Cited by 104Child Nutrition and Water AccessWater Resource Management and QualitySchool Health and Nursing Education

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Water, sanitation, and hygiene in schools: Status and implications of low coverage in Ethiopia, Kenya, Mozambique, Rwanda, Uganda, and Zambia

Morgan, Camille, Bowling, Michael, Bartram, Jamie, Lyn Kayser, Georgia·2017·International Journal of Hygiene and Environmental Health

DOI 10.1016/j.ijheh.2017.03.015

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Abstract

Adequate access to water, sanitation, and hygiene (WaSH) in schools impacts health, educational outcomes, and gender disparities. Little multi-country research has been published on WaSH in rural schools in Sub-Saharan Africa. In this multi-national cross-sectional WaSH study, we document WaSH access, continuity, quality, quantity, and reliability in 2270 schools that were randomly sampled in rural regions of six Sub-Saharan African countries: Ethiopia, Kenya, Mozambique, Rwanda, Uganda, and Zambia. Data collection included: school WaSH surveys containing internationally established WaSH indicators, direct observation, and field- and laboratory-based microbiological water quality testing. We found 1% of rural schools in Ethiopia and Mozambique to 23% of rural schools in Rwanda had improved water sources on premises, improved sanitation, and water and soap for handwashing. Fewer than 23% of rural schools in the six countries studied met the World Health Organization's recommended student-to-latrine ratios for boys and for girls. Fewer than 20% were observed to have at least four of five recommended menstrual hygiene services (separate-sex latrines with doors and locks, water for use, waste bin). The low access to safe and adequate WaSH services in rural schools suggest opportunities for WaSH interventions that could have substantive impact on health, education, and gender disparities.

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Authors: Morgan, C., Bowling, M., Bartram, J., & Lyn Kayser, G.
Affiliations: University of North Carolina at Chapel Hill (US)
ORCID: Morgan, Camille
Bartram, Jamie
Venue: International Journal of Hygiene and Environmental Health
Publisher: Elsevier BV
Published: 2017-08
Volume: 220
Issue: 6
Pages: 950-959
ISSN: 1438-4639 (ISSN-L)
DOI: 10.1016/j.ijheh.2017.03.015
OpenAlex: W2607172376
Cited by: 104
References: 31
Citations by year: 2026: 18 · 2025: 13 · 2024: 17 · 2023: 12 · 2022: 16 · 2021: 11 · 2020: 6 · 2019: 6 · 2018: 5
FWCI: 3.86
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: International Journal of Hygiene and Environmental Health (publishedVersion)
PubMed (publishedVersion)
Funders: United States Agency for International Development
World Health Organization
Institute for Health Metrics and Evaluation
Topics: Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
Physical Sciences › Environmental Science › Water Science and Technology › Water Resource Management and Quality
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › School Health and Nursing Education
Keywords: school water, sanitation and hygiene, rural schools, sub-Saharan Africa, latrine access, handwashing with soap, water quality, gender inequality in education, school health
MeSH terms: Female, Humans, Hygiene, Male, Surveys and Questionnaires, Rural Population, Sanitation, Schools, Water Supply, Africa South of the Sahara

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Water, sanitation, and hygiene in schools: Status and implications of low coverage in Ethiopia, Kenya, Mozambique, Rwanda, Uganda, and Zambia

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