Knowledge, awareness and practice of the importance of hand-washing amongst children attending state run primary schools in rural Malawi

Abstract

A study was undertaken to determine the efficacy of hygiene practices in 2 primary schools in Malawi. The study determined: (1) presence of Escherichia coli on the hands of 126 primary school pupils, (2) knowledge, awareness and hygiene practices amongst pupils and teachers and (3) the school environment through observation. Pupil appreciation of hygiene issues was reasonable; however, the high percentage presence of E. coli on hands (71%) and the evidence of large-scale open defaecation in school grounds revealed that apparent knowledge was not put into practice. The standard of facilities for sanitation and hygiene did not significantly impact on the level of knowledge or percentage of school children's hands harbouring faecal bacteria. Evidence from pupils and teachers indicated a poor understanding of principles of disease transmission. Latrines and hand-washing facilities constructed were not child friendly. This study identifies a multidisciplinary approach to improve sanitation and hygiene practices within schools.

Comprehensive assessment of handwashing and faecal contamination among elementary school children in an urban slum of Indonesia

“…In an urban area in India, bacterial pathogens were detected from all specimens sampled from students’ hands ( E. coli was 20%) , and in another study, 61% of children had potential pathogens on their hands ( E. coli was 12%) . In two elementary schools in Malawi, E. coli were detected on the hands of 67% and 75% of pupils , and in Kenya, on the hands of 41% of students . Thus, the detection rate of bacteria from the hands of children is not consistent, perhaps because of the difference in sampling methods, detection methods, etc.…”

“…Even so, there are no gold standards. Several studies investigated the relationship between faecal contamination of child's hands and handwashing behaviour and knowledge and awareness , but studies investigating the relationship between handwashing technique and faecal contamination are scarce. Moreover, targeting the frequency and technique of handwashing simultaneously is effective for handwashing behaviour change , making investigation of these practices necessary, particularly those of children, with a comprehensive assessment of behaviour, knowledge and awareness, and technique aspects.…”

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

“…A study conducted in two primary schools in Malawi concluded that both teachers and students had reasonable appreciation for hygiene. However, there was a limited understanding of disease transmission and a failure to put knowledge into practice, with continued open defecation despite the presence of sanitation facilities (Grimason et al, 2014). In a review of the literature on water, sanitation and hygiene among indigenous populations, Jimenez and colleagues (2014) identified that low-resource populations have lower rates of disease despite having limited access to improved infrastructure.…”

“…Sanitation facilities may not be accessible, be in such poor condition that they are no longer user friendly, or not physically paired with hand washing facilities. Grimason’s (2014) study of the Malawi primary schools found that the sanitation facilities were not child friendly, which likely contributed to their lack of use and preference for the bush. Furthermore, hygiene behaviours are generally habitual and grounded in social norms learnt and inherited from family and community members.…”

Saúde escolar no ensino fundamental: subsídios para a prevenção e controle da infecção

“…Em ambas as escolas, a higiene ao redor das latrinas era precárias, com presença de fezes, temperatura de até 45°C, odor fétido e atração de moscas (GRIMASON et al, 2014). O problema da falta de água, além das áreas onde esse problema já é antigo e conhecido, atualmente ela atinge regiões onde não havia esse problema e a água era abundante.…”