Shadi Saboori

Assessing the impact of a school‐based water treatment, hygiene and sanitation programme on pupil absence in Nyanza Province, Kenya: a cluster‐randomized trial

Objectives  There has been increased attention to access to water, sanitation and hygiene (WASH) at schools in developing countries, but a dearth of empirical studies on the impact. We conducted a cluster‐randomized trial of school‐based WASH on pupil absence in Nyanza Province, Kenya, from 2007 to 2008.

The Impact of School Water, Sanitation, and Hygiene Interventions on the Health of Younger Siblings of Pupils: a Cluster-Randomized Trial in Kenya

OBJECTIVES We examined the impact of school water, sanitation, and hygiene (WASH) interventions on diarrhea-related outcomes among younger siblings of school-going children. METHODS We conducted a cluster-randomized trial among 185 schools in Kenya from 2007 to 2009. We assigned schools to 1 of 2 study groups according to water availability. Multilevel logistic regression models, adjusted for baseline measures, assessed differences between intervention and control arms in 1-week period prevalence of diarrhea and 2-week period prevalence of clinic visits among children younger than 5 years with at least 1 sibling attending a program school. RESULTS Among water-scarce schools, comprehensive WASH improvements were associated with decreased odds of diarrhea (odds ratio [OR] = 0.44; 95% confidence interval [CI] = 0.27, 0.73) and visiting a clinic (OR = 0.36; 95% CI = 0.19, 0.68), relative to control schools. In our separate study group of schools with greater water availability, school hygiene promotion and water treatment interventions and school sanitation improvements were not associated with differences in diarrhea prevalence between intervention and control schools. CONCLUSIONS In water-scarce areas, school WASH interventions that include robust water supply improvements can reduce diarrheal diseases among young children.

Sustaining school hand washing and water treatment programmes: Lessons learned and to be learned

In Nyanza Province, Kenya, a sustainability evaluation of 55 pilot primary schools 2.5 years after the implementation of the Safe Water System (SWS) intervention revealed that programme activities were not successfully sustained in any of the schools visited. The most common criterion met was drinking water provision. We identified six enabling environment domains: financial capacity; accountability; technical feasibility and availability; community support; school leadership and management; and student engagement. While these domains pertain to the sustaining of the SWS activities in schools, they are likely to be applicable in creating an enabling environment and serve as proxy indicators for other school water, sanitation, and hygiene initiatives as well.

Is soapy water a viable solution for handwashing in schools

Despite the known health benefits of washing hands with soap, global handwashing rates are low. In Nyanza Province, Kenya, a follow-up of 55 pilot primary schools three years after the implementation of a safe water and hygiene intervention revealed that only 2 per cent (one school) provided soap for handwashing on the day of the assessment. After identifying barriers to soap provision, SWASH+ partners piloted a handwashing intervention using powdered soap mixed with water to create soapy water in place of bar soap in 11 schools. The first six months of unannounced visits showed high uptake (10 schools). A one-year follow-up visit revealed a decrease of soapy water use (four schools). This paper discusses the soapy water intervention, initial and follow-up monitoring findings, potential sustainability drivers of handwashing programmes in rural primary schools and next steps.

Assessing The Impact Of A School-Based Latrine Cleaning And Handwashing Program On Pupil Absence In Nyanza Province, Kenya: A Cluster-Randomized Trial

Improving school water, sanitation and hygiene (WASH) conditions reduces pupil absence and illness. However, these benefits may depend on the conditions of the latrines and availability of consumables. We sought to determine whether a low‐cost, policy‐relevant, environmental‐level latrine cleaning intervention could improve latrine cleanliness, increase its use and reduce absenteeism.

Impact of Regular Soap Provision to Primary Schools on Hand Washing and E. coli Hand Contamination among Pupils in Nyanza Province, Kenya: A Cluster-Randomized Trial

We assessed whether supplying soap to primary schools on a regular basis increased pupil hand washing and decreased Escherichia coli hand contamination. Multiple rounds of structured observations of hand washing events after latrine use were conducted in 60 Kenyan schools, and hand rinse samples were collected one time in a subset of schools. The proportion of pupils observed practicing hand washing with soap (HWWS) events was significantly higher in schools that received a soap provision intervention (32%) and schools that received soap and latrine cleaning materials (38%) compared with controls (3%). Girls and boys had similar hand washing rates. There were non-significant reductions in E. coli contamination among intervention school pupils compared with controls. Removing the barrier of soap procurement can significantly increase availability of soap and hand washing among pupils; however, we discuss limitations in the enabling policy and institutional environment that may have prevented reaching desired levels of HWWS.

Field report: Large-scale school rainwater harvesting systems: a pilot study in Nyanza Province, Kenya

In schools where water supply is either unavailable or insufficient, rainwater harvesting (RWH) systems may be a low-cost solution. We piloted large-scale RWH systems in rural primary schools in Nyanza Province, Kenya to investigate the sustainability of these systems several years post-implementation. This paper discusses the main findings of our pilot and, to our knowledge, is the only published study on school RWH performance in a low-income setting.