Abstract
Background: Poor hygiene and sanitation knowledge and practices pose serious health risks to vulnerable populations, such as school-going children. Kenya is among the 26 countries worldwide that account for 90% of open defecation. School-led total sanitation (SLTS) is a novel intervention that has been successfully implemented in South African countries to improve sanitation and hygiene outcomes among school-going children. Despite the intervention’s success elsewhere, it has not been implemented in Kenya. The main aim of this study was to assess SLTS’ effectiveness in improving sanitation and hygiene knowledge and practices among school-going children in Baringo County.
Methods: A quasi-experimental study was conducted involving 434 pupils divided into intervention and control groups across three schools in each study group. A six-month intervention included triggering, forming health clubs, training sessions, and distributing information, education, and information materials. Thereafter, an evaluation was performed 3 months post-intervention. The data were analyzed using SPSS V18. The Chi-square test was used to compare knowledge and practices in both groups, while the difference in differences (DID) method assessed intervention effectiveness.
Results: Compared to the control group (15.2%), children in the intervention group (63.2%) showed significantly high knowledge levels (χ2=104.67, df=1, P<0.0001). There was a 52.3% mean increase in knowledge among children in the intervention group. A more considerable number of pupils (85.6%) in the intervention schools washed their hands with soap compared to 65.5% (χ 2=23.57, df=1, P<0.0001) in the control group, demonstrating an increase of 19.6%. In the intervention group, there was a significantly lower proportion of pupils who practiced open defecation at home (16.3%) compared to 35.4% in the control group (χ 2=25.0, df=1, P<0.0001).
Conclusion: The SLTS intervention led to an increase in knowledge on sanitation and hygiene but a reduction in open defecation at home among school-going children. These findings revealed that SLTS is an effective approach that can be adopted by regional governments, national governments, and other stakeholders as an additional intervention to address the problem of poor hygiene and sanitation in Kenya.