The Impact of a School-Based Water, Sanitation and Hygiene Intervention on Knowledge, Practices, and Diarrhoea Rates in the Philippines
Open accessAbstract
A school-based water, sanitation, and hygiene (WASH) intervention in the Philippines was evaluated. Students and households from four schools that received the WASH intervention (intervention schools) were compared with four schools that had not (comparison schools). Knowledge of critical handwashing times was high across all schools, but higher in intervention schools. Students reported higher rates of handwashing after toilet use (92% vs. 87%; RR = 1.06; p = 0.003) and handwashing with soap (83% vs. 60%; RR = 1.4; p < 0.001) in intervention versus comparison schools. In intervention schools, 89% of students were directly observed to handwash after toilet use versus 31% in comparison schools (RR = 2.84; p < 0.0001). Observed differences in handwashing with soap after toilet use were particularly marked (65% vs. 10%; RR = 6.5; p < 0.0001). Reported use of school toilets to defecate (as opposed to use of toilet elsewhere or open defecation) was higher among intervention versus comparison schools (90% vs. 63%; RR = 1.4; p < 0.001). Multilevel modelling indicated that students from intervention schools reported a 10-fold reduction in odds (p < 0.001) of school absence due to diarrhoea. In addition to school-based findings, self-reported handwashing at critical times was found to be higher among household members of students from intervention schools. This school-based WASH program appeared to increase knowledge and hygiene behaviours of school students, reduce absences due to diarrhoea, and increase handwashing at critical times among household members.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 22 · Cited by 38
Research works printed but not linked: 10
- [1]GBD 2016 Diarrhoeal Disease Collaborators Estimates of the global, regional, and national morbidity, mortality, and aetiologies of diarrhoea in 195 countries: A systematic analysis for the Global Burden of Disease Study 2016 Lancet Infect. Dis. 2018 18 1211 1228 10.1016/S1473-3099(18)30362-1 30243583 PMC6202444 · DOI
- [2]Freeman M.C. Clasen T. Dreibelbis R. Saboori S. Greene L.E. Brumback B. Muga R. Rheingans R. The impact of a school-based water supply and treatment, hygiene, and sanitation programme on pupil diarrhoea: A cluster-randomized trial Epidemiol. Infect. 2014 142 340 351 10.1017/S0950268813001118 23702047 PMC9151148 · DOI · Paper page
- [3]Jasper C. Thanh-Tam L. Bartram J. Water and Sanitation in Schools: A Systematic Review of the Health and Educational Outcomes Int. J. Environ. Res. Public Health 2012 9 2772 2787 10.3390/ijerph9082772 23066396 PMC3447586 · DOI · Paper page
- [4]Joshi A. Amadi C. Impact of Water, Sanitation, and Hygiene Interventions on Improving Health Outcomes among School Children J. Environ. Public Health 2013 2013 10 10.1155/2013/984626 24454415 PMC3888759 · DOI · Paper page
- [9]Caruso B.A. Freeman M.C. Garn J. Dreibelbis R. Saboori S. Muga R. Rheingans R. Assessing the impact of a school-based latrine cleaning and handwashing program on pupil absence in Nyanza Province, Kenya: A cluster-randomized trial Trop. Med. Int. Health 2014 19 1185 1197 10.1111/tmi.12360 25055716 PMC4876949 · DOI · Paper page
- [15]Patel M.K. Harris J.R. Juliao P. Nygren B. Were V. Kola S. Sadumah I. Faith S.H. Otieno R. Obure A. Impact of a hygiene curriculum and the installation of simple hand-washing and drinking water stations in rural Kenyan primary schools on student health and hygiene practices Am. J. Trop. Med. Hyg. 2012 87 594 601 10.4269/ajtmh.2012.11-0494 22869631 PMC3516306 · DOI · Paper page
- [19]Dreibelbis R. Freeman M.C. Greene L.E. Saboori S. Rheingans R. The impact of school water, sanitation, and hygiene interventions on the health of younger siblings of pupils: A cluster-randomized trial in Kenya Am. J. Public Health 2014 104 91 97 10.2105/AJPH.2013.301412 PMC3910035 24228683 · DOI · Paper page
- [21]Pfadenhauer L.M. Rehfuess E. Towards effective and socio-culturally appropriate sanitation and hygiene interventions in the Philippines: A mixed method approach Int. J. Environ. Res. Public Health. 2015 12 1902 1927 10.3390/ijerph120201902 25664699 PMC4344701 · DOI
- [26]Garn J.V. Trinies V. Toubkiss J. Freeman M.C. The Role of Adherence on the Impact of a School-Based Water, Sanitation, and Hygiene Intervention in Mali Am. J. Trop. Med. Hyg. 2017 96 984 993 10.4269/ajtmh.16-0558 28093534 PMC5392652 · DOI · Paper page
- [27]Liu C. Luo R. Yi H. Zhang L. Li S. Bai Y. Medina A. Rozelle S. Smith S. Wang G. Soil-Transmitted Helminths in Southwestern China: A Cross-Sectional Study of Links to Cognitive Ability, Nutrition, and School Performance among Children PLoS Negl. Trop. Dis. 2015 9 e0003877 10.1371/journal.pntd.0003877 26110518 PMC4481344 · DOI
- Authors
- Vally, H., McMichael, C., Doherty, C., Li, X., Guevarra, G., & Tobias, P.
- Affiliations
- La Trobe University (AU)
- The University of Melbourne (AU)
- Austrian Red Cross (AT)
- Philippine Red Cross, Manila 1515, Philippines
- Corresponding author
- Vally, Hassan
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2019-10-23
- Volume
- 16
- Issue
- 21
- Pages
- 4056
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC6861971
- OpenAlex
- W2981577077
- Cited by
- 38
- References
- 22
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 8 · 2023: 7 · 2022: 8 · 2021: 7 · 2020: 2
- FWCI
- 3.23
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Own your potential (DEAKIN) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- La Trobe University
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Life Sciences › Agricultural and Biological Sciences › Food Science › Food Safety and Hygiene
- Keywords
- water, sanitation and hygiene, school-based intervention, hand washing, diarrhea, school absenteeism, handwashing with soap, school toilets, open defecation, hygiene knowledge, Philippines
- MeSH terms
- Child, Diarrhea, Female, Humans, Hygiene, Health Knowledge, Attitudes, Practice, Male, Philippines, Sanitation, School Health Services, Students
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
