DJ IBOUT I SCHOOL HYGIENE A ND SANITATION SURVEY 2009washinschoolsmapping.com/wengine/wp-content/... · NITAT 09 I HYGI ION S ENE A ... a Certificate of Fundamental Education is required

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El Zanaty & Assoociates

The 2009 Djibouti School Hygiene and Sanitation Survey (2009 DSHSS) was conducted on behalf of the Ministry of Education by El-Zanaty & Associates with support from DISED with financial support from UNICEF. The opinions expressed herein are those of the authors and do not necessarily reflect the views of UNICEF.

Additional information about the 2009 DSHSS may be obtained from Djibouti Ministry of National Education and higher Education, Republic Boulevard; Telephone: +253-353331 and Fax: [+253-350166].

Tables of contents i

TABLE OF CONTENTS LIST OF TABLES AND FIGURES ............................................................................. iii

PREFACE .................................................................................................................. vii

ACKNOWLEDGMENTS .............................................................................................. ix

SUMMARY OF FINDINGS .......................................................................................... xi

1 INTRODUCTION

1.1 Background on the Educational System in Djibouti ...........................................1 1.2 Djibouti School Hygiene and Sanitation Survey 2009 ........................................2 1.3 Survey Coverage .................................................................................................4

2 CHARACTERISTICS OF SCHOOLS, TEACHERS AND STUDENTS

2.1 School Characteristics .........................................................................................7 2.2 Primary Teachers' Characteristics .......................................................................9 2.3 Students Characteristics ......................................................................................9

3 SCHOOL HYGIENE AND HEALTH RELATED ACTIVITIES

3.1 School Sanitation and Hygiene Education .........................................................11 3.2 Parents Involvement with Hygiene Related Activities ........................................14 3.3 Teacher’s Involvement with Health Hygiene Activities .....................................15

4 STUDENT’S EXPOSURE TO MASS MEDIA

4.1 Exposure to Mass Media .....................................................................................17 4.1.1 Exposure to different mass communication channels ..........................17 4.1.2 Exposure to television ..........................................................................18 4.1.3 Exposure to the radio ............................................................................19 4.1.4 Exposure to printed media ....................................................................20

4.2 Communication about Health Hygiene ...............................................................20

5 STUDENT’S KNOWLEDGE OF PROPER HYGIENE HABITS

5.1 Student’s knowledge of ways to protect from illness ..........................................23 5.2 Students’ attitude towards the importance of hand washing ...............................24 5.3 Students’ knowledge towards specific hygienic practices ..................................28 5.4 Knowledge about general cleanliness and personal hygiene in school syllabus .34

6 STUDENT’S ATTITUDE TOWARDS PROPER HYGIENE HABITS

6.1 School Toilet Facilities ........................................................................................35 6.2 Drinking Water Facilities at School ....................................................................39 6.3 Hand Washing Facilities at School .....................................................................41

Tables of contents ii

7 STUDENT’S HYGIENE PRACTICES

7.1 Drinking water habits at school ...........................................................................45 7.2 Hand washing habits at school ............................................................................45 7.3 Cleaning habits of school students ......................................................................48 7.4 Discussion about hygienic practices with parents ...............................................55

ANNEX A LIAT OF TARGETED SCHOOLS FOR THE SURVEY ....................... 59

ANNEX B SAMPLING ERROR ................................................................................. 61

ANNEX C QUESTIONNAIRES ................................................................................... 63

List of tables and figures iii

LIST OF TABLES AND FIGURES 1 INTRODUCTION

Table 1.1 Results of survey interviews by residence .................................... 5

Table 1.2 Results of survey interviews by school type ................................. 5

2 CHARACTERISTICS OF SCHOOLS, TEACHERS AND STUDENTS

Table 2.1 Mean number of classes and number of shifts .............................. 7

Table 2.2 Mean number of students .............................................................. 7

Table 2.3 Class crowdness ............................................................................ 8

Table 2.4 Teachers headcount ....................................................................... 8

Table 2.5 Workers headcount ....................................................................... 8

Table 2.6 Teachers characteristics ................................................................ 9

Table 2.7 Students characteristics ................................................................. 10

Figure 2.1 Number of shifts in schools by school type ................................. 7

Figure 2.2 Primary student: teacher ratio by school location and type .......... 8


Table 3.1 School sanitation and hygiene education committees/ associations ................................................................................... 11

Table 3.2 School hygiene education ............................................................. 12

Table 3.3 Teaching students specific health hygiene issues ......................... 13

Table 3.4 Availability of materials to teach health issues ............................. 14

Table 3.5 Parent’s involvement with improving school sanitation and hygiene education ......................................................................... 14

Table 3.6 Teacher’s involvement with improving school sanitation and hygiene education ......................................................................... 15

Figure 3.1 Health issues taught to students by school location ...................... 13

4 STUDENT’S EXPOSURE TO MASS MEDIA

Table 4.1 Exposure to mass media ............................................................... 17

Table 4.2 Exposure to Television ................................................................. 18

Table 4.3 Exposure to the radio ................................................................... 19

Table 4.4 Exposure to printed media ............................................................ 20

Table 4.5 Knowledge about general cleanliness and health hygiene ............ 21

Figure 4.1 Sources of knowledge about general cleanliness and health hygiene .......................................................................................... 21

List of tables and figures iv


Table 5.1 Knowledge of ways of protection from stomachache and diarrhea by background characteristics ......................................... 23

Table 5.2 Knowledge of ways of protection from stomachache and diarrhea by selected characteristics .................................................................. 24

Table 5.3 Knowledge of appropriate hand washing practices by background characteristics ................................................................................ 25

Table 5.4 Knowledge of appropriate hand washing practices by selected characteristics ................................................................................ 26

Table 5.5 Knowledge of the importance of hand washing with water and soap by background characteristics ........................................ 27

Table 5.6 Knowledge of the importance of hand washing with water and soap by selected characteristics .............................................. 28

Table 5.7 Knowledge of specific hygiene habits by background characteristics ................................................................................ 29

Table 5.8 Knowledge of specific hygiene habits by selected characteristics 30

Table 5.9 Importance of cleanness by background characteristics ............... 31

Table 5.10 Importance of cleanness by selected characteristics ..................... 31

Table 5.11 Sources of knowledge about general cleanness and personal hygiene ........................................................................... 32

Table 5.12 Access to health hygiene education at school by background characteristics ................................................................................ 33

Table 5.13 Access to health hygiene education at school by selected characteristics ................................................................................ 33

Table 5.14 School syllabus and health hygiene .............................................. 34

Figure 5.1 Sources of knowledge about general cleanliness and personal hygiene .......................................................................................... 30


Table 6.1 Attitude towards using school toilets by school toilet characteristics ................................................................................ 36

Table 6.2 Attitude towards using school toilets by background characteristics ................................................................................ 37

Table 6.3 Usage of school toilet facilities by school toilet characteristics ... 38

Table 6.4 Usage of school toilet facilities by background characteristics .... 39

Table 6.5 Source of drinking water at school by school water sources characteristics ................................................................................ 40

Table 6.6 Source of drinking water at school by background characteristics ................................................................................ 41

List of tables and figures v

Table 6.7 Attitudes towards hand washing places at school by hand washing places characteristics ...................................................... 42

Table 6.8 Attitudes towards hand washing places at school by background characteristics ................................................................................ 43

Figure 6.1 Percentage who use hand washing places at school by age and location .......................................................................................... 43


Table 7.1 Drinking water habits at school .................................................... 45

Table 7.2 Washing hands at school by hand washing place characteristics . 45

Table 7.3 Washing hands at school by background characteristics .............. 46

Table 7.4 Using soap and bathing habits by background characteristics ...... 47

Table 7.5 Using soap and bathing habits by other selected characteristics .. 48

Table 7.6 Cleaning teeth practice by background characteristics ................. 50

Table 7.7 Cleaning teeth practice by other selected characteristics .............. 51

Table 7.8 General hygiene habits by background characteristics ................. 53

Table 7.9 General hygiene habits by other selected characteristics .............. 54

Table 7.10 Discussions about hygienic behaviors learned at school by background characteristics ............................................................ 56

Table 7.11 Discussions about hygienic behaviors learned at school by other selected characteristics .................................................................. 57

Figure 7.1 Washing hands and wash complete body with soap by age ........ 46

Preface vii

PREFACE Communication for Development (C4D) is an essential cross-cutting strategy within and across all Ministries and UNICEF focus areas. It is recognized as essential for the achievement of the MDGs for ensuring sustainability of results achieved, and for the wider realization of children’s rights.

In order to maximize the benefits from the services provided, behavioral change activities are critical and therefore have to be the first element to be integrated into education program. Without a prior understanding of people’s awareness, their perceptions and practices related to issues such as; hygiene and sanitation attitude and behavior, it will be ineffective to develop a plan to change behavior. Findings from studies carried out on Knowledge, Attitude and Practice (KAP) of target populations have proven to be instrumental in developing tools for effective planning of specific projects and addressing access gaps.

Accordingly, 2009 Djibouti Communication for Development School Hygiene and Sanitation Survey(SHSS) was conducted to collect data to investigate the Knowledge, Attitudes and Practices of school teachers and students about sanitation and hygiene practices that could be used to develop a communication intervention in this respect.

