“Safeguarding Lives” School Hygiene Project Final … Final...Final evaluation report for the...

Final evaluation report for the schools’ hand washing project 1

“Safeguarding Lives”

School Hygiene Project Final Evaluation

December 2011

The opinions expressed in this report are those of the authors and do not necessarily reflect the

views of other partners or donors.


Table of Contents

LIST OF TABLES .......................................................................................................................... 4

LIST OF FIGURES ........................................................................................................................ 4

LIST OF ACRONYMS AND ABBREVIATIONS ....................................................................... 6

ACKNOWLEDGEMENT .............................................................................................................. 7

EXECUTIVE SUMMARY ............................................................................................................ 9

1. INTRODUCTION ................................................................................................................. 12

1.1. Background to the hand washing project ................................................................................... 12

1.2. Project implementation, goal and objectives: ............................................................................ 12

1.3. Description of interventions undertaken during project implementation ................................. 12

1.4. Objectives of the final project evaluation ................................................................................... 13

2. METHODOLOGY ................................................................................................................ 14

2.1 Study area and population ................................................................................................................ 14

2.2 Sample size and Sampling method ............................................................................................. 14

2.3 Data collection procedures .......................................................................................................... 15

2.4 Data management and analysis .................................................................................................. 15

2.5 Ethical issues ............................................................................................................................... 16

2.6 Quality assurance ........................................................................................................................ 16

2.7 Limitations of the final evaluation .............................................................................................. 17

3. FINDINGS ................................................................................................................................ 18

3.1 Socio-demographic characteristics of midterm evaluation respondents ..................................... 18

3.2 Reported exposure to target hygiene messages and intervention activities ............................... 20

3.3 Schools’ capacity for effective hygiene promotion ....................................................................... 21

3.4 Children’s knowledge and understanding of benefits of hand washing and of the critical times 22

3.5 Status of facilities and hygiene in the schools ............................................................................... 22

3.6 Reported incidence of runny stomach (Diarrhea) ......................................................................... 23

3.7 Treatment of runny stomach ........................................................................................................ 24

3.8 Absenteeism from school due to Diarrhea ................................................................................... 25

3.9 Respondents’ reported hand washing practices ........................................................................... 25

3.10 Reported hand washing before eating ....................................................................................... 26

3.11 Reported hand washing after toilet use ...................................................................................... 27

3.12 Reported hand washing with water only .................................................................................... 28


3.13 Reported hand washing with soap and water ............................................................................ 29

3.14 Reported last place of hand washing .......................................................................................... 30

3.15 Children’s attitude towards hand washing ................................................................................. 30

3.16 Teachers attitude on the hygiene education program ............................................................... 31

3.17 The school to community linkage ............................................................................................... 31

3.18 Relevance of the project ............................................................................................................. 32

3.19 Usefulness of the project ............................................................................................................ 32

3.20 Effectiveness of the project ......................................................................................................... 32

3.21 Sustainability of project interventions ........................................................................................ 32

3.22 Challenges and suggested solution ............................................................................................. 32

Annex 1: Quality assurance aspects covered during the pre-data collection training workshop .. 34

Annex 2: Responsibilities of the final evaluation data collection team ........................................ 35

Annex 3: The pupils’ questionnaire .............................................................................................. 36

Annex 4: The teachers’ interview guide ....................................................................................... 38

Annex 5: The observation checklist .............................................................................................. 43


LIST OF TABLES

Table 1: Schools names and population size ................................................................................... 12 Table 2: Distribution of the sample population (n = 402) ............................................................... 14

Table 3: Socio-demographic characteristics .................................................................................... 18 Table 4: Existing number of toilets for pupils in the schools compared with school population .... 23 Table 5: Prevalence of runny stomach ............................................................................................. 24 Table 6: Absenteeism from school .................................................................................................. 25 Table 7: Hand washing before eating .............................................................................................. 26

Table 8: Hand wash after toilet use.................................................................................................. 27 Table 9: Hand wash with water ....................................................................................................... 28 Table 10: Hand washing with soap and water ................................................................................. 29

Table 11: Last Place of Hand washing ............................................................................................ 30 Table 12: Recommendation on the importance of hand washing .................................................... 31

LIST OF FIGURES

Figure 1: Age of respondents in years .......................................................................................... 19

Figure 2: Percentage of respondents in respective grades 1 to 7 .................................................. 19

Figure 3: Respondents Gender distribution in percentages .......................................................... 20 Figure 4: Reported incidence of runny stomach (Diarrhea) among pupils (?) ............................. 24

Figure 5: Reported incidence of runny stomach/ Diarrhea by school .......................................... 24 Figure 6: Treatment of runny stomach from hospital / clinic ....................................................... 25 Figure 7: Hand washing before eating .......................................................................................... 27

Figure 8: Hand wash after toilet use

.......................... 27

34.0%

49.0%

17.0%

69.3%

30.4%

0.3%

66.2%

33.8%

0.0% 0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

Always Sometimes Never

Hand wash after toilet use

Baseline

Midterm

Final


Figure 9: Hand wash after toilet use by school

.......................... 28 Figure 10: Hand washing with soap and water by School ............................................................ 29 Figure 11: Reported Last Place of hand washing

....................... 30

5.2%

18.9%

13.2%

19.4%

9.5%

14.9%

1.0%

7.0%

0.5%

10.4%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

BunyaCombined

School

EpundiPrimarySchool

KoomaPrimarySchool

OhalushuPrimaryschool

OwayelulaPrimarySchool

Hand wash after toilet use by school

Always

Sometimes

Never

21%

79%

30.70%

69.30%

85.40%

14.60%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

School Home

Reported Last Place of Hand washing

Baseline

Midterm

Final


Figure 12: Recommendation on the importance of hand washing

.............................. 31

LIST OF ACRONYMS AND ABBREVIATIONS

BCC Behavior Change Communication

CHCs Community Health Consultants

GHWD Global Hand washing Day

GRN Government of the Republic of Namibia

M&E Monitoring and Evaluation

MOE Ministry of Education

MCH Maternal and Child Health

70.30%

16.62% 10.90%

2.18%

All people Friends Family members communitymembers

Recommendation


n Total Number of study respondents

PS Primary School

SFH Society for Family Health

SPSS Statistical Package for Social Scientists

UNICEF United Nations Children's Fund

ACKNOWLEDGEMENT

Implementation of the Hand Washing Project and the final evaluation was made possible through

support provided by the Namibian Government, UNICEF and GlaxoSmithKline under the

“Safeguarding Lives” project for promoting healthy hand washing practices in children aged 6 to

12 years in five selected schools in Northern Namibia.

The Society for Family Health (SFH) extends its appreciation to UNICEF and GlaxoSmithKline

for funding the project implementation and the evaluation study; the management and children in

the five schools (Epundi Primary School – Ohangwena; Ohalushu Primary School – Ohangwena;

Bunya Combined School – Kavango; Onayeluka Primary School – Omusati and Kooma Primary

School – Omusati) that participated in the project implementation; and the Community Health

Consultants (CHCs) who facilitated the project’s implementation in the five schools and also

participated in data collection for the final project evaluation. SFH is equally grateful to the

Ministry of Education, especially the management of the five schools for creating an enabling

environment for project implementation.


SFH also extends its gratitude to its staff and volunteers for the tireless efforts to ensure

successful implementation of the project implementation and completion of the final evaluation.


