Translating Hand Hygiene Knowledge into Practice: A Study of Basic School Children in an Urban Community in Ghana

This paper generally examines the level of knowledge and practice of hand washing with soap (HWWS) among basic school pupils and the existing challenges. The study employed structured questionnaires, interviews and spot observations to obtain relevant information from 162 pupils  and 20 head teachers from 20 primary schools in Ofankor, in the Ga East Municipality, Ghana.  The pupils comprising of equal proportion of boys and girls were purposively selected from the lower and upper primary grades. Most pupils (87%) reported being educated on HWWS but 73% reported actually practicing HWWS after visiting the toilet. Protection from illnesses was generally mentioned (60%) as the major importance of HWWS. Apparently, pupils who claimed to be educated on HWWS are more likely to wash their hands after visiting the toilet and before eating as compared to those who have not been educated (χ²= 4.17; p < 0.05). Younger pupils (lower primary) are reportedly more likely to wash their hands after visiting the toilet and before eating as compared to older pupils (upper primary) (χ² = 13.40; p < 0.05). Conversely, no statistically significant association (χ² = 2.96; p > 0.05) was found between gender and these two critical moments for HWWS. Although pupils have good knowledge of HWWS, hand washing stations in the schools are not only sub-standard but also inadequate and soap provision is infrequent.  The best practices to ensure effective implementation of hand hygiene programme in schools are discussed in detail in the paper.