Skip to main content
Top
Published in: BMC Public Health 1/2021

Open Access 01-12-2021 | Research

The potential of school-based WASH programming to support children as agents of change in rural Zambian households

Authors: James C. Winter, Gary L. Darmstadt, Samantha J. Lee, Jennifer Davis

Published in: BMC Public Health | Issue 1/2021

Login to get access

Abstract

Background

Water, sanitation, and hygiene (WASH) interventions frequently assume that students who learn positive WASH behaviors will disseminate this information to their families. This is most prominent in school-based programs, which rely on students to act as “agents of change” to translate impact from school to home. However, there is little evidence to support or contradict this assumption.

Methods

We conducted a quasi-experimental, prospective cohort study in 12 schools in rural, southern Zambia to measure the impact of WASH UP!, a school-based WASH program designed by the creators of Sesame Street. WASH UP! is an educational program that uses stories and interactive games to teach students in grades 1–4 about healthy behaviors, such as washing hands and using the latrine. We completed in-person interviews with grade 1 and 4 students (N = 392 and 369, respectively), their teachers (N = 24) and caregivers (N = 729) using structured surveys containing both open- and closed-ended questions. We measured changes in knowledge and whether students reported sharing WASH-related messages learned in school with their caregivers at home.

Results

Student knowledge increased significantly, but primarily among students in grade 1. Overall rates of students reporting that they shared messages from the curriculum with their caregivers rose from 7 to 23% (p <  0.001). Students in grade 4 were 5.2 times as likely as those in grade 1 to report sharing a WASH-related message with their caregivers (ARR = 5.2, 95% C.I. = (2.3, 8.9); p <  0.001).

Conclusions

Although we measured only modest levels of student dissemination of WASH UP! messages from the school to the home, students in grade 4 showed significantly more promise as agents of change than those in grade 1. Future work should prioritize developing curricula that reflect the variability in needs, capabilities and support in the home and community among primary school students rather than a single approach for a wide range of ages and contexts.
Appendix
Available only for authorised users
Literature
7.
go back to reference Adams J, Bartram J, Chartier Y, Sims J. Water, sanitation and hygiene standards for schools in low-cost settings. Geneva: World Health Organization; 2009. Adams J, Bartram J, Chartier Y, Sims J. Water, sanitation and hygiene standards for schools in low-cost settings. Geneva: World Health Organization; 2009.
14.
go back to reference Caruso BA, Freeman MC, Garn JV, Dreibelbis R, Saboori S, Muga R, et al. 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 Heal. 2014;19(10):1185–97. https://doi.org/10.1111/tmi.12360.CrossRef Caruso BA, Freeman MC, Garn JV, Dreibelbis R, Saboori S, Muga R, et al. 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 Heal. 2014;19(10):1185–97. https://​doi.​org/​10.​1111/​tmi.​12360.CrossRef
15.
go back to reference Grover E, Hossain MK, Uddin S, Venkatesh M, Ram P, Dreibelbis R. Comparing the behavioural impact of a nudge-based handwashing intervention to high-intensity hygiene education: a cluster-randomised trial in rural Bangladesh. Trop Med Int Health. 2018;23(1):10–25.CrossRef Grover E, Hossain MK, Uddin S, Venkatesh M, Ram P, Dreibelbis R. Comparing the behavioural impact of a nudge-based handwashing intervention to high-intensity hygiene education: a cluster-randomised trial in rural Bangladesh. Trop Med Int Health. 2018;23(1):10–25.CrossRef
30.
go back to reference Mosavel M, Genderson MW. Daughter-Initiated Cancer Screening Appeals to Mothers. J Cancer Educ. 2016;31(4):767–75 Available from: file:///C:/Users/Carla Carolina/Desktop/Artigos para acrescentar na qualificação/The impact of birth weight on cardiovascular disease risk in the.pdf.CrossRef Mosavel M, Genderson MW. Daughter-Initiated Cancer Screening Appeals to Mothers. J Cancer Educ. 2016;31(4):767–75 Available from: file:///C:/Users/Carla Carolina/Desktop/Artigos para acrescentar na qualificação/The impact of birth weight on cardiovascular disease risk in the.pdf.CrossRef
31.
go back to reference Gadhoke P, Christiansen K, Swartz J, Gittelsohn J. “Cause it’s family talking to you”: children acting as change agents for adult food and physical activity behaviors in American Indian households in the upper Midwestern United States. Childhood. 2015;22(3):346–61. https://doi.org/10.1177/0907568214538290.CrossRef Gadhoke P, Christiansen K, Swartz J, Gittelsohn J. “Cause it’s family talking to you”: children acting as change agents for adult food and physical activity behaviors in American Indian households in the upper Midwestern United States. Childhood. 2015;22(3):346–61. https://​doi.​org/​10.​1177/​0907568214538290​.CrossRef
Metadata
Title
The potential of school-based WASH programming to support children as agents of change in rural Zambian households
Authors
James C. Winter
Gary L. Darmstadt
Samantha J. Lee
Jennifer Davis
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2021
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-021-11824-3

Other articles of this Issue 1/2021

BMC Public Health 1/2021 Go to the issue