EXECUTIVE SUMMARY

Background:

The Society for Family Health (SFH) facilitated implementation of a Schools’ Hand washing

project to raise awareness about hand washing and general hygiene in five selected schools

(Epundi Primary School – Ohangwena; Ohalushu Primary School – Ohangwena; Bunya

Combined School – Kavango; Onayeluka Primary School – Omusati and Kooma Primary School

– Omusati) in three Northern regions. The one year project was implemented from October 2010

to October 2011. A baseline study was done in October 2010, midterm review done in July 2011

and final evaluation in November 2011. The final evaluation was conducted to assess the project

performance and its impact on target population. Specific objectives of the final evaluation were

to:

1. Assess knowledge and understanding of benefits of hand washing and of the critical

times

2. Assess the exposure to target hygiene messages and intervention activities

3. Determine the incidence of diarrhea (runny stomach) among children in the five schools.

4. Establish status of facilities and hygiene in the schools (a reflection of school

commitment to a safe and clean school environment)

5. Assess attitude to hand washing

6. Assess hand washing practices with regard to:

6.1.Hand washing before eating

6.2.Hand washing after toilet use

6.3.Hand washing with soap and water

6.4.Hand washing with only water

6.5.Frequency of hand washing

6.6.Absence from school due to diarrhea

7. Assess the project’s successes, impact and challenge to inform future decisions about similar

programs

8. Assess the relevance, usefulness and effectiveness of project interventions

9. Assess the potential for sustainability of the project interventions.

Methods:

The final evaluation involved collecting data using a structured questionnaire administered to

randomly selected 402 (22.6%) of the 1778 children in the five schools in November 2011. The

respondents were aged between 6 and 12 years and attended classes in grades 1 to 6 in the five

schools. Data collection also included interviewing 32 teachers and conducting observations of

toilet and hand washing facilities used by children in the five schools.

Results:

The final evaluation findings reveal a considerable improvement in knowledge and practices

related to hand washing, as well as a remarkable improvement in health / hygiene indicators

measured at baseline and midterm evaluation.

i. Exposure to target hygiene messages and intervention activities:

Hygiene classes/sessions are held at each school 3 times weekly and are facilitated by trained

SFH community health consultants with the support of SFH Behavioural Change

Communication (BCC) Officers and school teachers. During a week, all grade classes are

exposed at least once.


One hundred percent of the interviewed pupils reported ever hearing of hand washing and of

these, 50% reported that they had heard the message from sessions at school.

ii. Knowledge and understanding the benefits of hand washing and of the critical times:

Children understand the need for washing hands at critical times including before

eating, after toilet use and that they should wash their hands with soap/ash and water.

The main reason given when children were asked why they should wash their hands

was: to remove germs (58%)

iii. Incidence of diarrhea (runny stomach) among children:

Findings show a reported reduction in diarrhea incidence from 50% reported at

baseline to 10.7% at final evaluation.

iv. Absenteeism from school

The survey shows a reduction from 40% at baseline to 5.3% at final evaluation in

absenteeism from school among children who experienced diarrhea in the 3 month

period preceding the final evaluation. The overall drop in the diarrhea incidents

among pupils increased attendance by 34.7%

v. Status of facilities and hygiene in the schools:

At final evaluation, 23(68%) of the existing 34 pupils latrines were functional. All

schools scored an average of 69% in terms of cleanliness and usage of toilet facilities

at the time of observation which shows an improvement compared to 50% at

midterm. There has been a great improvement in the accessibility of soap and water

directly due to the program intervention, and basins and/or buckets of water are

placed at specific key points in order to supplement the limited tap-points and better

facilitate hand washing.

vi. Attitudes towards hand washing

Almost all (99%) children who were interviewed indicated that they will recommend

the importance of hand washing to someone else.

vii. Hand washing practices before eating:

Hand washing before eating improved from 58% at baseline to 78.1 % for the aspect

“always” at final evaluation.

viii. Hand washing after toilet use:

Hand washing after toilet use improved from 34% reported at baseline to 66.2% at

final evaluation.

ix. Hand washing with soap and water

Children reporting always washing their hands with soap and water improved from

8% at baseline to 24% at final evaluation. More than half (62%) of the children

reported that they sometimes wash their hands with soap and water. Absence of water

and soap at school may be the contributing factors to the result of children sometimes

(not always?) washing their hands with soap and water.

x. Hand washing with only water:


Few children (3.5%) reported always using only water for washing hands and the

majority (72.5%) never only use water. The majority of children, as indicated above,

attempt to always or at least sometimes wash with soap and water.

xi. Frequency of hand washing: Frequency of hand washing at school increased from

baseline value of 21% to 85.4% at final evaluation, showing a significant

improvement in the practice. For this question, children were asked where they had

done their LAST hand washing.

Project’s successes, impact and challenge

The project is considered a success having achieved its aims of increased exposure to hygiene and

sanitation information, improved hygienic practices among the pupils in the target schools,

contributed to reduction in incidence of diarrhea and subsequent absenteeism from school due to

diarrhea. The respondents’ highlighted challenges included lack of sufficient IEC materials, limited

access to resources such as water and soap for hand washing, cleaning materials and toilet paper.

Relevance, usefulness and effectiveness of project interventions

The project was considered relevant for its contribution to reduction in incidence of diarrhea and

absenteeism of pupils from school due to diarrhea. The improvement in pupil’s knowledge, attitudes

and hand washing practices renders the project useful and effective.

Potential for sustainability of the project interventions

The potential for sustainability was evaluated based on commitment of the school management,

communities and pupils themselves; resource mobilization; and replicability of activities /

interventions. The findings from teachers’ interviews revealed a commitment of the pupils and

teachers towards hygiene education interventions, with teachers playing a pivotal role and

supporting pupils in their efforts to develop extra materials or design and participate in activities

such as drama for increased hygiene and sanitation education. The potential for replicating the

project interventions is schools was reported by teachers indicating the participation of children

and teachers from neighboring schools in events such as drama and role plays and subsequent

adoption of recommended behavior.

Conclusions and recommendations:

Generally, children’s knowledge on importance of hand washing as well as the practice

improved with the implementation of the hand washing project in the five targeted schools. The

incidence of diarrhea which is associated with unhygienic conditions and absenteeism from

school due to diarrhea significantly reduced, which could be attributed to the project

intervention. Children are more exposed to targeted hygiene messages and intervention activities.

An improvement in attitudes and hand washing practices among children were also observed.

Specific interventions such as increasing access to water for hand washing by increasing the

number of functional water taps in the schools; providing soaps for washing hands; increasing

schools’ functional toilet coverage to reduce pupil to toilet ratio; ensure the availability of

cleaning materials to ease cleaning of the toilets and avail toilet papers for children’s use. The

Ministry of Basic Education should endeavor to supply the necessary material/resources to the

schools and also ensure monitoring of their usage to minimize wastage. The schools should also

demonstrate increased ownership of hygiene interventions by encouraging child participation in

cleaning activities.


1. INTRODUCTION

1.1. Background to the hand washing project

The Schools Hand washing project was a partnership between UNICEF, SFH and the

Government of the Republic of Namibia (GRN) aimed at raising awareness about hand washing

and general hygiene in five selected schools in three Northern regions namely: Ohangwena,

Omusati and Kavango. The project was implemented in five selected schools with a total

population of 1778 pupils (Table 1).

Table 1: Schools’ names and population size

Region Name of School Pupil population as at November 2011

Ohangwena Epundi Primary School 302

Ohangwena Ohalushu Primary School 379

Kavango Bunya Combined School 758

Omusati Onayeluka Primary School 195

Omusati Kooma Primary School 144

Total 5 schools 1778

1.2. Project implementation, goal and objectives: Project implementation started on 15 October 2010 and ended on 4 November 2011.The project

was a pilot initiative aimed at providing lessons for scaling up. The project’s goal was to increase

awareness on the importance of hand washing with soap by means of mass-media as well as

activity interventions among school children aged 6 – 12 years in 5 schools in 3 regions with

pupils, teachers, parents and/or Caregivers, and monitoring of the outcome. Two project

objectives were:

1. By October 2010 Radio and print media stations partner with stakeholders, child

broadcasters, peer educators to promote a national awareness on Hand washing with soap

2. By June 2011, at least 20 % of pupils aged 6 – 12 years in 5 schools in 3 regions report

the improved practice of hand washing and basic hygiene in order to improve their

health.

1.3. Description of interventions undertaken during project implementation The UNICEF hand washing schools project consisted of:

1. Development of training manual and facilitation guides: The manual and guides were used

for training Community Health Consultants (CHCs) and teachers to prepare them to

implement the “Safeguarding Lives” project in the target schools.