The findings of the 2009 Djibouti C4D School Hygiene and Sanitation Survey together with other data from other surveys are very important in measuring the achievements of communication programs. Based on the above- mentioned considerations, the results of the 2009 Djibouti SHHS should be disseminated at different levels of health management, in the central offices as well as local offices, and to the community at large.

Finally, we would like to take this opportunity to thank the United Nations for Children’s Fund (UNICEF) for their financial support for the 2009 Djibouti SHSS.

Mr. Ibrahim Abdi Obesip

Minister of National Education

and higher Education

Acknowledgments ix

ACKNOWLEDGMENTS In order to maximize the health benefits from services provided, improvements in changing behavior are critical and therefore have to be integrated into health programs. A full understanding of people’s awareness, beliefs and behaviors is essential to plan strong and effective programs and policies to achieve behavioral change that would be of benefit to children, their families and societies. Findings from studies carried out on Knowledge, Attitude and Practice (KAP) of target population have proven to be instrumental in developing tools for effective planning of specific projects and addressing access gaps.

Accordingly, a standardize survey was developed to be used in MENA region countries to provide the data needed for planning communication interventions, and to achieve social development. The 2009 Djibouti Communication for Development School Hygiene and Sanitation Survey (SHSS) is the first survey to be conducted using the standardize instruments. The survey reflects the strong interest in information on knowledge, attitude, and practices of hygiene and sanitation among school students. The wealth of the data that the survey provides will be of great use in charting future directions for the communication planning and education programs.

This important survey could not have been implemented without the active support and dedicated efforts of a large number of institutions and individuals. H.E. Mr. Ibrahim Abdi Obesip, Minister of National Education and Higher Education for his interest in the survey results.

Funding and technical assistance for the survey was principally provided by UNICEF RO/ Amman through agreement with EL-Zanaty & Associates with additional support from UNCIEF Djibouti. I also acknowledge with gratitude Sabah Al-Bahlani Program Communication Specialist, UNICEF MENA-RO, and Vicente Teran, Monitoring and Evaluation Officer, UNICEF RO. Dr. Georges Gonzales, Deputy Representative UNICEF Djibouti, and Ahmedou Ould Sidi Ould Bahah, Water, Sanitation and Hygiene Specialist, and all staff working at UNICEF Djibouti for their support to facilitate and ensure the successful implementation of the survey.

I also gratefully acknowledge the Djibouti national statistical office DISED, especially Mr. Amarah Ali Said, Director of DISED, and Mr. Konaté Sekou Tidiani, Assistant Director of the National Statistical Office for their support in data collection of the survey.

I would like to express my appreciation for all the senior, administrative staff at El-Zanaty & Associates for the dedication and skill in which they performed their tasks.

Finally, I would like to express my appreciation to all households and caretakers who responded in the survey; without their participation this survey would have been impossible.

Josefa Marrato

UNICEF Representative

Summary of findings xi

SUMMARY OF FINDINGS The education system in Djibouti was developed mainly to cover limited demand for education; it was designed essentially for elites and was heavily borrowed from the French system (administrative structure and pedagogical methods).The educational system in Djibouti is influenced by the French system of formal study.

A restructured education system by New Education Law consists of nine years (five years of primary education followed by four years of middle education). This nine year education is now compulsory. In order to enter into the secondary educational system of three years, a Certificate of Fundamental Education is required.

The 2009 Djibouti School Hygiene and Sanitation Survey (SHSS 2009) is the first national-level school survey to be conducted in Djibouti under the C4D standardize survey which is funded by the UNICEF. The 2009 Djibouti School Hygiene and Sanitation Survey was carried out in order to provide nationally representative data on the sanitation and hygiene in schools. Also, the survey provides information about knowledge, attitudes and practice of school teachers and students about sanitation and hygiene practices that could be used to develop a communication intervention in this respect.

Information was collected from 50 (28 in urban and 22 in rural. A total of 250 teachers and 1181 students were successfully interviewed in the School Survey.

In the following the main finding out of the survey will be discussed in brief.

School Characteristics • The mean number of classes per school

was 14.5 in urban areas, compared to only 6.8 classes in rural areas. Also, the mean number of classes in public schools was 11.5 classes compared to 8.7 classes in private schools.

• Mean number of students in each grade is higher in urban or public schools than in rural or private schools for both male and female students.

• The mean number of students in class is relatively high (60 percent). Regarding differentials, the mean number of students per class is found to be lower for schools in urban areas (54.4) than in rural areas (66 percent) and in public schools (60 percent) than private schools (59 percent).

Students Characteristics • A total of 707 students from urban areas

and 474 students from rural areas. Out of those 1006 students were from public schools and 175 students from private schools.

• Age of the students ranged between less than 9 years to 13+ , and male students was 54 percent compared to 46 percent for female students.

School Sanitation and Hygiene Education • Fifty-eight percent (29 schools) have any

committees or association responsible for school sanitation, hygiene education and environment. The percentage is higher among public than private schools and among urban than rural schools.

• Data shows that 86 percent (43 schools) of schools in Djibouti offer education on hygiene and environmental sanitation to their students.

• Thirty-three percent of schools reported offering it less than once per week, 31 percent reported offering it once or more than once per day in 13 schools, and 17 percent reported offering it less than once per month.

• The topics reported to be taught to students are benefits of personal hygiene (70 percent), healthy eating habits (59 percent), and health in general (44 percent), environmental issues (39 percent), and worm infections (21 percent) with higher percentages in the schools in urban areas than in schools in rural areas.

• The main tutor of the health hygiene issues is the teacher (60 percent). Moreover, around one-fifth of the teachers reported that the tutor is the

Summary of findings xii

parent, student or it is a material prepared by the teacher. School doctor or nurse was reported by less than 10 percent of the teachers.

• Data showed that 45 percent of the teachers reported that the teachers are not trained to teach such issues and 41percent reported that the schools' curriculum did not contain these topics.

Parents and Students Involvement with Hygiene Related Activities • Data showed that in 30 percent of the

schools the parents are very involved in improving school sanitation and hygiene, in 36 percent of the schools they are involved, and in 26 percent of the schools they are somewhat involved.

• Parents are not involved at all in only 8 percent of schools. Parents are very involved in hygiene related activities in urban and public schools than in rural and private schools.

Students’ Exposure to Mass Media • Forty-eight percent of students watched

TV at least once per week, 24 listened to the radio at least once per week, and same percentage read magazines at least once per week.

• Younger children were more interested in watching television than older ones where 63 percent of children less than 9 years reporting watching TV at least once per week compared with only 38 percent of children aged 11 and older

• Student’s exposure to mass media at least once per week is significantly higher in urban than rural (75 percent versus 8 percent).

• Older children are more likely than younger students to listen to the radio at least once per week (33 percent of students aged 13 and older listen to the radio at least once per week compared with only 18 percent of students less than 9 years)

• Reading magazines is higher among female students compared with male students (28 percent and 21 percent respectively), and among school students in urban areas more than in rural areas (33 percent and 11 percent respectively).

• 75 percent of the children watched the television at evening time (between 6 pm and 9 pm), 27 percent watches it in the afternoon (between 3 pm and 6 pm), and 17 percent reported watching it at night (after 9 pm). As expected the least time for TV watching was the morning times especially between 9 am and 12 pm (3 percent), as most of the school students were in their schools at that time.

• The times that school children listen the most to the radio are in the afternoon (45 percent), followed by in the morning (44 percent) and the evening (29 percent).

Communication about Health Hygiene • Forty-one percent of school students

received information about general cleanliness and health hygiene within the six months prior to the survey. The percentage is higher among urban students than rural ones (50 percent and 27 percent respectively).

• Mass media is the main source of information (82 percent), followed by the school (73 percent), then family and relatives (51 percent). Television is the main source for school students in urban areas, where teachers were the main source of information for school students in rural areas (66 percent and 70 percent respectively).

Student’s knowledge of ways to protect from illness • Ninety-five percent of the students

mentioned that they must wash their hands after going to toilets as one method to protect themselves against diarrhea and stomachache, 73 percent of students mentioned use clean water.

• Thirty-eight percent of students mentioned wash fruits and vegetables is a method to protect them from getting diarrhea, one-third mentioned use latrine as a method of protection, 31 percent reported eating well cooked food, and 25 percent reported drinking clean/boiled water.

• Students from urban schools are more likely than students from rural schools to report different ways for protecting themselves from getting stomachache and diarrhea.

Summary of findings xiii

• Students whose schools offer education on hygiene and environmental sanitation, those who participated actively in maintaining hygiene, those exposed to information about cleanness and health hygiene during the 6 months preceding the survey are more likely than their counterparts to reported drinking clean water or boiled water as a way to protect themselves against stomachache and diarrhea

Students’ attitude towards the importance of hand washing • Ninety-eight of all students reported that

it is important to wash hands with water and soap before eating or after using the toilet, 96 percent mentioned after eating.

• Student’s whose school reported that students participate actively in maintaining hygiene were less likely than those whose schools reported that students don’t participate actively in maintaining hygiene to agree that it is important to wash hands with water and soap after taking care of home or farm animals.

• Ninety-six percent of students reported that washing hands with water and soap reduces the chance of getting diarrhea, 60 percent reported that it reduces the chance of getting other diseases/infection, 54 percent reported that it reduces stomachache, and 49 percent reported that it keeps hands clean.

• Children aged 13 and over were more likely than those less than 9 years old to report that washing hands with water and soap is a religious belief (38 percent and 20 percent respectively).

