09 - 2.59) were more likely to change menstrual materials at the main household sanitation facility than those with an unimproved sanitation facility. In contrast, households using improved sanitation facility were less likely to use bedroom/sleeping areas to change the menstrual materials (aOR=0.65, 95% CI: 0.42-0.99) than those with an unimproved facility. ConclusionAvailability of improved household sanitation is critical to good menstruation management practices. State-specific policy for menstrual health and hygiene could provide the much-needed impetus to strengthen WASH infrastructure in rural and tribal regions of Odisha.

Event Operation and Management in Risk Assessment for Outdoor Food Bazaar Events

This study evaluates risk management in organizing a food bazaar held in an open field at the Jakarta International Velodrome from May 31 to June 2, 2024. The research methodology includes direct observation, structured interviews with the organizing committee, and document analysis. The assessment results indicate that the event falls into the Very High Risk category for safety aspects, with potential hazards such as smuggling, theft, and fire. Additionally, the cleanliness of the area and healthcare facilities are deemed inadequate, categorized as High Risk. The limitations of hygiene facilities such as toilets and sinks, as well as the risk of dehydration, were also identified. This study recommends enhanced preparation and attention to risk management for similar events in the future to ensure the safety and comfort of visitors. By identifying, analyzing, and evaluating risks more comprehensively, it is hoped that event organizers can minimize potential hazards and improve the quality of future events. The study also emphasizes the importance of collaboration among various stakeholders, including the government, event organizers, security personnel, and healthcare services, to create a safe and comfortable event environment. Measures such as safety training for staff, adequate placement of healthcare facilities, and improved security systems can reduce the risks faced by visitors. Additionally, the study highlights the need for effective communication with the audience regarding safety and health protocols to be followed during the event. The implementation of technology such as crowd monitoring applications and early detection systems can also be a solution in managing risks more effectively.

Safely reopening and operating a primary healthcare facility after closure due to SARS-CoV-2 infection in a healthcare worker – Nairobi, Kenya, 2020

The first COVID-19 case in a healthcare worker in Kenya was reported on March 30, 2020, in Nairobi, leading to a 41-day closure of the health facility where he had worked. We assessed infection prevention and control (IPC) activities and implemented recommendations to re-open and operate the facility. We conducted a risk assessment of the facility in April 2020 using a modified World Health Organization, six-element IPC facility risk assessment tool. IPC recommendations were made, and a follow-up assessment of their implementation was conducted in July 2020. Breaches in IPC measures included poor ventilation in most service delivery areas; lack of physical distancing between patients; inadequate COVID-19 information, education, and communication materials; lack of standard operating procedures on cleaning and disinfecting high-touch areas; insufficient IPC training; inadequate hand hygiene facilities; insufficient personal protective equipment supplies; and an inactive IPC committee. Strengthening IPC measures is critical to prevent healthcare facility closures.

Evaluating water, sanitation, and hygiene in schools of Bangladesh: progress toward SDG compliance

ABSTRACT The availability of safe water, sanitation, and hygiene (WASH) facilities in schools is essential for a healthy learning environment and achieving sustainable development goals (SDGs) 4 and 6. Despite its importance, comprehensive studies on drinking water quality, sanitation, and hygiene in schools are scarce. This study explicitly assessed the WASH services and gaps in 43 educational institutions, located in Tongi, Bangladesh, through field and laboratory investigations. Thirteen physicochemical and bacteriological parameters were analyzed, and water quality was classified using an Integrated Water Quality Index (IWQI). Hygiene and sanitation were evaluated through observations and data from school administrators on water sources, toilets, handwashing facilities, and solid waste management. Results showed that WASH services exceeded the national average, but all schools had dangerously high Escherichia coli levels (mean: 43.95 CFU/100 mL) in drinking water, posing health risks. Additionally, 89.72% of samples showed elevated manganese levels, 35% had high iron, and 41.86% had increased conductivity. About 35% of water was unsuitable for drinking based on IWQI. Schools lacked the capacity to monitor WASH quality, especially drinking water. A strategic framework for safe WASH facilities is recommended. The findings can lead the policymakers to prioritize the improvements in WASH facilities for attaining SDG 6.

