Assessing the national school health policy on the status of water, hygiene and sanitation in primary schools of Sabatia, Vihiga County, Kenya
Kishasha, Meshack Kijungu
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School Health began in Kenya in 1960‟s as an initiative of UNESCO and FAO as an intervention tool to encourage attendance and reduce malnutrition in school-going children. The introduction of free, Universal Primary Education (UPE) in 2003 increased pupil enrolment from 5.9 to over 7.8 million thus overstretching water, hygiene and sanitation facilities hence necessitating for a policy. In 2009, the Kenya Government developed the National School-based health program with its policy in eight health thematic areas whose goal was to enhance the quality of health in school communities by creating a healthy and friendly environment for teaching and learning. One of the key areas addressed by the program was water, hygiene and sanitation in primary schools. The purpose of this study was therefore to assess the current health status on water, hygiene and sanitation in primary schools of Sabatia District based on this policy and its guidelines. The target population consisted of all the 102 primary schools in Sabatia district. Thirty one (31) schools were clusterly and randomly selected for study. The objectives of the study were to describe the current health status of the schools by determining the risk factors for disease transmission and identifying the measures that are in place for prevention and control of the diseases related to water, hygiene and sanitation in the schools. The study employed a cross-sectional research design that utilized both quantitative and qualitative paradigms. Probability sampling design was used which employed both cluster and simple random sampling techniques in the selection of the schools and the study participants respectively. The study captured a randomly selected sample size of 31out of 102 schools in the district for study. Structured, non-structured questionnaires, focus group discussions (FGDs), key informant interviews (KII) and observational checklist were employed to collect data. All the 31 schools were assessed on the compliance to national school health policy and guidelines; 31 FGDs and 3 KII were undertaken to identify barriers to implementing good hygiene, sanitation and provision of safe water for use in schools. The study identified gaps with regards to the status of water, hygiene and sanitation. There was insufficient (3%) quality surveillance and monitoring for water safety in schools. The pupil-toilet ratio was grossly inadequate at 50:1 against the recommended 30:1 for schools. Forty percent of the toilets were found to be dirty. There was significant statistical association between sources of water and diarrhea diseases among pupils in schools (p<0.0019). However, the following were identified in FGDs and KII; insufficient supervision by health and water authorities, lack of partnerships with local businessmen, local community and politicians to help build enabling structures for school health. The research concluded that there were potential risks for disease transmission in schools given the current status of water, hygiene and sanitation. The study therefore rejected the null hypothesis and that there was no existence of the policy document in all schools. The study recommended that there was dire need for schools to liaise with the national and county governments to develop and form an effective implementation Board that would oversee and enforce the national school health policy and programs. The key contribution of this study was to provide baseline data on school health for future planning, interventions and facilitate sound policy implementation of the National Comprehensive School Health Program.