Training intervention to improve hygiene practices in Islamic boarding school in Yogyakarta, Indonesia: A mixed-method study

Trends of Water, Sanitation, and Hygiene (WASH) Research in Indonesia: A Systematic Review

This study provides an overview of water, sanitation, and hygiene (WASH) research trends in Indonesia from 1975 until April 2021. The systematic review compiled 272 articles related to the Sustainable Development Goals 6.1 and 6.2 in Indonesia, which were published in the Web of Science and Scopus databases. The results showed that the water-related topic (41%) was discussed more often than sanitation (22%) or hygiene (13%). Furthermore, the social theme (39%) was dominantly found in all these articles, mostly finding determinants of WASH-related behavior. However, few WASH implementation studies or behavioral change interventions were recorded in Indonesia, suggesting a gap between science and policy or implementation. On the other hand, hygiene-related topics (14%) and WASH-related financial themes (6%) were the least studied in Indonesia. Combinations of topics (23%) and themes (15%) were also often conducted in Indonesia, suggesting that WASH researchers started to recognize the need to analyze WASH problems holistically, i.e., from multiple perspectives. In addition, the distribution of WASH research was still dominated in the central part of Indonesia, whereas the WASH-related problems, i.e., poor WASH services, and behavior, often occur in this area. This study also offers some research gaps, both in terms of topics, themes, and regional distribution, that need to be considered for the design of future WASH research in Indonesia.

Training intervention to improve hygiene practices in Islamic boarding school in Yogyakarta, Indonesia: A mixed-method study

Background

The primary objective of this study was to determine the effect of a training intervention in overall improvement in students’ (santris) knowledge, behavior, and outcome.

Methods

A mixed-methods exploratory sequential design was applied. First, qualitative data were collected from three focus group discussions with 20 supervisors and one in-depth interview with school principal to explore current hygiene practices. The information was then used to develop training intervention using either video, poster, and leaflet. To measure the effect, a stepped wedge cluster design with pre- and post-test analyses was conducted. A total of 452 junior high school santris in one Islamic boarding school were non-randomly allocated to either three intervention groups. Outcome measures were knowledge, personal behavior, and room hygiene. Codes and categories were produced in the qualitative analysis, while paired t-tests and Wilcoxon rank tests test were used in the quantitative analysis.

Results

The qualitative study identified poor practices on personal and room hygiene among the santris and proposed a training intervention. Overall, there was a significant increase in knowledge and personal behavior after the intervention (7.22 ± 1.34 pre-intervention to 7.70 ± 0.74 post-intervention and 9.75 ± 2.98 pre-intervention to 12.16 ± 2.12 post-intervention, respectively, p < 0.001). Room hygiene was significantly improved among boys and those who received leaflets.

Conclusion

Having developed a specific training materials, school-based hygiene training intervention improved knowledge and personal behavior. Its effect on room hygiene particularly for female santris needs further strengthening of the intervention in this Islamic boarding school setting.