Water, Sanitation and Hygiene Practice among Students in Secondary School, Ijebu Ode, Nigeria

Abstract

Studies have documented that poor WaSH is accountable for several cases of diarrhea globally, resulting in millions of unnecessary deaths each year, particularly among children, and most notably in underdeveloped countries where poor knowledge and practice of WaSH have been well documented. Therefore, the work prioritizes evaluation of WaSH practice among students in secondary school in Ijebu Ode, in light of the emergence of COVID-19, which has further highlighted the essence of WaSH practice, especially in our schools. A descriptive cross-sectional approach was adopted in the conduct of the investigation, wherein data was sourced from 60 students selected through random numbers from six randomly selected secondary schools (three public and three private), representing a total student population of 360. The data collected through structured questionnaire and personal interview were computed and analyzed descriptively using Microsoft Excel and Statistical Software for Social Scientist (version 20). Findings indicated that majority of the students in Ijebu Ode have adequate knowledge (78.9%) and inadequate practice (45.6%) on WaSH, and thus, concluded that whereas the participants have adequate knowledge on WaSH, it however did not translate into an actual practice. Hence, a need for an intensive effort that will facilitate adequate WaSH practices among the school students through the availability and accessibility of appropriate WaSH resources, with school and home schedules for WaSH practice.

Full text

Journal of Environmental Science and Economics ISSN: 2832-6032
https://doi.org/10.56556/jescae.v1i3.169
www.jescae.com 15
Water, Sanitation and Hygiene Practice among Students in Secondary School, Ijebu
Ode, Nigeria
Edet Otto1*, Ayodeji Opatoki2, Daisi Luyi3
*1,2Department of Environmental Health Science, POGIL College of Health Technology, Nigeria
3Department of Public Health Science, POGIL College of Health Technology, Ogun State, Nigeria
Corresponding Author: Edet Otto, klinzmannia@gmail.com
Received: 06 June, 2022, Accepted: 18 June, 2022, Published: 20 July, 2022
Abstract
Studies have documented that poor WaSH is accountable for several cases of diarrhea globally, resulting in millions of
unnecessary deaths each year, particularly among children, and most notably in underdeveloped countries where poor
knowledge and practice of WaSH have been well documented. Therefore, the work prioritizes evaluation of WaSH practice
among students in secondary school in Ijebu Ode, in light of the emergence of COVID-19, which has further highlighted the
essence of WaSH practice, especially in our schools. A descriptive cross-sectional approach was adopted in the conduct of
the investigation, wherein data was sourced from 60 students selected through random numbers from six randomly selected
secondary schools (three public and three private), representing a total student population of 360. The data collected through
structured questionnaire and personal interview were computed and analyzed descriptively using Microsoft Excel and
Statistical Software for Social Scientist (version 20). Findings indicated that majority of the students in Ijebu Ode have
adequate knowledge (78.9%) and inadequate practice (45.6%) on WaSH, and thus, concluded that whereas the participants
have adequate knowledge on WaSH, it however did not translate into an actual practice. Hence, a need for an intensive effort
that will facilitate adequate WaSH practices among the school students through the availability and accessibility of
appropriate WaSH resources, with school and home schedules for WaSH practice.
Keywords: Hygiene; Practice; Sanitation; Students; Wash; Water
Introduction
The right to foundational education for schoolchildren
requires a safe and appropriate water supply and sanitation
in schools (Mooijman 2012). For example, World Health
Organization (WHO) and United Nation Children Fund
(UNICEF) in 2015 reported that roughly one-third (31%) of
schools worldwide do not have appropriate water supply,
and many do not have proper sanitation (44%)
(WHO/UNICEF, 2015). This is especially concerning in
schools because children, who are considered a vulnerable
group, have a increased risk of disease transmission
(WHO/UNICEF, 2015; UNICEF, 1998). For example, poor
WaSH have been documented to be responsible for 88
percent of diarrhea cases globally, resulting in 1.5 million
unnecessary deaths each year, particularly among children
(Prüss-Üstün et al., 2015), and most notably in developing
countries where poor knowledge and practice have been
well documented (Egbinola & Amanambu, 2015; Olukanni
et al., 2014).
The attainment of Millennium Development Goals (MDG)
on worldwide fundamental education, gender equality, and
infant mortality, as well as the Sustainable Development
Goals, and in particular Goal 6 on safe water and sanitation
by 2030, have all been linked to the provision of adequate
water, sanitation, and hygiene (WaSH) facilities in schools
(United Nations (UN), 2015). Nonetheless, WaSH deficits
continue to constitute a problem in low and middle-income
countries (LMICs) around the world (United Nations
Children’s Fund (UNICEF), 2020), particularly in Nigeria,
which is party to the UN Pronouncement of the Fundamental
Right to WaSH-related activities but is among the first three
LMICs with poor WaSH amenities, practices, and education
awareness (WHO, 2015). It is suggested that, unsafe water
supplies, as well as poor sanitation and hygiene, are thought
to be responsible for about 88 percent of diarrheal illness
(WHO, 2004). Other preventable diseases such as polio,
hepatitis, cholera, and typhoid have spread across Africa due
to a lack of clean water and a lack of knowledge about good
hygiene (WHO/UNICEF, 2004).
Academic studies have demonstrated that having proper
WaSH activities in schools can help students improve their
knowledge, practice, and health by lowering the number of
days missed in school due to menstrual periods or giving
them more time to complete learning objectives (Bowen et

