Baseline assessment of handwashing behavior, hand hygiene conditions and wellbeing in primary schools in Nigeria

Objectives: In humanitarian settings, poor school hygiene conditions can severely impact children’s health and wellbeing. As part of a cluster randomized trial evaluating a multicomponent hand hygiene intervention, this baseline study assessed hand hygiene behaviors, school infrastructure, and wellbeing among schoolchildren in Nigeria. Methods: Between May and June 2023, cross-sectional data were collected from 26 schools using handwashing observations, questionnaires, infrastructure assessments, and hand rinse sampling. A total of 964 children were observed, 645 interviewed, and 311 provided samples. Results: Observed handwashing rates were extremely low: 4%–12% before eating and 2%–3% after toilet use. About half of schools lacked designated handwashing stations. General water points, though more available, were often inadequate. Soap was entirely absent. Over half of children’s hands rinse samples contained more than 100 colony-forming units (CFU) of Escherichia coli (E: coli) per 100 mL. Misconceptions about hygiene were widespread and gaps existed between reported and observed behavior. Conclusion: These findings underscore the need for integrated school-based WASH interventions in humanitarian contexts.

Keywords

Hand hygiene, Handwashing, Schoolchildren, Wash, Wellbeing

Subject (DDC)

600 - Technik, Medizin, angewandte Wissenschaften

Project

Event

Exhibition start date

Exhibition end date

Conference start date

Conference end date

Date of the last check

ISBN

ISSN

1661-8564
1661-8556

Language

English

Created during FHNW affiliation

Yes

Strategic action fields FHNW

Future Health

Publication status

Published

Review

Peer review of the complete publication

Open access category

Gold

License

Citation

Maani-Abuzahra, Y., Winkler, M. S., Hattendorf, J., Galli, A., Tamas, A., Abdulkarim, Z., Kolo, U. M., Shuaibu, M. A., Peter, M., Probst-Hensch, N., & Owen, B. N. (2025). Baseline assessment of handwashing behavior, hand hygiene conditions and wellbeing in primary schools in Nigeria. International Journal of Public Health, 70, 1608656. https://doi.org/10.3389/ijph.2025.1608656

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