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Research and Development of Hygiene Behaviour Change of Elementary Schoolchildren in the Philippines

This one-year project, led by IWC in partnership with the London School of Hygiene and Tropical Medicine, and in collaboration with UNICEF Philippines and the WinS Technical Working Group, was created to address gaps in understanding barriers to hygiene and sanitation practices in schools.

Creating significant, sustained changes in hygiene and sanitation behaviours in schools remains a huge challenge for both the education and public health sectors. There are few rigorous examples of success, and no single, proven, accepted approach.

In the Philippines, 82,000 school-age children die every year from preventable diseases, including diarrhoea, pneumonia and respiratory infections.

HWWS 2The Philippine Essential Health Care Program (EHCP) introduced simple but radical new ideas, marking a turning point in how health promotion was approached in the Philippines primary education system.

While the EHCP has been well received by WinS stakeholders and students, there was a gap in understanding the barriers to independent handwashing with soap (HWWS). To address these gaps, the Research and Development of Hygiene Behavioural Change of Elementary Schoolchildren in the Philippines project was initiated.

Dr Regina Souter, IWC WASH Projects Manager, said, "The aim of this work was to build on the existing group handwashing program in schools with some evidence-based activities to improve independent handwashing by children, in other words, to improve how often children wash their hands by themselves after going to the toilet and before eating."

HWWS 3HiFive

Based on findings from the formative research, a set of locally-stylised tools was developed for use by teachers in classrooms. "The HiFive for HySan package is a set of fun activities for children and teachers designed to deliver important messages about children's handwashing and the operation and maintenance of handwashing and toilet facilities," said Declan Hearne, the IWC Project Manager.

"An important feature of HiFive for HySan is that the design of the activities was based on research that identified what motivations, messages and communication tools would be most successful in the Philippine schools context."

While HiFive was only implemented for a limited period and a range of implementation challenges were observed, where it was implemented fully, HiFive plus a re-energised group handwashing program demonstrated consistent improvements in independent handwashing at critical times, and resulted in improved functionality of independent handwashing stations in both urban and rural schools.



More information

For more information about this project, contact Declan Hearne, IWC Project Manager:


Photos courtesy Dr Regina Souter


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