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al. 2007; Lopez-Quintero et al. 2009; Freeman et al. 2012;
Jasper et al. 2012). The reduction of diarrheal illnesses
among students is estimated to result in 1.9 billion school
days achieved (Hutton & Haller 2004), while lack of
sanitation is blamed for 272 million school days lost each
year and for the intestinal worm infestation of an estimated
400 million children (Hutton & Haller 2004; Zomerplaag &
Moojiman, 2005). According to UNICEF, most of the
world's schools lack clean bathrooms, drinking water, and
hygiene education for students, particularly schools in rural
areas, which either lack drinking water and sanitation
facilities, or have infrastructure that is both insufficient in
quality and quantity (UNICEF, 2004), creating high-risk
situations where diseases can readily spread (WHO, 1997).
Moreover, even with acceptable facilities and resources,
students' knowledge and practice of hygiene have a
significant impact on their hygiene activities. Studies have
demonstrated that, WaSH school-based interventions,
especially those focused on adequate knowledge and
practice, can help to lower the occurrence of diarrhea,
communicable diseases, and other vector-borne infections,
as well as infant mortality rates, all over the world (Prüss-
Üstün et al., 2008). Nonetheless, despite these advantages, a
lack of funds, water quality standards, accountability, and a
low priority for WaSH all contribute to failure to effectively
create and maintain water and hygiene services
(Montgomery & Elimelech, 2007), resulting in millions of
preventable illnesses and deaths each year (Montgomery &
Elimelech, 2007; WHO/UNICEF, 2004). For instance,
while initiatives have considerably increased the portion of
the populace with access to improved water sources and
appropriate sanitation around the world since 1990, they
have mostly concentrated on WaSH in the household or
community, rather than at the institutional level
(WHO/UNICEF, 2015). As a result, there are significant
gaps in WaSH access, awareness, and practice, especially in
school environments (WHO/UNICEF, 2015).
However, available studies and reports from development
partners' concerted efforts suggest that long-term low access
to adequate WaSH services and low awareness in rural
schools across the country actually provide opportunities for
affordable interventions on students' knowledge and
practice of WaSH. This is especially true in the face of the
emergence of COVID-19, which has highlighted the
importance of sanitation and hygiene, particularly in our
schools (Gammon & Hunt, 2020; Olukanni et al., 2014;
World Bank, 2017; Mackinnon et al., 2019). For this reason,
the study prioritizes assessing the knowledge of WaSH and
practice in some selected secondary schools in Ijebu Ode as
a part of the Sustainable Development Goals following the
2015 Millenium Development Goal deadline. Thus, the
investigation was conducted to explore the knowledge of
WaSH and practice among secondary school students in
Ijebu Ode, as the findings would enable policy intervention
on school-based education on the promotion and
implementation of WaSH practice.
Literature review
Concept of wash
Water and sanitation are critical components of a supportive
atmosphere and high-quality education. In many
impoverished countries, sanitary conditions in schools are
appalling (Ana, 2008), and are either insufficient or
unavailable, resulting in filthy latrines due to a shortage of
water or a far distance from it. These conditions increase the
risk of disease, which, according to Egbinola & Amanambu,
(2015) is particularly prevalent among children aged 5 to 14,
and can have a negative impact on cognition, growth,
concentration, physical activities, and academic
performance.
Moreover, despite the probable merits of adequate WaSH in
educational institutions to students' health and educational
performance, evidence reveals that these benefits are highly
variable (Freeman et al. 2012), as they are reliant on the
accessibility of vital materials and consumables including
water, soap, and anal cleansing products (McMahon et al.
2011; Greene et al. 2012; Saboori et al. 2011). It has been
suggested that the availability of an enabling environment,
which includes government control and commitment,
enough funds and a well-established supply line, defined
roles and functions, monitoring, and answerability, is related
to the effectiveness of sustaining these inputs (Saboori et al.
2011). More so, it has been identified that WaSH is crucial
for girls' education, as inadequate water supply, sanitation,
and cleanliness, which according to Lidonde (2004), have a
role in the low retention of females in schools. Similarly,
previous studies have demonstrated that a lack of sufficient
water and sanitation facilities is a significant contributor to
the significant impact on girls' enrollment and school leave
in Africa’s Sub-Saharan (Birdthistle et al., 2011;
UNICEF/WaterAid (2013).
Impact of Poor WaSH
Reports have indicated that satisfactory WaSH in
educational institutions could prevent gastrointestinal and
diarrheal infections (Lopez-Quintero et al. 2009; Jasper et
al. 2012). PrüssÜstün & Corvalán (2006) submitted that
94% of the causes of diarrheal diseases can be attributed to
environmental influences, which include unwholesome
drinking water and poor hygiene. For instance, in 2012, an
estimated 502,000 and 280,000 deaths were ascribed to poor
water and hygiene, respectively, out of the total 1.5 million
diarrhea-related deaths reported (Prüss-Ustün et al. 2014). It
has been reported that kids suffer from infectious,
gastrointestinal, neurocognitive, and psychosocial problems
as a result of insufficient WaSH in schools (Jasper, 2012).

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Inadequate WaSH circumstances have been said to be
connected to poor academic performance in children by
contributing to absenteeism and reduced cognitive
capacities (Alexander et al., 2013; O'Reilly et al., 2008; Bar-
David et al., 2005; Bartlett, 2003; Benton & Burgess, 2009).
In collaboration, Bartlett outlined the influence of filthy
environments and diarrheal disease on child malnutrition as
well as mental and social development, including school
achievement levels, working memory, and behavioral issues
(Bartlett, 2003). While a more recent literature review found
ambiguous data on the subject, the standard of hygiene
amenities in schools can affect girls' attendance rates,
especially if they have started menstruating (Doyle, 1995;
Birdthistle et al., 2011).
More so, there is some evidence to suggest that an absence
of adequate WaSH may also lead to absenteeism from
school (Pearson & Mcphedran, 2008), which is associated
with low educational activities, interruptions in academic, a
rate of school drop-out, and social development (Lamdin,
1996). WaSH and school absences are especially important
for menstruating girls who require personal hygiene
facilities (WHO/UNICEF, 2015; Pearson & Mcphedran,
2008; Freeman et al., 2012; Mooijman, 2012), and WaSH
interventions in schools may thus help reduce gender
disparities in school performance and attendance (Freeman
et al., 2012).
However, some limited work has been published on the
educational and health benefits of providing WaSH
interventions in schools. For example, Vally et al. (2019)
found that having an educational-based WaSH intervention
increased students' awareness and hygiene activities,
reduced absenteeism, and increased hand washing among
household members in a study on the impact of school-based
WaSH intervention on knowledge, practices, and diarrhea
frequency in the Philippines. In contrast, Ahmed et al.
(2021) found that academic attainment was significantly
correlated with WaSH interventions or policies in a study
conducted in Pakistan. Similarly, research has indicated that
pupils at WaSH intervention schools have fewer cases of
diarrhea and other sanitation-related disorders like
respiratory sickness and soil-transmitted helminths (Migele
et al., 2007; Freeman et al., 2012; Bieri et al., 2013; Trinies
et al., 2016).
In addition, inadequate WaSH is a key concern in schools
owing to the high chances for disease spread among school
learners, who are considered to be a vulnerable group.
However, improved knowledge and efficient hand-hygiene
practices, particularly among school-children, can
effectually decrease respiratory and gastrointestinal tract
illnesses, the two global leading causes of childhood illness
and death (Curtis & Cairncross, 2003; Mohammed et al.,
2016). The above is supported by research that shows that
schoolchildren who have a better understanding and practice
of WaSH have fewer sick days and absenteeism, as well as
higher grades (Vivas et al., 2010; Mohammed et al., 2016).
WaSH Services in LMICs
In many developing-country schools, the situation is
appalling. Sanitation is either non-existent or extremely
poor, making it potentially dangerous and a source of a
variety of diseases. According to reports, there is a
substantial shortage of WaSH activities in LMICs in
Africa’s Sub-Saharan, with 300 million people lacking
access to potable water and 700 million lacking access to
enhanced hygiene facilities. It has been projected that 71
million people will remain without access to improved water
and another 130 million will fail to satisfy sanitation
standards set by the MDGs (World Bank, 2017). However,
despite infrastructure investment and partnership with WHO
and UNICEF among LMICs in Africa’s Sub-Saharan, the
availability and provision of WaSH facilities in schools in
rural regions has remained a key concern. According to
Morgan et al., 2017 only around 22 percent of schools in
rural Uganda, Zambia, Kenya, Mozambique, Rwanda and
Ethiopia satisfy WHO standards for WaSH facilities and
adequacy.
Similarly, differences in wealth quantiles are mostly to
blame for the rural/urban divide as wealthier households and
greater economic power are more common in urban regions.
As a result, there is less political will in rural areas to provide
basic WaSH and social infrastructure (Ojima et al., 2020;
Sinharoy et al., 2019). When compared to the urban poor,
rural poor households were 29 times less likely to have
access to better water and 25 times less likely to have access
to improved sanitation facilities, according to another study
that tracked progress in WaSH in Africa’s Sub-Saharan
(Armah et al., 2018). In addition, when compared to other
rural households, wealthier households in these areas enjoy
superior WaSH services (Chasekwa et al., 2018).
WaSH in Nigeria
In Nigeria, like many other developing nations around the
world, a lack of continuous, effective, and safe services is a
typical occurrence, resulting in a high frequency of WaSH-
related diseases, leading many people, particularly children,
to become ill or even die (UNICEF, 1998). Despite efforts
by government parastatals, non-governmental and non-
profit organizations to improve access to safe water supply
and sustainable sanitation in Nigeria's major cities, by
supporting the provision of enhanced water sources and
hygiene amenities in rural communities and schools, thus
facilitating the realization of the national mark of 90 percent
by 2015 and 100 percent by 2020 (UNICEF, 2007), huge
figures of rural and urban schools and healthcare facilities
remain the same. Nigeria is currently among the countries
with sanitation coverage rates that are between 20% and
40% below the MDGs (Aremu, 2012; Banerjee and Morella,
2011). It has been reported that the majority of Nigerian

