Intervention to Promote Hygiene Behavior Among School Children
关键词
抽象
描述
Background:
Globally, communicable diseases are prevalent among school age children and the exposure to variety of pathogens causing preventable diseases in school population is inevitable. Underlying factors mainly rests on poor personal hygiene and inadequate sanitation practices leading to school absenteeism and life threatening illnesses among children (if continually neglected in the long run). The situation is worse in low and middle income countries due to inadequate health care facilities leading to compromised health status of school children.
Among communicable diseases, respiratory infections and diarrheal diseases are regarded as the deadliest killers of young children. Incidence of diarrheal disease in the initial years has been linked with impaired cognitive performance in the later childhood. In addition, in developing countries intestinal helminthic infection is a commonly cited problem among school-age children. Furthermore, oral health cavity infections are also commonly found in school going children worldwide. Frequent attacks of infection predispose young children to malnutrition and can form a vicious circle and retard children's physical and cognitive development. Moreover, the contextual factors such as poor socio-economic environment further deteriorate the health status of school children especially in low and middle income countries.
In the Pakistani context, alongside pneumonia and diarrhea worm infestation and scabies among school age children are the commonly reported health issues; manifesting poor personal hygiene. An evaluation study on water, sanitation and hygiene intervention on school child performance in two cities showed that almost 48% of government school children avoid going to school toilets due to poor sanitary condition. In local context, studies are mostly focused on oral hygiene assessment among children, showing satisfactory knowledge about using tooth paste. Comprehensive assessment about personal and environmental hygiene assessment among children, teachers and parents has remained a gap. Poor knowledge and practice of, and attitudes to personal hygiene have negative consequences on their long term development. This necessitates the designing and testing of school-based interventions aiming to improve hygiene behaviors among children, thereby minimizing their potential to capture preventable illnesses.
It is unfortunate that school health remains a neglected aspect of public health in Pakistan. In 2005, School Health Program was launched in 17 districts of the country by Ministry of Education, Pakistan in collaboration with United Nations Educational, Scientific and Cultural Organization (UNESCO). The program focused on various components including personal hygiene and environmental education but its impact was not determined . To the best of our knowledge, there is paucity of studies in Pakistan on school-based interventions to promote personal and environmental hygiene of school children, with child's parents and teachers' involvement. Towards designing school based programs, role of parents and teachers must be considered as they are the important role models for school going age children. And thus had detrimental effects in shaping children's overall health and hygiene behavior.
In this paper, Investigators present a study protocol using mixed-methods study design to be implemented in schools of a peri-urban community setting, Pakistan. The proposed study aims to improve the knowledge and practices of school children towards personal and environmental hygiene through school based intervention. To our knowledge, holistic assessment of hygiene among school children has not been studied in the local context. And the intervention to be implemented (with behavior change communication using adult to child and child to child approach, assessment of education curriculum on hygiene concepts) has never been studied before.
Primary research questions
1. Does school-based hygiene intervention facilitate improvement in knowledge and practices among primary school children studying in semi urban schools, Pakistan?
2. What are the enablers and barriers towards the adoption of personal and environmental hygiene practices by school children?
Secondary research questions Does improvement in knowledge and practices among the mothers of primary school children studying in semi-urban schools contributes to improved knowledge and practices of school children?
Methods Study design The study will employ a quasi-experimental design (pre-post intervention without control arm). The proposed study design is chosen as it will facilitate in evaluating school based interventions in the selected school settings without randomization. Similar to the randomized trials, quasi-experiments (community based trial) aims to demonstrate causality between an intervention and an outcome at the defined interval.
Study settings The study will be conducted in District Malir, Gaddap town in Karachi, Pakistan
Data collection methods The study is built on mixed method data collection approaches to gain insight of the hygiene literacy and practices among school children, teachers and child's mothers. Table 1 lists different data collection methods with its purpose and interval.
Study phases The study has been structured into 3 phases - pre-intervention, intervention and post-intervention.
日期
最后验证: | 04/30/2019 |
首次提交: | 04/30/2019 |
提交的预估入学人数: | 05/05/2019 |
首次发布: | 05/07/2019 |
上次提交的更新: | 05/08/2019 |
最近更新发布: | 05/09/2019 |
实际学习开始日期: | 12/20/2018 |
预计主要完成日期: | 12/29/2019 |
预计完成日期: | 07/19/2020 |
状况或疾病
干预/治疗
Behavioral: School Children
相
手臂组
臂 | 干预/治疗 |
---|---|
Experimental: School Children School children will be administered with behavioral change communication sessions as an intervention | Behavioral: School Children Behavior Change Communication sessions will be used to promote knowledge and practices among young children and to prevent communicable diseases.
This will include, capacity building of teachers and students, health awareness sessions at the school and improving school physical environment |
资格标准
有资格学习的性别 | All |
接受健康志愿者 | 是 |
标准 | Inclusion criteria for Schools: * Primary schools run by government or / NGO functional in District Malir, Gaddap town of Karachi Exclusion Criteria for Schools: * Consent not given by school administration. Inclusion Criteria for Children: - Students enrolled in primary grade (class 1-5) - Informed consent given by either of the child's parents. - After obtaining child's parents' consent, assent obtained from children. Exclusion Criteria for Children: * Assent not obtained from children Inclusion criteria for Mothers: - Mothers whose children are studying in grade 1-5 in selected/sample schools will be recruited. - Mothers available at the time of data collection - Mothers who gave consent Exclusion Criteria for Mothers: * Mothers who didn't meet the above eligibility criteria is excluded to participate. Inclusion Criteria for Teachers: - Teachers who are involved in teaching grade 1-5 students in the selected schools. - Those who are available at the time of the study will be recruited after their informed consent. Exclusion Criteria for Teachers: * Those teachers who didn't give consent will be excluded. Inclusion Criteria for Key Stakeholders: - District Education Officers (DEO) and District Health Officer (DHOs) who currently hold the offices will be interviewed. - Interviews with these respondents will only be held after obtaining their informed consent. Exclusion Criteria for Key Stakeholders: * Stakeholders who didn't provide consent will be excluded |
结果
主要结果指标
1. Assessment of Improved hygiene knowledge and practices among young children through survey tool [3-4 months]
次要成果指标
1. Change prevalence of communicable diseases among young children through structured questionnaire [3-4 months]