Students’ knowledge towards specific hygienic practices • Ninety-one percent of students agree that

not washing hands with water and soap before eating can lead to serious diseases, and 86 percent agree that using an unclean toilet can lead to diseases.

• Public school students are by far more likely than private school students to report agreement with this statement (31 percent and 5 percent respectively), and rural school students are more likely than

urban school students to report agreement with this statement (41 percent and 18 percent respectively).

• Students whose school students participate actively in maintaining hygiene were less likely to agree that washing hands with water only after using the bathroom is enough to protect from diseases than those in schools where students don’t participate actively in maintaining hygiene (63 percent compared to 74 percent).

Sources of knowledge about general cleanliness and personal hygiene • Overall, 75 percent of students reported

that they get this information at home, 56 percent reported school, and 36 percent reported TV/radio. Other sources of information were mentioned by less than 10 percent of students.

• Female students are twice as likely as male students to report health facility or friends as source of information about general cleanliness and personal hygiene.

• Three-quarter of them reported that they have learned about hygiene and cleanness from home, 56 percent have learned about it at school, and 36 percent have learned about it via radio or television.

• It is clear that students in public schools are more likely than those in private schools to report that they learn about general cleanness and personal hygiene at school (58 percent and 42 percent respectively).

• Ninety-four percent of students reported that their schools provide health hygiene activities. Differentials are minor by background characteristics.

• Forty-two percent reported that they get the health hygiene activities once per week, 28 percent reported once or twice per week, and 17 percent reported everyday. Students aged 9 years and less and students from public schools are the most likely to be given health hygiene activities everyday (25 percent and 19 percent respectively).

• Sixty-five percent receives health hygiene activities during classes, 13 percent receive it during breaks, and 11 percent receives it during school activities.

Summary of findings xiv

• Seven percent of the students whose school has committee or association responsible for school sanitation and hygiene education reported that their school provides health hygiene activities compared to 4 percent among those whose school does not have committee or association responsible for school sanitation and hygiene education.

Knowledge about general cleanliness and personal hygiene in school syllabus • Forty-two percent of the students reported

that the school syllabus contains information about health hygiene. The percentage is higher in urban schools than in rural schools (47 percent and 34 percent respectively) and in private school than in public schools (51 percent and 40 percent respectively).

• Forty-nine percent of students mentioned poster, 23 percent mentioned books and 17 percent mentioned brochure/ pamphlets. More than quarter of students (29 percent) reported that no materials are used to promote health hygiene, with slightly higher percentage among private and rural students than public and urban students.

School Toilet Facilities • Two-fifth of the students refuse to use the

school toilet. These percentages are higher in schools that have simple latrine or bucket latrine (44 percent),

• Sixty-eight percent reported that they don’t use it because it’s dirty, 38 percent reported that it smells bad, and 6 percent reported that there is no privacy.

• Dirt as a reason for not using the school toilet is more likely to be reported by students from schools whose toilet floor was observed to be dirty (86 percent), and in schools where many insects were observed in toilet (95 percent).

• Forty-two percent of students from public schools refuse to use the school toilet compared to 28 percent among those in private schools.

• About one-third of the students reported that they urinate/defecate outside school toilet. The highest percentage of urinating

or defecating outside school toilet was observed among students who reported that use of toilet facilities is difficult (65 percent).

• Male students are more likely to report that they urinate/defecate outside school toilets than female students (37 percent versus 27 percent respectively).

• Fifty-one percent of students in urban schools reported that they urinate/ defecate outside school compared to 20 percent among those in schools located in rural areas.

Drinking Water Facilities at School • One-third of the students (34 percent)

reported that drinking water is never available in their schools. On the other hand, 43 percent of the students reported that they drink from water points at school with the highest percentage being reported among students in school where all water sources are child friendly (61 percent) and some water sources are child safe (74 percent).

• Rural students (54 percent) are more likely than urban students (20 percent) to report that drinking water is never available at school

• Sixteen percent of students get the drinking water from their home with the percentage being higher among urban students than rural students (23 percent and 4 percent respectively).

Hand Washing Facilities at School • Slightly more than one- third of the

students (36 percent) use the hand washing facilities at schools.

• Seventy-one percent of those in schools were water is available all the time in hand washing places reported use hand washing place at school compared with 27 percent of those in school were water is not available at all in hand washing places.

• Eighteen percent of the students who do not use hand washing facilities in schools reported that they do not use it because it is very far, 35 percent reported lack of water and 52 percent reported lack of soap.

Summary of findings xv

• The percentage of those students who use the hand washing facilities is higher in urban schools than in rural schools (47 percent and 19 percent respectively), and higher in private schools than in public schools (74 percent and 29 percent respectively).

• Students in schools located in rural areas are more likely than those in other schools to report lack of soap as a reason for not using hand washing facility (87 percent). Students in private schools are more likely than those in private schools to report that hand washing facilities are far and that is why they do not use them (70 percent versus 13 percent).

Students Hygiene practices Drinking water habits at school • Thirty-seven percent of students use their

hands to drink water at school, 32 percent reported using unshared cup/bottle and 28 percent use cup/bottle shared with students.

Hand washing habits at school • The majority reported washing their

hands with water and soap before eating, after eating and after using the toilet with a mean score of student’s frequency of hand washing with water and soap before eating (4), after eating (4.2) and after suing the toilet (3.8) respectively.

• The mean score of washing hands after using the toilet is 4.5 among students in private schools, which is 0.8 higher than that observed among students in public schools.

• The mean score of washing hands with water and soap after using the toilet is 4.5 among students younger than 9 years and it drops to 3.3 among those aged 11 or 12 years.

Using Soap and bathing habits • Eighty-eight percent of students reported

that they use soap when they wash their hands and 92 reported that they use soap when they have a bath.

• Almost all students (99 percent) reported that they take a bath at least once a week. Only 1 percent of students never use soap.

Cleaning habits of school students • Eighty-three percent of students reported

that they clean their teeth everyday and 13 percent reported that they sometimes clean their teeth. Only minor percentage reported that they rarely or never clean their teeth (2 percent and 1 percent respectively).

• The majority of students (85 percent) use water and brush/sewak to clean their teeth, while only 14 percent clean their teeth using toothpaste and brush. The percentage of students who use toothpaste and brush to clean their teeth is higher among students in urban areas than students in rural areas (20 and 6 percent respectively).

• Virtually all students (99 percent) reported that they wash their teeth when they wake up, 35 percent said that they clean their teeth before going to sleep and 38 percent mentioned that they clean they teeth after eating.

• Forty-three percent of students clean hair and take care of their head monthly and only 1 percent do so weekly. The percentages of male students who never clean their hair or take care of their head is higher than female students (62 percent and 48 percent respectively).

• Only 35 percent of the students discuss hygienic behavior their learned at schools with their parents/family. The percentage is higher among students less than 9 years old, female students in urban areas and students in private schools.

• Only less than 10 percent of the students said that wash hand by water and soap after using toilets is important, while more than 90 percent said that these habits are not important (table 5.2).

• Other health issues that the school students discuss with their parents/families are build/improve health latrine (40 percent), not to eat unwashed fruits and vegetables (56 percent), prevent flies from approaching foods (57 percent), brush teeth (59 percent) and cut and clean nails (43 percent).

Introduction 1

1 INTRODUCTION 1.1 Background on the Educational System in Djibouti

The government of Djibouti put the priority for education sector; this is reflected by the budget allocated for education to represent around 20 percent of its budget. The main target of Djibouti government is to ensure that by 2015 children everywhere will be able to complete a full course of primary schooling and that girls and boys will have equal access to all levels of education (the two targets of the Millennium Development Goals (MDGs)). The plan of action for 2006-2008 and the policy for the education system in Djibouti comply with the MDGs.

The education system in Djibouti was developed mainly to cover limited demand for education; it was designed essentially for elites and was heavily borrowed from the French system (administrative structure and pedagogical methods). This system was not adapted to meet the country’s demand. However, there is increase in enrollment during the 1990s due to the government efforts in the area of education; the system is still below people’s expectations and the needs of a developing nation.

Since early 2000, significant progress has been made in basic education in Djibouti. overall, the net enrollment rate increased from 43 percent in 2002 to 66 percent in 2006. Differentials still clear between urban and rural. Around two-third of urban children are enrolled in primary education compared with around 50 percent only in rural areas. The gender disparity is not exist at the national level with a parity index of about 0.98 in 2006 in primary education compared with 0.82 in secondary. However, efforts have still to be made to achieve the Millennium Development Goals in Djibouti, since still there is around one-third of school age children don’t attend school. Girl’s school attendance rate is much lower than boys. Overall, the education system in Djibouti still face many problems of these; access, quality and illiteracy problems.

As part of a national campaign to promote children school attendance a survey was conducted by students to investigate reasons of non-enrollment. The main reasons reported of non-enrolment (Source: “The book on excluded children”, 2007) are; socio-cultural issues (domestic work, child labor) as well as the way parents perceive education (non-enrolment of girls and disabled children), poverty and social problems (orphanage status, children abandoned or neglected by parents, divorce, street children); legal status problems (difficulties inherent to birth certificate issuance); and disability (physical disability, deafness, blindness, mental disorders).

According to the World Bank, one of the highest illiteracy rates among developing countries is found in Djibouti. About 66 percent of the total population and 85 percent of women in rural areas are illiterate.