2. Training of Teachers & CHCs: 15 teachers and 10 Community Health Consultants (CHCs) (3

teachers and 2 CHCs per school) were selected and trained on Hand washing to facilitate the

sessions in the schools


3. Mass Media programs in child-friendly formats: The mass media programs in this project

included:

Radio messages covering key aspects of hand washing, hygiene and health

Interviews about hand washing and the health benefits

Printed media messages such as hand washing leaflets with messages about the benefits

of hand washing and the steps to be taken during hand washing

Dramas and songs that were developed and used for in-classroom activities as well as for

performance at community platforms.

4. Global Hand Washing Day (GHWD) Celebration: Two GHWD celebrations were held

during project time, one on 15th

October 2010 where a total of 2533 people attended, and

another on 15th

October 2011 with participation of 2613 people.

5. Ongoing schools activities: The activities included hand washing sessions with learners in the

classrooms through various models such as drama songs, drawings, and role plays. Messages

were also passed onto the children and school communities during extracurricular activities

such as:

Community dramas about handwashing and hygiene acted out by the children for

the adults in their community

Schoolyard cleaning

Drama performances about handwashing and hygiene at school functions

1.4. Objectives of the final project evaluation The general objective was to determine the project performance and short term impact of the

hand washing project on the knowledge and practices of the children in the five participating

schools. It also aimed at assessing the project’s successes, impact and challenge to inform future

decisions about similar programs.

Specific objectives

The specific objectives were to:

1. Assess the exposure to target hygiene messages and intervention activities

2. Assess knowledge and understanding of benefits of hand washing and of the critical times

3. Determine the incidence of diarrhea (runny stomach) among children in the five schools.

4. Establish status of facilities and hygiene in the schools (a reflection of school commitment to

a safe and clean school environment)

5. Assess attitude to hand washing

6. Assess hand washing practices with regard to:

1. Hand washing before eating

2. Hand washing after toilet use

3. Hand washing with soap and water

4. Hand washing with only water

5. Frequency of hand washing

6. School absenteeism sue to diarrhea


7. Assess the project’s successes, impact and challenge to inform future decisions about similar

programs

8. Assess the relevance, usefulness and effectiveness of project interventions

9. Assess the potential for sustainability of the project interventions.

2. METHODOLOGY

2.1 Study area and population The final evaluation was conducted in 3 regions in Northern Namibia. The study population

included all 1778 children aged 6 to 12 years studying in the five target schools. The 6-12 year

olds were selected as pupils could understand the messages. A sample of 402 pupils with age

ranging from 6 to 12 years and attending classes from grade 1 to grade 7 in the 5 schools where

the hand washing project was implemented participated in the final evaluation. Table 2 shows

the distribution of the sample in the target schools.

Table 2: Distribution of the sample population (n = 402) Region Name of School School

population as

at November

2011

Number of

respondents

(Baseline)

Number of

respondents

(midterm

evaluation)

Number of

respondents

(Final

evaluation)

Percent (%)

of

respondents

(Final

evaluation)

Ohangwena Epundi Primary

School

302 80 83 80 19.9

Ohangwena Ohalushu Primary

School

379 81 80 80 19.9

Kavango Bunya Combined

School

758 68 80 81 20.1

Omusati Onayeluka Primary

School

195 81 83 80 19.9

Omusati Kooma Primary

School

144 80 85 81 20.1

Total 5 schools 1778 390 411 402 100.0

2.2 Sample size and Sampling method

2.2.1 Sample Size

A representative sample of the target population was drawn across all the five schools, all ages 6-

12 years and all classes grade 1 to grade 7. An average of 80 respondents were interviewed per

school to get at least 400 respondents, an estimated equivalent of at least 20% of the total

population in the five schools. The average of 80 pupils was taken to maintain a close link with

the sample sizes per school used in the baseline and midterm studies. A total of 402 students

were interviewed for the final evaluation.

Respondents included

1. Pupils 6-12 years old / or in grades 1-7

2. Trained teachers in the 5 schools

3. Other key informant in the schools e.g. Head teachers

2.2.2 Sampling Method


Random sampling was used to select pupils to respond to the questionnaires. Pupils eligible to

participate were those in grade 1 to 7, ages between 6 and 12 years. All the eligible pupils i.e.

children in grade 1 to 7 between the ages of 6 and 12 years were told to line up randomly. Based

on the number of children required to participate in the study, pupils were randomly selected by

counting and selecting every 5th

child in the line.

2.3 Data collection procedures

The data collection process involved the following steps:

1. Seeking permission from the school’s management to interview pupils and teachers

2. Randomly sampling the respondents

3. Seeking consent from each respondent

4. Administering questionnaires – to pupils

5. Completing observation checklist with support of relevant school staff

6. Interviewing selected teachers

7. Checking data collection tools to ensure completeness

8. Providing quick feedback to the school administrations on the exercise upon conclusion

of the data collection exercise.

A semi structured questionnaire (annex 3) was used to collect data from pupils on socio

demographic characteristics, exposure, knowledge, attitude and practice aspects under study.

Data collection using the questionnaire was conducted by a team of 10 trained Community

Health Consultants (CHCs) under the supervision of SFH’s Behavior Change Communication

(BCC) officers and the teachers who were trained under the project for quality assurance.

A second tool, the teachers’ interview guide (annex 4), was used to collect information from the

teachers who were trained to assist with program implementation. A total of 12 teachers were

interviewed using the tool.

To gather information on status of the school facilities and children’s practice of hand washing

after toilet use, SFH staff collected data on schools’ hygiene status and hand washing after toilet

use. An observation checklist (annex 5) was used to collect the related information.

SFH staff reviewed the questionnaires for completeness. All completed questionnaires were

submitted to SFH Head Office in Windhoek. Each questionnaire was assigned a unique ID for

tracking its entry into the electronic database. This is the same criterion that was used for

collecting the baseline and mid-term information.

The data collection team comprised of the same people that collected the baseline and midterm

information in October 2010 and July 2011; hence their familiarity with the tool and data

collection process.

2.4 Data management and analysis

.MS Excel and SPSS (version 17) software was used to enter and analyze the data.


The results are presented in form of figures (charts) and tables in the results section of this report.

The information generated from observation and teachers’ interviews was recorded and is part of

the information in this report.

2.5 Ethical issues Permission to conduct the study: SFH contacted the five schools’ administrations for (written?)

permission to conduct the evaluation study with their pupils and teachers in the respective

schools and to carry out observation on the schools’ hygiene status.

Respondents’ consent: Upon selection of the pupils and teachers to respond to questionnaires/

interviews, individual informed consent was obtained from each of them.

Confidentiality: Respondents were assured of confidentiality. The names of the participating

children were not taken and access to the questionnaires and data set was limited to SFH staff.

Serial numbers were used instead of respondent pupils’ names on the questionnaires.

Participants’ rights: Both participating pupils and teachers were informed that their

participation in the evaluation was voluntary and that they were free to opt out without any

penalty for refusal to participate.

2.6 Quality assurance The quality assurance measures taken during the final evaluation exercise included training of

data collection team to ensure understanding of the concept, method and tools to be used; Child-

supported completion of the questionnaire to provide opportunity for clarifications; and SFH

staff’s direct involvement at all stages of the processes and implement the necessary checks.

2.6.1 Training of the data collection team

Prior to data collection, the M&E Manager and the National MCH Coordinator conducted

training for the CHCs and BCC officers. The training had 5 objectives:

i) To create a common understanding of the methodology to be used for the final evaluation

ii) To clarify the data collection procedures and responsibilities of BCC Officers and CHCs

iii) To familiarize the team with the data collection tools

iv) To sensitize the data collection team on data quality issues and research ethics

v) To equip the data collection team with knowledge and skills for effective data collection

The training covered the following aspects:

1. Overview of the hand washing project, its intended objectives and activities

2. Objectives of the final project evaluation

3. Sources of information for the final project evaluation

4. Data collection procedures

5. Ethical issues

6. Data quality assurance

7. Responsibilities of members of the data collection team

8. Tips for data collection

Note:

1. The quality assurance aspects that were covered during the training are indicated in

annex 1 at the back of this report


2. The responsibilities of the different categories of people in the final evaluation team

are listed in annex 2 at the back of this report.

