Assessing the Health Impact of the following Measures in Schools in Maradi (Niger): Construction of Latrines, Clean Water Supply, Establishment of Hand Washing Stations, and Health Education

Abstract

Objective. To assess the effect on health of the following measures in schools in Maradi (Niger): clean water supply, construction of latrines, establishment of hand washing stations, and health education. Methodology. It was a “before and after” intervention study on a sample of school children aged 7 to 12 years in the Maradi region. The interventions included building of latrines, supplying clean water, setting up hand washing stations, and teaching health education lessons. An individual questionnaire, analysis of stool samples, and a group questionnaire were administered to children and teachers, respectively. The threshold for significance was set at P < 0.05. Results. A statistically significant reduction in cases of diarrhoea and abdominal pains was noted after the project. Overall, carriage of at least one parasite increased from 7.5% before the project to 10.2% after it (P = 0.04). In the programme group schools, there was a statistically significant increase in the prevalence of Hymenolepis nana, from 0 to 1.9 (P = 0.02). Pinworm prevalence remained stable in this group but increased significantly in the control group. Conclusions. Putting health infrastructure in place in schools obviously had an impact on hygiene-related habits in the beneficiary schools and communities.

Water, Sanitation and Hygiene (WASH) in Schools in Low-Income Countries: A Review of Evidence of Impact

“…Of the 38 articles: 47% reported the intervention impact on diarrhoeal disease and other hygiene-related diseases in school students; 34% reported changes in WASH knowledge, attitudes and hygiene behaviours among students; 16% reported impact on disease burden and hygiene behaviours in students’ households and communities; 32% reported changes in student enrolment and school attendance; and 11% reported on intervention fidelity (see Table 1). Twelve studies reported outcome measures across more than one category [7,8,9,10,11,12,13,14,15,16,17,18] (see Table 1).…”

“…All of the 13 publications that examined changes in WASH knowledge, attitudes and hygiene behaviours reported evidence of positive change among students in intervention schools including hand-washing with soap or sanitizer [8,16,29,30,31], improved knowledge of WASH-related diseases, and improved hygiene habits [7,13].…”

“…And, importantly, evaluations of WASH interventions in low-resource settings often measure outcomes—such as diarrheal disease—via self-report, an approach prone to recall and social desirability biases, subjective interpretations of the definition of “diarrhea”, and imprecise measurements of incidence [9]. It is notable that of the 18 studies in this review that report disease-related outcomes, ten (56%) included objective rather than self-reported measures of disease and infection: for example, fecal samples were examined for soil-transmitted helminths, intestinal protozoa and other parasites [7,8,10,11,20,22,24,26], blood samples were collected to measure blood hemoglobin concentration [26], and hand-rinse samples were analysed for E. coli [17,25].…”

Dwarf tapeworm (Hymenolepis nana): Characteristics in the Northern Territory 2002–2013

“…Reduction in H. nana infections have been studied. Sanitation interventions alone have had mixed results in decreasing H. nana prevalence, and other factors such as maternal education, household wealth indexes and remoteness are important risk factor for infection . H. nana prevalence may therefore be a marker of the above parameters and a possible means of assessing health interventions.…”

Assessing the environmental context of hand washing among school children in Limpopo, South Africa

“…Among children aged 7–12 years in the Maradi region of Niger, improvements in health infrastructure in schools including clean water, latrines, and hand washing stations, combined with health education, significantly improved hygiene-related habits in the beneficiary schools and communities, with a significant decrease in reported cases of diarrhoea and abdominal pains (Mainassara & Tohon, 2014). Public health policy and practice should recognize the relationship of all human behaviours to an interplay of complex components that make up our unique environmental contexts.…”