Assessment of water, sanitation and hygiene situation in public secondary schools in Blantyre city

Abstract

Background: There is a growing demand on school hygiene and sanitation facilities given the growing number of school enrolments in Malawi. The provision of safe water, improved sanitary facilities and good hygiene practices in schools has been established to improve health, boost educational achievement, and promote gender equity which has a positive impact on the society. It is really important to regularly expose and document the status of water, sanitation and hygiene (WASH) in schools so that improvements may be done accordingly, if any required. Very often, however, most of the studies on WASH in Malawi have directed their attention on primary schools and insufficient attention is paid to secondary schools. For this reason, it is documented that Malawi has a lot of data pertaining to the status of WASH in primary schools and no country statistics are available for secondary school sanitation. Aim of the study: The study aimed at assessing the current situation of water, sanitation and hygiene (WASH) in public secondary schools in Blantyre City. Methods: A total of 10 secondary schools in Blantyre City were selected using stratified and purposive sampling techniques. Samples of 37 students and 8 teachers from each school were also selected using systematic and simple random sampling methods respectively. Semi-structured questionnaire containing open-ended questions was used to collect qualitative data on knowledge of WASH among learners and teachers. Structured questionnaire containing close-ended questions was used to collect quantitative data on basic school information and number of WASH facilities from head teachers. Observation checklist incorporating international standards for WASH in schools by UNICEF and recommendations by the Ministry of Education Science and technology (MoEST) was used as the guiding principles to evaluate the adequacy of the various WASH components in the selected schools. Record reviews were also done to collect secondary data on various WASH projects recently implemented in schools throughout Malawi. Results: In terms of availability of drinking water, all 10 public secondary schools visited had water supply systems connected to the Blantyre Water Board. However, the majority (7 schools) had no alternative water source (borehole or tanks) in case of water crisis. Additionally, in 8 schools, non-functional water access points outnumbered functional ones. The overall water access points to student ratio was 1:239, which was about twice less and significantly lower (α= vii 0.05, p≤0.03) than the recommended ratio of 1:150. This meant that 8 of the 10 schools did not comply with the recommended water access point to students‟ ratio. In terms of availability of improved sanitation and hygiene facilities, in 8 schools (80%) toilet ratios for boy and girls were less than the recommended ones, especially in Community Day Secondary Schools (CDSSs). The average toilet ratios for boys and girls in the sampled secondary schools were 1:74 and 1:43 versus the recommended ones of 1:50 and 1:25 respectively. The ratio for female students was significantly lower (α= 0.05, p≤0.04) than that for males. In 6 of the 10 schools visited, toilet hygiene was not satisfactory. Faecal matter and urine were observed around the drop-holes or the seats of flush toilets such that 33% of the students could not use the toilet facilities because they were always dirty and produced unpleasant odour. Hand washing facilities were completely not available in 3 of the 10 public secondary schools, especially in CDSSs. Where the hand washing points were available, 86% of them, in total, were in a deplorable state and no soap was provided to students for hand washing in all schools. School-based WASH committees and clubs were unheard of in all schools, indicating a lack of hygiene promotion and education. Conclusion: The results from this study indicate that the present status of WASH in secondary schools within Blantyre City, especially CDSSs, is not satisfactory due to inadequate access to potable water by students, inadequate and deplorable sanitation and hygiene facilities, and absence of hygiene promotion and education. Therefore, the study vividly recommends that there should be a deliberate programme/project on WASH in secondary schools that will work towards: (a) provision of additional functioning water access points/ repairing non-functional ones (b) installation of water tanks to ensure continuous water availability even during water crisis (c) building additional toilets especially for female students giving priority to CDSS (d) provision of hand washing facilities where the facilities are not available, and (e) promotion of good hygiene practices by involving students in health clubs and WASH education.