2.6.2 Other quality assurance aspects

A tool similar to the one used during baseline and mid-term evaluations was used for data

collection from the pupils to enable comparison of findings to be done. The questionnaire was

reviewed by SFH program and M&E personnel as well as UNICEF technical staff.

SFH’s BCC officers and the trained teachers in the 5 targets schools supervised the data

collection that was being done by the CHCs. This was done to ensure completeness of responses.

The observation of schools’ hygiene status was conducted by SFH staff to minimize bias.

All the 402 questionnaires from the schools were securely transported and safely kept at SFH

Head Office, where unauthorized access was not allowed for confidentiality purposes and to

avoid any alterations.

2.7 Limitations of the final evaluation

The findings of the final evaluation presented in this report mainly comprise responses made by

the participating children and teachers. Data collection did not include further verification of the

participants’ responses such as by way of reviewing of records or observation of hand washing

practices at all critical times, nor additional interviews and focus group discussions for the

pupils. However, the use of individual questionnaires enhanced privacy, minimized fear by

children and hence minimized bias of children’s responses to the questions. This improved the

reliability of the answers given. Data was collected from a sample derived from randomly

selected children in the age range of 6 to 12 years and from a cross section of all the grades i.e.

grade 1 to grade 7.

Observation of school hygiene status or children’s hand washing practice after toilet use was

done just in one single day and this may not be representative enough of the usual practice or

status. The ideal should have been observation of hand washing practice for at least the period of

one week. This could not be done due to time and financial resource constraints; given that an

extensive evaluation exercise had not been planned for in the project concept.

Notwithstanding the limitations aforementioned, the results are good and very informative on the

situation. They are valid and recommended for use in decision making.


3. FINDINGS

3.1 Socio-demographic characteristics of midterm evaluation respondents

This section provides a profile of the respondents who were interviewed in the final evaluation.

The information is presented on a number of basic characteristics which includes: Age, gender,

grade and school. Overall, 402 pupils from grade 1 to grade 7 in the age ranges of 6 to 12 years

participated in the evaluation from the five targeted schools where the hand washing project was

implemented. The social demographics of the children who participated in the final evaluation

are shown below.

The data obtained indicate that the respondents’ age ranges from 6 to 12 years with the majority

being 12 years (21.1%).

Table 3: Socio-demographic characteristics

Midterm (%) Final (%)

(n=411) (n=402)

Age (years)

6 1.7 2.2

7 9.7 17.4

8 12.2 17.7

9 12.2 13.2

10 16.1 11.2

11 20.7 16.4

12 27.5 21.1

No response 0.7

Gender

Female 53 50.5 Male 47 49.5

Grade

1 10.0 22.0 2 17.5 22.1 3 15.8 17.7 4 22.4 14.2 5 18.7 13.9 6 15.6 7.2 7 2.5 No response 0.5

School

Epundi Primary School 20.2 19.9

Ohalushu Primary School 19.5 19.9

Bunya Combined School 19.5 20.1

Onayeluka Primary School 20.2 19.9

Kooma Primary School 20.7 20.1

The demographic data in Table 3 are graphically shown in Figures 1, 2, 3 and 4.


Figure 1: Age of respondents in years

The data obtained indicate that the respondents’ age ranges from 6 to 12 years with the majority

being 12 years (21.1%).

Figure 2: Percentage of respondents in respective grades 1 to 7

The majority of the respondents were in Grade 2 (22.1%) with the least of the pupils who

participated in the interview being in Grade 7 (2.5%)

2.2%

17.4% 17.7%

13.2% 11.2%

16.4%

21.1%

6 7 8 9 10 11 12

Age (years)

Age (years)

22% 22.1%

17.7%

14.2% 13.9%

7.2%

2.5%

0%

5%

10%

15%

20%

25%

1 2 3 4 5 6 7

Grade (%)


Figure 3: Respondents Gender distribution in percentages

The chart above shows an almost even distribution of gender, with 50.5% being female and 49.5% male.

An almost equal representation of about 20% of respondents from each of the 5 schools is

evident.

Record of participants in the teachers’ interview per school Name of School Total number interviewed and designations

represented

Total

Epundi Primary School 3x teachers 3

Ohalushu Primary School 2xteachers and 1xcleaner 3

Bunya Combined School 1xteacher 1

Onayeluka Primary School 2xteacher 2

Kooma Primary School 2xteacher and 1xprincipal 3

12

A total of 12 respondents participated in the teachers’ interview. The summary of respondents

per school is shown in the table above.

3.2 Reported exposure to target hygiene messages and intervention activities Children were asked if they had ever heard of hand washing and from which source they got the

information. All 402 interviewed children reported ever hearing of hand washing and of these,

majority (50%) indicated that they had heard the message from sessions at schools.

Male , 50.5% Female, 49.5%


Children who reported having heard the message from school were asked if they found the

trainings / sessions good and useful. All (100%) respondents indicated that the trainings/sessions

were good and majority (99.7%) indicated that they were useful.

3.3 Schools’ capacity for effective hygiene promotion

There is need for continuity of the project interventions in the respective schools as one way of

sustaining the results. For the hygiene education and promotion to continue, it was deemed necessary

to assess the schools’ capacity for such action. Thus, the final evaluation exercise sought data on

schools’ capacity for effective hygiene promotion, since the schools were considered appropriate

venues for the hygiene education and promotion.

Presence and activity of trained teachers to facilitate interventions

About 3 teachers from each school have been trained in school sanitation and hygiene education. The

training conducted in preparation for project implementation was useful for equipping the teachers

who reportedly made use of the knowledge and skills. All teachers interviewed could correctly

explain what sanitation means, which shows possession of correct knowledge to be passed on to the

learners. All teachers from each of the 5 targeted schools reported that they had taught children

about hygiene and did observations on the condition and status of facilities at schools. The life skills

teacher at Epundi Primary School incorporated the messages in classes where lessons on hygiene are

taught. Teachers indicated during the interviews that they had taught children about hygiene and

taken the initiative to emphasize the message by letting the kids do role plays, drama, songs and

demonstrations.

Availability and use of hygiene promotion materials and methods

Posters educating children on hand washing practices and hygiene were observed on classroom

walls. Booklets and other written materials are mainly available and used in the different schools.

Sanitation committees or clubs and special materials such as games, toys etc. used for hygiene

promotion need regular monitoring of usage, general maintenance and upkeep by the teachers.

On average, the schools scored 82% on the use of hygiene promotion materials and methods.

Sessions at school 50%

Printed material e.g.

posters 42%

Radio 8%

Reported exposure sources


Participation of external community in the schools’ hygiene and sanitation interventions

The teachers’ interviews during the final evaluation sought information on participation of the

external community and local / government authorities in schools’ hygiene and sanitation

interventions. This information was necessary as continuity of such project interventions requires

support from the external communities and leaders / authorities. Respondents from some of the five

targeted schools mentioned that they did not get any material support from the government for

hygiene and sanitation interventions. Those who got support indicated that they received toilet papers

and some cleaning materials. The local authority also provided Onayeluka primary school with

plastic bags for garbage collection. Furthermore, it was reported that since the latrine: pupil ratio is

too high, the toilets are often dirty and the cleaning materials provided by the Government are

insufficient.

3.4 Children’s knowledge and understanding of benefits of hand washing and of the

critical times Children understand the need for washing hands at critical times including before eating, after

toilet use and that they should wash their hands with soap and water. The main reason given

when children were asked why they should wash their hands was to remove germs (58%). Other

reasons included to prevent illness and to keep hands clean. Minimal (1%) of the total

interviewed children indicated that they do not know why it is important to wash their hands.

3.5 Status of facilities and hygiene in the schools

There are relatively few toilets to comfortably serve the schools’ population as seen from a

calculated average proportion of 1 toilet per 80 pupils based on functional toilets at time of

observation. The existing number of toilets in the schools is summarized in Table 4.