Access to water, sanitation and hygiene facilities by women with disabilities in Zimbabwe’s Harare Metropolitan Province during COVID-19

This study was conducted in three low-income areas of Harare Metropolitan Province in Zimbabwe to understand how women with disabilities accessed water, sanitation, and hygiene (WASH) facilities during COVID-19. Qualitative data were collected through structured interviews and focus group discussions involving 104 purposively sampled women with disabilities. Key informant interviews were held with seven representatives of organisations working with persons with disabilities in Harare. Findings indicated that overt discrimination against women with disabilities increased as households struggled to access WASH facilities. These women risked gender harassment from community boreholes ‘marshals’, and urogenital infections resulting from unhygienic menstruation management practices. Poor waste disposal and water reticulation systems restricted high water, sanitation and hygiene standards required to fight the pandemic. The study recommends the full implementation of the national disability policy and the constitutional provisions to safeguard the rights of women with disabilities in times of crises.

Effects of health education intervention on menstrual hygiene knowledge and practices among the adolescent girls of Pokhara Metropolitan, Nepal.

Poor menstrual hygiene practices are one of the major public health problems in Nepal. Due to persistent taboos and socio-cultural constraints, adolescent girls are often unaware of scientific facts, knowledge, and practices related to menstrual hygiene. This paper aims to assess the effects of health education intervention on menstrual hygiene knowledge and practices among adolescent girls in Pokhara Metropolitan, Nepal. A true experimental study was conducted in two government basic schools in Pokhara Metropolitan, Nepal. The study population was adolescent girls who had attended the menarche. Firstly, a pretest with the help of a self-administered questionnaire was done to find out the socio-demographic information, knowledge and practices of menstrual hygiene. Next, health education sessions were conducted among the intervention group. Finally, after one month of intervention, a post-test was conducted among the intervention and non-intervention group. Data analysis was done through descriptive and inferential statistics. The findings showed significant improvement in the knowledge and practice level of adolescent girls on menstrual hygiene after health education intervention. Participants in the intervention group showed a significant increase in knowledge scores from 10.0% to 67.0%, while the non-intervention group remained unchanged at 7.5%. Good menstrual hygiene practices scores in the intervention group increased significantly from 22.5% to 67.0%, whereas the non-intervention group saw a slight rise from 20.0% to 22.5%. Regarding observed practice scores in menstrual hygiene, significant improvement was observed in the intervention group (45.0% to 100.0%) in contrast to the non-intervention group (25.0% to 27.5%). This study highlights the crucial role of school health education interventions in promoting menstrual hygiene among adolescent girls. It emphasizes the importance of comprehensive educational programs tailored to early teenage girls, addressing timing, content, and delivery methods alongside ensuring the availability of Water, Sanitation and Hygiene (WASH) facilities.

Influence of Perceived Health Risk Factors on Adoption of Community-Led Total Sanitation: A Case of Turkana Central Sub-County, Turkana County, Kenya

The primary objective of Sustainable Development Goal 6 target 2 is to achieve widespread accessibility to sufficient sanitation and hygiene facilities, therefore eliminating the practice of open defecation by the year 2030. One strategy for achieving this objective involves the implementation of Community-Led Total Sanitation (CLTS), a participatory method that allows communities to take on accountability for their sanitation behaviors. However, sustaining favorable changes after the implementation of the intervention continues to be a significant obstacle. The objective of this study was to investigate the influence of perceived health risk factors on adoption of Community-Led Total Sanitation. The study was carried out on the household members of Lodwar township and Kalokol ward, targeting a sample size of 382 respondents The research utilized a convergent design methodology, which combined quantitative and qualitative data collection methods, enabling the simultaneous gathering of both types of data. Quantitative data were collected using structured questionnaires and observation checklist, while qualitative data were collected from Focus Group Discussions. A stratified sampling technique was applied to group the village units into strata and simple random sampling used in selection of household heads. Qualitative results were structured into themes and direct quotes. The study determined that an increase in perceived knowledge regarding health risks was associated with a higher likelihood of latrine presence (p-value&lt; 0.05). Findings from multiple regression analysis also showed that education level was a significant predictor for awareness, understanding, and knowledge (p=0.000&lt;0.05), while gender demonstrated a significant negative relationship with awareness and understanding p= -0.2573, suggested males score lower in these areas compared to females. Age correlated positively with awareness and was marginally significant for understanding (p=0.043), indicating that older individuals had higher scores. The study concluded that increased knowledge regarding health risk in terms of vulnerability and susceptibility influenced latrine presence at the households and thus the adoption of community-led total sanitation programs in Turkana Central Sub-County. The study highlighted the critical role of knowledge in achieving open defecation-free status in the area. The study recommended that CLTS interventions by the Ministry of Health and sanitation implementers place a particular focus on knowledge enhancement, to ensure that communities are better informed, which could lead to a higher likelihood of adopting improved sanitation practices, thereby reducing the prevalence of open defecation and related health issues.

