Improving water, sanitation, and hygiene in schools in Indonesia: A cross-sectional assessment on sustaining infrastructural and behavioral interventions
Abstract
Water, sanitation, and hygiene (WASH) in schools are important for child health, development, and educational performance; yet coverage in Indonesian schools remains low. To address this deficiency, UNICEF and partners conducted a WASH intervention in 450 schools across three provinces in Indonesia. A survey evaluating the sustainability of infrastructure and behavioral interventions in comparison to control districts was conducted one year after completion of the intervention. The survey data were also compared with national government data to assess the suitability of government data to report progress on the Sustainable Development Goals (SDGs). Logistic regression was used to explore associations between WASH conditions and behaviors. Intervention schools were more likely to have handwashing stations with soap and water. In multivariable analyses, schools with a toilet operation and maintenance fund were more likely to have functional toilets. Students who learn hygiene skills from their teachers were less likely to defecate openly, more likely to share hygiene knowledge with their parents, and more likely to wash their hands. Survey data were comparable with government data, suggesting that Indonesian government monitoring may be a reliable source of data to measure progress on the SDGs. This research generates important policy and practice findings for scaling up and sustaining WASH in schools and may help improve WASH in schools programs in other low-resource contexts.
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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, improved knowledge of WASH-related diseases, and improved hygiene habits.
“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].”
From Water, Sanitation and Hygiene (WASH) in Schools in Low-Income Countries: A Review of Evidence of Impact (2019) · cites this paper as [13]
Cites
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McMichael, C. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16030359 · Cited by 220 · see citing works
“2017 [13] Indonesia Cross-sectional study 75 schools (1780 students) Beneficiary schools received: capacity building; improved toilet and water facilities and handwashing construction; hygiene promotion; strengthening of School Committees to create school WASH action plans.”
Background
- Authors
- Karon, A. J., Cronin, A. A., Cronk, R., & Hendrawan, R.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- United Nations Children's Fund (US)
- Corresponding author
- Cronin, Aidan A.
- ORCID
- Cronk, Ryan
- Venue
- International Journal of Hygiene and Environmental Health
- Publisher
- Elsevier BV
- Published
- 2017-05
- Volume
- 220
- Issue
- 3
- Pages
- 539-550
- ISSN
- 1438-4639 (ISSN-L)
- OpenAlex
- W2588538926
- Cited by
- 64
- References
- 4
- Citations by year
- 2026: 1 · 2025: 14 · 2024: 8 · 2023: 12 · 2022: 9 · 2021: 6 · 2020: 2 · 2019: 6 · 2018: 5 · 2017: 1
- FWCI
- 3.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Hygiene and Environmental Health (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Dubai Cares
- NIH National Institute of Environmental Health Sciences (T32ES007018)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Physical Sciences › Environmental Science › Water Science and Technology › Water Resource Management and Quality
- Keywords
- school water, sanitation and hygiene, hand washing station, open defecation, resource-limited settings
- MeSH terms
- Behavior, Child, Conservation of Natural Resources, Female, Government Agencies, Humans, Hygiene, Indonesia, Health Knowledge, Attitudes, Practice, Male, Surveys and Questionnaires, Sanitation, Schools, Water Supply, Logistic Models, Federal Government
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