58% 20%

21%

1%

Importance of hand washing To remove germsTo keep my hands cleanTo prevent illness


Table 4: Existing number of toilets for pupils in the schools compared with school population

Name of School Total

school

pupil

population

Total*

existing

number of

toilets

Number of functional toilets** Current***

Toilet to Pupil

ratio For Girls

only

For Boys

only

Total

Epundi PS 302 10 2 2 4 1:75

Ohalushu PS 379 8 2 2 4 1:96

Bunya CS 758 8 4 4 8 1:103

Onayeluka PS 195 4 1 2 3 1:65

Kooma PS 144 4 2 2 4 1:36

5 schools 1778 34 11 12 23 1:80

*Includes both functional and non-functional toilets as at time of observation in November 2011.

**Data included is for pupil’s toilets that were functional as at time of observation in November 2011.

***Based on number of functional toilets as at time of observation.

At the time of evaluation, 23 (68%) of the existing 34 latrines were functional. The survey

indicates that there is a high demand for toilets as all functional toilets are in use. It was observed

that 32% of the latrines at the different schools exist but are not functional or in use and also

smelly and soiled with excreta which was attributed to lack of cleaning materials. This situation

may be a representation of what happens in the five schools as the ratio of toilets to pupils is high

(Table 4). Teachers at all schools, except Bunya Combined school, further mentioned that

whenever there is a good supply of cleaning materials, toilets are often clean. They further stated

that they try to keep it locked after hours to guide against wastage and misuse.

There has been no change in the number or construction of toilets, although the cleanliness have

somewhat improved.

On average, schools scored 82% in the overall ranking of the general upkeep and maintenance of

the schools’ sanitation materials and 69% in terms of cleanliness and usage of toilet facilities.

The verification scores were based on the physical observation of utilities, material availability

and usage.

Comparing the existing functional facilities (toilets and water taps) observed at final evaluation,

there is basically no improvement in the resources to aid children’s practice of basic hygiene as

taught. The level of cleanliness, although improved, is still not conducive to increased use of the

resources.

Children’s’ participation in school hygiene intervention plays a major role in the effectiveness of

the program. Children are divided in groups and take turns to clean the classrooms and the

surrounding area. Three of the targeted schools mentioned that the children do not clean the

toilets due to unwillingness. The cleaning and upkeep of the toilets is therefore left for the

cleaner to do.

3.6 Reported incidence of runny stomach (Diarrhea)

Children were asked if they had a runny stomach in the 3 months preceding the study. The

overall result shows an improvement in the reported incidence of diarrhea cases in the mid-term

and the final evaluation. Only 10.7% of the respondents reported diarrhea incidents in the 3


months preceding the evaluation. This result shows a considerable improvement of 39%

compared to Baseline.

Table 5: Reported incidence of runny stomach

Reported Diarrhea Baseline (N=390) Midterm (N=411) Final (N=402)

Yes 49.7% 20.0% 10.7%

Figure 4: Reported incidence of runny stomach (Diarrhea) among pupils (?)

Figure 5: Reported incidence of runny stomach/ Diarrhea by school

3.7 Treatment of runny stomach

Of the 10.7% children who responded “yes” to the question of “runny stomach during the 3

months preceding the study”, 79% % reported that they went to a hospital or clinic.

Baseline (49.7%)

Midterm (20%)

Final (10.7%)

59%

47%

58%

38% 36%

18% 11%

30.50%

17.10% 23.20%

6% 0% 1% 0% 3%

0%

10%

20%

30%

40%

50%

60%

70%

BunyaCombined

School

Epundi PrimarySchool

Kooma PrimarySchool

OhalushuPrimary school

OnayelukaPrimary School

Reported Diarrhoea incidence by school

Baseline Mid term Final


This shows that the message on seeking treatment is well received which minimizes the severity

of diarrhea and prevents children from missing additional school days. The results are shown in

Figure 7 below.

Figure 6: Treatment of runny stomach from hospital / clinic

3.8 Absenteeism from school due to Diarrhea

Only 5.3% children reported absenteeism due to runny stomach during the 3 months preceding

the study. This is a significant drop in absenteeism from 40% during the baseline survey. This

means that the school hand washing program is clearly effective at the different schools. The

results are shown in the table below.

Table 6: Absenteeism from school

Absenteeism from school

Baseline 40.0%

Final 5.3%

3.9 Respondents’ reported hand washing practices


Wash hands before eating Baseline 58% 39% 3%

Midterm 87.10% 12.50% 0.20%

Final 78.10% 21.90% 0%

Wash hands after toilet use Baseline 34% 49 17

34.0%

12.7%

79.0%

Baseline Mid term Final

Treatment of runny stomach

Treated at Hospital/Clinic (%)


Midterm 69.3 30.4 0.3

Final 66.2 33.8 0

Wash hands with only water Baseline 10 55.7 33.8

Midterm 10 5 34

Final 3.5 24 72.5

Wash hands with soap/ash

and water

Baseline 8 54 39

Midterm 53 46.2 0.5

Final 24 62 14

The data in Table 3 are graphically shown and explained in the Figures to follow

3.10 Reported hand washing before eating Table 7: Hand washing before eating


Wash hands before eating Baseline 58% 39% 3%

Midterm 87.10% 12.50% 0.20%

Final 78.10% 21.90% 0%


Figure 7: Hand washing before eating

Children were asked if they wash their hands before eating. Majority of the respondents (78%)

reported that they always wash their hands before eating. Although this shows a decrease in

children always washing hands before eating compared to midterm, the final evaluation shows

that no children responded that they ‘never’ wash their hands before eating.

3.11 Reported hand washing after toilet use

Children were asked whether they wash their hands after using the toilet. Majority (66.2%) of the

respondents reported always washing their hands after using the toilet. No children responded

that they ‘never’ wash their hands after toilet use.

Table 8: Hand wash after toilet use

Figure 8: Hand

wash after toilet

use

58%

39%

3%

87%

13%

0.2%

78%

22%

0% 0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


Reported hand washing before eating

Baseline

Midterm

Final


Wash hands after toilet use Baseline 34% 49 17

Midterm 69.3 30.4 0.3

Final 66.2 33.8 0


Figure 9: Hand wash after toilet use by school

Children at Bunya combined school could not wash their hands due to lack of water at the school

at the time of observation. All other children observed at least washed their hands; half of them

washed their hands with water and soap, while others washed their hands with water only.

Children are taught ways of how to properly wash their hands which includes rubbing both hands

for at least 3 times. This practise was observed and all children who washed their hands with

soap and water carried this out positively.

3.12 Reported hand washing with water only

Analysis of hand washing with water only for the respective schools shows Bunya combined

school as having the highest percentage (3.5%) children reporting always washing hands with

water only. Overall, a quarter of the children sometimes wash their hands with water only. This

could be partly due to the fact that soap is sometimes not available to the children. Table 9: Hand wash with water

34.0%

49.0%

17.0%

69.3%

30.4%

0.3%

66.2%

33.8%

0.0% 0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%


Hand wash after toilet use

Baseline

Midterm

Final

5.2%

18.9%

13.2%

19.4%

9.5%

14.9%

1.0%

7.0%

0.5%

10.4%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

BunyaCombined

School

EpundiPrimarySchool

KoomaPrimarySchool

OhalushuPrimaryschool

OwayelulaPrimarySchool

Hand wash after toilet use by school

Always

Sometimes

Never


School Always Never Sometimes Total

Bunya Combined School 3.5% 0.5% 15.8% 19.8%

Epundi Primary School 19.5% 0.5% 20.0%

Kooma Primary School 17.3% 3.0% 20.3%

Ohalushu Primary school 19.3% 0.8% 20.0%

OnayelukaPrimary School 16.0% 4.0% 20.0%

Grand Total 3.5% 72.5% 24.0% 100.0%


Wash hands with only water Baseline 10 55.7 33.8

Midterm 10 5 34

Final 3.5 24 72.5

3.13 Reported hand washing with soap and water

Children (respondents) were asked if they always or sometimes or never wash their hands with

soap and water. More than half (62%) of the children reported that they sometimes wash their

hands with soap/ash and water, while 24% reported as always doing so.