The level of implementation of water, sanitation, and hygiene (WASH) practices among the public basic schools in Ghana

ABSTRACT Water, sanitation and hygiene practices (WASH) have been a major challenge facing many basic schools in Ghana for many decades. The school authority have made a number of complaints to the Ghana government through the Ministry of Education in relation to the inadequate potable water, sanitation facilities and hygiene practices in basic schools which the government has remained silent on. The aim of this study was to assess the level of implementation of Water, sanitation and hygiene practices in basic schools in the Sunyani East Education Directorate. Both qualitative and quantitative data were collected using questionnaires and interviews. The results indicate that hygiene and sanitation facilities available in schools under study included urinals, toilets, handwashing materials and solid waste disposal facilities. It was revealed that wooden slap pit latrine toilet was present in all schools except Methodist school which has cemented slaps. There were absence of toilet rolls, tap facilities and hand washing soap in all schools visited. The pupils fetched water from neighbouring houses and used it. The study recommends that the Parent-Teacher Association, School Management Committee, District Education Directorate and Ghana Education Service should team up to provide these essential facilities to basic schools in Sunyani East.

Growth of Horticultural Export Market: The implication of Post-harvest Handling Practices among Small Scale Farmers in South Rift, Kenya

The inclusion of rural smallholder farmers in the export of horticultural products has two major implications: increased household income through access to a promising global market and enhanced productivity, cumulatively contributing to the growth of Gross Domestic Product (GDP) and foreign exchange. Currently, there are an estimated 2,500 smallholder farmers participating in horticultural exports South Rift of Kenya. Consequently, this study aimed to investigate the relationship between post-harvest handling practices by smallholder farmers and the growth of the horticultural export market. Quantitative data were collected using a structured questionnaire from a sample of 334 small-scale horticultural farmers, randomly selected for the study. Validity and reliability tests were conducted prior to the main study. Descriptive statistics and simple linear regression were employed to analyze the data. Post-harvest handling practices were assessed through the utilization of packaging materials, storage facilities, energy supply, hygiene, and transportation facilities. The findings indicated a statistically significant relationship between post-harvest handling practices and the growth of horticultural export markets. However, deficiencies were observed among small-scale farmers in South Rift, Kenya, in managing horticultural products after harvest. The study recommended for strategic interventions for the adoption of modern technologies in every stage of the supply chain and establishes collaborations with key stakeholders in order to minimize cost of investment per farmer and ultimately enhancing market standards compliance and competitiveness in the fruit and vegetable export market. Keywords: Post harvest, storage, packaging, Hygiene, Export, Markets

Disparities in access to water, sanitation, and hygiene (WASH) services and the status of SDG-6 implementation across districts and states in India

IntroductionAccess to affordable and improved Water, Sanitation, and Hygiene (WASH) facilities is essential for people's daily lives, and it is the primary goal of Sustainable Development Goal 6 (SDG-6). However, achieving this goal is a significant challenge for many countries, including India. The aim of this study is to assess the progress made towards achieving SDG-6 targets in Indian districts, states, and Union Territories (UTs) and to identify clusters by measuring spatial inequality of WASH coverage in India. Aim and objectiveThe primary objective of this study is to measure the progress made towards achieving the SDG-6 targets for WASH facilities in Indian districts, states, and UTs. To fulfill this objective, the study used the household data of the National Family Health Survey-5 (NFHS-5) conducted from 2019 to 21. Data and methodsThe study used the household data of NFHS-5, which is a nationally representative survey that provides information on household and individual-level characteristics related to health and nutrition. The study identified the variables associated with WASH and created a composite index to measure WASH coverage separately and combined. The study used Gini coefficient to show WASH inequality, and Moran's statistics were used to show spatial dependency. ResultThe study found that the inequality of improved water coverage sources in Indian districts was high. Western and northeastern districts need to catch up in terms of achieving the SDG-6 targets. The value of the Gini coefficient (0.29) indicates that inequality in sanitation coverage is also high. All states have reached close to SDG-6 achievement in hygiene indicators. Goa, Sikkim, Andaman & Nicobar Islands, and Lakshadweep are close to the overall WASH coverage achievements of SDG-6. However, Jharkhand, Orissa, Tripura, Assam, and Rajasthan are behind in meeting the goal of SDG-6. ConclusionThe study suggests that more government initiatives and investments are needed to increase the availability, accessibility, and affordability of WASH facilities to improve WASH conditions in western and northeastern Indian districts. The localization or bottom-up approach by giving responsibility to rural and urban local bodies can also help enforce the achievement of SDG-6. The findings of this study can be used to guide policymakers in developing targeted interventions to improve WASH conditions and reduce inequality in India.

