Sanitation & Hygiene In
Basic Schools In Ghana
The Links Between Sanitation in Schools and in
Households
BY
JOAN AWUNYO-AKABA
PRESENTATION OUTLINE
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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)
 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)
 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
 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.)
 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
 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.)
 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
FINDINGS
 Children’s Perception & Expectations
- Difficulty to demonstrate
understanding of good S&H concept
- Forgot about latrine and water use
behaviours.
- Environmental cleanliness only
mentioned
- Latrine and urinal facilities – Clean not too
pungent.
FINDINGS
 Roles Children Play
- Performed ALL S&H functions
- Guided by S&H prefects mainly.
- Gender roles assessment - boys
did less
Findings (cont)
HYGIENE EDUCATION IN SCHOOL

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 handwashing behaviour at critical times
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 (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 (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 (cont)
Poor Performers of SSHE
 Teachers lacked 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 (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
Child’s Behaviour Capacity,
Adoption, Change and Behaviour
Setting
Provides Observational
Learning through
Social
Interactions
Home/School Environment
Provides Opportunity and
Facilities for Cues & Triggers for
Linking Theory with Practical
Action
Reinforcements
•Direct
Vicarious
Reinforces Child’s behaviour selection
Mastering Learning through skills
Acquisition
Provides Knowledge and
skills that lead
to Behaviour
Capacity
Fig. 2 - The Child’s Sanitation and
Hygiene Behaviour Impact Process Model
f) SUSTAINABILITY OF
PROGRAM’S IMPACT
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
CHILD AS
THE KEY
RESOURCE
d) Physical Mental & Social Health
Development
Active Participant in
Developmental Process
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.
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
Fig. 3 - Sanitation and Hygiene Behaviour
Sustainability Model
2) Involvement of
Community
leadership:
- Build Community
Capacity
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’
1) SOCIAL
NETWORKS &
SOCIAL SUPPORT
Multiple Levels of
Influence
Pool of Committee Stake
Holders
Influential and
Supportive of School
Environment
6) CHILD
Promotion of
Developmental
Socialization
Sustained Sanitation and
Hygiene behaviour
Ability & opportunity to
link Sanitation & Hygiene
theory with practice.
Acquisition of Behaviour
capacity & Adoptions
4) Advocators for
Effective
SSHE Interventions:
To
Government /District
Assembly, NGO, CSO
Mass Communications
Media
SHEP Policy Change
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
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.
RECOMMENDATIONS
 1) Improving SSHE
Programme
 2) Guide for SHEP Policy Document
Finalization
 3) Further Research
1) Improving SSHE
Programme- Short Term
 Short-term i.e., 1-3 years
 Develop concept of good S&H in
schools Strategies:
- Broaden S&H scope of Sch Chn
- Expose chn to S&H options,
- Exchange visits, tours / excursions
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
(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
(cont)
 3rd - Promote innovative & appropriate
methods of teaching S&H
– Adapt & Use behaviour change
communication models
 Reduce teaching workload by teaching S&H
during the holiday period.
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
 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?
CONCLUSION
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]
CONCLUSION
“Schools bring little influence to
bear on a child’s achievement
that is independent of his
background and general social
context”
 [James Coleman, 1964]
CONCLUSION
 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)]