Figure 10: Hand washing with soap and water by School

Table 10: Hand washing with soap and water


Wash hands with soap/ash and water

Baseline 8% 54% 39%

Midterm 53% 46.2% 0.5%

Final 24% 62% 14%

0.50%

5.49%

9.48%

14.96%

9.98%

18.45%

14.46%

10.47%

4.99%

9.98%

1.25%

Bunya CombinedSchool

Epundi PrimarySchool

Kooma PrimarySchool

Ohalushu Primaryschool

Onayeluka PrimarySchool

Hand wash with soap and water by school



3.14 Reported last place of hand washing

The respondents were asked where they had last washed their hands. Majority (85.4%) had

reportedly washed their hands at school. Only a few (14.6%) washed their hands at home. When

compared to the Baseline, more children wash their hands at school which emphasizes the fact

that the school hand washing program is clearly effective at the different schools. Most (31%) of

the children’s interviews were conducted in the later hours of the morning between 11 and 12

am. The reported hand washing is a clear indication of appreciation and hygienic practice as

recommended and taught through the project intervention. The findings reveal an improvement

in hand washing practices at school from the baseline value of 21% to 85.4% at final evaluation.

Table 11: Last Place of Hand washing

REPORTED LAST PLACE OF HAND WASHING

School Home

Baseline 21% 79% Midterm 69.30% 30.70% Final 85.40% 14.60%

Figure 11: Reported Last Place of hand washing

3.15 Children’s attitudes towards hand washing Recommendation on the importance of hand washing: Children were asked if they would

recommend / tell someone about the importance of hand washing, and who they would tell.

Almost all (99.24%) children who were interviewed said that they will recommend the

importance of hand washing to someone. The 99% affirmative response is a significant

improvement from the 58% response at baseline, implying great appreciation of the hand

washing knowledge and recommended practices.

21%

79%

30.70%

69.30%

85.40%

14.60%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

School Home

Reported Last Place of Hand washing

Baseline

Midterm

Final


Table 12: Recommendation on the importance of hand washing

Recommendation about the importance of hand washing

yes no

99.24% 0.76%

Figure 12: Recommendation on the importance of hand washing

Of the 99.24% respondents who will recommend the importance of hand washing to someone,

the majority (70.3%) will recommend it to all people. The figure above shows a break down as to

who the respondent will recommend the importance of hand washing.

3.16 Teachers attitude on the hygiene education program

The teachers’ attitude about the program and its interventions is critical for continuity. The final

evaluation included a general assessment of the teachers’ attitudes about the hygiene education

program. According to the interviewers, all teachers who participated in the study seemed very

interested and motivated on the hygiene education programme and want the project to continue for as

long as possible. Furthermore, the interview discussions showed that teachers are committed and

willing to help in sustaining the project.

3.17 The school to community linkage Participation of the external community and local / government authorities in schools’

hygiene and sanitation interventions

One of the final valuations objectives was to assess the project’s successes, impact and challenge to

inform future decisions about similar programs. All the teachers interviewed indicated that the

community expresses interest in the school hygiene program. They further stated that the project

alleviates diseases and absenteeism from school. The health department was invited at Onayeluka

70.30%

16.62% 10.90%

2.18%

All people Friends Family members communitymembers

Recommendation


primary school to talk to school children about diseases in general, although not specifically on hand

washing.

3.18 Relevance of the project Teachers reported an overall drop in the incidents of diarrhea among students and minimal

absenteeism from school due to diarrhea... “The learners have gained a lot of knowledge and their

health is improved’, the teachers stated.

3.19 Usefulness of the project Since the implementation of the hand washing project, the learners’ hand washing practices

improved. Teachers interviewed reported that the children often correctly wash their hands before

eating and after toilet use. Teachers are more involved and play a pivotal role in ensuring that the

children are healthy.

3.20 Effectiveness of the project The overall effectiveness of the project is rated as good because whenever possible, the school

management ensures that there is water and soap in the toilets and near class rooms. The general

behavior of the children with regard to hygiene has also improved.

3.21 Sustainability of project interventions

3.21.1 Commitment The individual schools need to own the program and drive it. For this reason, the school

management, communities and students give sessions 3 times a week. Teachers and children

have organized themselves very well in developing extra materials/activities to make it more

interesting.

3.21.2 Resources Teachers were asked how they would mobilize resources to ensure the high quality standards of

hygiene and sanitation were maintained. They indicated that they will raise funds and involve

local businesses in the project implementation. Others mentioned that they will ask parents to

donate a small amount of money and/or will issue raffle tickets for fundraising purposes.

3.21.3 Replicability The teachers were asked if there is any advocacy work to replicate those interventions

somewhere and all schools responded positively. The teachers mentioned that whenever there

are hand washing activities at their respective schools such as drama, role plays etc., children

from the neighboring schools normally attend and have adapted the hand washing behavior.

Principals from neighboring schools also attended the commemoration of the hand washing day

at different targeted schools.

3.22 Challenges and suggested solution Teachers who participated in the interviews were asked to list any three key challenges that their

schools faced in implementing the hand washing, school hygiene and sanitation program. They

were also asked to suggest solutions to the problems mentioned and make recommendations for

improving hygiene and sanitation practices in their schools. Their responses are summarized

below.


Comments

Key Challenges in

implementing hand washing,

school hygiene and sanitation

programs

The Ministry of Education is not supporting the project with cleaning materials

and toilet paper

Children struggle to wash their hands due to water being temporarily closed or

due to broken taps

There are not enough containers for hand washing

Some toilets do not flush and the number of toilets in schools are not enough

Limited IEC materials

Suggested solutions

MOE should show interest in the project and support it, and parents should play a

role in children’s' hygiene

Schools need large tanks to store water. SFH/UNICEF should provide containers

The community should raise funds to buy cleaning materials and toilet papers

More IEC materials should be provided

Recommendation for

improving hygiene and

sanitation practices in schools

mobilize learners to keep themselves clean and practise good hygiene

Schools should find more resources with support from NGOs, the GRN and from

local businesses


Annex 1: Quality assurance aspects covered during the pre-

data collection training workshop

1. Accuracy

• Ensure that data are the correct values, valid, and attached to the correct tool.

2. Comprehensiveness

• Ensure that all required data items are included; that the entire scope of data is collected

and documentation of limitations is done.

3. Currency

• The data should be up-to–date e.g. the school information such as Number of pupils,

functional toilets

4. Consistency

• The value of the data should be reliable and the same across applications.

• Check responses e.g. a child says they ALWAYS wash hands with soap and water AND

also says they ALWAYS wash with water ONLY.

• Note: The two practices cannot be possibly happening. It’s either one or the other

5. Definition

• Clear definitions should be provided so the current and future data users will know what

the data mean; each data element should have clear meaning and acceptable values.

• Note: *Provide explanations to the pupils and teachers about each aspect of the question

so that they are clear about the concepts they are responding to*.

6. Relevancy

• The data are meaningful to the performance of the process or application for which they

are collected.

• Note: Especially for additional information collected from observation and interviews

with teachers

7. Timeliness

• Timeliness is determined by how the data are being used and their context.

• Note: Ensure data collected e.g. on diarrhoea incidence is with reference to past three

months as indicated in the question


Annex 2: Responsibilities of the final evaluation data

collection team

General responsibilities

1. Respect the administrative rules, culture, and customs of the schools

2. Adhere to guidelines provided for the evaluation exercise

3. Master data collection procedure and questionnaires / observation checklist

4. Strive to improve data quality

5. Keep the data and survey information confidential

6. Follow established timelines

7. Maintain data collection tools (questionnaires and checklists)

8. Work collaboratively to achieve team and evaluation objectives

9. Travel to the schools as planned / scheduled

BCC Officers’ responsibilities

1. Coordinate work of CHCs with the school administrations

2. Monitor/ supervise data collection by CHCs

3. Conduct interviews with the teachers

4. Complete the school observation checklist

CHCs’ responsibilities

1. Support the pupils to complete the questionnaire

2. Participate in the completion of the observation checklist as guided by the BCC Officers


Annex 3: The pupils’ questionnaire

Project: School Hand washing Project Final Project Questionnaire 2011

Please tick “X” in the appropriate boxes Date: …………………………………… Time……………………………….

SECTION A (Demographics)

1.

Name of School: ……………………………………………………………………………

2.

Village: / Town/ Region……………………………………………

3.