The educational system in Djibouti is influenced by the French system of formal study. A restructured education system by New Education Law consists of nine years (five years of primary education followed by four years of middle education). This nine year education is now compulsory. In order to enter into the secondary educational system of three years, a Certificate of Fundamental Education is required. Education system in Djibouti consists of:

1- Pre-primary education (two years). 2- Primary education (five years) 3- Middle education (four years) 4- Secondary education (three years) 5- Tertiary education

Introduction 2

1.2 Djibouti School Hygiene and Sanitation Survey 2009

UNICEF defines C4D as “a systematic, planned and evidence-based strategic process to promote positive and measurable individual behavior and social change that is an integral part of development programs, policy advocacy and humanitarian work” (2009 UNICEF).

The UNICEF C4D aims increasing knowledge and awareness of all children, families and communities via having accessibility access to the information, skills and technologies. Also, the UNICEF C4D aims at influencing attitudes and social norms; and thus consequently achieving change in individual behavior and practices. C4D promotes the use of a well- designed mix of participatory communication strategies and approaches in order to increase the impact of development programs.

The 2009 Djibouti School Hygiene and Sanitation Survey (SHSS 2009) is the first national-level school survey of its kind to be conducted in Djibouti. It is a component of the C4D standardize survey which is funded by the UNICEF. The 2009 Djibouti School Hygiene and Sanitation Survey was carried out in order to provide nationally representative data on the sanitation and hygiene in schools. Also, the survey provides information about knowledge, attitudes and practice of school teachers and students about sanitation and hygiene practices that could be used to develop a communication intervention in this respect.

The 2009 SHSS was conducted under the auspices of the Ministry of Education and has been implemented by El- Zanaty & Associates under the agreement of C4D standardize survey project. El-Zanaty & Associates contracted Djibouti Statistical office (DISED) for data collection stage.

El- Zanaty provided all technical support for survey activities and carried out DISED which is mainly data collection and data entry. Technical support of the 2009 DC4DS was provided also by UNICEF. Additionally, UNICEF provided the financial support solely for the survey.

Objectives of the 2009 Djibouti School Hygiene and Sanitation Survey The 2009 Djibouti School Hygiene and Sanitation Survey was designed to:

• Collect information about the sanitation and hygiene in schools. • Identify the knowledge, attitudes, and practices of school children regarding sanitation and

hygiene practices. • Identify the knowledge and attitudes of school teachers regarding sanitation and hygiene

practices of school children. • Identify the communication channels that could be used to improve the sanitation and

hygiene practices of school children.

Sample Design and Selection The main objective of the School hygiene and sanitation survey sample was to provide estimates with acceptable precision of key indicators for total Djibouti school students and for urban –rural school students.

To achieve the above objectives a two stage probability sample was designed and selected. A total of 50 schools were targeted. To ensure urban rural presentation a sample of 28 schools from urban and 22 schools were targeted.

First Stage: the sample frame was prepared for urban and rural. The list of schools in urban stratum and the list of schools in rural stratum were prepared using the Ministry of Education list. Then the sample of schools from each stratum was selected using a simple random sampling

Second stage: a target sample of students (25) form grade 4 and 5 and teachers ( 5) were selected from each school. For selection of students the list of students from grade 4, and 5 in each school was prepared and a random sample of 25 students was selected randomly taking into consideration

Introduction 3

male –female representation.

As for teachers ; five were selected from primary school teachers at random from each school.

Development of instruments The 2009 Djibouti School Hygiene and Sanitation Survey(DSHSS), involved three questionnaires: School Questionnaire, teacher Questionnaire, and student Questionnaire. The three questionnaires were developed by El-Zanaty& Associates with technical support from UNICEF/RO through C4D standardize survey project. The questionnaires were developed in English and then translated into French to be piloted in Djibouti. School hygiene and sanitation Survey questionnaires are presented in Annex A. In the following a brief description of the three questionnaires

I. SCHOOL QUESTIONNAIRE

The school questionnaire included basic information about the school: educational grades, number of classes, number of school students in each grade, number of school teachers etc. Also information about water and sanitation and environment including the sources of drinking water, water storage in school, school toilets/latrines and school building condition (classrooms, school yards, canteen etc.) were also included in the questionnaire. The questionnaire including an observation of school building, classes, toilets, source of water to assess the condition of the school environment.

The eligible respondent to the school questionnaire was the head master.

2. TEACHER QUESTIONNAIRE

The objectives of teacher questionnaire were to identify teacher's knowledge and attitudes about water sanitation and health hygiene practices, together with their perception about health hygiene practices of school children.

The teacher questionnaire consists of the following sections:

• Teacher background. • Knowledge of correct hygiene habits • School health activities.

3. STUDENT QUESTIONNAIRE

The objectives of student's questionnaire were to identify students' knowledge, attitudes and practices regarding water sanitation and health hygiene practices. The results will help to indentify practices that need to be promoted and planned for primary school students.

The student questionnaire consists of the following:

• Student background. • Exposure to mass media and sources of information. • Knowledge of correct hygiene habits. • School environment and attitudes toward correct hygiene habits. • Practice of hygiene habits.

Training of field Staff The 2009 Djibouti School Hygiene and Sanitation Survey training program was conducted over a five-day period in November 2009. The Djibouti DISED was responsible for recruiting the fieldwork staff. The DISED had a list of interviewers and supervisors who worked for them in previous surveys. Using this list, candidates were selected to participate in the training. Fourteen candidates were recruited for the training, 13 enumerators, including 3 girls and 10 boys and 1 supervisor (male) participated in the training.

Introduction 4

Training was conducted in two phases. First training for interviewers for the 2009 DC4DS data collection began on the 31st of October, 2009 and lasted for 6 days including field practice. Then due to some modifications in questionnaires after the field practice (language and other issues) it was decided to review the whole translation of questionnaires. Subsequently further training for three days took place to ensure the Good question wording and mastery in their national languages. The training was delivered by experts from the El-Zanaty attended by experts from DISED, the UNICEF office in Djibouti and the Regional Office of UNICEF.

Twelve out of the 14 candidates were selected to be part of the data collection teams for the 2009 Djibouti School Hygiene and Sanitation Survey.

The training course was held in Djibouti and included the following:

• Lectures related to basic interview techniques and to specific survey topics • Sessions on how to fill out the questionnaires • Role playing and mock interviews • Field practice in areas not covered in the survey

A variety of materials was developed for use in training personnel involved in the fieldwork. A lengthy interviewer's manual, including general guidelines for conducting an interview as well as specific instructions for asking each of the questions of the survey questionnaires, was prepared and given to all field staff. Also, a special manual describing the duties of the team supervisor and the rules for field editing was prepared.

Data Collection and Data Processing Data collection for the 2009 Djibouti School Hygiene and Sanitation Survey took place from the last week of November till mid December 2009. The data collection of school hygiene and sanitation survey began November 21, 2009 in Djibouti City. Six teams involved in data collection; each included two interviewers. The teams were closely supervised by a field work coordinator, and other senior staff from DISED.

In some localities of the country, especially in rural areas, it was not possible to find a sufficient number of students in 4th and 5th year. Thus the number of completed questionnaires to students is sometimes less than 25. It is the same for the teacher questionnaires which in some schools there was less than five teachers. In this case all teachers interviewed.

Staff from the DISED were responsible for collecting questionnaires from the teams as soon as interviewing in a school was completed. Office editors reviewed questionnaires for consistency and completeness, and a few questions (e.g., School codes) were coded in the office prior to data entry. Data entry started around mid December 2009 and last by mid January.

The data from the questionnaires were entered and edited on microcomputers using the Census and Survey Processing System (CSPro), a software package for entering, editing, tabulating, and disseminating data for censuses and surveys. A data processing expert from EL-Zanaty develops the data entry program and trains the data entry staff for one week.

Ten data entry personnel used ten microcomputers to process the 2009 Djibouti School Hygiene and Sanitation Survey data.

1.3 Survey Coverage

Table 1.1 summarizes the outcome of the fieldwork for the 2009 Djibouti School Hygiene and Sanitation Survey by residence. A total of 50 schools were selected, all of them were successfully interviewed, yielding a school response rate of 100 percent. A total of 250 teachers were identified and 224 were successfully interviewed, yielding a response rate of 90 percent. Of the 1250 eligible students identified in the schools sampled, data were obtained for 1181 students (95 percent). In general response rate was much higher in urban areas than in rural areas for teachers and students.

Introduction 5

This is due to the fact that in rural areas some schools have less than five teachers and less than 25 students in grade 4 and 5.

Table 1.1 Results of survey interviews by school location Number of schools, teachers and students, interviews, and response rates, according to urban-rural location and region (unweighted), Djibouti, SHSS 2009.

Interview results Urban Rural Total

School interviews Schools target sample 28 22 50 Schools interviews completed 28 22 50 School interviews response rate 100.0 100.0 100.0

Teacher interviews Teachers target sample 140 110 250 Teacher interviews completed 137 87 224 Teacher interviews response rate 97.9 79.1 89.6

Student interviews Students target sample 700 550 1250 Students interviews completed 707 474 1181 Students interviews response rate 99.0 86.2 94.5

Table 1.2 shows response rates for the 2009 Djibouti School Hygiene and Sanitation Survey according to type of school. From the 50 selected schools 43 were public schools and 7 were private. Regarding the teachers, the total number of teachers participated in the survey were 224 teachers, 190 teachers were from public schools and 34 teachers were from private schools. The total number of students participated in the survey were 1181 students from them 1006 were from public schools and 175 students were from the private schools. In general the response rates of teachers and students were higher among private schools than among public schools. Also response rates were higher among students than among teachers (95 percent compared to 90 percent respectively).

