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Final evaluation report for the schools’ hand washing project 1
“Safeguarding Lives”
School Hygiene Project Final Evaluation
December 2011
The opinions expressed in this report are those of the authors and do not necessarily reflect the
views of other partners or donors.
Final evaluation report for the schools’ hand washing project 2
Table of Contents
LIST OF TABLES .......................................................................................................................... 4
LIST OF FIGURES ........................................................................................................................ 4
LIST OF ACRONYMS AND ABBREVIATIONS ....................................................................... 6
ACKNOWLEDGEMENT .............................................................................................................. 7
EXECUTIVE SUMMARY ............................................................................................................ 9
1. INTRODUCTION ................................................................................................................. 12
1.1. Background to the hand washing project ................................................................................... 12
1.2. Project implementation, goal and objectives: ............................................................................ 12
1.3. Description of interventions undertaken during project implementation ................................. 12
1.4. Objectives of the final project evaluation ................................................................................... 13
2. METHODOLOGY ................................................................................................................ 14
2.1 Study area and population ................................................................................................................ 14
2.2 Sample size and Sampling method ............................................................................................. 14
2.3 Data collection procedures .......................................................................................................... 15
2.4 Data management and analysis .................................................................................................. 15
2.5 Ethical issues ............................................................................................................................... 16
2.6 Quality assurance ........................................................................................................................ 16
2.7 Limitations of the final evaluation .............................................................................................. 17
3. FINDINGS ................................................................................................................................ 18
3.1 Socio-demographic characteristics of midterm evaluation respondents ..................................... 18
3.2 Reported exposure to target hygiene messages and intervention activities ............................... 20
3.3 Schools’ capacity for effective hygiene promotion ....................................................................... 21
3.4 Children’s knowledge and understanding of benefits of hand washing and of the critical times 22
3.5 Status of facilities and hygiene in the schools ............................................................................... 22
3.6 Reported incidence of runny stomach (Diarrhea) ......................................................................... 23
3.7 Treatment of runny stomach ........................................................................................................ 24
3.8 Absenteeism from school due to Diarrhea ................................................................................... 25
3.9 Respondents’ reported hand washing practices ........................................................................... 25
3.10 Reported hand washing before eating ....................................................................................... 26
3.11 Reported hand washing after toilet use ...................................................................................... 27
3.12 Reported hand washing with water only .................................................................................... 28
Final evaluation report for the schools’ hand washing project 3
3.13 Reported hand washing with soap and water ............................................................................ 29
3.14 Reported last place of hand washing .......................................................................................... 30
3.15 Children’s attitude towards hand washing ................................................................................. 30
3.16 Teachers attitude on the hygiene education program ............................................................... 31
3.17 The school to community linkage ............................................................................................... 31
3.18 Relevance of the project ............................................................................................................. 32
3.19 Usefulness of the project ............................................................................................................ 32
3.20 Effectiveness of the project ......................................................................................................... 32
3.21 Sustainability of project interventions ........................................................................................ 32
3.22 Challenges and suggested solution ............................................................................................. 32
Annex 1: Quality assurance aspects covered during the pre-data collection training workshop .. 34
Annex 2: Responsibilities of the final evaluation data collection team ........................................ 35
Annex 3: The pupils’ questionnaire .............................................................................................. 36
Annex 4: The teachers’ interview guide ....................................................................................... 38
Annex 5: The observation checklist .............................................................................................. 43
Final evaluation report for the schools’ hand washing project 4
LIST OF TABLES
Table 1: Schools names and population size ................................................................................... 12 Table 2: Distribution of the sample population (n = 402) ............................................................... 14
Table 3: Socio-demographic characteristics .................................................................................... 18 Table 4: Existing number of toilets for pupils in the schools compared with school population .... 23 Table 5: Prevalence of runny stomach ............................................................................................. 24 Table 6: Absenteeism from school .................................................................................................. 25 Table 7: Hand washing before eating .............................................................................................. 26
Table 8: Hand wash after toilet use.................................................................................................. 27 Table 9: Hand wash with water ....................................................................................................... 28 Table 10: Hand washing with soap and water ................................................................................. 29
Table 11: Last Place of Hand washing ............................................................................................ 30 Table 12: Recommendation on the importance of hand washing .................................................... 31
LIST OF FIGURES
Figure 1: Age of respondents in years .......................................................................................... 19
Figure 2: Percentage of respondents in respective grades 1 to 7 .................................................. 19
Figure 3: Respondents Gender distribution in percentages .......................................................... 20 Figure 4: Reported incidence of runny stomach (Diarrhea) among pupils (?) ............................. 24
Figure 5: Reported incidence of runny stomach/ Diarrhea by school .......................................... 24 Figure 6: Treatment of runny stomach from hospital / clinic ....................................................... 25 Figure 7: Hand washing before eating .......................................................................................... 27
Figure 8: Hand wash after toilet use
.......................... 27
34.0%
49.0%
17.0%
69.3%
30.4%
0.3%
66.2%
33.8%
0.0% 0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
Always Sometimes Never
Hand wash after toilet use
Baseline
Midterm
Final
Final evaluation report for the schools’ hand washing project 5
Figure 9: Hand wash after toilet use by school
.......................... 28 Figure 10: Hand washing with soap and water by School ............................................................ 29 Figure 11: Reported Last Place of hand washing
....................... 30
5.2%
18.9%
13.2%
19.4%
9.5%
14.9%
1.0%
7.0%
0.5%
10.4%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
BunyaCombined
School
EpundiPrimarySchool
KoomaPrimarySchool
OhalushuPrimaryschool
OwayelulaPrimarySchool
Hand wash after toilet use by school
Always
Sometimes
Never
21%
79%
30.70%
69.30%
85.40%
14.60%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
School Home
Reported Last Place of Hand washing
Baseline
Midterm
Final
Final evaluation report for the schools’ hand washing project 6
Figure 12: Recommendation on the importance of hand washing
.............................. 31
LIST OF ACRONYMS AND ABBREVIATIONS
BCC Behavior Change Communication
CHCs Community Health Consultants
GHWD Global Hand washing Day
GRN Government of the Republic of Namibia
M&E Monitoring and Evaluation
MOE Ministry of Education
MCH Maternal and Child Health
70.30%
16.62% 10.90%
2.18%
All people Friends Family members communitymembers
Recommendation
Final evaluation report for the schools’ hand washing project 7
n Total Number of study respondents
PS Primary School
SFH Society for Family Health
SPSS Statistical Package for Social Scientists
UNICEF United Nations Children's Fund
ACKNOWLEDGEMENT
Implementation of the Hand Washing Project and the final evaluation was made possible through
support provided by the Namibian Government, UNICEF and GlaxoSmithKline under the
“Safeguarding Lives” project for promoting healthy hand washing practices in children aged 6 to
12 years in five selected schools in Northern Namibia.
The Society for Family Health (SFH) extends its appreciation to UNICEF and GlaxoSmithKline
for funding the project implementation and the evaluation study; the management and children in
the five schools (Epundi Primary School – Ohangwena; Ohalushu Primary School – Ohangwena;
Bunya Combined School – Kavango; Onayeluka Primary School – Omusati and Kooma Primary
School – Omusati) that participated in the project implementation; and the Community Health
Consultants (CHCs) who facilitated the project’s implementation in the five schools and also
participated in data collection for the final project evaluation. SFH is equally grateful to the
Ministry of Education, especially the management of the five schools for creating an enabling
environment for project implementation.
Final evaluation report for the schools’ hand washing project 8
SFH also extends its gratitude to its staff and volunteers for the tireless efforts to ensure
successful implementation of the project implementation and completion of the final evaluation.