Grade: ……………

4. Sex: Male Female

5. Age: ………………………………………………….years

SECTION B (Exposure)

6. Have you ever heard of hand washing? Yes No

7. If you heard the message, Where did you hear the message from?

(1) Sessions at school (2)Radio

(3) Printed material e.g. posters (4) Community /Family members

(5) Other (Specify) ________________________________________

8. If you heard the message from school, were the

trainings /sessions GOOD?

Yes No

9. Were the trainings /sessions USEFUL? Yes No

SECTION C (Knowledge)

10. Why should you wash your hands? (Mark all answers that the pupil mentions)

(1) To remove germs (2) To keep my hands clean

(3)To prevent illness (4) I don’t know

SECTION D: Incidence of diarrhea (runny stomach) and absence from school

11. Have you had runny stomach in the last three (3)

months?

Yes No


12. If yes, did you go to a hospital or clinic? Yes No

13. Were you absent from school because of the runny

stomach during the last three months?

Yes No

14. How many days were you absent from school for each time you had runny stomach?

(1). One (1) day (2). Two days (3). More than 2 days

SECTION E (Practices ) Always Sometimes Never

15. I wash my hands before eating

16. I wash my hands after using the toilet

17. I wash my hands with only water

18. I wash my hands with soap and water

19. I wash my hands with ash and water

20. How often do you wash your hands each day?

21. When was the last time you washed your hands today? Home School

SECTION F (Attitude)

22. Would you recommend/tell someone about the importance of

hand washing?

Yes No

23. If you are to tell someone about hand washing, who would you tell?

1. Friends 2. Family members 3. Community members

4. All people


Annex 4: The teachers’ interview guide

Hand Washing Project – Final Evaluation (October 2011)

FOCUS GROUP Interview WITH TEACHERS ALONE Date:

______________________________

Name of school being surveyed: _________________________ Name of Region:

____________________

Name of interviewer: ____________________________ Title:

____________________________

Introduction and Purpose:

(Greetings/introduction). I would like to ask some questions about hygiene and sanitation

interventions and practices in this school.

The Society for Family Health (SFH) with support from UNICEF has been implementing a

project “Safeguarding lives, school hand washing program” in this school from October 2010 to

October 2011. SFH is conducting an evaluation of the program to assess its successes, impact

and challenge to inform future decisions about similar programs.

1. Interview participants:

Name Designation

1.

2.

3.

School capacity for Effective Hygiene Promotion

2. Have the teachers of this school been trained in School Sanitation and Hygiene

Education?

__________________________________________________________________________

__________________________________________________________________________

Use of training in school

3. Have the teachers taught anything about hygiene (safe water, household sanitation,

personal hygiene, hand washing)? Ask the teachers. Ask some students.

________________________________________________________________________

______________________________________________________________________


4. Can teacher or head teacher show any teaching material, book or learning materials or a

chapter in a book about this subject? (State your observation below)

Note: materials must appear to have been used.

___________________________________________________________________

__________________________________________________________________

5. Can teacher explain correctly what sanitation means to him or her?

(Sanitation is the hygienic means of promoting health through prevention of human contact with

the hazards of wastes.)

____________________________________________________________________________

6. Write anything interesting the teacher says or any interesting hygiene/health activities

teacher or school has carried out with children.

____________________________________________________________________________

___________________________________________________________________________

______________________________________________________________________________

Participation of the external community and local / government authorities in school’s

hygiene and sanitation interventions

7. Do the local / government authorities in this area express interest in the school hygiene

programme?

____________________________________________________________________________

____________________________________________________________________________

8. Did the teachers get any support from GRN or local authorities towards project

implementation? What kind of support did teachers get from Government / constituency/

School Management Committee (SMC)?

________________________________________________________________________

________________________________________________________________________

_______________________________________________________________________

Child Participation in school hygiene intervention

9. Do the children in the school help clean, including the toilets?

______________________________________________________________________________

____________________________________________________________________________

10. Do the children take turns (rotate) in doing this? (Ask teachers. Ask children in a separate

small group, outside the class).

http://en.wikipedia.org/wiki/Hygiene

http://en.wikipedia.org/wiki/Health_promotion

http://en.wikipedia.org/wiki/Hazard_prevention

http://en.wikipedia.org/wiki/Hazard

http://en.wikipedia.org/wiki/Waste


_______________________________________________________________

______________________________________________________________________

School to Community Linkage

11. Do the parents or community know about the sanitation and hygiene interventions at the

school?

________________________________________________________________________

12. What percentage (%) of the school fundraising goes towards the sanitation and hygiene

intervention at the school?

______ ___________________________________________________________________

13. Has the school conducted events to promote School Sanitation and Hygiene Education in

the community?

____________________________________________________________________

14. How frequently? ___________________________

15. Hygiene promotion activities by children in their homes and in the community

(Score / rank the school)

Options Scores Score

1. No hygiene promotion done by children in their homes or in their

village 0

2. Children participate in rallies and marches through the village on

special days; but nothing more 25

3. Benchmark: In addition to rallies and marches, children speak to their

parents about the need for good hygiene behavior (e.g., by requesting

access to material like nail cutters, soap and ash), and at least one child

reports a change in access to material in their homes.

50

4. In addition, most children report change in access to material (e.g., nail

cutters, soap and ash) in their homes OR teachers and students have

identified and solved at least one community-level hygiene or sanitation

problem

75

5. Ideal: In addition, teachers involve children in a regular system to

identify hygiene and sanitation problems in their houses or village, and

find practical solutions by discussing with the parents, teachers or

Community Health Consultants (CHCs)

100

Comment

Supervisor or cluster


16. Has there been a schools cluster meeting in the past three months to discuss

health/hygiene and sanitation?

____________________________________________________

17. Has any official from the Region’s Ministry of Basic Education in charge of sanitation

and hygiene or anyone from health sector visited the school during the past three months?

________________________________________________________________________

18. Do the Local leaders / School Inspectors have information or records about the sanitation

status of schools?

_______________________________________________________________________

19. How is sanitation monitored and standards measured in this school?

___________________ __________________________________________

20. Is there a regional Sanitation [and Hygiene Education] implementation plan with a budget

that has specific allocations for school hygiene?

____________________________________________________________________

Relevance of the project:

21. Did the project support and interventions address the needs of children, teachers and

communities? How relevant were the interventions in addressing the issues and reaching the

objectives/targets? The issues being evaluated must be linked to a clear and important set of

stakeholder interests i.e. improving the health and learning outcomes of students.

_________________________________________________________________

_____________________________________________________________________

Usefulness:

22. How useful were the project hygiene and hand washing messages and behavior change

communication interventions in enhancing knowledge, skills and adopting the hygienic

behaviors?

______________________________________________________________________

____________________________________________________________________

Effectiveness

23. How effective were the project interventions? Comment on the interventions i.e. sessions by

CHCs, drama by kids, hand washing practices, etc.

_______________________________________________________________________

________________________________________________________________________

Clear commitment for sustaining those interventions and accountability to ensure high

quality standards:

24. Are the school management, communities and students themselves committed to sustain

those interventions?

____________________________________________________________________

_____________________________________________________________________


25. If they are committed how would they mobilize resources to ensure the high quality

standards of hygiene and sanitation are maintained? List some examples.

________________________________________________________________________

_______________________________________________________________________

Replicability: 26. Any advocacy work to replicate those interventions elsewhere e.g. in neighboring / other

schools?

_________________________________________________________________________

Challenges and suggested solutions

27. List any three key challenges that the school faces in implementing the hand washing, school

hygiene and sanitation programs.

i. _____________________________________________________________

ii. _____________________________________________________________

iii. _____________________________________________________________

28. Suggest solutions to the problems listed above.

i. _______________________________________________________________

ii. _________________________________________________________________

iii. __________________________________________________________________

29 Suggest any recommendations for improving hygiene and sanitation practices in the school.

i. __________________________________________________________________

ii. __________________________________________________________________

iii. ______________________________________________________________

General assessment (interviewer’s assessments, comment and general opinion)

30. Do the teachers and head teacher seem motivated and interested in the hygiene education

programme?

