Factors influencing uptake of water, sanitation and hygiene practices among children in early childhood development schools in Nyando sub county, Kenya

Abstract

The World Health Organization (WHO) defines sanitation as access to and use of facilities and services, for the safe and disposal of human excreta. It further describes hygiene as the conditions and practices aimed at maintaining health and preventing the spread of diseases. Globally, it is estimated that in 2017, 2.7 million children below the age of five died due to preventable diseases caused by poor water, sanitation, and hygiene practices. In developing countries, an estimated 88% of the childhood morbidities are caused by unsafe drinking water, inadequate sanitation and hygiene. According to the Kenya Environmental Sanitation and Hygiene Policy 2016-2030, ECD schools still do not have adequate access to safe water and sanitation facilities. In Kisumu County, according to the district health information system (DHIS2), Nyando Sub County reported the highest incidence of preventable illnesses often associated with poor water, sanitation, and hygiene practices among ECD going children as compared to the other rural sub counties in the last four years. In the year, 2018, a total of 3,969 cases of WASH related illnesses were reported in the Sub County between January to June. This study sought to assess the factors influencing uptake of water, sanitation, and hygiene practices among children in early childhood and development schools in Nyando Sub County, Kenya. The specific objectives were to; determine the level of knowledge of teachers on WASH, and its influence on children’s WASH practices, determine the status of WASH facilities in the ECD schools, establish the WASH practices of children in the ECD schools and to assess the measures put in place to ensure sustained access to water, sanitation, and hygiene services in ECD schools in Nyando Sub County. A crosssectional study design adopting qualitative and quantitative research approaches was used. Study population was 217 ECD teachers and 422 children in 132 schools. Random sampling technique was used to select participating schools, teachers and children. A pretested questionnaire, observation checklist and KII guide were used to collect data. Quantitative data was entered; cleaned and both descriptive and inferential statistical analysis done using Stata. Statistical significance of the variables was tested at a p-value of p=0.05 and association tested by use of chi square test at 95% confidence interval. The data was grouped according to respective themes. Analysis and interpretation was done using narratives, with results displayed in graphs, tables and charts. The study established that teacher’s knowledge on water sources (P=0.012), water treatment technologies (P=0.006) and proper toilet use (0.026) had significant relationship with the uptake of WASH among the children in the ECD schools. The teachers had accurate knowledge on water, sanitation and hygiene. The ECD schools had functional WASH facilities, however the sanitation facilities had foul smell and presence of urine and anal cleansing materials on the floors. On observation of the children’s WASH practices, 257 (61%) of the children washed hands after visiting the toilet, 207 (49%) did not crowd at the drinking water source and 224(53%) did not properly use the toilet. Sustainability measures in place included Intersectoral collaboration and advocacy for increased funding for WASH in ECD schools. In conclusion, the level of knowledge of teachers on WASH and availability of WASH infrastructure influence the uptake of WASH practices among Children in ECD schools in Nyando. The study recommended the provision of educational materials to teachers on WASH that are relevant to teach ECD children. The study further suggests that the County Government of Kisumu should prioritize WASH interventions in ECD schools to improve the health and educational outcomes of children in ECD schools in Nyando sub county and by extension Kisumu County.