Final evaluation report for the schools’ hand washing project 9
EXECUTIVE SUMMARY
Background:
The Society for Family Health (SFH) facilitated implementation of a Schools’ Hand washing
project to raise awareness about hand washing and general hygiene in five selected schools
(Epundi Primary School – Ohangwena; Ohalushu Primary School – Ohangwena; Bunya
Combined School – Kavango; Onayeluka Primary School – Omusati and Kooma Primary School
– Omusati) in three Northern regions. The one year project was implemented from October 2010
to October 2011. A baseline study was done in October 2010, midterm review done in July 2011
and final evaluation in November 2011. The final evaluation was conducted to assess the project
performance and its impact on target population. Specific objectives of the final evaluation were
to:
1. Assess knowledge and understanding of benefits of hand washing and of the critical
times
2. Assess the exposure to target hygiene messages and intervention activities
3. Determine the incidence of diarrhea (runny stomach) among children in the five schools.
4. Establish status of facilities and hygiene in the schools (a reflection of school
commitment to a safe and clean school environment)
5. Assess attitude to hand washing
6. Assess hand washing practices with regard to:
6.1.Hand washing before eating
6.2.Hand washing after toilet use
6.3.Hand washing with soap and water
6.4.Hand washing with only water
6.5.Frequency of hand washing
6.6.Absence from school due to diarrhea
7. Assess the project’s successes, impact and challenge to inform future decisions about similar
programs
8. Assess the relevance, usefulness and effectiveness of project interventions
9. Assess the potential for sustainability of the project interventions.
Methods:
The final evaluation involved collecting data using a structured questionnaire administered to
randomly selected 402 (22.6%) of the 1778 children in the five schools in November 2011. The
respondents were aged between 6 and 12 years and attended classes in grades 1 to 6 in the five
schools. Data collection also included interviewing 32 teachers and conducting observations of
toilet and hand washing facilities used by children in the five schools.
Results:
The final evaluation findings reveal a considerable improvement in knowledge and practices
related to hand washing, as well as a remarkable improvement in health / hygiene indicators
measured at baseline and midterm evaluation.
i. Exposure to target hygiene messages and intervention activities:
Hygiene classes/sessions are held at each school 3 times weekly and are facilitated by trained
SFH community health consultants with the support of SFH Behavioural Change
Communication (BCC) Officers and school teachers. During a week, all grade classes are
exposed at least once.
Final evaluation report for the schools’ hand washing project 10
One hundred percent of the interviewed pupils reported ever hearing of hand washing and of
these, 50% reported that they had heard the message from sessions at school.
ii. Knowledge and understanding the benefits of hand washing and of the critical times:
Children understand the need for washing hands at critical times including before
eating, after toilet use and that they should wash their hands with soap/ash and water.
The main reason given when children were asked why they should wash their hands
was: to remove germs (58%)
iii. Incidence of diarrhea (runny stomach) among children:
Findings show a reported reduction in diarrhea incidence from 50% reported at
baseline to 10.7% at final evaluation.
iv. Absenteeism from school
The survey shows a reduction from 40% at baseline to 5.3% at final evaluation in
absenteeism from school among children who experienced diarrhea in the 3 month
period preceding the final evaluation. The overall drop in the diarrhea incidents
among pupils increased attendance by 34.7%
v. Status of facilities and hygiene in the schools:
At final evaluation, 23(68%) of the existing 34 pupils latrines were functional. All
schools scored an average of 69% in terms of cleanliness and usage of toilet facilities
at the time of observation which shows an improvement compared to 50% at
midterm. There has been a great improvement in the accessibility of soap and water
directly due to the program intervention, and basins and/or buckets of water are
placed at specific key points in order to supplement the limited tap-points and better
facilitate hand washing.
vi. Attitudes towards hand washing
Almost all (99%) children who were interviewed indicated that they will recommend
the importance of hand washing to someone else.
vii. Hand washing practices before eating:
Hand washing before eating improved from 58% at baseline to 78.1 % for the aspect
“always” at final evaluation.
viii. Hand washing after toilet use:
Hand washing after toilet use improved from 34% reported at baseline to 66.2% at
final evaluation.
ix. Hand washing with soap and water
Children reporting always washing their hands with soap and water improved from
8% at baseline to 24% at final evaluation. More than half (62%) of the children
reported that they sometimes wash their hands with soap and water. Absence of water
and soap at school may be the contributing factors to the result of children sometimes
(not always?) washing their hands with soap and water.
x. Hand washing with only water:
Final evaluation report for the schools’ hand washing project 11
Few children (3.5%) reported always using only water for washing hands and the
majority (72.5%) never only use water. The majority of children, as indicated above,
attempt to always or at least sometimes wash with soap and water.
xi. Frequency of hand washing: Frequency of hand washing at school increased from
baseline value of 21% to 85.4% at final evaluation, showing a significant
improvement in the practice. For this question, children were asked where they had
done their LAST hand washing.
Project’s successes, impact and challenge
The project is considered a success having achieved its aims of increased exposure to hygiene and
sanitation information, improved hygienic practices among the pupils in the target schools,
contributed to reduction in incidence of diarrhea and subsequent absenteeism from school due to
diarrhea. The respondents’ highlighted challenges included lack of sufficient IEC materials, limited
access to resources such as water and soap for hand washing, cleaning materials and toilet paper.
Relevance, usefulness and effectiveness of project interventions
The project was considered relevant for its contribution to reduction in incidence of diarrhea and
absenteeism of pupils from school due to diarrhea. The improvement in pupil’s knowledge, attitudes
and hand washing practices renders the project useful and effective.
Potential for sustainability of the project interventions
The potential for sustainability was evaluated based on commitment of the school management,
communities and pupils themselves; resource mobilization; and replicability of activities /
interventions. The findings from teachers’ interviews revealed a commitment of the pupils and
teachers towards hygiene education interventions, with teachers playing a pivotal role and
supporting pupils in their efforts to develop extra materials or design and participate in activities
such as drama for increased hygiene and sanitation education. The potential for replicating the
project interventions is schools was reported by teachers indicating the participation of children
and teachers from neighboring schools in events such as drama and role plays and subsequent
adoption of recommended behavior.
Conclusions and recommendations:
Generally, children’s knowledge on importance of hand washing as well as the practice
improved with the implementation of the hand washing project in the five targeted schools. The
incidence of diarrhea which is associated with unhygienic conditions and absenteeism from
school due to diarrhea significantly reduced, which could be attributed to the project
intervention. Children are more exposed to targeted hygiene messages and intervention activities.
An improvement in attitudes and hand washing practices among children were also observed.
Specific interventions such as increasing access to water for hand washing by increasing the
number of functional water taps in the schools; providing soaps for washing hands; increasing
schools’ functional toilet coverage to reduce pupil to toilet ratio; ensure the availability of
cleaning materials to ease cleaning of the toilets and avail toilet papers for children’s use. The
Ministry of Basic Education should endeavor to supply the necessary material/resources to the
schools and also ensure monitoring of their usage to minimize wastage. The schools should also
demonstrate increased ownership of hygiene interventions by encouraging child participation in
cleaning activities.
Final evaluation report for the schools’ hand washing project 12
1. INTRODUCTION
1.1. Background to the hand washing project
The Schools Hand washing project was a partnership between UNICEF, SFH and the
Government of the Republic of Namibia (GRN) aimed at raising awareness about hand washing
and general hygiene in five selected schools in three Northern regions namely: Ohangwena,
Omusati and Kavango. The project was implemented in five selected schools with a total
population of 1778 pupils (Table 1).
Table 1: Schools’ names and population size
Region Name of School Pupil population as at November 2011
Ohangwena Epundi Primary School 302
Ohangwena Ohalushu Primary School 379
Kavango Bunya Combined School 758
Omusati Onayeluka Primary School 195
Omusati Kooma Primary School 144
Total 5 schools 1778
1.2. Project implementation, goal and objectives: Project implementation started on 15 October 2010 and ended on 4 November 2011.The project
was a pilot initiative aimed at providing lessons for scaling up. The project’s goal was to increase
awareness on the importance of hand washing with soap by means of mass-media as well as
activity interventions among school children aged 6 – 12 years in 5 schools in 3 regions with
pupils, teachers, parents and/or Caregivers, and monitoring of the outcome. Two project
objectives were:
1. By October 2010 Radio and print media stations partner with stakeholders, child
broadcasters, peer educators to promote a national awareness on Hand washing with soap
2. By June 2011, at least 20 % of pupils aged 6 – 12 years in 5 schools in 3 regions report
the improved practice of hand washing and basic hygiene in order to improve their
health.
1.3. Description of interventions undertaken during project implementation The UNICEF hand washing schools project consisted of:
1. Development of training manual and facilitation guides: The manual and guides were used
for training Community Health Consultants (CHCs) and teachers to prepare them to
implement the “Safeguarding Lives” project in the target schools.