______________________________________________________________________________

______________________________________________________________________________

_

End of interview. Check that all 30 questions have responses as applicable.

Thank the teachers for their responses and suggestions.


Annex 5: The observation checklist

Society for Family Health United Nations Children Fund

Hand Washing Project Purpose: Establish status of facilities and hygiene in the schools

General Information 1. Name of School: 4. Name of Field

Investigator 1:

2. Constituency: 5. Name of Field Investigator 2:

3. Region: 6. Date of Observation:

General Details

7. Type of School: 1.Pre-School/Kindergarten 2.Grade 1-4 (Lower Primary School) 3. Grade 5-7 (Upper Primary School) 4.Grade 8-10 (Junior Secondary) 5. Grade 11-12 (Senior Secondary)

8. Category of personnel trained to implement hand washing / hygiene lessons / activities

Total Number per category

Number appointed Before Oct 2010

Number appointed On or after Oct 2010

Number ACTIVE

a. Male Female

b. Teachers

c. Community Health Consultants (CHCs)

d. Hygiene Cleaners for toilets and environment

e. Total

Current School Enrollment 9 Number of School Children Girls Boys Total

Pre-School/Kindergarten

Grade 1-4 (Lower Primary School)

Grade 5-7 (Upper Primary School)

Grade 8-10 (Junior Secondary)

Grade 11-12 (Senior Secondary)

10 Classes Assessed (mark all applicable)

Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12

1. The Use of hygiene promotion materials and methods (Mark the

appropriate box, then put a score for the school in the second part of the

table)


Options Available and used

Available but NOT used

Not available/ Not applicable

1.

Booklets and other written materials like posters available in the school for hygiene promotion (hand washing)

2.

Booklets and other written materials used in the hygiene promotion and school sanitation committees or clubs formed by the children

3.

Special materials (games, toys, etc) are used for hygiene promotion and school sanitation committees or clubs are active

4.

Teachers involve children in regular monitoring of school sanitation facilities and in the regular upkeep and maintenance (e.g. reporting and solving problems)

5. Ranking of the school

6. Options Scores school Score

7. No special materials for hygiene promotion (hand washing) available in the school 0

8. Booklets and other written materials available in the school but not used 25

9. Benchmark: Booklets and other written materials used in the hygiene promotion and school sanitation committees or clubs formed by the children

50

10. In addition: special materials (games, toys, etc) are used for hygiene promotion and school sanitation committees or clubs are active

75

11. Ideal: Teachers involve children in regular monitoring of school sanitation facilities and in the regular upkeep and maintenance (e.g. reporting and solving problems)

100

12. Comments:

2. Frequency of Hygiene Education


3. Status of Latrines / toilets, school yard, compound and classrooms Options YES

(1) NO (2)

Total # of latrines meeting given description Scores

School score given

1. Total number of functional latrines for use by pupils # for boys = ________ and # for girls = __________

2 Latrines exist and functional but not in use (i.e. no

demand)

0

3. Latrines exist but are not functional or not being used

0

4. Latrines exist and are in use but they are dark, smelly and soiled with excreta

10

5. Latrines exist and are in use, with adequate daylight, but soiled with excreta.

25

6. Benchmarks: Latrines are clean (no excreta in pans, walls or floor) and protected against misuse (e.g. locked after hours)

50

7. In addition: There is water, soap or ash for 75

Frequency YES (1) NO (2)

1. Hygiene education classes held in this school (BEFORE UNICEF/SFH programme started)

2. Hygiene education classes held in this school (AFTER UNICEF/SFH programme started)

3. Hygiene education messages only on special days (e.g. 26 January and 15 August) – no more than once per

quarter

4. Benchmark: Hygiene promotion done during morning assembly or prayers

5 Hygiene promotion classes are held in the weekly time table but not always held

6. Ideal: Hygiene promotion classes are in the time table and are held regularly (every week)

Rank / rate the school

Frequency Scores Score the

school

No hygiene education classes held in this school (before UNICEF/SFH programme started) 0

No hygiene education classes held in this school (after UNICEF/SFH programme started) 0

Hygiene education messages only on special days (e.g. 15 October) – no more than once per quarter 25

Benchmark: Hygiene promotion during morning assembly or prayers 50

In addition, hygiene promotion classes are held in the weekly time table but not always held 75

Ideal: Hygiene promotion classes are in the time table and are held regularly (every week) 100

7. Comments:

Frequency YES (1) NO (2)

1. Hygiene education classes held in this school (BEFORE UNICEF/SFH programme started)

2. Hygiene education classes held in this school (AFTER UNICEF/SFH programme started)

3. Hygiene education messages only on special days (e.g. 26 January and 15 August) – no more than once per

quarter

4. Benchmark: Hygiene promotion done during morning assembly or prayers

5 Hygiene promotion classes are held in the weekly time table but not always held

6. Ideal: Hygiene promotion classes are in the time table and are held regularly (every week)

Rank / rate the school

Frequency Scores Score the

school

No hygiene education classes held in this school (before UNICEF/SFH programme started) 0

No hygiene education classes held in this school (after UNICEF/SFH programme started) 0

Hygiene education messages only on special days (e.g. 15 October) – no more than once per quarter 25

Benchmark: Hygiene promotion during morning assembly or prayers 50

In addition, hygiene promotion classes are held in the weekly time table but not always held 75

Ideal: Hygiene promotion classes are in the time table and are held regularly (every week) 100

7. Comments:


hand washing within easy reach of the children

8. Ideal: Latrines are child friendly (e.g. pans are smaller, colorful walls, etc)

100

9 Is the School yard / compound clean (free

from visible garbage on ground)?

10 Are the observed classrooms clean (free

from visible garbage on ground)?

11 Comments:

4. Latrine availability

For Boys Only

For Girls Only

For Boys and Girls combined

For teachers only

For all (not separated for categories)

# of boys per Latrine/ urinals

# of girls per Latrines/ urinals

Total # of urinals

Total # of Latrines

# FUNCTIONAL

# currently in use

Comments:

5. Observation: Materials for hand washing

Options YES

(1)

NO

(2)

Scores Yes=1

School total score (out of 9)

1. Is water for hand washing available?

(describe source)

_________________________________________

2. Is soap or ash available for hand washing?

3. Are water and soap within reach of each other?

4. Are there hand washing facilities in the latrines or within 40-50

yards of the latrine?

5. Is water available from start to end of school day or at certain hours

(e.g. just before lunch)

6. Is there a functioning water point WITHIN the school area?

7. If outside – how far from school compound is it? _______meters

8. Is the water source used by others – community members?

9. Is water point functioning at time of visit and in the dry season?

(Ask teachers if water point works in Dec/January )

10. Comments:

6. Observation: Drinking water storage and quality


Options YES

(1)

NO

(2)

Scores Yes=1

School total score (out of 9)

1. Are there containers available for storing drinking water?

2. Do the water storage containers appear to be clean?

3. Where are the water storage containers located?

a) In the classrooms?

b) Or where positioned in the school compound?

_____________

4. Is there water in the container for drinking?

5. Is all the drinking water in the containers covered?

6. (a) If water containers have no spout, is there a ladle (scoop,

dipper, cup) for taking water out?

(b) Is it kept clean?

7. Does the water appear to be free from visible particles and

mosquito larvae?

8. Is the water apparently of drinking quality at the water point?

(Ask teachers to indicate last time water testing was done)

_______________________

9. Are the water storage containers frequently cleaned?

(ask teacher how frequently they are cleaned): e.g. Weekly,

Monthly, other _____________

10. Comments:

8. Hand washing habits (Observe at least 5 children as they leave the latrine /

toilet to assess hand washing practices)

Note: Only one answer is possible per observed child. Put “X” in appropriate box

Sex of observed child Never washed hands

Washed hands with water only

Washed hands with both water and soap/ash

Male Female

Child # 1

Child # 2

Child # 3

Child # 4

Child # 5

9. Ask a child to demonstrate how to wash hands in the place where this is usually done and

write your observation.

Note: Does the child rub both hands a lot, at least 3 times?

Observation: ________________________________________________________

END. Check to ensure that all sections are completely filled in.

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