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public secondary schools lack basic water and sanitation
facilities, and hygiene teaching programs are frequently
insufficient (Adam et al., 2009).
Studies have shown that the lack of basic school-WaSH
services has been proven to be widespread in Nigeria,
contributing considerably to youth and adolescent sanitation
and hygiene practices (Egbinola & Amanambu, 2015; Wada
et al., 2020; Wada & Oloruntoba, 2021). According to the
World Bank, about 90% of rural Nigerians defecate in the
open while 51% of rural communities lacked access to better
water in 2017 (World Bank, 2017). In addition, improper
sanitation and hygiene practices among Nigerian
adolescents and youths have been linked to a lack of
information and a negative attitude toward fundamental
hygiene practise (UNICEF, 2015; Azuogu et al., 2016).
In a research to evaluate the WaSH in secondary schools in
Ibadan, Nigeria, Egbinola & Amanambu (2015) found that
W/C were used in just 24% of the schools, while pit toilets
were utilized in 76% of the schools, with 88 percent of them
being regular pit toilets and only 12% being VIP. But the
study also showed that, in 77 percent of the schools, there
were no wash basins, and in 88 percent of the ones that did
have wash basins, there was no soap. A similar study on the
WaSH program in public secondary schools in South-
Western Nigeria, conducted by Olukanni in 2013, found that
the majority of the schools lacked adequate WaSH practices.
Of the 12 public secondary schools surveyed, only 3 (or
25%) had access to drinking water, and 40% of the schools
lacked separate latrines for boys and girls. One (10%) of the
schools had handwashing stations but no soap (Olukanni,
2013).
More so, An empirical study on hand-washing habits among
secondary school pupils in Ebonyi, Nigeria, revealed a
significant prevalence of infectious disorders including
diarrhea among secondary schools, which was linked to
dirty hands. The study found that washing hands with soap
and water under flowing water stops the transmission of
illnesses (Azuogu et al., 2016). Similarly, Ikogho &
Igbudu's (2013) investigation into the accessibility and use
of hand-washing facilities among primary school students in
Ughelli North, Delta State, indicated that there are few
facilities available, and usage is hampered by a lack of
supplies and a poor maintenance culture. The study also
suggested that if infectious infections were not controlled by
practicing adequate handwashing, they could result in
significant morbidity and mortality among schoolchildren as
well as absenteeism.
However, with several Nigerians in school, prioritizing
school-based intervention is critical for imparting
appropriate sanitation and hygiene knowledge and practices
in future generations (UNICEF, 2012).
MATERIALS AND METHODS
Study Area
The evaluation of WaSH practice among students in
secondary school was conducted in Ijebu Ode, the second
largest city in Ogun State, Nigeria, which is located some 60
kilometers north-west of Lagos and has an estimated
population of 154,032 (National Population Commission,
2007). (See figure 1).
Figure 1: Ijebu Ode Spatial Map (Otto, 2022)
Sampling, Collection and Analysis of Data
The study is based on primary data collected by the
researchers between January and March 2022, and which
involved the use of questionnaires, interviews, and personal
observation to elicit information on the respondents’
knowledge and practice of WaSH. The simple random
approach was used, relying on random numbers to select
sample schools from the list of schools in Ijebu Ode. A total
of six (three public and three private) schools were selected
from the 26 and 49 public and private secondary schools,
respectively. An aggregate of sixty (60) students were
selected through random numbers from the six randomly
selected schools (three public and three private),
representing a total student population of 360. The data,
which was collected via structured questionnaire and
observation were computed and analyzed descriptively
using Microsoft Excel and Statistical Package for Social
Scientist (version 20.0), and the result presented by using
frequency tables, graphs, and charts.
Classification of Levels of Knowledge and Practice of
WaSH
The respondents’ WaSH knowledge and practice were
categorized as adequate, moderate, and low, respectively.
Knowledge scores ranged from 0 to 15, and respondents
who possessed adequate knowledge obtained scores of
between 12 and 15 (more than 75%), moderate 8 to 11 (50–
75%), while those with low knowledge had scores below 8