Table 1.2 Results of survey interviews by school type

Number of schools, teachers and students, interviews, and response rates, according to school type (unweighted), Djibouti, SHSS 2009.

Interview results Public Private Total

School interviews Schools target sample 43 7 50 Schools interviews completed 43 7 50 School interviews response rate 100.0 100.0 100.0

Teacher interviews Teachers target sample 215 35 250 Teacher interviews completed 190 34 224 Teacher interviews response rate 88.4 97.1 89.6

Student interviews Students target sample 1075 175 1250 Students interviews completed 1006 175 1181 Students interviews response rate 93.6 100.0 94.5

2

This chSHSS.studen

2.1

The some gather of schoclassesteacher

Table primarschoolschoolnumbein urbclassesnumbe11.5 cl

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ool s. s, number ofrs, etc.,

2.1 presentsry and prepl, and the nl day the scher of classes ban areas, cos in rural arer of classes lasses compa

rning the nunt of scholess to the

n or rural). Hmore likely schools.

2.2 shows and female ding to locatil type (publ

It is noticeadents in eaor public sc

e schools fornts is higher i

Table 2.2 Mean numb

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Location Urban Rural School typ Public Private

RACTERSTUDEN

nts informatchapter prese

interviewed

Characteri

estionnaire and observa

n about charasuch as nu

f students, n

the mean nparatory clanumber of shool works. T

per school ompared to reas. Also, tin public schared to 8.7 cl

umber of shiools had tlocation of owever, privto have one

the mean students in ion (urban orlic or privatable that me

ach grade ischools than r both male ain private sch

Mean numberber of students by

d tics

Gr

Boys

80.1 47.2

e 69.1 44.1

RISTICSNTS tion on the bents informatd for the Scho

istics

included ations to acteristics umber of

number of

number of asses per shifts per The mean was 14.5 only 6.8

the mean hools was lasses in priv

ifts in a schotwo shifts the school

vate schools e shift than

number of each grade r rural) and te) in each ean number s higher in in rural or

and female sthools than in

r of students y grade and sex, a

rade 1 G

s Girls Boy

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62.7 70.38.6 43.

Cha

S OF SC

background ction on backool Hygiene

vate schools.

ool day, 28 p

tudents. Onln public scho

according to back

Grade 2

ys Girls Bo

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Table 2.1 MeMean number distribution of characteristics,

Background characteristics

Location Urban Rural

School type Public Private

Number of sch

23

Figu

aracteristics o

CHOOLS

characteristickground charand Sanitatio

percent of sc

y in grade fiols.

kground character

Grade 3

oys Girls Bo

6.5 79.5 731.5 34.9 38 0.4 63.1 613.9 40.1 40

ean number ofof primary and schools by the nuDjibouti, SHSS 2

Mean c

Primary

14.5 6.8

11.5 8.7

hools 50

3.3

76.7

Public

ure 2.1 Numbs

One shif

f schools, teac

S, TEAC

cs of the schoracteristics oon Survey.

chools had o

ive, the mean

ristics, Djibouti, S

Grade 4

oys Girls Bo

3.8 68.9 788.8 33.1 41

1.4 54.9 640.3 42.6 48

f classes and nupreparatory sch

umber of shifts, 2009.

number of classes

Preparatory

1.3 1.4

1.4 0.9 7

ber of shifts ichool type

ft Two shif

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CHERS

ools sampledof the teache

one shift, wh

n number of

SHSS 2009.

Grade 5

oys Girls

8.7 75.1 1.3 35.7 4.5 56.9 8.4 63.0

umber of shiftshool classes and according to bac

Number of shifts

One Two

28.6 71.4 27.3 72.7

23.3 76.7 57.1 42.9 14 36

57.142.9

Private

in schools by

fts

dents

d in the ers, and

hile, 72

f female

s percent

kground

Total

100.0 100.0

100.0 100.0

50

y

7

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Class mean nof studschoolhigh (studen(54.4) percen

Table femaleaccordof primteacherteachermale teacherschoolfemaleIn regteacherschoolof stuapprox48 in u42 stud

Table workervery liin scho5 (3 mnumbeis 3 (twnumbeprivateschoolin publ

aracteristics of

crowdednesnumber of stdents in priml. In General (60 percent)nts per class

than in rurnt) than priva

2.4 presentse teachers peding to schoomary teacherrs and 9 femrs per schooteachers p

rs were rals, where, te teachers in gards to ther ratio, it is ls located in udents per ximately 67 urban areas. dents in priva

TablMeanratio chara

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Loca Urb Rur Scho Pub Priv

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ral areas (66ate schools (5

s informatioer school, anol backgrounrs per schoolmale teacherol in rural arper schoolarely foundthe mean nprimary sche primary found that rural areas tteacher is students coThis ratio deate schools.

le 2.4 Teachern number of prim

(i.e. number of acteristics, Djibou

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ation ban 12ral 7

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hat the meanan teachers imean numben areas is apfemales), whs in schools id one femalers other thanhigher than t

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umber of stug differential

be lower fo6 percent) an59 percnet).

n on the mend the primarnd characterls in urban ars per schooreas was 7 l. Female

d in rural number of ools is 0.3. student to in primary

the number very high

ompared to ecreases to

s headcountmary and preparaf student per teauti, SHSS 2009.

Primary

ales Females

2.5 8.7 .0 0.3

0.6 5.1 .1 3.9

n number ofin schools iser of workerspproximatelyhile the meanin rural arease). The meann teachers inthat in publicompared to 4

dents

mportant inlculated usin

mber of primdents in clasls, the meanor schools innd in public

ean number ry student toristics. The mareas was arool. The mea

tory teachers by acher for the prim

Total Male

21.2 0.47.3 0.1

15.7 0.311.0 0.0

f s s y n s n n c 4

Table 2.5Mean numcleaninworaccording

Backgrouncharacteris

LocationUrban Rural

School typPublic Private

48

Urb

Figu

dicators. Thng the numbe

mary classes iss is relativeln number on urban areac schools (6

of male ano teacher ratimean numbeound 13 malan number o

sex and the primmary level), acc

Preparatory

es Females T

4 0.0 0.1

0.1

0 0.0

5 Workers heamber of male andrkers who are reto background ch

nd stics

Wor

Male

3.2 2.0

pe 2.6 3.1

.1

67

ban Rur

ure 2.2 Primaschool

he er in ly of as 60

nd io er le of

mary student to tecording to backg

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teacherTotal

0.4 48.0.2 67.

0.4 59.0.0 42.

Table 2.Mean nustudents backgrouDjibouti,

Backgroucharacteri

LocationUrban Rural

School tyPublic Private

Total

adcountd female workersesponsible for cleharacteristics, Dji

rkers Cle

Female M

2.2 11.0 0

1.4 03.0 0

.459

ral Pub

ary student: l location and

eacher ground

mary ent: r ratio

.1 .4

.1 .2

.3 Class crowdumber of primary

per class, accorund charac

SHSS 2009.

und istics

Mean nustudent

n 5466

ype 5958

59

s other than teacheaning sanitary fibouti, SHSS 200

eaning workers

Male Female

1.2 1.1 0.5 0.9

0.9 0.9 0.9 1.7

.1

42

blic Priv

teacher ratiod type

dnessy school rding to teristics,

umber of ts/class

4.5 6.1

9.8 8.5

9.6

hers and facilities, 09.

Total

7.7 4.4

5.8 8.7

.2

vate

o by

Characteristics of schools, teachers and students 9

2.2 Primary Teachers' Characteristics

Table 2.6 presents the percent distribution of primary school teachers by specific characteristics such as age, sex, years of experience, and position in school, according to urban-rural residence, and type of school. Three quarters of the teachers interviewed were aged between 25 and 39 years. Younger teachers aged 20-24 years are present only in public schools, and are more present in rural areas than in urban areas. The highest age of a teacher in rural and public schools is 49 years, while in urban and private schools you can find few teachers aged 65 or higher.

Regarding the gender issue, the majority of teachers interviewed were males (80 percent). Also the percentage of female teachers in rural areas is very limited (2 percent), while the percentage of female teachers in urban areas was much higher (32 percent). Table 2.6 also shows that more than two-thirds of the interviewed teachers had less than 5 years of experience. This percentage is higher in schools in rural areas than in schools in urban areas (78 percent compared to 65).

When inquiring about the position of the teacher in school, it was found that the majority of teachers were working as class teachers (96 percent) while only 3 percent were working as subject teachers. The percentage of subject teachers was higher in private schools (15 percent).

2.3 Students Characteristics

Table 2.7 shows the distribution of students by age, sex, grade, and parent/ guardian' education, according to urban-rural school location, and type of school. This survey was conducted with primary school students in grades 4 and 5 only.

The total number of students who participated in the survey was 1181 students, 707 students from urban areas and 474 students from rural areas. The total number of students who participated from public schools was 1006 compared to only 175 students from private schools.

The age of the students ranged between less than 9 years to 13+. It should be noted that the age is recorded by complete years, so if a student age is 8 years and 11 months, it will be recorded as less than 9. Younger children (less than 9 years) are present in higher percentages in private schools than in public schools and in schools in urban areas than schools in rural areas.

