Effect of water, sanitation and hygiene facilities on health, regularity in attendance and educational achievement among basic school students

Abstract

This research assesses the effect of the availability of Water, Sanitation, and Hygiene (WASH) facilities in schools on health, regularity in attendance, and educational achievement among basic school students in Nepal. The overarching objective of this research is to assess whether combining WASH facilities in schools affects the health, school attendance, and educational achievements of students. It applies a pragmatic paradigm, 'QUAN+qual' mixed methods, and a causal- comparative research design. The research was carried out among 800 respondents, split between 400 in the improved group and 400 in the unimproved group. Among them, 768 respondents participated in the quantitative and 32 in the qualitative study. Overall, school WASH facilities, including attitude, subjective-norms, self-efficacy, and intention, were found to have a statistically significant on students' health, school attendance, and educational achievements (p<0.001). Students with improved school WASH facilities are less likely to have sick (cOR=0.388; 95% CI; 0.290-0.519, p<0.001), more likely to attend school (cOR=2.802; 95% CI; 2.033-3.862, p<0.001), and more likely to achieve higher educational achievements (cOR=2.769; 95% CI; 2.062-3.720, p<0.001) than those without access to improved school WASH facilities. Furthermore, students who have good health status are more likely to be regular (cOR=3.160, 95%, CI; 2.585-5.042, p<0.001), and regular students are more likely to get higher educational achievements (cOR=0.641, 95% CI; 0.472-0.872, p<0.01) compared to students with poor health and irregular, respectively. Although school WASH facilities have a statistically significant and predictors on students' health, attendance, and educational achievements, methods of managing these facilities are just as important as their availability.