2. Training of Teachers & CHCs: 15 teachers and 10 Community Health Consultants (CHCs) (3
teachers and 2 CHCs per school) were selected and trained on Hand washing to facilitate the
sessions in the schools
Final evaluation report for the schools’ hand washing project 13
3. Mass Media programs in child-friendly formats: The mass media programs in this project
included:
Radio messages covering key aspects of hand washing, hygiene and health
Interviews about hand washing and the health benefits
Printed media messages such as hand washing leaflets with messages about the benefits
of hand washing and the steps to be taken during hand washing
Dramas and songs that were developed and used for in-classroom activities as well as for
performance at community platforms.
4. Global Hand Washing Day (GHWD) Celebration: Two GHWD celebrations were held
during project time, one on 15th
October 2010 where a total of 2533 people attended, and
another on 15th
October 2011 with participation of 2613 people.
5. Ongoing schools activities: The activities included hand washing sessions with learners in the
classrooms through various models such as drama songs, drawings, and role plays. Messages
were also passed onto the children and school communities during extracurricular activities
such as:
Community dramas about handwashing and hygiene acted out by the children for
the adults in their community
Schoolyard cleaning
Drama performances about handwashing and hygiene at school functions
1.4. Objectives of the final project evaluation The general objective was to determine the project performance and short term impact of the
hand washing project on the knowledge and practices of the children in the five participating
schools. It also aimed at assessing the project’s successes, impact and challenge to inform future
decisions about similar programs.
Specific objectives
The specific objectives were to:
1. Assess the exposure to target hygiene messages and intervention activities
2. Assess knowledge and understanding of benefits of hand washing and of the critical times
3. Determine the incidence of diarrhea (runny stomach) among children in the five schools.
4. Establish status of facilities and hygiene in the schools (a reflection of school commitment to
a safe and clean school environment)
5. Assess attitude to hand washing
6. Assess hand washing practices with regard to:
1. Hand washing before eating
2. Hand washing after toilet use
3. Hand washing with soap and water
4. Hand washing with only water
5. Frequency of hand washing
6. School absenteeism sue to diarrhea
Final evaluation report for the schools’ hand washing project 14
7. Assess the project’s successes, impact and challenge to inform future decisions about similar
programs
8. Assess the relevance, usefulness and effectiveness of project interventions
9. Assess the potential for sustainability of the project interventions.
2. METHODOLOGY
2.1 Study area and population The final evaluation was conducted in 3 regions in Northern Namibia. The study population
included all 1778 children aged 6 to 12 years studying in the five target schools. The 6-12 year
olds were selected as pupils could understand the messages. A sample of 402 pupils with age
ranging from 6 to 12 years and attending classes from grade 1 to grade 7 in the 5 schools where
the hand washing project was implemented participated in the final evaluation. Table 2 shows
the distribution of the sample in the target schools.
Table 2: Distribution of the sample population (n = 402) Region Name of School School
population as
at November
2011
Number of
respondents
(Baseline)
Number of
respondents
(midterm
evaluation)
Number of
respondents
(Final
evaluation)
Percent (%)
of
respondents
(Final
evaluation)
Ohangwena Epundi Primary
School
302 80 83 80 19.9
Ohangwena Ohalushu Primary
School
379 81 80 80 19.9
Kavango Bunya Combined
School
758 68 80 81 20.1
Omusati Onayeluka Primary
School
195 81 83 80 19.9
Omusati Kooma Primary
School
144 80 85 81 20.1
Total 5 schools 1778 390 411 402 100.0
2.2 Sample size and Sampling method
2.2.1 Sample Size
A representative sample of the target population was drawn across all the five schools, all ages 6-
12 years and all classes grade 1 to grade 7. An average of 80 respondents were interviewed per
school to get at least 400 respondents, an estimated equivalent of at least 20% of the total
population in the five schools. The average of 80 pupils was taken to maintain a close link with
the sample sizes per school used in the baseline and midterm studies. A total of 402 students
were interviewed for the final evaluation.
Respondents included
1. Pupils 6-12 years old / or in grades 1-7
2. Trained teachers in the 5 schools
3. Other key informant in the schools e.g. Head teachers
2.2.2 Sampling Method
Final evaluation report for the schools’ hand washing project 15
Random sampling was used to select pupils to respond to the questionnaires. Pupils eligible to
participate were those in grade 1 to 7, ages between 6 and 12 years. All the eligible pupils i.e.
children in grade 1 to 7 between the ages of 6 and 12 years were told to line up randomly. Based
on the number of children required to participate in the study, pupils were randomly selected by
counting and selecting every 5th
child in the line.
2.3 Data collection procedures
The data collection process involved the following steps:
1. Seeking permission from the school’s management to interview pupils and teachers
2. Randomly sampling the respondents
3. Seeking consent from each respondent
4. Administering questionnaires – to pupils
5. Completing observation checklist with support of relevant school staff
6. Interviewing selected teachers
7. Checking data collection tools to ensure completeness
8. Providing quick feedback to the school administrations on the exercise upon conclusion
of the data collection exercise.
A semi structured questionnaire (annex 3) was used to collect data from pupils on socio
demographic characteristics, exposure, knowledge, attitude and practice aspects under study.
Data collection using the questionnaire was conducted by a team of 10 trained Community
Health Consultants (CHCs) under the supervision of SFH’s Behavior Change Communication
(BCC) officers and the teachers who were trained under the project for quality assurance.
A second tool, the teachers’ interview guide (annex 4), was used to collect information from the
teachers who were trained to assist with program implementation. A total of 12 teachers were
interviewed using the tool.
To gather information on status of the school facilities and children’s practice of hand washing
after toilet use, SFH staff collected data on schools’ hygiene status and hand washing after toilet
use. An observation checklist (annex 5) was used to collect the related information.
SFH staff reviewed the questionnaires for completeness. All completed questionnaires were
submitted to SFH Head Office in Windhoek. Each questionnaire was assigned a unique ID for
tracking its entry into the electronic database. This is the same criterion that was used for
collecting the baseline and mid-term information.
The data collection team comprised of the same people that collected the baseline and midterm
information in October 2010 and July 2011; hence their familiarity with the tool and data
collection process.
2.4 Data management and analysis
.MS Excel and SPSS (version 17) software was used to enter and analyze the data.
Final evaluation report for the schools’ hand washing project 16
The results are presented in form of figures (charts) and tables in the results section of this report.
The information generated from observation and teachers’ interviews was recorded and is part of
the information in this report.
2.5 Ethical issues Permission to conduct the study: SFH contacted the five schools’ administrations for (written?)
permission to conduct the evaluation study with their pupils and teachers in the respective
schools and to carry out observation on the schools’ hygiene status.
Respondents’ consent: Upon selection of the pupils and teachers to respond to questionnaires/
interviews, individual informed consent was obtained from each of them.
Confidentiality: Respondents were assured of confidentiality. The names of the participating
children were not taken and access to the questionnaires and data set was limited to SFH staff.
Serial numbers were used instead of respondent pupils’ names on the questionnaires.
Participants’ rights: Both participating pupils and teachers were informed that their
participation in the evaluation was voluntary and that they were free to opt out without any
penalty for refusal to participate.
2.6 Quality assurance The quality assurance measures taken during the final evaluation exercise included training of
data collection team to ensure understanding of the concept, method and tools to be used; Child-
supported completion of the questionnaire to provide opportunity for clarifications; and SFH
staff’s direct involvement at all stages of the processes and implement the necessary checks.
2.6.1 Training of the data collection team
Prior to data collection, the M&E Manager and the National MCH Coordinator conducted
training for the CHCs and BCC officers. The training had 5 objectives:
i) To create a common understanding of the methodology to be used for the final evaluation
ii) To clarify the data collection procedures and responsibilities of BCC Officers and CHCs
iii) To familiarize the team with the data collection tools
iv) To sensitize the data collection team on data quality issues and research ethics
v) To equip the data collection team with knowledge and skills for effective data collection
The training covered the following aspects:
1. Overview of the hand washing project, its intended objectives and activities
2. Objectives of the final project evaluation
3. Sources of information for the final project evaluation
4. Data collection procedures
5. Ethical issues
6. Data quality assurance
7. Responsibilities of members of the data collection team
8. Tips for data collection
Note:
1. The quality assurance aspects that were covered during the training are indicated in
annex 1 at the back of this report
Final evaluation report for the schools’ hand washing project 17
2. The responsibilities of the different categories of people in the final evaluation team
are listed in annex 2 at the back of this report.
2.6.2 Other quality assurance aspects
A tool similar to the one used during baseline and mid-term evaluations was used for data
collection from the pupils to enable comparison of findings to be done. The questionnaire was
reviewed by SFH program and M&E personnel as well as UNICEF technical staff.
