Gaps in hygiene promotion at schools in Pakistan: qualitative descriptive research

Summary School health remains an ignored domain in Pakistan. This article presents gaps in understanding hygiene promotion efforts in school settings in urban squatter settlements by exploring perspectives of the key stakeholders and undertaking a review of the education curriculum. Using qualitativ...

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Bibliographic Details
Published in:Health promotion international 2023-06, Vol.38 (3)
Main Authors: Pradhan, Nousheen Akber, Haider, Fatima, Khudadad, Umerdad, Zahidie, Aysha, Asim, Muhammed, Ladak, Asma Akbar, Iqbal, Shagufta, Mevawalla, Areesh, Siddiqi, Uswah, Ali, Tazeen Saeed, Karmaliani, Rozina
Format: Article
Language:English
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Summary:Summary School health remains an ignored domain in Pakistan. This article presents gaps in understanding hygiene promotion efforts in school settings in urban squatter settlements by exploring perspectives of the key stakeholders and undertaking a review of the education curriculum. Using qualitative methodology, 13 in-depth interviews were held with the key informants (teachers, health and education officers) and three focus group discussions were conducted with 36 mothers. The study setting includes three schools located in a semi-urban area in the province of Sindh, Pakistan. The semi-structured guide was utilized to obtain perspectives of key stakeholders on factors constraining hygiene promotion efforts in school settings. The primary education curriculum was reviewed using the content analysis approach to assess the integration of hygiene concepts into the curriculum. Analysis of qualitative interviews and curriculum review resulted in five categories under a theme that addressed multiple factors constraining hygiene promotion in the school settings. These include (i) Gaps in the school curriculum, (ii) Poor accountability of the local administration in the upkeep of schools, (iii) Parent’s negligence toward children’s hygiene, (iv) Inadequate training of school teachers on hygiene concepts, and (v) Lack of interdepartmental coordination between health and education sectors. Hygiene promotion at schools has been deterred by multiple factors at the selected primary schools in Pakistan. Recommended actions include integration of health and hygiene concepts into the education curriculum, capacity building of teachers, reviving water, sanitation and hygiene infrastructure, coordination among Education and Health Departments and ownership among the local government to ensure cleanliness at schools. Lay Summary Schools are not only expected to provide education to children, their mandate also includes health and hygiene promotion. Keeping in view the dearth of evidence in understanding the role of schools in hygiene promotion in the local context, this research was conducted in three semi-urban school settings in Sindh province, Pakistan. We aimed to identify factors that constrain hygiene promotion efforts at the school level. As part of this research, we interviewed multiple stakeholders. This includes (teachers, mothers, education and health officers) at the primary school level. Our findings revealed serious gaps in hygiene promotion at schools. This i
ISSN:0957-4824
1460-2245
DOI:10.1093/heapro/daac046