Influence of hygiene education in schools on household hygiene knowledge and behaviors in Addis Ababa, Ethiopia

Abstract

Background: Despite significantly improved access to clean water in Addis Ababa, Ethiopia in the past ten years, diarrheal diseases have risen to the leading cause of death nationwide and use of soap remains low. Improving student hygiene behaviors through school-based hygiene programming has proven to be effective but changing adult behaviors remains a challenge. Objectives: To evaluate if and how hygiene programming aimed at students in schools in Addis Ababa, Ethiopia influences handwashing knowledge and behaviors in the home. The findings will lay the groundwork for further research on strengthening the link between school-based programming and household behaviors and influence how WASH organizations work to improve disease outcomes and quality of life. Methods: Semi-structured interviews, environment observations, and handwashing demonstrations were conducted. Participants: Thirty-five adult family members of children enrolled in Addis Ababa government primary schools between January and March 2018 (26 intervention and 9 control participants). Results: Participants overwhelmingly believed that adults can learn from children. Participants of children enrolled in their school’s Hygiene Club perceived and could identify changes in their children’s and their own hygiene behaviors, while participants without a Hygiene Club member could not. Regardless of children’s Hygiene Club enrollment status, intervention participants demonstrated significantly better handwashing and were significantly more likely to have soap present at their handwashing station than control participants. Conclusions: Study findings suggest strong potential for improving household hygiene behaviors through school-based hygiene education.