SFH’s BCC officers and the trained teachers in the 5 targets schools supervised the data
collection that was being done by the CHCs. This was done to ensure completeness of responses.
The observation of schools’ hygiene status was conducted by SFH staff to minimize bias.
All the 402 questionnaires from the schools were securely transported and safely kept at SFH
Head Office, where unauthorized access was not allowed for confidentiality purposes and to
avoid any alterations.
2.7 Limitations of the final evaluation
The findings of the final evaluation presented in this report mainly comprise responses made by
the participating children and teachers. Data collection did not include further verification of the
participants’ responses such as by way of reviewing of records or observation of hand washing
practices at all critical times, nor additional interviews and focus group discussions for the
pupils. However, the use of individual questionnaires enhanced privacy, minimized fear by
children and hence minimized bias of children’s responses to the questions. This improved the
reliability of the answers given. Data was collected from a sample derived from randomly
selected children in the age range of 6 to 12 years and from a cross section of all the grades i.e.
grade 1 to grade 7.
Observation of school hygiene status or children’s hand washing practice after toilet use was
done just in one single day and this may not be representative enough of the usual practice or
status. The ideal should have been observation of hand washing practice for at least the period of
one week. This could not be done due to time and financial resource constraints; given that an
extensive evaluation exercise had not been planned for in the project concept.
Notwithstanding the limitations aforementioned, the results are good and very informative on the
situation. They are valid and recommended for use in decision making.
Final evaluation report for the schools’ hand washing project 18
3. FINDINGS
3.1 Socio-demographic characteristics of midterm evaluation respondents
This section provides a profile of the respondents who were interviewed in the final evaluation.
The information is presented on a number of basic characteristics which includes: Age, gender,
grade and school. Overall, 402 pupils from grade 1 to grade 7 in the age ranges of 6 to 12 years
participated in the evaluation from the five targeted schools where the hand washing project was
implemented. The social demographics of the children who participated in the final evaluation
are shown below.
The data obtained indicate that the respondents’ age ranges from 6 to 12 years with the majority
being 12 years (21.1%).
Table 3: Socio-demographic characteristics
Midterm (%) Final (%)
(n=411) (n=402)
Age (years)
6 1.7 2.2
7 9.7 17.4
8 12.2 17.7
9 12.2 13.2
10 16.1 11.2
11 20.7 16.4
12 27.5 21.1
No response 0.7
Gender
Female 53 50.5 Male 47 49.5
Grade
1 10.0 22.0 2 17.5 22.1 3 15.8 17.7 4 22.4 14.2 5 18.7 13.9 6 15.6 7.2 7 2.5 No response 0.5
School
Epundi Primary School 20.2 19.9
Ohalushu Primary School 19.5 19.9
Bunya Combined School 19.5 20.1
Onayeluka Primary School 20.2 19.9
Kooma Primary School 20.7 20.1
The demographic data in Table 3 are graphically shown in Figures 1, 2, 3 and 4.
Final evaluation report for the schools’ hand washing project 19
Figure 1: Age of respondents in years
The data obtained indicate that the respondents’ age ranges from 6 to 12 years with the majority
being 12 years (21.1%).
Figure 2: Percentage of respondents in respective grades 1 to 7
The majority of the respondents were in Grade 2 (22.1%) with the least of the pupils who
participated in the interview being in Grade 7 (2.5%)
2.2%
17.4% 17.7%
13.2% 11.2%
16.4%
21.1%
6 7 8 9 10 11 12
Age (years)
Age (years)
22% 22.1%
17.7%
14.2% 13.9%
7.2%
2.5%
0%
5%
10%
15%
20%
25%
1 2 3 4 5 6 7
Grade (%)
Final evaluation report for the schools’ hand washing project 20
Figure 3: Respondents Gender distribution in percentages
The chart above shows an almost even distribution of gender, with 50.5% being female and 49.5% male.
An almost equal representation of about 20% of respondents from each of the 5 schools is
evident.
Record of participants in the teachers’ interview per school Name of School Total number interviewed and designations
represented
Total
Epundi Primary School 3x teachers 3
Ohalushu Primary School 2xteachers and 1xcleaner 3
Bunya Combined School 1xteacher 1
Onayeluka Primary School 2xteacher 2
Kooma Primary School 2xteacher and 1xprincipal 3
12
A total of 12 respondents participated in the teachers’ interview. The summary of respondents
per school is shown in the table above.
3.2 Reported exposure to target hygiene messages and intervention activities Children were asked if they had ever heard of hand washing and from which source they got the
information. All 402 interviewed children reported ever hearing of hand washing and of these,
majority (50%) indicated that they had heard the message from sessions at schools.
Male , 50.5% Female, 49.5%
Final evaluation report for the schools’ hand washing project 21
Children who reported having heard the message from school were asked if they found the
trainings / sessions good and useful. All (100%) respondents indicated that the trainings/sessions
were good and majority (99.7%) indicated that they were useful.
3.3 Schools’ capacity for effective hygiene promotion
There is need for continuity of the project interventions in the respective schools as one way of
sustaining the results. For the hygiene education and promotion to continue, it was deemed necessary
to assess the schools’ capacity for such action. Thus, the final evaluation exercise sought data on
schools’ capacity for effective hygiene promotion, since the schools were considered appropriate
venues for the hygiene education and promotion.
Presence and activity of trained teachers to facilitate interventions
About 3 teachers from each school have been trained in school sanitation and hygiene education. The
training conducted in preparation for project implementation was useful for equipping the teachers
who reportedly made use of the knowledge and skills. All teachers interviewed could correctly
explain what sanitation means, which shows possession of correct knowledge to be passed on to the
learners. All teachers from each of the 5 targeted schools reported that they had taught children
about hygiene and did observations on the condition and status of facilities at schools. The life skills
teacher at Epundi Primary School incorporated the messages in classes where lessons on hygiene are
taught. Teachers indicated during the interviews that they had taught children about hygiene and
taken the initiative to emphasize the message by letting the kids do role plays, drama, songs and
demonstrations.
Availability and use of hygiene promotion materials and methods
Posters educating children on hand washing practices and hygiene were observed on classroom
walls. Booklets and other written materials are mainly available and used in the different schools.
Sanitation committees or clubs and special materials such as games, toys etc. used for hygiene
promotion need regular monitoring of usage, general maintenance and upkeep by the teachers.
On average, the schools scored 82% on the use of hygiene promotion materials and methods.
Sessions at school 50%
Printed material e.g.
posters 42%
Radio 8%
Reported exposure sources
Final evaluation report for the schools’ hand washing project 22
Participation of external community in the schools’ hygiene and sanitation interventions
The teachers’ interviews during the final evaluation sought information on participation of the
external community and local / government authorities in schools’ hygiene and sanitation
interventions. This information was necessary as continuity of such project interventions requires
support from the external communities and leaders / authorities. Respondents from some of the five
targeted schools mentioned that they did not get any material support from the government for
hygiene and sanitation interventions. Those who got support indicated that they received toilet papers
and some cleaning materials. The local authority also provided Onayeluka primary school with
plastic bags for garbage collection. Furthermore, it was reported that since the latrine: pupil ratio is
too high, the toilets are often dirty and the cleaning materials provided by the Government are
insufficient.
3.4 Children’s knowledge and understanding of benefits of hand washing and of the
critical times Children understand the need for washing hands at critical times including before eating, after
toilet use and that they should wash their hands with soap and water. The main reason given
when children were asked why they should wash their hands was to remove germs (58%). Other
reasons included to prevent illness and to keep hands clean. Minimal (1%) of the total
interviewed children indicated that they do not know why it is important to wash their hands.
3.5 Status of facilities and hygiene in the schools
There are relatively few toilets to comfortably serve the schools’ population as seen from a
calculated average proportion of 1 toilet per 80 pupils based on functional toilets at time of
observation. The existing number of toilets in the schools is summarized in Table 4.
58% 20%
21%
1%
Importance of hand washing To remove germsTo keep my hands cleanTo prevent illness
Final evaluation report for the schools’ hand washing project 23
Table 4: Existing number of toilets for pupils in the schools compared with school population
Name of School Total
school
pupil
population
Total*
existing
number of
toilets
Number of functional toilets** Current***
Toilet to Pupil
ratio For Girls
only
For Boys
only
Total
Epundi PS 302 10 2 2 4 1:75
Ohalushu PS 379 8 2 2 4 1:96
Bunya CS 758 8 4 4 8 1:103
Onayeluka PS 195 4 1 2 3 1:65
Kooma PS 144 4 2 2 4 1:36
5 schools 1778 34 11 12 23 1:80
*Includes both functional and non-functional toilets as at time of observation in November 2011.