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(less than 50%). Similarly, practice levels range from 0 to
14. Students with adequate practice obtained scores between
11 and 14 (more than 75%), and those with moderate
practice had scores between 7 and 10 (50–75%), while
students with low practice had scores below 7 (less than
50%). This was adapted from a previously published study
(Kudavidanage et al., 2011; Wada et al., 2022).
Ethical Consideration
An official approval was gotten from the Institutional Ethics
Committee, and informed consent was secured from all the
secondary schools and participants with the utmost
assurance of confidentiality.
Results and discussions
The present work was carried out to evaluate WaSH practice
among students in secondary school, Ijebu Ode. The results
of the analysis of students’ knowledge of WaSH indicated
that a good number of participants (78.9%) had adequate
knowledge of WaSH (see table 1, figure 2). In contrast, these
results are inconsistent with those of other studies that
documented inadequate knowledge of WaSH (Gomathi et
al., 2018; Wada et al., 2022). Our study suggests that
adequate knowledge of WaSH is one of the prerequisites for
effective WaSH practice, provided essential WaSH
resources (water, soap, toilets, etc.) are available and
accessible.
Moreover, analysis of data also reveals that 85% of the
students understand that dumping of refuse in public drains
can lead to flooding, while a similarly high number of them,
73.6%, are also knowledgeable that burning of waste is not
a good waste disposal approach due to its environmental
effects. Similar results were demonstrated by Safo-Adu &
Hanson, 2019.
Further analysis indicated that 89.7% of the students knew
that preserving water in a container with a tight-fitting cover
is necessary to safeguard the water against potential physical
or microbial contamination. These results agree with the
findings of other studies that documented adequate
knowledge by students on the importance of regular
cleaning and proper covering of water containers (Shrestha
et al., 2018; Vivas et al., 2011). Statistical results on simple
treatment of water showed that 93.6% of students had an
understanding that germs are killed during the boiling
process of water. This result is consistent with Shrestha et
al. (2018), who reported similar findings (95%) among
students, but differs from the results of other research
reports (Vivas et al., 2010; Vivas et al., 2011; Javaeed et al.,
2018).
Additionally, approximately 69% knew that washing hands
without soap after visiting the latrine is an unhygienic
practice. Similarly, Dajaan et al. (2018) documented that
100% of Saudi school students understand the need for
handwashing with soap and water. The present finding was
further corroborated by Shrestha et al. (2018) who reported
that 84% of the students had good knowledge about the
importance of hand-washing after defecation, but the
finding was different in comparison to others (Vivas et al.,
2010; Shilunga et al., (2018).
Moreover, most students 95% recognized that hygienic and
clean surroundings are needed for good health and that dirty
surroundings contribute to disease spread by 92.8%.
Similarly, the majority of them (93.9%) attested that it is the
responsibility of people in the households to clear bushes
and weeds around their houses. Regrettably, about 26.9%
never knew that allowing stagnant water in their
surroundings was a bad sanitation and hygiene practice. In
a similar observation, Mourad et al. (2019) found that 26.5%
of students believe that draining stagnant water and
removing bushes surrounding the house can help avoid
malaria.
Nonetheless, a majority of 87.2% of the students agree that
defecating in the open spaces can adversely affect the health
of the people living within the area. In a recent study, Wada
et al. (2022) in a recent work suggested that 83.4% of
students recognize that open defecation in school could lead
to the spread of disease, as did Javaeed et al. (2018) in a
similar investigation. Contrarily, Shilunga et al. (2018) in a
previous report identified that over half of the students
(53%) did not know whether defecation in the open spaces
or bush could lead to the spread of illness.
More so, results on students’ practice on WaSH showed
significant evidence of inadequate WaSH practices, with
less than 50% shown to have adequate WaSH practice (see
table 2, figure 3). The results from our work suggest that
having adequate knowledge of WaSH does not necessarily
translate into actual practice, and these are evidently
attributable to several factors. Notwithstanding, the current
finding is consistent with recent observation by Gomathi et
al. (2018) who documented that only (14%) of students in
Mangalagiri reportedly have adequate practices on WaSH.
The result of the current investigation was, however,
contrary to (Sibiya & Gumbo (2013).
Regarding hand washing with soap and water, 73.6% of the
students always wash their hands after using the latrine,
whereas 65.3% wash their hands before and after meals. In
support of the results, Almoslem et al. (2021) recently
revealed that roughly 86% and 87% of the students washed
their hands after using the toilet and before meals. In
addition, recent evidence suggests that 94.4% of learners
reported always washing their hands before eating and after
toilet use (Shilunga et al., 2018). Sibiya & Gumbo (2013) in
a previous study reported that hand washing (65%) was
mostly done before eating and after visiting the toilet. Our
study suggests the relevance of hand-washing as an effective
preventive measure against the spread of faeco-oral and
helminthic infections (such as, diarrhea, typhoid,
amoebiasis, ascariasis, etc.) and the recent emergence of the

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novel COVID-19 has been reported by several researchers
(Curtis & Cairncross, 2003; Ruan et al., 2011; Sheren, 2012;
Lee et al., 2014; Alzyood et al., 2020; Zhang et al., 2016;
Gammon & Hunt, 2020). Similarly, in concordance with the
results of the present study, it has been documented that the
two most important moments of hand-washing are after
using the toilet and before eating (UNICEF, 2020).
Additionally, on the practice of open defecation, 13.6% of
the students reported always defecating in open spaces and
nearby bushes, which has severe implications for public
health, especially surface and ground water contamination.
In agreement with the present results, previous research has
reported the practice of open defecation among students
(Mourad et al., 2019; Wada et al., 2022). Regarding the
students’ performance, 86.4% of them reported always
covering their drinking water containers at home, while
70.8% always clean the drinking water containers every day.
However, a significant number of the students (93.6%)
knew that boiling water kills germs and therefore renders it
safe, but only 34.7% reportedly boil water meant for
drinking, which is the simplest method of household water
treatment that renders the water safe from disease-causing
organisms.
Moreover, our findings have shown that, though most of the
students 78.9% had adequate knowledge of WaSH,
relatively few (less than 50%) actually practiced WaSH.
This is in line with the study by Aswathy (2015) and Mohd
and Malik (2017), who reported that there was no
relationship between respondents' knowledge and practice
of hygiene. It is reasonable to assume that though the
awareness of WaSH exists, the inadequacy of essential
resources may negatively influence the effective practice of
WaSH among the students. Although we did not collect data
on the availability of resources in students' schools, the
resources offered in schools are often lacking (Vivas et al.,
2011; Sibiya & Gumbo, 2013; Wada et al., 2022; Jordanova
et al., 2015; Shilunga et al., 2018; Weaver et al., 2016;
Egbinola & Amanambu, 2015). According to a UNICEF
survey done in Ethiopia, only around a third of schools have
water points, and just 5% have hand washing facilities, none
of which had soap (UNICEF 2009).
This current work therefore contributes to existing
knowledge and practice on WaSH among students by
adding to an increasing body of empirical evidence that will
prove useful to donors, service providers, and policy makers
in enhancing affordable but highly effective intervention
programs that will significantly improve WaSH practices
among students in diverse settings. This study was cross-
sectional and did not capture changes in knowledge and
practice of WaSH by the students, nor factors thought to
influence these over time. A further study with more focus
on the aforementioned is therefore suggested.
Table 1: Knowledge of WaSH
S/N
Knowledge Variables
YES
NO
F
%
F
%
1
Used items such as nylon bags, papers, metal scrap, cans, abandoned
woods are all wastes
279
77.5
81
22.5
2
Dumping refuse in gutters, on open street and surroundings can lead to
flooding
306
85.0
54
15.0
3
Burning of waste is not a good way of waste disposal and poses
environmental effects
265
73.6
95
26.4
4
Burying of waste is not the right approach to dispose of refuse
286
79.4
74
20.6
5
Washing of hands without soap after using the toilet is a bad practice
250
69.4
110
30.6
6
Defecating in open spaces can affect people that are living in the area
314
87.2
46
12.8
7
The accurate way to preserve water meant for drinking is to in a
container with a cover
323
89.7
37
10.3
8
Drinking water should be odorless, tasteless and colorless
329
91.4
31
8.6
9
Storing refuse in wastebin with no cover is not a good practice
303
84.2
57
15.8
10
It is the duty of people in house to cut weeds and clear bushes around
their homes.
338
93.9
22
6.1
11
Presence of stationary water around the surroundings is good
sanitation practice
97
26.9
263
73.1
12
Adults and kids should not be tolerable to defecate in open
surroundings
323
89.7
37
10.3
13
A dirty surroundings contributes to disease spread
334
92.8
26
7.2
14
Hygienic surroundings is needed for good health
342
95.0
18
5.0
15
Boiling of water can kill the germs in it.
337
93.6
23
6.4

