Personal Hygiene and sanitation practices of pupils: A comparison between an intervention and a control site in Kajiado District, Kenya.
Mugambi, Evelyn Makena
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This research was based on Personal Hygiene and Sanitation Education (PHASE) project initiated by African Medical and Research Foundation (AMREF) in Central Division of Kajiado District in the year 2000. The Programme aims at changing the behaviour associated with poor hygiene and sanitation and the ultimate goal is to achieve a decrease in morbility and mortality associated with diarrhoea diseases as well as improve the health status of communities in the intervention sites. The study, therefore sought to establish the impact of (PHASE) in promoting basic hygiene practices among the primary school going children in Kajiado District. A cross - sectional comparative study was carried out among 744 respondents selected proportionally from both intervention site (Central Division) and the control site (Ngong Division) of Kajiado District. The sample population comprised of standard three, five and seven pupils and class teachers of the three classes in each school. To the pupils in standard seven and five pre-tested questionnaires were administered, one to one interviews were conducted for class three pupils using same questions as those used in the classes five and seven questionnaires. Observation checklists and focus group discussions were also used to collect qualitative data. Descriptive data analysis was done by use of Statistical Package of Social Sciences (SPSS). Chi- square test () was used to establish the differences between the two Divisions in terms of knowledge and practice of personal hygiene and sanitation. The same test (Chi- square test of independence) was also used to determine the association between knowledge and practice of the respondents in selected personal hygiene aspects. The results were presented in frequency tables, percentages, pie charts and bar graphs. More boys 55.2%, n=744 than girls 44.8%, n=744 participated in the study. In both Divisions most respondents were aged between 11 and 13 years 45.7%, n=744. Majority of the respondents in both Divisions were protestants with Ngong Division having 60.9%, n=366) and Central Division 42.5%, n=372). Data showed significant differences between the two Divisions in knowledge regarding correct definition of personal hygiene (= 13.884, df1; p =0.000***) and its usefulness (= 9.889, df=1; p =0.002***). The results revealed significant differences in knowledge between the two Divisions in regard to some health aspects such as washing of the face (= 30.794, df=1; p =0.000***), brushing of teeth (= 39.558, df=1; p =0.000***), washing of hands (= 9.225, df=1; p =0.002***), body (= 13.702, df=1; p =0.000***) and clothes (= 6.062, df1; p =0.014***). In most cases respondents in Central Division were more knowledgeable compared to those from Ngong. There was no significant difference between the two Divisions in the correct practice regarding washing of ones face (= 1.968, df=1; p =0.161). However significant differences were found in frequency of brushing teeth (= 7.067, df=1; p =0.008**), bathing (= 15.478, df=1; p =0.000***) and proper disposal of human waste (= 7.960, df1; p =0.005**) between the two Divisions. An association was found between knowledge and practice (both Divisions) in the selected health aspects, (washing of the face (= 0.117, df=1; p =0.000***) and brushing of teeth (= 14.465, df=1; p =0.000***). It was therefore, concluded that acquisition of knowledge on personal hygiene may influence ones routine practice. Apart from adding empirical evidence to what the PHASE project had projected, the findings will be useful to the implementing NGO in evaluating the impact of the programme on school children's hygiene practices. The study will help health educators to understand that knowledge does not always lead to practice, the hardware such as latrines, pumps and pipes for water need to be provided for hygiene practices to be sustained. It is recommended that health teaching methods should be revisited and more emphasis given to the use of teaching aids such as pictures and charts. Teachers should ensure periodic evaluations of personal hygiene and sanitation practices of the pupils through daily school inspections and home visits. It is also recommended that PHASE be incorporated in the national school curriculum so that all other schools can benefit. It is also noted that children observe personal hygiene for fear of punishment, rather than prevention of health problems. Therefore, appropriate messages on the health importance of personal hygiene should be given to them. Overall, it is concluded that initiatives aimed at improving access to water and sanitation must be more holistic if meaningful gains are to be realized.