**Data included is for pupil’s toilets that were functional as at time of observation in November 2011.
***Based on number of functional toilets as at time of observation.
At the time of evaluation, 23 (68%) of the existing 34 latrines were functional. The survey
indicates that there is a high demand for toilets as all functional toilets are in use. It was observed
that 32% of the latrines at the different schools exist but are not functional or in use and also
smelly and soiled with excreta which was attributed to lack of cleaning materials. This situation
may be a representation of what happens in the five schools as the ratio of toilets to pupils is high
(Table 4). Teachers at all schools, except Bunya Combined school, further mentioned that
whenever there is a good supply of cleaning materials, toilets are often clean. They further stated
that they try to keep it locked after hours to guide against wastage and misuse.
There has been no change in the number or construction of toilets, although the cleanliness have
somewhat improved.
On average, schools scored 82% in the overall ranking of the general upkeep and maintenance of
the schools’ sanitation materials and 69% in terms of cleanliness and usage of toilet facilities.
The verification scores were based on the physical observation of utilities, material availability
and usage.
Comparing the existing functional facilities (toilets and water taps) observed at final evaluation,
there is basically no improvement in the resources to aid children’s practice of basic hygiene as
taught. The level of cleanliness, although improved, is still not conducive to increased use of the
resources.
Children’s’ participation in school hygiene intervention plays a major role in the effectiveness of
the program. Children are divided in groups and take turns to clean the classrooms and the
surrounding area. Three of the targeted schools mentioned that the children do not clean the
toilets due to unwillingness. The cleaning and upkeep of the toilets is therefore left for the
cleaner to do.
3.6 Reported incidence of runny stomach (Diarrhea)
Children were asked if they had a runny stomach in the 3 months preceding the study. The
overall result shows an improvement in the reported incidence of diarrhea cases in the mid-term
and the final evaluation. Only 10.7% of the respondents reported diarrhea incidents in the 3
Final evaluation report for the schools’ hand washing project 24
months preceding the evaluation. This result shows a considerable improvement of 39%
compared to Baseline.
Table 5: Reported incidence of runny stomach
Reported Diarrhea Baseline (N=390) Midterm (N=411) Final (N=402)
Yes 49.7% 20.0% 10.7%
Figure 4: Reported incidence of runny stomach (Diarrhea) among pupils (?)
Figure 5: Reported incidence of runny stomach/ Diarrhea by school
3.7 Treatment of runny stomach
Of the 10.7% children who responded “yes” to the question of “runny stomach during the 3
months preceding the study”, 79% % reported that they went to a hospital or clinic.
Baseline (49.7%)
Midterm (20%)
Final (10.7%)
59%
47%
58%
38% 36%
18% 11%
30.50%
17.10% 23.20%
6% 0% 1% 0% 3%
0%
10%
20%
30%
40%
50%
60%
70%
BunyaCombined
School
Epundi PrimarySchool
Kooma PrimarySchool
OhalushuPrimary school
OnayelukaPrimary School
Reported Diarrhoea incidence by school
Baseline Mid term Final
Final evaluation report for the schools’ hand washing project 25
This shows that the message on seeking treatment is well received which minimizes the severity
of diarrhea and prevents children from missing additional school days. The results are shown in
Figure 7 below.
Figure 6: Treatment of runny stomach from hospital / clinic
3.8 Absenteeism from school due to Diarrhea
Only 5.3% children reported absenteeism due to runny stomach during the 3 months preceding
the study. This is a significant drop in absenteeism from 40% during the baseline survey. This
means that the school hand washing program is clearly effective at the different schools. The
results are shown in the table below.
Table 6: Absenteeism from school
Absenteeism from school
Baseline 40.0%
Final 5.3%
3.9 Respondents’ reported hand washing practices
Always Sometimes Never
Wash hands before eating Baseline 58% 39% 3%
Midterm 87.10% 12.50% 0.20%
Final 78.10% 21.90% 0%
Wash hands after toilet use Baseline 34% 49 17
34.0%
12.7%
79.0%
Baseline Mid term Final
Treatment of runny stomach
Treated at Hospital/Clinic (%)
Final evaluation report for the schools’ hand washing project 26
Midterm 69.3 30.4 0.3
Final 66.2 33.8 0
Wash hands with only water Baseline 10 55.7 33.8
Midterm 10 5 34
Final 3.5 24 72.5
Wash hands with soap/ash
and water
Baseline 8 54 39
Midterm 53 46.2 0.5
Final 24 62 14
The data in Table 3 are graphically shown and explained in the Figures to follow
3.10 Reported hand washing before eating Table 7: Hand washing before eating
Always Sometimes Never
Wash hands before eating Baseline 58% 39% 3%
Midterm 87.10% 12.50% 0.20%
Final 78.10% 21.90% 0%
Final evaluation report for the schools’ hand washing project 27
Figure 7: Hand washing before eating
Children were asked if they wash their hands before eating. Majority of the respondents (78%)
reported that they always wash their hands before eating. Although this shows a decrease in
children always washing hands before eating compared to midterm, the final evaluation shows
that no children responded that they ‘never’ wash their hands before eating.
3.11 Reported hand washing after toilet use
Children were asked whether they wash their hands after using the toilet. Majority (66.2%) of the
respondents reported always washing their hands after using the toilet. No children responded
that they ‘never’ wash their hands after toilet use.
Table 8: Hand wash after toilet use
Figure 8: Hand
wash after toilet
use
58%
39%
3%
87%
13%
0.2%
78%
22%
0% 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Always Sometimes Never
Reported hand washing before eating
Baseline
Midterm
Final
Always Sometimes Never
Wash hands after toilet use Baseline 34% 49 17
Midterm 69.3 30.4 0.3
Final 66.2 33.8 0
Final evaluation report for the schools’ hand washing project 28
Figure 9: Hand wash after toilet use by school
Children at Bunya combined school could not wash their hands due to lack of water at the school
at the time of observation. All other children observed at least washed their hands; half of them
washed their hands with water and soap, while others washed their hands with water only.
Children are taught ways of how to properly wash their hands which includes rubbing both hands
for at least 3 times. This practise was observed and all children who washed their hands with
soap and water carried this out positively.
3.12 Reported hand washing with water only
Analysis of hand washing with water only for the respective schools shows Bunya combined
school as having the highest percentage (3.5%) children reporting always washing hands with
water only. Overall, a quarter of the children sometimes wash their hands with water only. This
could be partly due to the fact that soap is sometimes not available to the children. Table 9: Hand wash with water
34.0%
49.0%
17.0%
69.3%
30.4%
0.3%
66.2%
33.8%
0.0% 0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
Always Sometimes Never
Hand wash after toilet use
Baseline
Midterm
Final
5.2%
18.9%
13.2%
19.4%
9.5%
14.9%
1.0%
7.0%
0.5%
10.4%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
BunyaCombined
School
EpundiPrimarySchool
KoomaPrimarySchool
OhalushuPrimaryschool
OwayelulaPrimarySchool
Hand wash after toilet use by school
Always
Sometimes
Never
Final evaluation report for the schools’ hand washing project 29
School Always Never Sometimes Total
Bunya Combined School 3.5% 0.5% 15.8% 19.8%
Epundi Primary School 19.5% 0.5% 20.0%
Kooma Primary School 17.3% 3.0% 20.3%
Ohalushu Primary school 19.3% 0.8% 20.0%
OnayelukaPrimary School 16.0% 4.0% 20.0%
Grand Total 3.5% 72.5% 24.0% 100.0%
Always Sometimes Never
Wash hands with only water Baseline 10 55.7 33.8
Midterm 10 5 34
Final 3.5 24 72.5
3.13 Reported hand washing with soap and water
Children (respondents) were asked if they always or sometimes or never wash their hands with
soap and water. More than half (62%) of the children reported that they sometimes wash their
hands with soap/ash and water, while 24% reported as always doing so.