According to the sex of the students, the percentage of male students was 54 percent compared to 46 percent for female students. The ratio of males to females is about 1:1 in urban areas. While in rural areas, 60 percent of the students were males and 40 percent females. Also, percentage of male students was higher among public schools than among private schools. On the contrary,

Table 2.6 Teachers characteristics Percent distribution of primary school teachers by specific characteristics, according to urban-rural school location, and type of school, Djibouti, SHSS 2009.

Type of school

Characteristics Urban Rural Public Private Total

Age 20-24 5.1 11.5 8.9 (0.0) 7.6 25-29 30.7 26.4 30.5 (20.6) 29.0 30-34 29.2 39.1 33.7 (29.4) 33.0 35-39 17.5 6.9 13.7 (11.8) 13.4 40-44 7.3 12.6 9.5 (8.8) 9.4 45-49 7.3 3.4 3.7 (17.6) 5.8 50-54 1.5 0.0 0.0 (5.9) 0.9 55-59 0.0 0.0 0.0 (0.0) 0.0 60-64 0.7 0.0 0.0 (2.9) 0.4 65+ 0.7 0.0 0.0 (2.9) 0.4

Sex Male 67.9 97.7 80.5 (73.5) 79.5 Female 32.1 2.3 19.5 (26.5) 20.5

Years of experience Less than 2 years 35.0 41.4 34.7 (52.9) 37.5 2-4 29.9 36.8 35.8 (14.7) 32.6 5-7 15.3 6.9 12.6 (8.8) 12.1 8-10 7.3 10.3 7.9 (11.8) 8.5 More than 10 years 12.4 4.6 8.9 (11.8) 9.4

Position Principle 0.7 1.1 1.1 (0.0) 0.9 Vice principle 0.0 0.0 0.0 (0.0) 0.0 Senior teacher 0.0 0.0 0.0 (0.0) 0.0 Subject teacher 4.4 0.0 0.5 (14.7) 2.7 Class teacher 93.4 98.9 97.4 (85.3) 95.5 Other 1.5 .0 1.1 (0.0) .9

Number of teachers 137 87 190 34 224

Note: Figures in parentheses are based on 30-50 unweighted cases.

Characteristics of schools, teachers and students 10

percentage of female students was found to be higher in private schools than in public schools (48 percent compared to 46).

The majority of the grade 4 or 5 students interviewed had more than three siblings (85 percent). This figure reaches its peak in public schools (88 percent) and is lowest among students in private schools (71 percent).

Table 2.7 also presents information about the level of education of the student's guardians. Half of the male guardians didn't attend school at all, compared to 62 percent of the female guardians. The percentages of male guardians who had secondary or higher level of education were higher among children whose schools are private and in urban areas. Also, the percentages of female guardians whose level of education was secondary or higher were higher among students whose schools are private and in rural areas.

Table 2.7 Students characteristics Percent distribution of primary school students by specific characteristics, according to urban-rural school location, and type of school Djibouti, SHSS 2009.

Type of school

Characteristics Urban Rural Public Private Total

Age Less than 9 34.9 30.4 31.6 41.7 33.1 9-10 36.2 30.8 35.2 27.4 34.0 11-12 24.3 31.9 28.0 23.4 27.3 13+ 4.5 7.0 5.2 7.4 5.5 Sex Male 49.8 59.5 54.0 52.0 53.7 Female 50.2 40.5 46.0 48.0 46.3 Grade 4th grade 47.9 46.4 47.6 45.7 47.3 5th grade 52.1 53.6 52.4 54.3 52.7 Number of brothers/sisters 0 2.0 2.7 1.7 5.7 2.3 1-2 13.2 11.0 10.4 22.9 12.3 3-4 25.7 27.6 27.0 24.0 26.5 5+ 59.1 58.6 60.9 47.4 58.9 Female guardian education Primary 7.9 4.4 6.2 8.6 6.5 Preparatory 11.5 2.3 7.3 10.9 7.8 Secondary 3.8 0.8 1.5 9.1 2.6 Higher 3.1 0.2 0.9 8.0 1.9 Never attended school 56.6 70.6 67.0 34.9 62.2 No female guardian .6 .6 .4 1.7 .6 Don’t know 16.5 20.9 16.8 26.9 18.3 Male guardian education

Primary 9.2 7.2 8.5 7.4 8.4 Preparatory 16.5 8.0 12.2 18.3 13.1 Secondary 6.8 1.7 4.2 8.0 4.7 Higher 7.8 1.1 3.4 14.9 5.1 Never attended school 40.9 63.5 54.0 26.9 50.0 No male guardian 1.6 0.6 1.1 1.7 1.2 Don’t know 17.3 17.9 16.6 22.9 17.5 Number of students 707 474 1006 175 1181

School hygiene and health related activities 11


Schools are interested in active participation of students and their parents in the school activities through formulation of school committees or associations. This chapter present information about school activities related to sanitation and health hygiene. Then parents, students, and teachers involvement in sanitation and health hygiene activities at school will be discussed.

3.1 School Sanitation and Hygiene Education

Table 3.1 presents the percentage of schools that have any committees or association responsible for school sanitation, hygiene education and environment. In addition, among those who have committees/associations percentage by committees/association activities and percent distribution by frequency of committees meetings. Data revealed that 58 percent (29 schools) have any committees or association responsible for school sanitation, hygiene education and environment. The percentage is higher among public than private schools and among urban than rural schools.

Among the committee association activities are advocate locally for improvement in water supply, sanitation and hygiene (69 percent), raise funds (55 percent), support maintenance of facilities (38 percent), and build new facilities (14 percent). Moreover, the majority of schools reported that the committees/associations meet once a month (62 percent), 21 percent reported when the need is raised, 10 percent reported once a week, and only 7 percent reported once a term.

Table 3.1 School sanitation and hygiene education committees/associations Percentage of schools that have any committees or association responsible for school sanitation, hygiene education and environment, and among those who have committees/associations percentage by committees/association activities and percent distribution by frequency of committees meetings, according to urban-rural location, and type of school Djibouti, SHSS 2009.

Location Type of school

Urban Rural Public Private Total

School have any committees or association responsible for school sanitation, hygiene education and environment 60.7 54.5 65.1 14.3 58.0

Number of schools 28 22 43 7 50 Committee/association activities

Advocate locally for improvement in water supply, sanitation and hygiene 70.6 66.7 67.9 * 69.0

Support maintenance of facilities 47.1 25.0 35.7 * 37.9 Build new facilities 23.5 0.0 10.7 * 13.8 Raise funds 70.6 33.3 53.6 * 55.2 Other 0.0 25.0 10.7 * 10.3 Frequency of committee meetings Once a week 11.8 8.3 10.7 * 10.3 Once a month 58.8 66.7 60.7 * 62.1 Once a term 5.9 8.3 7.1 * 6.9 When need arise 23.5 16.7 21.4 * 20.7

Number of schools that have sanitation and hygiene education committees/associations 17 12 28 1 29

Note: An asterisk indicates figure based on 1 unweighted school.

One of the important roles of schools is health and hygiene education. Table 3.2 shows the Percentage of schools that offer education on hygiene and environmental sanitation, and among schools that offer such education percent distribution by frequency of offering hygiene education and environmental sanitation, teaching aids used to promote for personal hygiene activities and who providing the teaching about sanitation and health hygiene.


Data shows that 86 percent (43 schools) of schools in Djibouti offer education on hygiene and environmental sanitation to their students with somewhat lower percentage among private schools (4 out of 7 schools). Regarding the frequency of offering the hygiene and health education, 33 percent of schools reported offering it less than once per week, 31 percent reported offering it once or more than once per day in 13 schools, and 17 percent reported offering it less than once per month.

The teaching aids that are used in hygiene and health education are posters and charts (67 percent), books (54 percent), models (14 percent), and radio or video programs (5 percent).

Teachers are the personnel that usually provide teaching on sanitation and health hygiene (95 percent), while students (9 percent) and peer education (5 percent) is used in small percentage of schools.

Table 3.2 School hygiene education Percentage of schools that offer education on hygiene and environmental sanitation, and among schools that offer such education percent distribution by frequency of offering hygiene education and environmental sanitation, teaching aids used to promote for personal hygiene activities and who providing the teaching about sanitation and health hygiene, according to urban-rural location, and type of school Djibouti, SHSS 2009.



School offer education on hygiene and environmental sanitation 85.7 86.4 90.7 57.1 86.0

Number of schools 28 22 43 7 50 Frequency of offering such education Once or more than once per day 20.8 42.1 30.8 (25.0) 31.0 Once every 2-3 days 4.2 0.0 0.0 (25.0) 2.4 Once per week 0.0 0.0 0.0 (0.0) 0.0 Less than once per week 37.5 26.3 33.3 (25.0) 33.3 Less than once per month 20.8 10.5 17.9 (0.0) 16.7 Don’t know 16.7 21.1 17.9 (25.0) 16.7 Teaching aids Books 50.0 57.9 48.7 (100.0) 53.5 Models 16.7 10.5 15.4 (0.0) 14.0 Poster/charts 75.0 57.9 64.1 (100.0) 67.4 Video programs 8.3 0.0 0.0 (50.0) 4.7 Radio programs 4.2 5.3 5.1 (0.0) 4.7 Other 8.3 0.0 5.1 (0.0) 4.7

Who provide teaching on sanitation and health hygiene

Teachers 91.7 100.0 94.9 (100.0) 95.3 Students 12.5 0.0 10.3 (0.0) 9.3 Peer education 4.2 0.0 5.1 (0.0) 4.7 Other 4.2 0.0 2.6 (0.0) 2.3

Number of schools that offer education on hygiene and environmental sanitation 24 19 39 4 43

Note: Figures in parentheses are based on less than 5 unweighted school.

