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Evaluation report

1999 Vietnam: KAP Study on School Sanitation and Control of Worm Infection



Author: Vach, T. H.; WATSAN Centre, Thai Binh Medical College, Institute of Malaria, Parasitology and Entomology

Executive summary

Background

Purpose / Objective

Thousands of sanitation facilities have been built in primary schools since 1991, with support from UNICEF Hanoi, through the integrated program on Health Education, Water and Environmental Sanitation - Ministry of Education and Training. In most schools, health education, in general, and water and environmental sanitation education, in particular, have been conducted through hygiene education campaign, health education curriculum, posters, leaflets and mass media.

Specific objectives:
- To assess knowledge, attitude and practice on water, environmental sanitation, control of worm infection of school children, their parents and community members
- To asses if the information on water, environmental sanitation and control of worm infection reached pupils
- To assess if the information is transferred to families and communities
- To assess the level of intestinal parasite infection among school children and to evaluate the impact of water and sanitation, and parasite control activities toward the reduction of infection rate
- To give recommendations for better management and implementation of the program

Methodology

Four provinces in different ecological areas of the North were selected. In each province, one district undergoing UNICEF school sanitation program was chosen. In each district, four communes with UNICEF school sanitation facilities (case) and two communes without school sanitation facilities (control) were randomly selected.

At each commune, interviews with structured questionnaires were conducted for 40 pupils in grades 3 through 5, 40 pupils' parents and 40 other adults. Participants were selected randomly. At each province, 16 in-depth interviews were conducted: two chairpersons of communal people's committee, two principals of primary schools, four teachers, four pupils and four parents of pupils. At each province, four group discussions were held: one for teachers, one for pupils and one for parents of pupils. Direct observation of school and household sanitation facilities was done.

Stool samples were taken from 428 students from two case schools, and from 428 students from two control schools. 20 soil samples from school grounds and near paths were collected from each school.

Key Findings and Conclusions

In general, primary school pupils have good knowledge on sanitation and control of worm infection. Knowledge of students in schools with sanitation facilities provided by UNICEF is higher than those at control schools: 7.9% of students at the case schools knew three to four types of sanitary latrines versus 1.6% of control students; 99.2% know one to four sources of safe water compared to 96.2%; and 95.8% desire to have a sanitary latrine at home compared to 74.3%.

88.7% of pupils talked to their parents about health education while 69.6% of pupils' parents reported that they had received information from their children. The parents of pupils from a school with sanitation facilities provided by UNICEF had significantly better KAP on sanitation and control of worm infection than the parents of students in the control schools: 97.6% vs. 94.1% knew about sanitary latrines; 20.8% vs. 13.7% knew three to four sources of safe water; and 61.7% vs. 53.1% frequently wash hands before meals and after defecation.

Direct observation on 1,907 households revealed a higher rate of sanitary latrines in community with case schools than in communities of the control schools. Sanitary conditions of water sources and latrines of all the households is poor; only 48.3% of latrines met sanitary requirements, and 35% of households had access to safe water. De-worming has not been regularly conducted for pupils and community members. Only a few people took de-worming pills. People in these areas continue to use untreated or improperly treated excreta for fertilizing or fishing.

The infection rate of pupils showed no significant differences between the groups of schools and was high 74%, though the rate of heavy infection is very low. The infection rate of soil samples was significantly lower at the case schools 65%, than at the control schools 95%.

The school sanitation facilities funded by UNICEF are being effectively operated and used. 93.8% of facilities are used frequently, serving teachers and the community. 75% of facilities met technical and sanitary requirements.

Recommendations

The policy to build school sanitation facilities with financial and technical assistance from UNICEF should be strengthened to include more primary schools. It has been shown that health education should be conducted in parallel with sanitary practices at schools.

Infection rate and density of worm infection among pupils is high. De-worming program should be implemented at schools.



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Report information

Date:
1999

Region:
EAPRO

Country:
Vietnam

Type:
Survey

Theme:
Water and Environmental Sanitation

Partners:
UNICEF, Ministry of Health

PIDB:

Follow Up:

Language:
English

Sequence Number:
1999/020

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