Prevalence and factors associated with unmet need for menstrual hygiene management in six countries in Sub-Saharan Africa: A multilevel analysis

BackgroundMenstruation is a normal biological process experienced by more than 300 million women globally every day. Women require clean menstrual absorbents that can be changed as often as needed in a private and safe place with proper hygiene and disposal facilities. These needs must be met consistently throughout the duration of the menstrual cycle. Access to menstrual needs is crucial for women’s health, wellbeing, and dignity. This study assessed the prevalence and factors associated with unmet need for menstrual hygiene management (MHM) in Ethiopia, Kenya, Uganda, Burkina Faso, Ghana, and Niger.MethodsWe used data from the Performance Monitoring for Action (PMA) 2020 surveys. We defined the unmet need for MHM as the “lackof resources, facilities and supplies for MHM.” Sample characteristics were summarised using frequencies and percentages, while prevalence was summarised using proportions and their respective confidence intervals (CI). Factors associated with unmet need for MHM were assessed using multilevel logistic regression models.ResultsThe study included 18,048 women of reproductive age from the six countries. The prevalence of unmet need for MHM was highest in Burkina Faso (74.8%), followed by Ethiopia (69.9%), Uganda (65.2%), Niger (57.8%), Kenya (53.5%), and lowest in Ghana (34.2%). Unmet need for MHM was consistently higher among uneducated and multiparous women, those who reused MHM materials, practiced open defecation, and lived in rural areas across all six countries. The odds of unmet need for MHM were higher among younger women under 35 years, unmarried women, those with lower education levels, and those from poorer households. Similarly, the reuse of MHM materials, use of shared or non-improved toilet facilities, and open defecation increased the odds of unmet need for MHM. In contrast, the presence of handwashing facilities reduced the odds of unmet need for MHM.ConclusionMore than half of the women in five of the six countries have an unmet need for MHM, with significantly higher odds among younger women, those with low wealth status, the unmarried, and those with inadequate access to sanitary facilities. This study highlights the state of period poverty in Sub-Saharan Africa. Efforts to end period poverty should consider MHM needs as an integrated whole, as addressing each need in isolation is insufficient.

Analyzing child health and water, sanitation, hygiene facilities in Punjab, Pakistan: A multilevel and spatial approach

AbstractThe health and well‐being of children can be achieved through access to clean water, proper sanitation, and hygiene practices. The current study investigates the effect of water, sanitation, and hygiene (WASH) on health outcomes using the multiple indicator cluster surveys (MICS) data. The household‐level and district‐level determinants of child health are analyzed using logistic regression models and multilevel logistic regression models. The results indicate that there are significant relationships between water availability, sanitation facilities, hygiene practices, and health outcomes. Access to clean water, an increase in sanitation facilities, and proper hygiene have a significant positive relationship with child health. Better access to clean water enhances children's well‐being. The level of parental education, household head dynamics, and WASH indicators at the district level also have a significant relationship with child health. The bivariate Local Moran's I analysis of child health and WASH facilities shows positive spatial autocorrelation (0.441). It also identifies the districts with significant high–high and low–low clustering patterns. This study contributes to achieving SDGs 3 and 6 to develop policies, programs, and future‐based solutions to promote the health and well‐being of children in Punjab and other similar areas.

How Menstrual Hygiene Management Facilities are Supportive to Girl Students in the School Environment in Tanzania

The study aimed at examining how menstrual hygiene facilities are supportive to girl students in the school environment in selected secondary school in Dodoma city. The study adopted exploratory research design. This study employed a qualitative approach with semi-structured interviews and focus group discussion as data collection tools. A total of 29 students from four different private and public schools in Dodoma city were involved. The study found that menstrual hygiene management facilities were not supportive to girl students in the school environment. Most girls faced different challenges when they were at school; this study found out that there was insufficient water, soap, pads, scarce toilets and no private rooms. Most of them waited until the end of the session; they would not leave the class until they were the last to leave and when they leave, would wrap sweaters around their waists. The findings revealed that the selected secondary schools in Dodoma City have no private changing rooms. Female students were use conventional restroom facilities as personal changing areas. The study recommends that the government, through the Ministry of Health, should make available sanitary pads and distribute them to all secondary school girls for free. Further, the government should set aside 1% of all education budget to be used in the production of sanitary pads. The government may exempt tax to all sanitary products produced within and outside the country to reduce the price of the product.

