1
|
Shkalim Zemer V, Cohen HA, Richenberg Y, Gerstein M, Atias I, Gur S, Laks Y, Levinsky Y, Dvir O, Brown I, Cohen M, Ben Meir D. Personal hygiene, environmental conditions, and toilet use of children in primary schools: A cohort study. J Pediatr Urol 2023; 19:721-727. [PMID: 37357079 DOI: 10.1016/j.jpurol.2023.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/07/2023] [Accepted: 06/06/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Many primary school children withhold urine and stool whilst at school for various reasons. Limited toilet access and the failure to provide safe, sanitary toilets are putting children at risk for toilet avoidance behavior. OBJECTIVE We aimed to examine personal hygiene, environmental conditions, the perception of these on children, and their toilet use in primary schools. STUDY DESIGN Children aged 6-12 and their parents were asked to complete a self-report questionnaire regarding toilet behavior and the perception of school toilet standards. RESULTS The main findings are listed below using the data from the questionnaire. DISCUSSION We found that 9% and 63% of the children avoided urination and defecating at school, respectively. Similar results were reported previously. The participants' perceptions regarding the environmental conditions of school toilets and conditions revealed that 34% of the children felt that the toilets were dirty or very dirty. Around one-third of them reported a lack of toilet paper sometimes or most of the time. These unsatisfying hygienic conditions of school toilets can be easily solved. Unfortunately, 46% of the children in our study experienced bullying in school toilets. These worrisome data are seldom reported in other studies. The urination habits of the girls, who mostly preferred to partially squat or stand may lead to dysfunctional voiding and incomplete bladder emptying. Our study was limited by the relatively small population, the subjectiveness of the self-reporting questionnaire, and the voiding and defecation habits of the investigated children during school hours. These hours do not necessarily reflect the children's habits after school hours and during the weekends. Despite these limitations, the discussed issues regarding personal hygiene and the environmental conditions in the sampled primary schools are extremely important. CONCLUSION Nearly half of the school children had negative perceptions of school toilets. This should raise awareness and concern for school staff to consider and investigate potential facilities improvement in light of the impact observed here. Implementation of appropriate education and a better environment of toilet facilities and security is important for the children's well-being.
Collapse
Affiliation(s)
- Vered Shkalim Zemer
- Clalit Health Services, Dan-Petach-Tikva District, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel.
| | - Herman Avner Cohen
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; Pediatric Ambulatory Community Clinic, Petach Tikva, Israel.
| | | | - Maya Gerstein
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; Pediatric Ambulatory Community Clinic, Petach Tikva, Israel.
| | - Ifat Atias
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; Neve Gan Clinic, Petach Tikva 4926040, Israel.
| | - Shmuel Gur
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; Pediatric Ambulatory Community Clinic, Kfar Saba 4422941, Israel.
| | - Yoseph Laks
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; Pediatric Ambulatory Community Clinic, Ramat Aviv, Tel Aviv 6905234, Israel.
| | - Yoel Levinsky
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; Schneider Children's Medical Center of Israel, Petach Tikva 49420235, Israel.
| | - Or Dvir
- Pediatric Urology Unit, Schneider Children's Medical Center of Israel, Petach Tikva 49420235, Israel.
| | - Iris Brown
- Pediatric Urology Unit, Schneider Children's Medical Center of Israel, Petach Tikva 49420235, Israel.
| | - Moriya Cohen
- Microbiology Unit, Ariel University, Ariel 98603, Israel.
| | - David Ben Meir
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; Pediatric Urology Unit, Schneider Children's Medical Center of Israel, Petach Tikva 49420235, Israel.