Teachers must have a role in hygiene and sanitation education in schools. Table 3.3 shows the percentage of teachers who reported that students were taught the prompted health issues during the last school year and who taught those health issues, and among those who reported that none of the health issues were taught, and percentage by reason for not teaching those health issues. Overall, data about teaching students specific health hygiene issues showed that 195 teachers reported that the students are taught about health issues the year prior to the survey. The topics reported to be taught to students are benefits of personal hygiene (70 percent), healthy eating habits (59 percent), and health in general (44 percent), environmental issues (39 percent), and worm infections (21 percent) with higher percentages in the schools in urban areas than in schools in rural areas.


The main tutor of the health hygiene issues is the teacher (60 percent). Moreover, around one-fifth of the teachers reported that the tutor is the parent, student or it is a material prepared by the teacher. School doctor or nurse was reported by less than 10 percent of the teachers.

Teachers who reported that students were not taught the prompted health issues during the last school year were asked about the reason for such an issue. Data showed that 45 percent of the teachers reported that the teachers are not trained to teach such issues and 41percent reported that the schools' curriculum did not contain these topics. Other reasons were mentioned by small percentage of teachers.

Table 3.3 Teaching students specific health hygiene issues Percentage of teachers who reported that students were taught the prompted health issues during the last school year and who taught those health issues, and among those who reported that none of the health issues were taught, percentage by reason for not teaching those health issues, according to urban-rural location and type of school Djibouti, SHSS 2009.



Students taught Health in general 46.0 41.4 42.6 (52.9) 44.2 Worm infections 24.8 13.8 17.9 (35.3) 20.5 Healthy eating habits 66.4 48.3 55.3 (82.4) 59.4 Benefits of personal hygiene 73.0 65.5 71.1 (64.7) 70.1 Environmental issues 43.1 33.3 40.5 (32.4) 39.3

Number of teachers 137 87 190 34 224 Tutor School doctor 12.0 4.3 10.4 (3.2) 9.2 School nurse 8.8 7.1 9.8 (0.0) 8.2 School teacher 63.2 54.3 59.1 (64.5) 60.0 Parents 24.8 18.6 25.0 (9.7) 22.6 Students 24.8 20.0 25.0 (12.9) 23.1 It is a topic prepared by teacher 19.2 21.4 21.3 (12.9) 20.0 Other 13.6 2.9 7.9 (19.4) 9.7

Number of teachers who reported that students were taught health issues 125 70 164 31 195

Reasons for not teaching health issues School doesn’t care about students personal hygiene * * * * * School curriculum doesn’t contain these subjects * * * * * I don’t believe in such activities * * * * * Teachers are not trained to teach these subjects * * * * * Other * * * * *

Number of teachers who reported that students weren’t taught health issues 12 17 26 3 29

Note: Figures in parentheses are based on 30-50 unweighted cases, An asterisk indicates figure based on fewer than 30 unweighted cases and has been suppressed.

Table 3.4 shows information about the availability of educational materials at the schools in Djibouti to teach health issues. The most available educational materials are the posters (45 percent), followed by the textbooks (34 percent) and guidelines for teachers (33 percent). Other

46

24.8

66.473

43.141.4

13.8

48.3

65.5

33.3

Health in general Worm infections Healthy eating habits

Benefits of personal hygiene

Environmental issues

Figure 3.1 Health issues taught to students by school location

Urban Rural


available educational materials are pamphlets (17 percent), flip charts (13 percent), educational games (7 percent), videos (5 percent) and slides (3 percent). The data shows that the availability of the educational materials are higher in schools in urban areas more than schools in rural areas and in private schools than public schools.

Table 3.4 Availability of materials to teach health issues Percentage of teachers who reported the availability of different educational materials at school to teach health issues, according to urban-rural location, and type of school Djibouti, SHSS 2009.

Location Type of school Total number of teachers

Urban Rural Public Private

Available educational materials Guidelines for teachers 32.8 33.3 34.2 (26.5) 33.0 Textbooks 39.4 25.3 31.6 (47.1) 33.9 Flip charts 13.1 12.6 11.6 (20.6) 12.9 Posters 48.2 40.2 43.7 (52.9) 45.1 Pamphlets 20.4 10.3 13.7 (32.4) 16.5 Slides 3.6 1.1 2.1 (5.9) 2.7 Videos 8.0 1.1 3.7 (14.7) 5.4 Educational games 8.0 5.7 7.4 (5.9) 7.1 Others 5.8 2.3 3.7 (8.8) 4.5 Number of teachers 137 87 190 34 224


3.2 Parents Involvement with Hygiene Related Activities

Parents’ involvement in hygienic related activities is important to help the school administration improve the sanitation and hygienic practices of the students. Table 3.5 presents the percent distribution of schools by the reported extent of parent’s involvement on improving school sanitation and hygiene education, and frequency of their involvement.

Table 3.5 Parent’s involvement with improving school sanitation and hygiene education Percent distribution of schools by the reported extent of parent’s involvement on improving school sanitation and hygiene education, and frequency of their involvement, according to urban-rural location, and type of school Djibouti, SHSS 2009.

Type of school


Extend of parent’s involvement on improving school sanitation and hygiene education

Very involved 42.9 13.6 32.6 14.3 30.0 Involved 32.1 40.9 34.9 42.9 36.0 Somewhat involved 14.3 40.9 30.2 0.0 26.0 Not involved at all 10.7 4.5 2.3 42.9 8.0 Frequency of involvement Very often 39.3 27.3 39.5 0.0 34.0 Often 25.0 50.0 39.5 14.3 36.0 Sometimes 10.7 18.2 14.0 14.3 14.0 Never 25.0 4.5 7.0 71.4 16.0 Number of schools 28 22 43 7 50

Data showed that in 30 percent of the schools the parents are very involved in improving school sanitation and hygiene, in 36 percent of the schools they are involved, and in 26 percent of the schools they are somewhat involved. Parents are not involved at all in only 8 percent of schools. Parents are very involved in urban and public schools than in rural and private schools.

Regarding the frequency of involvement, 36 percent of the schools reported that the involvement is often and in 34 percent of the schools the involvement is very often.


3.3 Teacher’s Involvement with Health Hygiene Activities

Table 3.6 shows the percent distribution of teachers by the reported extent of their involvement on improving school sanitation and hygiene education, and frequency of their involvement. Overall, 25 percent only of teachers reported that they participated in any activities or events to promote student’s health with the percentage being much higher in urban than rural areas (29 percent and 18 percent respectively). The majority of teachers who reported that they participated in any activities or events to promote student’s health reported that they participate in cleaning campaigns inside the school (76 percent). Moreover, around one quarter of the teachers reported that they participate in school gardening, implementing health campaigns, and producing wall magazines/posters. Other activities were reported by less than 10 percent of teachers.

Teachers who reported that they didn’t participate in activities or events to promote student’s health were asked about the reasons for not participating. About two-third of the teachers reported that there is no such activities run in school and one-quarter reported that they don’t have time to participate.

Table 3.6 Teacher’s involvement with improving school sanitation and hygiene education Percentage of teachers who participated in activities/events to promote student’s health and among those percentage by the reported activities/events they participated in, and among teachers who didn’t participate in such activities/events percentage by the reported reasons for not participating in such activites, according to urban-rural location, and type of school Djibouti, SHSS 2009.

Type of school


Participated in any activities or events to promote student’s health 28.5 18.4 24.2 (26.5) 24.6

Number of teachers 137 87 190 34 224

Activities or events participated in Clean campaigns inside the school (74.4) * (80.4) * 76.4 School gardening (33.3) * (28.3) * 27.3 Health education seminars at school (12.8) * (8.7) * 9.1 Housekeeping (5.1) * (8.7) * 7.3 Implementing health campaigns (28.2) * (23.9) * 23.6 Producing wall magazines/posters (28.2) * (21.7) * 23.6 Activities during morning assembly (5.1) * (4.3) * 3.6 Open day (5.1) * (6.5) * 5.5 Peer education activities (10.3) * (6.5) * 7.3 Other (2.6) * (10.9) * 9.1

Number of teachers who participated in activities to promote student’s health 39 16 46 9 55

Reason for not participating in activities or events No such activities run in school 60.2 66.2 61.8 * 62.7 I don’t have time to participate 25.5 23.9 27.1 * 24.9 I don’t believe in such activities 5.1 1.4 3.5 * 3.6 Other 11.2 8.5 8.3 * 10.1

Number of teachers who didn’t participate in activities to promote student’s health 98 71 144 25 169


Student’s exposure to mass media 17

4 STUDENT’S EXPOSURE TO MASS MEDIA Mass media plays an important role in increasing the knowledge of population. Exposure to mass media by school students increases their awareness about different subjects including health and sanitation issues. This chapter presents information about the exposure of primary school children in Djibouti to mass communication channels. The information that will be presented in this chapter could help communication –for-development program to identify the best communication channels that could be used for health/ sanitation messages for school students.

