KNOWLEDGE AND PRACTICE OF HAND WASHING AMONG SECONDARY SCHOOL STUDENTS IN IBADAN NORTH-WEST LOCAL GOVERNEMENT AREA, OYO STATE, NIGERIA

Abstract

Hand Washing (HW) is known to reduce the transmission of communicable diseases. However, poor HW practice in schools remains a public health challenge. Although studies have documented HW practices among primary school pupils, whereas adolescents are the groups most affected by diseases transmitted through poor hand washing practices; little is known about this practice among secondary school students in Ibadan North-West Local Government Area (IBNWLGA). This study was therefore designed to examine the knowledge and practice of HW among secondary school students in IBNWLGA. The study was cross-sectional in design and a combination of qualitative and quantitative methods was used to collect data. A three-stage sampling technique was used to select the schools, classes and 600 students from ten public and five private secondary schools. A semistructured self-administered questionnaire was used to collect information on socio-demographic characteristics, 23-point HW knowledge scale, 15-point practice scale, barriers to HW practices and facilitators of HW practice from respondents. Knowledge scores were categorised into poor (≤10), fair (11-16) and good (≥17) while practice score of 12-15 and <12 were rated as healthy and unhealthy respectively. Eight Focus Group Discussions (FGD) sessions (4 male and female each) in five public and three private schools were conducted. Purposive sampling was used to observe One hundred students for actual practice of HW (50 each after defeacation and before eating) using a observational checklist. Qualitative data were analysed using thematic approach while the quantitative data were analysed using descriptive statistics, logistic regression and spearman correlation at 5% level of significance. Age of respondents was 13.5+2.7 years and 56.2% were females. The knowledge score was 16.1± 3.1 with 64.3% having good knowledge of HW while 64.0% had received health education on HW. Most (90.0%) respondents had water facilities in their schools. The main sources of water supply were well (55.5%) and pipe-borne water (22.3%). About 87.5% reportedly washed their hands before meal while 81.7% did so after meal. Perceived reasons for unhealthy HW practice included inadequate water supply (71.5%), lack of soap (60.8%) and inadequate knowledge (49.5%). Perceived facilitator of HW practices included creation of hygiene clubs in school (78.2%) and observance of HW day (71.7%). Students in private schools were more likely to exhibit healthy HW practices before eating (OR=2.15, 95% CI =1.53-3.97) and after defeacation (OR = 2.42, 95% CI = 1.40-4.19) than their public school counterparts. A significant positive correlation (r = 0.327) was found between respondents knowledge and practice scores of HW. The FGD indicated that HW reduces communicable diseases. Observation revealed that 25.0% washed their hands with water only while 7.5% washed hands with soap and water before eating. Similarly, 62.5% washed their hands with water only after defeacation while 37.5% did so with water and soap. The secondary school students of IBNWLGA had good knowledge of hand washing but observed practice was low. Provision of water and soap is essential to improve hand washing practice in schools.