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Impact of School WASH Facilities on Handwashing Practices among Primary School Pupils in Nigeria

Abstract

Hand hygiene is an important component of infection prevention and health promotion among school-aged children. Regular and appropriate handwashing can reduce exposure to infectious agents and may help prevent diarrhoeal diseases, respiratory infections, and other communicable diseases among primary school pupils. However, the practice of handwashing in Nigerian schools may be affected by inadequate water supply, insufficient handwashing stations, lack of soap, poor maintenance of WASH facilities, overcrowding, limited hygiene education, and inconsistent supervision. School Water, Sanitation and Hygiene (WASH) facilities provide an important environmental foundation for promoting appropriate handwashing practices by ensuring that pupils have convenient access to water, soap, handwashing stations, toilets, and other hygiene infrastructure. Against this background, this study investigates the impact of school WASH facilities on handwashing practices among primary school pupils in Nigeria. The study will be anchored on the Social Ecological Model, Health Belief Model, and Social Cognitive Theory. The Social Ecological Model emphasizes the influence of individual, interpersonal, school, community, and environmental factors on children's hygiene behaviour. The Health Belief Model explains how pupils' perceptions of infection risks, perceived benefits of handwashing, perceived barriers, and cues to action may influence their handwashing practices. Social Cognitive Theory emphasizes observational learning, behavioural reinforcement, self-efficacy, and the influence of the school environment on the development and maintenance of healthy behaviours. Collectively, these theoretical perspectives provide a suitable framework for explaining how school WASH facilities may influence handwashing practices among primary school pupils in Nigeria. The study will adopt a quantitative analytical cross-sectional or quasi-experimental research design. The study population will comprise pupils enrolled in selected public and private primary schools in Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, schools, classes, and eligible pupils. School WASH facilities will be assessed using indicators such as availability of functional handwashing stations, accessibility of water, availability of soap or other appropriate hand-cleansing materials, reliability of water supply, pupil-to-handwashing-station ratio, condition and cleanliness of facilities, availability of age-appropriate facilities, accessibility for pupils with disabilities where applicable, toilet availability, waste-disposal facilities, drainage, maintenance practices, and school WASH management. Handwashing practices will be assessed using indicators such as frequency of handwashing, handwashing at critical times, use of soap, duration and technique of handwashing, handwashing before eating, after toilet use, after cleaning activities, and after contact with potentially contaminated materials. Where feasible, direct observation of pupils' handwashing behaviour and structured observation of handwashing facilities will be used to complement questionnaire responses. Data will be collected using structured questionnaires, school WASH observation checklists, direct behavioural observation, school health records, facility maintenance records, and interviews with teachers or school health personnel. Descriptive statistics will be used to summarize pupils' characteristics, availability of WASH facilities, and handwashing practices. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of school WASH facilities on handwashing practices. Where a quasi-experimental design is adopted, handwashing practices before and after improvement of school WASH facilities may be compared, or schools with adequate WASH facilities may be compared with similar schools with inadequate facilities. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that adequate and functional school WASH facilities have a significant positive impact on handwashing practices among primary school pupils in Nigeria. Pupils attending schools with reliable water supplies, accessible handwashing stations, soap availability, adequate sanitation facilities, and effective WASH maintenance systems are expected to demonstrate better handwashing practices than pupils attending schools with inadequate WASH infrastructure. Convenient access to handwashing facilities may reduce practical barriers and make it easier for pupils to wash their hands at critical times. Regular hygiene education and teacher supervision may further reinforce appropriate practices. However, intermittent water supply, lack of soap, poorly maintained facilities, overcrowding, inadequate funding, vandalism, poor drainage, and limited school-level WASH management may reduce the effectiveness of available infrastructure. The study therefore expects adequately designed, accessible, functional, and well-maintained school WASH facilities to contribute significantly to improved handwashing practices among primary school pupils in Nigeria. The study is expected to contribute to the literature on school WASH, handwashing practices, hygiene behaviour, school health, infection prevention, environmental health, child health, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, National Primary Health Care Development Agency, state ministries of health and education, local education authorities, primary schools, school health personnel, environmental health officers, development partners, non-governmental organizations, and policymakers regarding strategies for improving hygiene in schools. The study will also provide evidence-based recommendations for increasing access to functional school WASH facilities, ensuring reliable water and soap supplies, improving maintenance systems, strengthening school hygiene education, promoting teacher supervision, establishing routine WASH monitoring, improving sanitation infrastructure, and integrating WASH interventions into comprehensive school health programmes across Nigeria.

Keywords: School WASH facilities, handwashing practices, primary school pupils, water sanitation and hygiene, school health, hygiene behaviour, infection prevention, child health, environmental health, Nigeria, public health.