Journal of Environmental Science and Economics
www.jescae.com 16
General Knowledge
>75 78.9%
50 – 75 20.3%
<50 0.8%
Figure 2: General Knowledge of WaSH
Table 2: Practice of WaSH
S/n
Practice Variables
Always
Sometimes
Never
F
%
F
%
F
%
1
I put waste into garbage sags and dump into gutters and
on the street
79
21.9
79
21.9
202
56.1
2
When I finished using the toilet, I wash my hands with
water and soap
265
73.6
91
25.3
4
1.1
3
I cover my dustbin after placing in waste
262
72.8
82
22.8
16
4.4
4
Accumulate refuse in house for one or two days before
putting into the wastebin
101
28.1
125
34.7
134
37.2
5
I clear weeds and clean the household surroundings
221
61.4
127
35.3
12
3.3
6
I clean the latrine facility often
296
82.2
53
14.7
11
3.1
7
I defaecate in open spaces and nearby bushes
49
13.6
39
10.8
272
75.6
8
I allow the presence stagnant water around my
surroundings
68
18.9
71
19.7
221
61.4
9
I get involved in community sanitation activities
183
50.8
137
38.1
40
11.1
10
I cover my drinking water storage at home
311
86.4
37
10.3
12
3.3
11
I wash hands properly before, and also after meals
235
65.3
83
23.1
42
11.7
12
I leave the refuse there each time I sweep
85
23.6
67
18.6
208
57.8
13
I boiled water before drinking
125
34.7
179
49.7
56
15.6
14
Clean drinking water storage everyday
255
70.8
82
22.8
23
6.4
General Practice
>75 45.6%
50 – 75 38.9%
<50 15.5%
79%
20% 1%
>75
50 - 75
<50

Journal of Environmental Science and Economics
www.jescae.com 15
Figure 3: General Practice on WaSH
Conclusion
This study provides insights into the level of knowledge and
practice of students towards WaSH, in view of its health
implications, vis-a-vis potential impact on disease
promotion and prevention among school students. The
findings of this study indicated that most of the secondary
school students in Ijebu Ode have adequate knowledge
(78.9%) and inadequate practice (45.6%) on WaSH, and
thus, concluded that whereas the participants have adequate
knowledge on WaSH, it however did not translate into an
actual practice. Hence, a need for a concentrated effort that
will facilitate adequate WaSH practices among the school
students through the availability and accessibility of
appropriate WaSH resources, with school and home
schedules for WaSH practice.
References
Adam J., J. Bartram, Y. Chartier and J. Sims. (2009). Water,
Sanitation and Hygiene Standards for Schools in
Low Cost Settings. World Health Organization,
Geneva, Switzerland.
Ahmed, J., Wong, L. P., Chua, Y. P., Hydrie, M. Z. I., &
Channa, N. (2021). Drinking water, sanitation, and
hygiene (WASH) situation in primary schools of
Pakistan: the impact of WASH-related interventions
and policy on children school performance.
Environmental Science and Pollution Research, 1-
19.
Ana, G.R.E.E., Oloruntoba, E.O., Stridhar, M.K.C. and
Adekolu, A., (2008). Water and Sanitation problems
in selected schools in Ibadan, Nigeria. In:
Proceedings of the 33rd WEDC International
Conference: Ghana, Accra: Global Partnerships and
Local Actions, p.12.
Alexander, K.T.; Dreibelbis, R.; Freeman, M.C.; Ojeny, B.,
Rheingans, R. (2013). Improving service
delivery of water, sanitation, and hygiene in primary
schools: A cluster-randomized trial in western
kenya. J. Water Health, 11, 507–519.
Almoslem, M. M., Alshehri, T. A., Althumairi, A. A.,
Aljassim, M. T., Hassan, M. E., & Berekaa, M. M.
(2021). Handwashing Knowledge, Attitudes, and
Practices among Students in Eastern Province
Schools, Saudi Arabia. Journal of Environmental
and Public Health, 2021, 1–10.
https://doi.org/10.1155/2021/6638443
Alzyood, M., Jackson, D., Aveyard, H., & Brooke, J.(
2020). COVID-19 reinforces the importance of
handwashing, Journal of Clinical Nursing, vol. 29,
no. 15-16, pp. 2760-2761.View at: Publisher Site |
Google Scholar
Aremu A. S. (2012). Assessment of Sanitation Facilities in
Primary Schools within Ilorin, Nigeria. Journal of
Applied Sciences in Environmental Sanitation. 7(1):
29-33.
Armah, F. A., Ekumah, B., Yawson, D. O., Odoi, J. O.,
Afitiri, A.-R., & Nyieku, F. E. (2018). Access to
improved water and sanitation in sub-Saharan
Africa in a quarter century. Heliyon, 4(11), e00931.
https://doi.org/10.1016/j.heliyon.2018.e00931
45.60%
38.90%
15.5%
>75 50 - 75 <50