Do school Water, Sanitation, and Hygiene facilities affect students' health status, attendance, and educational achievements? A qualitative study in Nepal.

Access to safe and sufficient drinking Water, Sanitation, and good Hygiene (WASH) facilities in schools play a crucial role in preventing students from numerous Neglected Tropical Diseases, improving the learning environment in schools, and creating resilient communities living in a healthy environment. This study aims to explore the impact of combining WASH facilities on students' health status, school attendance, and educational achievements. Four schools, two with improved and two without improved WASH facilities, were selected purposively from Dhanusha and Chitwan districts of Nepal. A total of 24 participants, 16 students, and eight teachers were also purposively selected based on the Theory of Data Saturation. The participants were interviewed face-to-face using study guidelines; Key Informants Interview for teachers and In-depth Interview for students. The data were audio recorded and analyzed thematically using Dedoose 9.0.17 qualitative data management and analysis software. School WASH facilities have a significant impact on students' health and well-being. Poor school-WASH facilities hindered students' school attendance, particularly for menstruating girls. School without separate toilets for girls, including menstruation hygiene facilities, lack of water and soap, sanitary pad, and secure toilet's door often have higher rates of absenteeism among girls. Poor teacher and students' relationships, students' low interest in education, household chores, and participation in social customs also contribute to students' absence from school and low educational performance. It is important to note that inadequate WASH facilities affect not only students, but also teachers in the same school. The lack of safe and sufficient drinking water, unimproved sanitation, and poor hygiene facilities were seen by students and teachers as reducing their health and well-being, school attendance, and academic performance. Thus, schools need prioritize and promote the provision of improved WASH facilities for the betterment of students' health, attendance, and educational proficiency.

The economic impact of COVID-19 on Syrian Refugees in Jordan: A review of existing evidence and policies

The global COVID-19 crisis has precipitated an economic downturn in many countries, subsequently raising concerns about the potential challenges faced by marginalized populations, such as refugees, in accessing essential healthcare, hygiene facilities, and critical health information and safety guidelines within the context of Jordan. Consequently, it is of paramount importance to investigate and evaluate the specific economic hurdles related to COVID-19 that refugees are encountering. This inquiry will serve as a valuable foundation for shaping public health interventions aimed at containing the virus’s spread and guiding policymakers on strategies to enhance the well-being of refugees in Jordan. This paper offers a comprehensive examination of Syrian refugees in Jordan, including an analysis of the policies implemented by Jordan concerning Syrian refugees in the context of the COVID-19 pandemic. Moreover, the report assesses whether international assistance, both through bilateral and multilateral channels, can mitigate the impact of COVID-19 on Jordan’s capacity to continue hosting Syrian refugees. It also delves into the economic consequences of COVID-19, covering aspects such as poverty, education, the health sector budget, healthcare accessibility, essential needs, livelihoods, the labor market, and food security among Syrian refugees in Jordan.

A study to assess the knowledge and practice regarding sanitation and hygiene among women living in selected areas of Dhaka city

Background: Access to improved sanitation and hygiene is one of the prime concerns around the globe. This study aimed at assessing knowledge and practice regarding sanitation and hygiene among women living in selected areas of Dhaka city. Methods: A community-based cross-sectional study was conducted in the urban slums of Vellore using the systematic random sampling method. Data was analyzed using frequency and WASH scoring. Further bi-variate and multivariate analyses was done using chi-square test and logistic regression. A total number of 140 households were surveyed using a semi-structured, pilot-tested questionnaire. Results: The 230 participants, with a mean age of 43.2 years, who were mostly from nuclear families (72.6%) and had monthly family incomes of at least 20,000 BDT, were included in the study. The 37% of respondents had hygienic sanitation facilities, while 42% of respondents had access to Kacha latrines. 69% of the participants used sandals while defecating, and 64% washed their hands with water and soap or ash. A significant association between WASH practices and household members with less than five members and upper middle SES group was found by multivariate logistic regression analysis, with a significance level of less than 0.01. Conclusions: Since good hygiene will stop the spread of infectious diseases, knowledge and practice of proper personal hygiene and sanitation are essential in day-to-day living. Comprehensive knowledge, more awareness programs, and subsidy policies should be implemented in order to improve sanitation and reduce the burden of transmissible diseases while taking into account regional variations in hygiene practice.