Poor sanitation, shortage of water, low water quality, and improper hygiene behaviors are the major causes of risk for the health of school children who spent long hours at the school compound. This study findings discussed based on the objectives outlined in the introduction and their influence on hygiene behavior among primary school children.
In this study, 59.7% of school children had positive hygiene behavior which is consistent with the study done in Angola, Ethiopia, and 52.3% of the participants practiced positive hygiene behaviour (11).The study was also consistent with the study conducted among school children in Tigray region, Ethiopia 61.7% of the participants had practiced positive hygiene behavior (10).This study is consistent with a study done in Kenya, the respondents reported that high knowledge, proper hygiene behavior and their institutions had appropriate WASH facilities were significantly less likely to report WASH related illness (12).
Knowledge may make a significant contribution to practicing positive hygiene behavior on latrine utilization 58% and hand washing practices 36.6% of the students. This finding is relatively comparable with a study done in 2016 in Oromia, Ethiopia, where 59% of the participants had good knowledge on hygiene behavior (13) and a study done in Tigray Region, Ethiopia showed that there is a significant difference on knowledge of latrine utilization 91.1% of the study participants did not know proper latrine but 71% of respondents had knowledge on hand washing practices in Tigray Region. This discrepancy might be large sample size(n = 528) in Tigray study (10). This finding was consistent with the study done in Hosanna, Ethiopia, where 69.9% of students had knowledge on hand washing practices (14).
These study findings revealed about 73.0% of respondents were aware on latrine utilization, and 55.8% of the respondents were not aware on hand washing practices. This result is higher than the study done in Tigray region, 80.5% of the respondents were not aware on latrine but 58.9% respondents were aware on hand washing practices (10). The variation might be the majority of the respondents in Delanta district visited model schools and trained on water, sanitation, and hygiene activities. The finding of this study is consistent with the study done in Kenya that school child awareness is one of the best ways to avoid getting sick and spreading illness (12).
From this research finding, the presence of hand washing facilities nearer to latrines had a significant influence on practicing positive hygiene behavior among school children. This study revealed 88.9% of school latrines did not have functional hand washing facilities. The research finding is consistent with a study conducted in Ghana, of 37 participating schools, 84% of them had not functional washing stations (15). The study was also consistent with the study done in North Shewa, Amhara, where 94% of primary schools lack functional hand washing facilities (16).
Getting water from protected sources in primary schools is a protective factor for poor hygiene behavior among primary school students. This study revealed that almost half of the schools (50%) access water from protected sources and students who have got water from protected sources, 72.3% of them are more likely to practice positive hygiene behaviour than others. This finding is a different finding from a study conducted in Ginchi, Oromia, Ethiopia, where 96% of schools were not getting adequate water supply. This is might be mainly associated with budget differences and low awareness on the importance of the facilities (13).
Training on water, sanitation, and hygiene activities demonstrated a positive influence on the hygiene behavior of school children. This study revealed that 49.6% participants were trained on hygiene sanitation, and 64.4% of them had positive hygiene behaviors. The study finding was consistent with the study done in Tigray region, 60.3% in which students who were trained on hygiene sanitation practiced positive hygiene behavior counterparts (10).
This study found out that the presence of a hygiene sanitation club was significantly associated with practicing positive hygiene behaviour among school children.
Primary school clubs (WASH) in the district promote proper utilization, latrine, water handling, and hand washing practices. Similarly, School clubs (WASH) in Malawi promote the importance of clean water, good hygiene, and improved sanitation. Club members create their own songs, dramas, and games to communicate safe water and hygiene messages within their schools and communities (17). A study done in Tanzania shows that the top three activities conducted by school WASH clubs were latrine cleaning, promotion of hygiene behaviour, and practice through art, drama, and/or poetry either in the schools 63% or in the community 40% (18).
Strength and limitations of the study
It has never been done with similar studies in the study area before. Therefore, it can serve as a resource for those who want to work on this next study. Because the study was conducted on school children who are change agents, changing the hygiene behaviors of school children, it can also help to change the disease burden in students’ families and their community at large.
The short coming of this study was its cross-sectional nature of the study, which is unable to correctly demonstrate the way of relationship or association. Due to financial limitations, the study could not cover private schools. As a result, the finding is not generalized to all schools in the study area.