Figure 10: Hand washing with soap and water by School
Table 10: Hand washing with soap and water
Always Sometimes Never
Wash hands with soap/ash and water
Baseline 8% 54% 39%
Midterm 53% 46.2% 0.5%
Final 24% 62% 14%
0.50%
5.49%
9.48%
14.96%
9.98%
18.45%
14.46%
10.47%
4.99%
9.98%
1.25%
Bunya CombinedSchool
Epundi PrimarySchool
Kooma PrimarySchool
Ohalushu Primaryschool
Onayeluka PrimarySchool
Hand wash with soap and water by school
Always Sometimes Never
Final evaluation report for the schools’ hand washing project 30
3.14 Reported last place of hand washing
The respondents were asked where they had last washed their hands. Majority (85.4%) had
reportedly washed their hands at school. Only a few (14.6%) washed their hands at home. When
compared to the Baseline, more children wash their hands at school which emphasizes the fact
that the school hand washing program is clearly effective at the different schools. Most (31%) of
the children’s interviews were conducted in the later hours of the morning between 11 and 12
am. The reported hand washing is a clear indication of appreciation and hygienic practice as
recommended and taught through the project intervention. The findings reveal an improvement
in hand washing practices at school from the baseline value of 21% to 85.4% at final evaluation.
Table 11: Last Place of Hand washing
REPORTED LAST PLACE OF HAND WASHING
School Home
Baseline 21% 79% Midterm 69.30% 30.70% Final 85.40% 14.60%
Figure 11: Reported Last Place of hand washing
3.15 Children’s attitudes towards hand washing Recommendation on the importance of hand washing: Children were asked if they would
recommend / tell someone about the importance of hand washing, and who they would tell.
Almost all (99.24%) children who were interviewed said that they will recommend the
importance of hand washing to someone. The 99% affirmative response is a significant
improvement from the 58% response at baseline, implying great appreciation of the hand
washing knowledge and recommended practices.
21%
79%
30.70%
69.30%
85.40%
14.60%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
School Home
Reported Last Place of Hand washing
Baseline
Midterm
Final
Final evaluation report for the schools’ hand washing project 31
Table 12: Recommendation on the importance of hand washing
Recommendation about the importance of hand washing
yes no
99.24% 0.76%
Figure 12: Recommendation on the importance of hand washing
Of the 99.24% respondents who will recommend the importance of hand washing to someone,
the majority (70.3%) will recommend it to all people. The figure above shows a break down as to
who the respondent will recommend the importance of hand washing.
3.16 Teachers attitude on the hygiene education program
The teachers’ attitude about the program and its interventions is critical for continuity. The final
evaluation included a general assessment of the teachers’ attitudes about the hygiene education
program. According to the interviewers, all teachers who participated in the study seemed very
interested and motivated on the hygiene education programme and want the project to continue for as
long as possible. Furthermore, the interview discussions showed that teachers are committed and
willing to help in sustaining the project.
3.17 The school to community linkage Participation of the external community and local / government authorities in schools’
hygiene and sanitation interventions
One of the final valuations objectives was to assess the project’s successes, impact and challenge to
inform future decisions about similar programs. All the teachers interviewed indicated that the
community expresses interest in the school hygiene program. They further stated that the project
alleviates diseases and absenteeism from school. The health department was invited at Onayeluka
70.30%
16.62% 10.90%
2.18%
All people Friends Family members communitymembers
Recommendation
Final evaluation report for the schools’ hand washing project 32
primary school to talk to school children about diseases in general, although not specifically on hand
washing.
3.18 Relevance of the project Teachers reported an overall drop in the incidents of diarrhea among students and minimal
absenteeism from school due to diarrhea... “The learners have gained a lot of knowledge and their
health is improved’, the teachers stated.
3.19 Usefulness of the project Since the implementation of the hand washing project, the learners’ hand washing practices
improved. Teachers interviewed reported that the children often correctly wash their hands before
eating and after toilet use. Teachers are more involved and play a pivotal role in ensuring that the
children are healthy.
3.20 Effectiveness of the project The overall effectiveness of the project is rated as good because whenever possible, the school
management ensures that there is water and soap in the toilets and near class rooms. The general
behavior of the children with regard to hygiene has also improved.
3.21 Sustainability of project interventions
3.21.1 Commitment The individual schools need to own the program and drive it. For this reason, the school
management, communities and students give sessions 3 times a week. Teachers and children
have organized themselves very well in developing extra materials/activities to make it more
interesting.
3.21.2 Resources Teachers were asked how they would mobilize resources to ensure the high quality standards of
hygiene and sanitation were maintained. They indicated that they will raise funds and involve
local businesses in the project implementation. Others mentioned that they will ask parents to
donate a small amount of money and/or will issue raffle tickets for fundraising purposes.
3.21.3 Replicability The teachers were asked if there is any advocacy work to replicate those interventions
somewhere and all schools responded positively. The teachers mentioned that whenever there
are hand washing activities at their respective schools such as drama, role plays etc., children
from the neighboring schools normally attend and have adapted the hand washing behavior.
Principals from neighboring schools also attended the commemoration of the hand washing day
at different targeted schools.
3.22 Challenges and suggested solution Teachers who participated in the interviews were asked to list any three key challenges that their
schools faced in implementing the hand washing, school hygiene and sanitation program. They
were also asked to suggest solutions to the problems mentioned and make recommendations for
improving hygiene and sanitation practices in their schools. Their responses are summarized
below.
Final evaluation report for the schools’ hand washing project 33
Comments
Key Challenges in
implementing hand washing,
school hygiene and sanitation
programs
The Ministry of Education is not supporting the project with cleaning materials
and toilet paper
Children struggle to wash their hands due to water being temporarily closed or
due to broken taps
There are not enough containers for hand washing
Some toilets do not flush and the number of toilets in schools are not enough
Limited IEC materials
Suggested solutions
MOE should show interest in the project and support it, and parents should play a
role in children’s' hygiene
Schools need large tanks to store water. SFH/UNICEF should provide containers
The community should raise funds to buy cleaning materials and toilet papers
More IEC materials should be provided
Recommendation for
improving hygiene and
sanitation practices in schools
mobilize learners to keep themselves clean and practise good hygiene
Schools should find more resources with support from NGOs, the GRN and from
local businesses
Final evaluation report for the schools’ hand washing project 34
Annex 1: Quality assurance aspects covered during the pre-
data collection training workshop
1. Accuracy
• Ensure that data are the correct values, valid, and attached to the correct tool.
2. Comprehensiveness
• Ensure that all required data items are included; that the entire scope of data is collected
and documentation of limitations is done.
3. Currency
• The data should be up-to–date e.g. the school information such as Number of pupils,
functional toilets
4. Consistency
• The value of the data should be reliable and the same across applications.
• Check responses e.g. a child says they ALWAYS wash hands with soap and water AND
also says they ALWAYS wash with water ONLY.
• Note: The two practices cannot be possibly happening. It’s either one or the other
5. Definition
• Clear definitions should be provided so the current and future data users will know what
the data mean; each data element should have clear meaning and acceptable values.
• Note: *Provide explanations to the pupils and teachers about each aspect of the question
so that they are clear about the concepts they are responding to*.
6. Relevancy
• The data are meaningful to the performance of the process or application for which they
are collected.
• Note: Especially for additional information collected from observation and interviews
with teachers
7. Timeliness
• Timeliness is determined by how the data are being used and their context.
• Note: Ensure data collected e.g. on diarrhoea incidence is with reference to past three
months as indicated in the question
Final evaluation report for the schools’ hand washing project 35
Annex 2: Responsibilities of the final evaluation data
collection team
General responsibilities
1. Respect the administrative rules, culture, and customs of the schools
2. Adhere to guidelines provided for the evaluation exercise
3. Master data collection procedure and questionnaires / observation checklist
4. Strive to improve data quality
5. Keep the data and survey information confidential
6. Follow established timelines
7. Maintain data collection tools (questionnaires and checklists)
8. Work collaboratively to achieve team and evaluation objectives
9. Travel to the schools as planned / scheduled
BCC Officers’ responsibilities
1. Coordinate work of CHCs with the school administrations
2. Monitor/ supervise data collection by CHCs
3. Conduct interviews with the teachers
4. Complete the school observation checklist
CHCs’ responsibilities
1. Support the pupils to complete the questionnaire
2. Participate in the completion of the observation checklist as guided by the BCC Officers
Final evaluation report for the schools’ hand washing project 36
Annex 3: The pupils’ questionnaire
Project: School Hand washing Project Final Project Questionnaire 2011
Please tick “X” in the appropriate boxes Date: …………………………………… Time……………………………….