| |
Collapse
|
2
|
Uwadia RC, Oloruntoba EO, Wada OZ, Aluko OO. Menstrual Hygiene Management Inequalities among School Girls in Badagry, Nigeria. Trop Med Int Health 2022; 27:970-980. [PMID: 36057780 DOI: 10.1111/tmi.13817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The study assessed menstrual hygiene management (MHM) inequalities among public and private in-school adolescents in Badagry, southwest Nigeria. Also assessed was the impact of available water, sanitation, and hygiene (WASH) facilities on MHM within the school premises. METHODS For this descriptive, cross-sectional study 420 students were selected via multi-stage sampling and data were obtained via a validated semi-structured questionnaire and observational checklist. Data were analysed at 95% confidence limit. RESULTS The students had a mean age of 15.3±1.6 years. All the private schools had functioning WASH facilities whereas only 50% of public schools did. The toilet to student ratios for the private and public schools were 1:155 and 1:296, respectively. Over two-thirds (67.1%) of the students reportedly use sanitary napkins for MHM, followed by tissue (17.1%), and clothes (15.5%). Additionally, the private school students were two times less likely to use alternatives to sanitary napkins and 9.8 times more likely to obtain sanitary materials at school if required (p<0.001). A significantly higher proportion of public-school menstruating in-school adolescents changed their sanitary towels in the bush (p=0.003) due to lack of privacy and took their used sanitary materials home (p<0.001) for management due to reduced access to sanitary bins. CONCLUSION Even though the situation in the public schools was worse, both public and private schools lack the enabling environment for MHM. School health promotion interventions, such as provision of subsidized/affordable menstrual pads and basic WASH facilities and campaigns to break the culture of silence are required for the wellbeing of girls. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Ruth C Uwadia
- Department of Environmental Health Sciences, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
| | - Elizabeth O Oloruntoba
- Department of Environmental Health Sciences, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
| | - Ojima Z Wada
- Department of Environmental Health Sciences, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria.,Division of Sustainable Development, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Olufemi O Aluko
- Department of Community Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile Ife, Nigeria
| |
Collapse
|
3
|
Wada OZ, Olawade DB, Oladeji EO, Amusa AO, Oloruntoba EO. School water, sanitation, and hygiene inequalities: a bane of sustainable development goal six in Nigeria. CANADIAN JOURNAL OF PUBLIC HEALTH 2022; 113:622-635. [PMID: 35411423 PMCID: PMC8999996 DOI: 10.17269/s41997-022-00633-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 03/18/2022] [Indexed: 11/17/2022]
Abstract
Abstract
Objectives
The importance of school water, sanitation, and hygiene (WASH) in achieving the Sustainable Development Goal targets 6.1 and 6.2 in developing countries cannot be overemphasized. However, widespread WASH inequalities remain an impediment to achieving the targets by 2030. Hence, this study was conducted to examine current school-WASH disparities among public and private schools in a low-income Nigerian community using mixed methods.
Methods
The cross-sectional survey utilized multi-stage sampling to select 400 students from five public and five private schools in Akinyele, Ibadan. Semi-structured questionnaires and observational checklists were used to obtain data. Inferential statistics were measured at a 95% confidence interval. Independent variables like the students’ sociodemographic characteristics, school type, and available WASH facilities were associated with dependent variables like respondents’ hand hygiene and sanitation practices and WASH-associated knowledge and attitude to examine existing inequalities.
Results
Classifying the available WASH facilities based on the WHO/UNICEF Joint Monitoring Programme, none of the public schools provided any sanitation and hygiene service, while all the private schools provided both services. Furthermore, the private-school students had significantly better WASH knowledge (p<0.001; Ƞ2p=0.152) and attitude (p<0.001; Ƞ2p=0.036) compared with the public-school students. Also, a significantly higher portion of public-school students practiced open defecation at school (p<0.001; odds ratio (OR)=7.4; confidence interval (CI)=4.1–13.5) and at home (p<0.001; OR=7.8; CI=3.7–16.7).
Conclusion
WASH disparities among socioeconomic groups remain a persistent challenge. Sole reliance on the Government to narrow the inequalities has persistently proven unfruitful. There is a need to empower local community stakeholders to facilitate sustainable school-WASH interventions.
Collapse
Affiliation(s)
- Ojima Zechariah Wada
- Division of Sustainable Development, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar.
- Department of Environmental Health Sciences, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria.
| | - David Bamidele Olawade
- Department of Environmental Health Sciences, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
| | | | - Aminat Opeyemi Amusa
- Roseberry Park Hospital, Tees, Esk and Wear Valleys, Middlesbrough, United Kingdom
| | | |
Collapse
|