Journal of Environmental Science and Economics
www.jescae.com 16
Aswathy, S. K. (2015). Knowledge and practice regarding
environmental sanitation and hygiene among
general population. A cross sectional survey. Global
Journal for Research Analysis. 4(11), 2277 – 8160.
Azuogu, V. C., Cajetan, I. I., Ignatius, O. N., Benedict, N.
A., & Chinagorom, O. (2016). Extent of hand
washing practice among secondary school students
in Ebonyi State, Nigeria. International Journal of
Education, Learning and Development, 4(7), 11–
22. https://www.eajournals.org/wp-
content/uploads/Extent-of-Hand-Washing-Practice-
among-Secondary-School-Students-in-
Ebonyi-State-Nigeria.pdf
Banerjee S. G. and Morella E. (2011). Africa’s Water and
Sanitation Infrastructure: Access, Affordability and
Alternatives. The International Bank for
Reconstruction and Development/ the World Bank,
Washington DC, U. S. A.
Bar-David, Y.; Urkin, J.; Kozminsky, E. (2005). The effect
of voluntary dehydration on cognitive functions of
elementary school children. Acta Paediatr, 94,
1667–1673.
Bartlett, S. (2003). Water, sanitation and urban children:
The need to go beyond “improved” provision.
Environ. Urban. 15, 57–70.
Benton, D. & Burgess, N. (2009). The effect of the
consumption of water on the memory and attention
of children. Appetite, 53, 143–146.
Bieri, F.A.; Gray, D.J.; Williams, G.M.; Raso, G.; Li, Y.;
Yuan, L.; He, Y.; Li, R.S.; Guo, F.Y.; Li, S.M.(
2013). Health-Education Package to PreventWorm
Infections in Chinese Schoolchildren. NEJM, 368,
1603–1612. [CrossRef] [PubMed]
Birdthistle, I., Dickson, K., Freeman, M., and Javidi, L.,
(2011). What impact does the provision of separate
toilets for girls at schools have on their primary and
secondary school enrolment, attendance and
completion?: A systematic review of the evidence,
London: EPPI-Centre, Social Science Research
Unit, Institute of Education, University of London.
Bowen, A., Ma, H., Ou, J., Billhimer,W., Long, T., Mintz,
E., Hoekstra, R. M. & Luby, S. (2007). A cluster-
randomized controlled trial evaluating the effect of
a handwashing promotion program in Chinese
primary schools. The American Journal of Tropical
Medicine and Hygiene 76, 1166–1173.
Chasekwa, B., Maluccio, J. A., Ntozini, R., Moulton, L. H.,
Wu, F., Smith, L. E., Matare, C. R., Stoltzfus, R. J.,
Mbuya, M. N. N., Tielsch, J. M., Martin, S. L.,
Jones, A. D., Humphrey, J. H., & Fielding, K.
(2018). Measuring wealth in rural communities:
Lessons from the Sanitation, Hygiene, Infant
Nutrition Efficacy (SHINE) trial. PLOS ONE,
13(6), e0199393.
https://doi.org/10.1371/journal.pone.0199393
Curtis V, Cairncross S. (2003). Effect of washing hands with
soap on diarrhea risk in the community: a systematic
review. Lancet Infect Dis.3:275–81.
Dajaan, D. S., Addo, H. O., Ojo L., et al., (2018). “Hand-
washing knowledge and practices among public
primary schools in the Kintampo Municipality of
Ghana,” International Journal of Community
Medicine and Public Health, vol. 5, no. 6, pp. 2205–
2216. View at: Publisher Site | Google Scholar
Doyle, B.A. (1995). Increasing Education and Other
Opportunities for Girls and Women with Water,
Sanitation and Hygiene. Available online:
http://www.ircwash.org/resources/increasing-
education-and-otheropportunities- girls-and-
women-water-sanitation-and-hygiene (accessed on
20 May 2022).
Egbinola, C. N., & Amanambu, A. C. (2015). Water supply,
sanitation and hygiene education in secondary
schools in Ibadan, Nigeria. Bulletin of Geography.
https://doi.org/10.1515/bog-2015-0023
Freeman, M.C.; Greene, L.E.; Dreibelbis, R.; Saboori, S.;
Muga, R.; Brumback, B.; Rheingans, R. (2012).
Assessing the impact of a school-based water
treatment, hygiene and sanitation programme on
pupil absence in Nyanza Province, Kenya: A
cluster-randomized trial. Trop. Med. Int. Health, 17,
380–391. [CrossRef] [PubMed]
Gammon, J., & Hunt, J. (2020). COVID-19 and hand
hygiene: The vital importance of hand drying.
British Journal of Nursing, 29(17), 1003–1006.
https://doi.org/10.12968/bjon.2020.29.17.1003
Greene, L. E., Freeman, M. C., Akoko, D., Saboori, S., Moe,
C. & Rheingans, R. (2012). Impact of a school-
based hygiene promotion and sanitation
intervention on pupil hand contamination in
Western Kenya: a cluster randomized trial. The American
Journal of Tropical Medicine and Hygiene 87, 385–
393. [CrossRef] [PubMed]
Gomathi, S., Samitha, P. C., Kanaka Nishanth, B., Praveen
Kumar, N., & Sireesha, K. (2018). A study to assess
the knowledge and practices regarding WASH
among school children in selected school,
Mangalagiri, Guntur district, Andhra Pradesh.
International Journal Of Community Medicine And
Public Health, 6(1), 253.
https://doi.org/10.18203/2394-
6040.ijcmph20185252
Houghton, F.; Gleeson, M.; Kelleher, K. (2003). The use of
primary/national school absenteeism as a proxy
retrospective child health status measure in an
environmental pollution investigation. Public
Health,117, 417–423. [CrossRef]
Hutton, G. & Haller, L. (2004). Evaluation of the Costs and
Benefits of Water and Sanitation Improvements at

Journal of Environmental Science and Economics
www.jescae.com 17
the Global Level. Water, Sanitation, and Health,
Protection of the Human
Environment, World Health Organization.
Ikogho, D.E. &Igbudu, U. (2013). Availability and
Utilization; of Handwashing facilities among
primary school pupils in Ughelli North L.G.A; of
Delta State. Academic Research International. 4 (5)
Jasper, C., Le, T.-T. & Bartram, J. (2012). Water and
sanitation in schools: a systematic review of the
health and educational outcomes. International
Journal of Environmental Research and Public
Health 9, 2772–2787.
Javaeed, A., Tabbasum, T., Arif, U., Ghauri, S., Khan, S., &
Wajid, Z. (2018). Knowledge, Attitude and Practice
of Water, Sanitation and Hygiene of Students in
Azad Kashir. Rawal Medical Journal, 43(3), 536–
539.
Jordanova, T., Cronk, R., Obando, W., Medina, O.,
Kinoshita, R., & Bartram, J. (2015). Water,
Sanitation, and Hygiene in Schools in Low Socio-
Economic Regions in Nicaragua: A Cross-Sectional
Survey. International Journal of Environmental
Research and Public Health, 12(6), 6197–6217.
https://doi.org/10.3390/ijerph120606197
Kudavidanage, B. P., Gunasekara, T. D., & Hapuarachch, S.
(2011). Knowledge, attitudes and practices on hand
hygiene among ICU staff in Anuradhapura
Teaching Hospital. Medical Journal; 1, 29-40. doi:
http://doi.org/10.4038/amj.v5i1.5781
Lamdin, D.J. (1996). Evidence of student attendance as an
independent variable in education production
functions. J. Educ. Res., 89, 155–162. [CrossRef]
Lee, M. S., Hong, S. J., and Kim, Y. T. (2015 ). “Hand-
washing with soap and national handwashing
projects in Korea: focus on the national hand-
washing survey, 2006-2014,”
Epidemiology and Health, vol. 37, Article ID e2015039.
View at: Publisher Site | Google Scholar
Lidonde, R., (2004). Scaling up school sanitation and
hygiene promotion and gender concerns. In: School
Sanitation and Hygiene Education Symposium. The
Way Forward: Construction is Not Enough! In:
Proceedings of School Sanitation and Hygiene
Education Symposium, the Netherlands, Delft:
WEDC, GWA. Available at:
http://www.irc.nl/page/13136, DoA:13 December
2013.
Lopez-Quintero, C., Neumark, Y and Freeman, P., (2009).
Hand washing among school children in Bogota,
Colombia. In: Health American Journal of Public
Health, Vol. 99, No. 1, pp. 94-101.
Mackinnon, E., Ayah, R., Taylor, R., Owor, M.,
Ssempebwa, J., Olago, D. i., Kubalako, R., Dia,
T.A., Gaye, C., Campos, L.C., & Fottrell, E., (2019).
21ST Century Research in Urban WASH and Health
in Sub-Sharan Africa; Methods and Outcomes in
Transition. International Journal of Environmental
Health Research. Vol 29, N0. 4, 457-478.
McMahon, S., Caruso, B. A., Obure, A., Okumu, F. &
Rheingans, R. D. (2011) Anal cleansing practices
and faecal contamination: a preliminary
investigation of behaviours and conditions in
schools in rural Nyanza Province, Kenya. Tropical
Medicine & International Health 16, 1536–1540.
Migele, J.; Ombeki, S.; Ayalo, M.; Biggerstaff, M. (2007).
Quick, R. Diarrhea prevention in a Kenyan school
through the use of a simple safe water and hygiene
intervention. Am. J. Trop. Med. Hyg., 76, 351–353.
Mohammed G, Nihar D, Bashayer A, Hiba I, Rasha A, Zaid
A. (2016). Knowledge and Practice of Personal
Hygiene among Primary School Students in
Sharjah-UAE. J Health Sci.6(5):67-73.
Mohd, G., & Malik, I. (2017). Sanitation and hygiene
knowledge, attitude and practices in urban setting of
Bangalore: Across sectional study. Journal of
Community Medicine and Health Education. 7(4),
540 – 545.
Montgomery, M.A.; Elimelech, M. (2007). Water and
sanitation in developing countries: Including health
in the equation. Environ. Sci. Technol., 41, 17–24.
[CrossRef] [PubMed]
Mooijman, A. (2012). Water, Sanitation and Hygiene
(WASH) in Schools. In A Companion to the Child
Friendly Schools Manual; UNICEF: New York,
NY, USA.
Morgan, C., Bowling, M., Bartram, J., & Lyn Kayser, G.
(2017). Water, sanitation, and hygiene in schools:
Status and implications of low coverage in Ethiopia,
Kenya, Mozambique, Rwanda, Uganda, and
Zambia. International Journal of Hygiene and
Environmental Health, 220(6), 950–959.
https://doi.org/10.1016/j.ijheh.2017.03.015
Mourad, K. A., Habumugisha, V., & Sule, B. F. (2019).
Assessing Students’ Knowledge on WASH-Related
Diseases. International Journal of Environmental
Research and Public Health, 16(11), 2052.
https://doi.org/10.3390/ijerph16112052
National Population Commission (NPC), (2007).
Population census and household data survey for
Nigeria, Abuja: Federal Government of Nigeria.
Ojima, Z.W., David, B. O., Temitope, D. A., Awe, O. O.,&
Iyanuoluwa, G. A. (2020). Prevalence of
hypertension among rural adults and availability of
management services in Abimbola Community,
Ayedaade Local Government Area, Osun State,
Nigeria. Journal of Hypertension and Management,
6(1), 10.23937/2474–13690/1510046.
Olukanni, D. O. (2013). Assessment Of Wash Program In
Public Secondary Schools In South-Western