SECTION A (Demographics)
1.
Name of School: ……………………………………………………………………………
2.
Village: / Town/ Region……………………………………………
3.
Grade: ……………
4. Sex: Male Female
5. Age: ………………………………………………….years
SECTION B (Exposure)
6. Have you ever heard of hand washing? Yes No
7. If you heard the message, Where did you hear the message from?
(1) Sessions at school (2)Radio
(3) Printed material e.g. posters (4) Community /Family members
(5) Other (Specify) ________________________________________
8. If you heard the message from school, were the
trainings /sessions GOOD?
Yes No
9. Were the trainings /sessions USEFUL? Yes No
SECTION C (Knowledge)
10. Why should you wash your hands? (Mark all answers that the pupil mentions)
(1) To remove germs (2) To keep my hands clean
(3)To prevent illness (4) I don’t know
SECTION D: Incidence of diarrhea (runny stomach) and absence from school
11. Have you had runny stomach in the last three (3)
months?
Yes No
Final evaluation report for the schools’ hand washing project 37
12. If yes, did you go to a hospital or clinic? Yes No
13. Were you absent from school because of the runny
stomach during the last three months?
Yes No
14. How many days were you absent from school for each time you had runny stomach?
(1). One (1) day (2). Two days (3). More than 2 days
SECTION E (Practices ) Always Sometimes Never
15. I wash my hands before eating
16. I wash my hands after using the toilet
17. I wash my hands with only water
18. I wash my hands with soap and water
19. I wash my hands with ash and water
20. How often do you wash your hands each day?
21. When was the last time you washed your hands today? Home School
SECTION F (Attitude)
22. Would you recommend/tell someone about the importance of
hand washing?
Yes No
23. If you are to tell someone about hand washing, who would you tell?
1. Friends 2. Family members 3. Community members
4. All people
Final evaluation report for the schools’ hand washing project 38
Annex 4: The teachers’ interview guide
Hand Washing Project – Final Evaluation (October 2011)
FOCUS GROUP Interview WITH TEACHERS ALONE Date:
______________________________
Name of school being surveyed: _________________________ Name of Region:
____________________
Name of interviewer: ____________________________ Title:
____________________________
Introduction and Purpose:
(Greetings/introduction). I would like to ask some questions about hygiene and sanitation
interventions and practices in this school.
The Society for Family Health (SFH) with support from UNICEF has been implementing a
project “Safeguarding lives, school hand washing program” in this school from October 2010 to
October 2011. SFH is conducting an evaluation of the program to assess its successes, impact
and challenge to inform future decisions about similar programs.
1. Interview participants:
Name Designation
1.
2.
3.
School capacity for Effective Hygiene Promotion
2. Have the teachers of this school been trained in School Sanitation and Hygiene
Education?
__________________________________________________________________________
__________________________________________________________________________
Use of training in school
3. Have the teachers taught anything about hygiene (safe water, household sanitation,
personal hygiene, hand washing)? Ask the teachers. Ask some students.
________________________________________________________________________
______________________________________________________________________
Final evaluation report for the schools’ hand washing project 39
4. Can teacher or head teacher show any teaching material, book or learning materials or a
chapter in a book about this subject? (State your observation below)
Note: materials must appear to have been used.
___________________________________________________________________
__________________________________________________________________
5. Can teacher explain correctly what sanitation means to him or her?
(Sanitation is the hygienic means of promoting health through prevention of human contact with
the hazards of wastes.)
____________________________________________________________________________
6. Write anything interesting the teacher says or any interesting hygiene/health activities
teacher or school has carried out with children.
____________________________________________________________________________
___________________________________________________________________________
______________________________________________________________________________
Participation of the external community and local / government authorities in school’s
hygiene and sanitation interventions
7. Do the local / government authorities in this area express interest in the school hygiene
programme?
____________________________________________________________________________
____________________________________________________________________________
8. Did the teachers get any support from GRN or local authorities towards project
implementation? What kind of support did teachers get from Government / constituency/
School Management Committee (SMC)?
________________________________________________________________________
________________________________________________________________________
_______________________________________________________________________
Child Participation in school hygiene intervention
9. Do the children in the school help clean, including the toilets?
______________________________________________________________________________
____________________________________________________________________________
10. Do the children take turns (rotate) in doing this? (Ask teachers. Ask children in a separate
small group, outside the class).
Final evaluation report for the schools’ hand washing project 40
_______________________________________________________________
______________________________________________________________________
School to Community Linkage
11. Do the parents or community know about the sanitation and hygiene interventions at the
school?
________________________________________________________________________
12. What percentage (%) of the school fundraising goes towards the sanitation and hygiene
intervention at the school?
______ ___________________________________________________________________
13. Has the school conducted events to promote School Sanitation and Hygiene Education in
the community?
____________________________________________________________________
14. How frequently? ___________________________
15. Hygiene promotion activities by children in their homes and in the community
(Score / rank the school)
Options Scores Score
1. No hygiene promotion done by children in their homes or in their
village 0
2. Children participate in rallies and marches through the village on
special days; but nothing more 25
3. Benchmark: In addition to rallies and marches, children speak to their
parents about the need for good hygiene behavior (e.g., by requesting
access to material like nail cutters, soap and ash), and at least one child
reports a change in access to material in their homes.
50
4. In addition, most children report change in access to material (e.g., nail
cutters, soap and ash) in their homes OR teachers and students have
identified and solved at least one community-level hygiene or sanitation
problem
75
5. Ideal: In addition, teachers involve children in a regular system to
identify hygiene and sanitation problems in their houses or village, and
find practical solutions by discussing with the parents, teachers or
Community Health Consultants (CHCs)
100
Comment
Supervisor or cluster
Final evaluation report for the schools’ hand washing project 41
16. Has there been a schools cluster meeting in the past three months to discuss
health/hygiene and sanitation?
____________________________________________________
17. Has any official from the Region’s Ministry of Basic Education in charge of sanitation
and hygiene or anyone from health sector visited the school during the past three months?
________________________________________________________________________
18. Do the Local leaders / School Inspectors have information or records about the sanitation
status of schools?
_______________________________________________________________________
19. How is sanitation monitored and standards measured in this school?
___________________ __________________________________________
20. Is there a regional Sanitation [and Hygiene Education] implementation plan with a budget
that has specific allocations for school hygiene?
____________________________________________________________________
Relevance of the project:
21. Did the project support and interventions address the needs of children, teachers and
communities? How relevant were the interventions in addressing the issues and reaching the
objectives/targets? The issues being evaluated must be linked to a clear and important set of
stakeholder interests i.e. improving the health and learning outcomes of students.
_________________________________________________________________
_____________________________________________________________________
Usefulness:
22. How useful were the project hygiene and hand washing messages and behavior change
communication interventions in enhancing knowledge, skills and adopting the hygienic
behaviors?
______________________________________________________________________
____________________________________________________________________
Effectiveness
23. How effective were the project interventions? Comment on the interventions i.e. sessions by
CHCs, drama by kids, hand washing practices, etc.
_______________________________________________________________________
________________________________________________________________________
Clear commitment for sustaining those interventions and accountability to ensure high
quality standards:
24. Are the school management, communities and students themselves committed to sustain
those interventions?
____________________________________________________________________
_____________________________________________________________________
Final evaluation report for the schools’ hand washing project 42
25. If they are committed how would they mobilize resources to ensure the high quality
standards of hygiene and sanitation are maintained? List some examples.
________________________________________________________________________
_______________________________________________________________________
Replicability: 26. Any advocacy work to replicate those interventions elsewhere e.g. in neighboring / other
schools?
_________________________________________________________________________
Challenges and suggested solutions
27. List any three key challenges that the school faces in implementing the hand washing, school
hygiene and sanitation programs.
i. _____________________________________________________________
ii. _____________________________________________________________
iii. _____________________________________________________________
28. Suggest solutions to the problems listed above.
i. _______________________________________________________________
ii. _________________________________________________________________
iii. __________________________________________________________________
29 Suggest any recommendations for improving hygiene and sanitation practices in the school.
i. __________________________________________________________________
ii. __________________________________________________________________
iii. ______________________________________________________________
General assessment (interviewer’s assessments, comment and general opinion)
30. Do the teachers and head teacher seem motivated and interested in the hygiene education
programme?