Journal of Environmental Science and Economics
www.jescae.com 18
Nigeria. ARPN Journal of Engineering and
Applied Sciences. 8(3), 7. ISSN 1819-6608
Olukanni, D.O., Ducoste, J.J. & George, T.O. (2014).
Creating Water, Sanitation and Hygiene(WASH)
Program Awareness in Schools; A Tool towards the
Success of Community WASH program.
Proceedings of EDULEARN14 Conference, 7th-19th
July, 2014. Barcelona, Spain. ISBN 978-84-6170-
0557-3
O’Reilly, C.E.; Freeman, M.C.; Ravani, M.; Migele, J.;
Mwaki, A.; Ayalo, M.; Ombeki, S.;
Hoekstra, R.M.; Quick, R. (2008). The impact of a school-
based safe water and hygiene programme on
knowledge and practices of students and their
parents: Nyanza Province, western Kenya, 2006.
Epidemiol. Infect., 136, 80–91.
Otto, E. (2022). Evaluation of Abattoir Practices in Ijebu
Ode, Nigeria. International Journal of Advances in
Life Science and Technology, 6(1), 12–23.
https://doi.org/10.18488/72.v6i1.3013
Pearson, J.; Mcphedran, K. (2008). A literature review of
the non-health impacts of sanitation. Waterlines, 27,
48–61. [CrossRef]
Prüss-Ustün, A., Bartram, J., Clasen, T., Colford, J. M.,
Cumming, O., Curtis, V., Bonjour, S., Dangour, A.
D., De France, J. & Fewtrell, L. (2014). Burden of
disease from inadequate water, sanitation and
hygiene in low-and middle-income settings: a
retrospective analysis of data from 145 countries.
Tropical Medicine & International Health 19, 894–
905.
Prüss-Üstün, A.; Bos, R.; Gore, F.; Bartram, J. (2008).
Others Safer Water, Better Health: Costs, Benefits
and Sustainability of Interventions to Protect and
Promote Health. Available online:
https://www.cabdirect.org/cabdirect/abstract/20083
318172 (accessed on May 20, 2022).
Prüss-Üstün, A. & Corvalán, C. (2006). Preventing Disease
Through Healthy Environments. World Health
Organization, Geneva.
Ruan, F., Yang, T., Ma H. et al., (2011 ). “Risk factors for
hand, foot, and mouth disease and herpangina and
the preventive effect of hand-washing,” Pediatrics,
vol. 127, no. 4, pp.e898–904,. View at: Publisher
Site | Google Scholar
Saboori, S., Mwaki, A., Porter, S., Okech, B., Freeman, M.
& Rheingans, R. (2011). Sustaining school hand
washing and water treatment programmes: lessons
learned and to be learned. Waterlines 30, 298–311.
Safo-Adu, G., & Hanson, R. (2019). Practices And
Knowledge About Environmental Sanitation And
Hygiene Among Urban Dwellers in Gomoa East
District, Ghana. European Journal of Earth And
Environment, 6(1), 11.
Sheren, N. A. (2012). Knowledge and attitudes of pupils in
some primary schools regarding personal hygiene in
Erbil city, Kufa Journal for Nursing Sciences, vol.
2, no. 1, pp. 142–150,. View at: Google Scholar
Shilunga, A. P. K., Amukugo, H. J., & Mitonga, K. H.
(2018). Knowledge, attitudes and practices of
primary schools learners on sanitation and hygiene
practices. International Journal Of Community
Medicine And Public Health, 5(8), 3197.
https://doi.org/10.18203/2394-
6040.ijcmph20183051
Shrestha, M. V., Manandhar, N., & Joshi, S. K. (2018).
Study on Knowledge and Practices of Water,
Sanitation and Hygiene among Secondary School
Students. Journal of College of Medical Sciences-
Nepal, 14(3), 160–165.
https://doi.org/10.3126/jcmsn.v14i3.21158
Sibiya, J., & Gumbo, J. (2013). Knowledge, Attitude and
Practices (KAP) Survey on Water, Sanitation and
Hygiene in Selected Schools in Vhembe District,
Limpopo, South Africa. International Journal of
Environmental Research and Public Health, 10(6),
2282–2295.
https://doi.org/10.3390/ijerph10062282
Sinharoy, S. S., Pittluck, R., & Clasen, T. (2019). Review of
drivers and barriers of water and sanitation policies
for urban informal settlements in low-income and
middle-income countries. Utilities Policy, 60,
100957. https://doi.org/10.1016/j.jup.2019.100957
Trinies, V.; Garn, J.; Chang, H.; Freeman, M. (2016). The
Impact of a School-BasedWater, Sanitation, and
Hygiene Program on Absenteeism, Diarrhea, and
Respiratory Infection: A Matched–Control Trial in
Mali. Am. J. Trop.Med. Hyg., 94, 1418–1425.
[CrossRef] [PubMed]
UNICEF, (2004). Life skills-based hygiene education.
Available at: http://www.wsp.org/Hygiene-
Sanitation-Water-
Toolkit/Resources/Readings/life%20skills%20Post
ma.pdf, DoA: 3 December 2013.
UNICEF. (2012). Raising even more clean hands:
Advancing learning, health and equity through
WASH in schools.
https://www.unicef.org/wash/schools/files/Raising
_Even_More_Clean_Hands_Web_17_October_20
12.pdf. Accessed 2 May 2019.
UNICEF, (2013). Gender and water, sanitation and hygiene
(WASH): Eastern and Southern Africa. Available
at:
http://www.unicef.org/esaro/7310_Gender_and_W
ASH.html, DoA: 12 November 2013.
UNICEF, (2020). Evaluation of the UNICEF supported
Federal Government of Nigeria Water, Sanitation
and Hygiene Programme (2014-2017). Final

Journal of Environmental Science and Economics
www.jescae.com 19
Report. UK: International Organisation
Development.
UNICEF/IRC. (2007). Towards Effective Programming for
WASH in Schools: A manual on scaling up
programmes for water, sanitation and hygiene in
schools.
http://www.unicef.org/wash/files/TP_48_WASH_S
chools _07.pdf. Accessed 05/03/2012.
United Nations Children’s Fund. (1998). A Manual on
School Sanitation and Hygiene. Water,
Environment and Sanitation Technical Guidelines
Series No. 5. New York, NY Available at
ww.irc.nl/. Accessed 15/01/2012.
United Nations Children’s Fund. Water, Sanitation, and
Hygiene Annual Report. [Accessed August 5,
2009]. Available at: www.unicef.org/wash
United Nations General Assembly (2015). Transforming
Our World: the 2030 Agenda for Sustainable
Development. United Nations, New York.
https://sustainabledevelopment.un.org/post2015/tra
nsformingourworld (accessed 2 February 2017).
Vally, H.; McMichael, C.; Doherty, C.; Li, X.; Guevarra, G.;
Tobias, P. (2019). The impact of a school-based
water, sanitation and hygiene intervention on
knowledge, practices, and diarrhoea rates in the
Philippines. Int. J. Environ. Res. Public Health, 16,
4056.[CrossRef]
Vivas A, Gelaye B, Aboset N, Kumie A, Berhane Y,
Williams MA. (2010). Knowledge, Attitudes, and
Practices (KAP) of Hygiene among School Children
in Angolela, Ethiopia. J Prev Med Hyg.;51(2): 73–
9.(https://www.ncbi.nlm.nih.gov/pubmed/2115540
9.
Vivas, A., Gelaye, B., Aboset, N., Kumie, A., Berhane, Y.,
& Williams, M. A. (2011). Knowledge, Attitudes,
and Practices (KAP) of Hygiene among School
Children in Angolela, Ethiopia. 16.
Wada, O. Z., & Oloruntoba, E. O. (2021). Safe reopening of
schools during COVID-19: An evaluation of
handwash facilities and students’ hand hygiene
knowledge and practices. European Journal of
Environment and Public Health, 5(2), em0072.
https://doi.org/10.21601/ejeph/9704
Wada, O. Z., Oloruntoba, E. O., Adejumo, M., & Aluko, O.
O. (2020). Classification of sanitation services and
students’ sanitation practices among schools in
Lagos, Nigeria. Environment and Natural Resources
Research. https://doi.org/10.5539/enrr.v10n3p55
Wada, O. Z., Olawade, D. B., Oladeji, E. O., Amusa, A. O.,
& Oloruntoba, E. O. (2022). School water,
sanitation, and hygiene inequalities: A bane of
sustainable development goal six in Nigeria.
Canadian Journal of Public Health.
https://doi.org/10.17269/s41997-022-00633-9
Weaver, E. R. N., Agius, P. A., Veale, H., Dorning, K.,
Hlang, T. T., Aung, P. P., Fowkes, F. J. I., &
Hellard, M. E. (2016). Water, Sanitation, and
Hygiene Facilities and Hygiene Practices
Associated with Diarrhea and Vomiting in Monastic
Schools, Myanmar. The American Journal of
Tropical Medicine and Hygiene, 95(2), 278–287.
https://doi.org/10.4269/ajtmh.15-0290
WHO, (1997). Primary school physical environment and
health. WHO Global School Health Initiative. In:
WHO Information Series on School Health,
Document Two. Available at:
http://whqlibdoc.who.int/hq/1997/WHO_SCHOOL
_97.2.pdf, DoA: 31 January 2014 .
WHO, (2004). Guidelines for drinking-water quality, 3rd ed.
Recommendations, Vol. 1, Geneva:WHO.
World Bank Group. (2017). Reducing inequalities in water
supply, sanitation, and hygiene in the era of the
sustainable development goals: Synthesis Report of
the WASH Poverty Diagnostic Initiative.
https://openknowledge.worldbank.org/handle/1098
6/27831
World health organization (2015). Nigeria: Demographic
and Economic Estimates, GLAAS, un-Water Global
Analysis and Assessment of Sanitation and
Drinking Water;WHO/FWC/WSH/1.579.
WHO/UNICEF. (2004). Meeting the MDG Drinking Water
and Sanitation Target: A Mid-Term Assessment of
Progress; Joint Monitoring Programme for Water
Supply and Sanitation: Geneva, Switzerland,.
WHO/UNICEF. Progress on Sanitation and Drinking Water
(2015). Update and MDG Assessment; World
Health Organization: Geneva, Switzerland, 2015.
WHO/UNICEF/WSSCC, (2004). Global water supply and
sanitation assessment 2000 report, Geneva: World
Health Organization/United Nations Children’s
Fund Water Supply and Sanitation Collaborative
Council.
Zhang, D., Li, Z. Zhang W. et al., (2016). Hand-washing:
the main strategy for avoiding hand, foot and mouth
disease, International Journal of Environmental
Research and Public Health, vol. 13, no. 6, p. 610,.
View at: Publisher Site | Google Scholar
Zomerplaag, J. and Mooijman, A., (2005). Child-friendly
hygiene and sanitation facilities in schools:
indispensable to effective hygiene education. In:
Technical Paper Series, No. 47, New York: IRC
International Water and Sanitation Centre, Delft and
United Nations Children’s Fund, pp 1-36.