______________________________________________________________________________
______________________________________________________________________________
_
End of interview. Check that all 30 questions have responses as applicable.
Thank the teachers for their responses and suggestions.
Final evaluation report for the schools’ hand washing project 43
Annex 5: The observation checklist
Society for Family Health United Nations Children Fund
Hand Washing Project Purpose: Establish status of facilities and hygiene in the schools
General Information 1. Name of School: 4. Name of Field
Investigator 1:
2. Constituency: 5. Name of Field Investigator 2:
3. Region: 6. Date of Observation:
General Details
7. Type of School: 1.Pre-School/Kindergarten 2.Grade 1-4 (Lower Primary School) 3. Grade 5-7 (Upper Primary School) 4.Grade 8-10 (Junior Secondary) 5. Grade 11-12 (Senior Secondary)
8. Category of personnel trained to implement hand washing / hygiene lessons / activities
Total Number per category
Number appointed Before Oct 2010
Number appointed On or after Oct 2010
Number ACTIVE
a. Male Female
b. Teachers
c. Community Health Consultants (CHCs)
d. Hygiene Cleaners for toilets and environment
e. Total
Current School Enrollment 9 Number of School Children Girls Boys Total
Pre-School/Kindergarten
Grade 1-4 (Lower Primary School)
Grade 5-7 (Upper Primary School)
Grade 8-10 (Junior Secondary)
Grade 11-12 (Senior Secondary)
10 Classes Assessed (mark all applicable)
Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12
1. The Use of hygiene promotion materials and methods (Mark the
appropriate box, then put a score for the school in the second part of the
table)
Final evaluation report for the schools’ hand washing project 44
Options Available and used
Available but NOT used
Not available/ Not applicable
1.
Booklets and other written materials like posters available in the school for hygiene promotion (hand washing)
2.
Booklets and other written materials used in the hygiene promotion and school sanitation committees or clubs formed by the children
3.
Special materials (games, toys, etc) are used for hygiene promotion and school sanitation committees or clubs are active
4.
Teachers involve children in regular monitoring of school sanitation facilities and in the regular upkeep and maintenance (e.g. reporting and solving problems)
5. Ranking of the school
6. Options Scores school Score
7. No special materials for hygiene promotion (hand washing) available in the school 0
8. Booklets and other written materials available in the school but not used 25
9. Benchmark: Booklets and other written materials used in the hygiene promotion and school sanitation committees or clubs formed by the children
50
10. In addition: special materials (games, toys, etc) are used for hygiene promotion and school sanitation committees or clubs are active
75
11. Ideal: Teachers involve children in regular monitoring of school sanitation facilities and in the regular upkeep and maintenance (e.g. reporting and solving problems)
100
12. Comments:
2. Frequency of Hygiene Education
Final evaluation report for the schools’ hand washing project 45
3. Status of Latrines / toilets, school yard, compound and classrooms Options YES
(1) NO (2)
Total # of latrines meeting given description Scores
School score given
1. Total number of functional latrines for use by pupils # for boys = ________ and # for girls = __________
2 Latrines exist and functional but not in use (i.e. no
demand)
0
3. Latrines exist but are not functional or not being used
0
4. Latrines exist and are in use but they are dark, smelly and soiled with excreta
10
5. Latrines exist and are in use, with adequate daylight, but soiled with excreta.
25
6. Benchmarks: Latrines are clean (no excreta in pans, walls or floor) and protected against misuse (e.g. locked after hours)
50
7. In addition: There is water, soap or ash for 75
Frequency YES (1) NO (2)
1. Hygiene education classes held in this school (BEFORE UNICEF/SFH programme started)
2. Hygiene education classes held in this school (AFTER UNICEF/SFH programme started)
3. Hygiene education messages only on special days (e.g. 26 January and 15 August) – no more than once per
quarter
4. Benchmark: Hygiene promotion done during morning assembly or prayers
5 Hygiene promotion classes are held in the weekly time table but not always held
6. Ideal: Hygiene promotion classes are in the time table and are held regularly (every week)
Rank / rate the school
Frequency Scores Score the
school
No hygiene education classes held in this school (before UNICEF/SFH programme started) 0
No hygiene education classes held in this school (after UNICEF/SFH programme started) 0
Hygiene education messages only on special days (e.g. 15 October) – no more than once per quarter 25
Benchmark: Hygiene promotion during morning assembly or prayers 50
In addition, hygiene promotion classes are held in the weekly time table but not always held 75
Ideal: Hygiene promotion classes are in the time table and are held regularly (every week) 100
7. Comments:
Frequency YES (1) NO (2)
1. Hygiene education classes held in this school (BEFORE UNICEF/SFH programme started)
2. Hygiene education classes held in this school (AFTER UNICEF/SFH programme started)
3. Hygiene education messages only on special days (e.g. 26 January and 15 August) – no more than once per
quarter
4. Benchmark: Hygiene promotion done during morning assembly or prayers
5 Hygiene promotion classes are held in the weekly time table but not always held
6. Ideal: Hygiene promotion classes are in the time table and are held regularly (every week)
Rank / rate the school
Frequency Scores Score the
school
No hygiene education classes held in this school (before UNICEF/SFH programme started) 0
No hygiene education classes held in this school (after UNICEF/SFH programme started) 0
Hygiene education messages only on special days (e.g. 15 October) – no more than once per quarter 25
Benchmark: Hygiene promotion during morning assembly or prayers 50
In addition, hygiene promotion classes are held in the weekly time table but not always held 75
Ideal: Hygiene promotion classes are in the time table and are held regularly (every week) 100
7. Comments:
Final evaluation report for the schools’ hand washing project 46
hand washing within easy reach of the children
8. Ideal: Latrines are child friendly (e.g. pans are smaller, colorful walls, etc)
100
9 Is the School yard / compound clean (free
from visible garbage on ground)?
10 Are the observed classrooms clean (free
from visible garbage on ground)?
11 Comments:
4. Latrine availability
For Boys Only
For Girls Only
For Boys and Girls combined
For teachers only
For all (not separated for categories)
# of boys per Latrine/ urinals
# of girls per Latrines/ urinals
Total # of urinals
Total # of Latrines
# FUNCTIONAL
# currently in use
Comments:
5. Observation: Materials for hand washing
Options YES
(1)
NO
(2)
Scores Yes=1
School total score (out of 9)
1. Is water for hand washing available?
(describe source)
_________________________________________
2. Is soap or ash available for hand washing?
3. Are water and soap within reach of each other?
4. Are there hand washing facilities in the latrines or within 40-50
yards of the latrine?
5. Is water available from start to end of school day or at certain hours
(e.g. just before lunch)
6. Is there a functioning water point WITHIN the school area?
7. If outside – how far from school compound is it? _______meters
8. Is the water source used by others – community members?
9. Is water point functioning at time of visit and in the dry season?
(Ask teachers if water point works in Dec/January )
10. Comments:
6. Observation: Drinking water storage and quality
Final evaluation report for the schools’ hand washing project 47
Options YES
(1)
NO
(2)
Scores Yes=1
School total score (out of 9)
1. Are there containers available for storing drinking water?
2. Do the water storage containers appear to be clean?
3. Where are the water storage containers located?
a) In the classrooms?
b) Or where positioned in the school compound?
_____________
4. Is there water in the container for drinking?
5. Is all the drinking water in the containers covered?
6. (a) If water containers have no spout, is there a ladle (scoop,
dipper, cup) for taking water out?
(b) Is it kept clean?
7. Does the water appear to be free from visible particles and
mosquito larvae?
8. Is the water apparently of drinking quality at the water point?
(Ask teachers to indicate last time water testing was done)
_______________________
9. Are the water storage containers frequently cleaned?
(ask teacher how frequently they are cleaned): e.g. Weekly,
Monthly, other _____________
10. Comments:
8. Hand washing habits (Observe at least 5 children as they leave the latrine /
toilet to assess hand washing practices)
Note: Only one answer is possible per observed child. Put “X” in appropriate box
Sex of observed child Never washed hands
Washed hands with water only
Washed hands with both water and soap/ash
Male Female
Child # 1
Child # 2
Child # 3
Child # 4
Child # 5
9. Ask a child to demonstrate how to wash hands in the place where this is usually done and
write your observation.
Note: Does the child rub both hands a lot, at least 3 times?
Observation: ________________________________________________________
END. Check to ensure that all sections are completely filled in.