4.1 Exposure to Mass Media

4.1.1 Exposure to different mass communication channels Table 4.1 shows information about the percentage of students who were exposed to specific media channels (TV, radio or magazines) at least once per week. This includes those exposed to media channels everyday or at least once per week. Overall, data showed that 48 percent of students watched TV at least once per week, 24 listened to the radio at least once per week, and same percentage read magazines at least once per week. Results varied by different background characteristics. Younger children were more interested in watching television than older ones where 63 percent of children less than 9 years reporting watching TV at least once per week compared with only 38 percent of children aged 11 and older. However, differentials by residence are striking. Only 8 percent of students in rural areas watch television at least once per week compared to 75 percent of students in urban areas. Moreover, the percentage of students in private school watching television more than once per week were higher than those students in public school (85 percent and 42 percent respectively).

Table 4.1 Exposure to mass media Percentage of students who are exposed to specific media at least once per week by background characteristics, Djibouti, SHSS 2009.

Background Characteristic

Watches television at least

once a week

Listens to theradio at least once a week

Reads a magazines at least

once a week

All three mediaat least once a

week

No media at least

once a week

Number of

students

Age Less than 9 62.5 17.9 35.7 3.6 21.4 56 9-10 52.5 25.0 27.0 6.0 30.0 737 11-12 38.0 23.2 17.7 4.0 44.9 323 13+ 38.3 33.4 15.0 1.7 36.7 60

Sex Male 47.6 25.2 20.8 5.4 37.5 634 Female 48.5 23.5 27.9 4.8 30.3 547

Grade 4th grade 47.6 22.3 27.0 6.1 35.3 558 5th grade 48.5 26.6 21.6 4.2 33.3 622

School location Urban 74.8 23.1 33.1 8.2 15.1 707 Rural 8.4 26.6 10.8 0.4 62.7 474

School type Public 41.9 25.4 24.6 5.4 38.8 1006 Private 84.5 18.9 21.1 3.4 8.0 175

Total 48.2 24.4 24.2 5.1 34.2 1181

The differentials among the students regarding listening to the radio was different than TV. On the contrary to the TV, older children are more likely than younger students to listen to the radio at least once per week (33 percent of students aged 13 and older listen to the radio at least once per week compared with only 18 percent of students less than 9 years). Listening to radio at least once


per week was 27 percent in rural areas compared to 23 percent in urban areas. The percentage of students listing to radio at least once per week is higher among public schools students (25 percent) than private schools students (19 percent).

Regarding reading magazines, the percentage of younger students were higher than those older students (36 percent of students less than 9 years old and 15 percent of students aged 13 and older). Interestingly, reading magazines is higher among female students compared with male students (28 percent and 21 percent respectively), and among school students in urban areas more than in rural areas (33 percent and 11 percent respectively).

Moreover, Table 4.1 shows that about one third of school students in Djibouti are not exposed to any media at least once per week, most of them were in rural areas (63 percent) and in public school (39 percent).

4.1.2 Exposure to television For better planning for communication and health promotion campaigns using the television as a channel for communication, it is important to know the best times of watching television and the preferred channels and programs. Table 4.2 shows the percent distribution of students by the frequency of watching TV and among those who watched TV during the past 4 weeks percentage according to the times of watching, the three most watched TV channels and the three most watched TV programs.

Table 4.2 indicates that almost half of the students reported that they watched TV during the 4 weeks prior to the survey: 41 percent watched TV everyday, 7 percent watched TV at least once a week and less than 1 percent watched TV at least once a month. Urban students are much more likely than rural students to watch TV everyday (64 percent of students residing in urban areas reported watching TV everyday compared to 8 percent only among those in rural areas).

Data shows that, 75 percent of the children watched the television at evening time (between 6 pm and 9 pm), 27 percent watches it in the afternoon (between 3 pm and 6 pm), and 17 percent reported watching it at night (after 9 pm). As expected the least time for TV watching was the morning times especially between 9 am and 12 pm (3 percent), as most of the school students were in their schools at that time. Same watching pattern is observed among students in urban and rural schools.

Table 4.2 Exposure to Television Percent distribution of students by frequency of watching TV and among those who watched TV during the last 4 weeks percentage by times of watching TV, the three most watched channels, the three most watched TV programs, and mean number of hours watching TV per day , by urban-rural school location, Djibouti, SHSS 2009.

Urban Rural Total

Frequency of watching TV Everyday 63.9 7.8 41.4

At least once a week 10.9 0.6 6.8 At least once a month 0.4 0.0 0.3 Didn’t watch TV in the past 4 weeks 9.6 9.7 9.7 Don’t own TV 15.1 81.9 41.9

Number of students 707 474 1181

Times of watching TV Morning (6 am : 9 am) 12.0 (10.0) 11.9 Forenoon (9 am: 12 pm) 3.4 (2.5) 3.3 Noon (12 pm: 3 pm) 9.8 (12.5) 10.0 After noon (3 pm: 6 pm) 28.2 (10.0) 26.9 Evening (6 pm: 9 pm) 74.2 (85.0) 75.0 Night (after 9 pm) 16.0 (27.5) 16.8 No specific time 3.8 (0.0) 3.5

Three most watched TV channels Rtd tv 70.3 (85.0) 71.3 T V 5 32.5 (10.0) 30.9 MBC 63.9 (65.0) 64.0 2m (Maroc) 6.2 (2.5) 5.9

Zee Aflam (ar.) 19.2 (42.5) 20.8 Etn (som) 4.3 (0.0) 4.0

Ertv (erythree) 2.8 (0.0) 2.6 LBC (liban) 2.6 (0.0) 2.4 France 24 6.0 (0.0) 5.6 Canal + harizons 11.5 (0.0) 10.7 Nessma (films) 21.6 (35.0) 22.6 Other 7.9 (2.5) 7.5

Three most watched TV programmes Cartoon 66.2 (6.4) 38.6 TV series 20.1 (40.0) 21.5 Films 59.0 (52.5) 58.6 Sports 29.1 (25.0) 28.8 Talk show 1.9 (7.5) 2.3 Educational programme 8.3 (2.5) 7.9 Documentary 3.6 (0.0) 3.3 Religious programme 36.8 (40.0) 37.1 Other 4.7 (15.0) 5.4 None 1.7 (0.0) 1.6 Don’t Know 5.8 (0.0) 5.4

Mean number of hours watching TV per day 1.9 (0.9) 1.8

Number of students who watch TV 532 40 572



The French channel Rtd, was the most watched TV channels by the school children during the week prior to the survey either in urban or rural schools (71 percent), followed by the Arabic channel MBC (64 percent). Zee aflam is watched by a quite high percentage of rural students (43 percent) while the French channel TV 5 is watched by a quite high percentage of urban students (33 percent).

Regarding the most watched TV programs by the school students, cartoon programs was the most TV program that watched by urban students (66 percent), followed by films (49 percent and religious programs (37 percent). Among rural students, the most watched TV program was films (53 percent) followed by TV series and religious programs (40 percent each). The mean number of hours spent watching television is 1.8 hour per day and is much higher among urban students (1.9 hour/day) than rural students (0.9 hour /day).

4.1.3 Exposure to the radio Radio is a common mass media channel especially in rural areas. Table 4.3 shows information about the percentage of school students in Djibouti according to their exposure to the radio. Overall, one- quarter of the students reported that they listened to the radio during the past 4 weeks, whereas 54 percent reported that they didn’t listen to it and 21 percent reported that they don’t have a radio. Variations exist by urban-rural residence. Two-thirds of urban students didn’t listen to the radio during the 4 weeks preceding the survey compared to 38 percent among students in rural areas.

The times that school children listen the most to the radio are in the afternoon (45 percent), followed by in the morning (44 percent) and the evening (29 percent).

The radio channel that are heard the most during the week prior to the survey are the Rtd (97 percent) followed by BBC either by Somali languages or Arabic languages (21 percent), and voice of America (18 percent). Regarding the radio programs, religious programs are the most programs listened to (57 percent) followed by news (50 percent) and radio series (43 percent).

Table 4.3 Exposure to the radio Percent distribution of students by frequency of listening to the radio and among those who listened to the radio during the last 4 weeks percentage by times of listening to radio, the three most listened to radio channels, the three most listened to radio programs, by urban-rural school location, Djibouti, SHSS 2009.

Urban Rural Total

Frequency of listening to radio Everyday 13.2 17.1 14.7 At least once a week 9.9 9.5 9.7

At least once a month 0.3 0.0 0.2 Didn’t listen to the radio in the past 4 weeks 67.0 35.7 54.4

Don’t own radio 9.6 37.8 20.9


Times of listening to radio Morning (6 am : 9 am) 34.5 55.6 43.6 Forenoon (9 am: 12 pm) 6.1 2.4 4.5 Noon (12 pm: 3 pm) 12.1 3.2 8.2 After noon (3 pm: 6 pm) 30.9 62.7 44.7 Evening (6 pm: 9 pm) 26.1 31.7 28.5 Night (after 9 pm) 21.2 32.5 26.1 No specific time 8.5 1.6 5.5

Three most listened to radio channels Rtd 95.8 99.2 97.3 Sawa (ar.) 22.4 4.0 14.4 Voice of America 21.2 12.7 17.5 BBC (som., ar.) 25.5 15.1 21.0 Other 3.0 0.8 2.1

Three most listened to radio programmes

Radio series 35.2 53.2 43.0 News 38.2 64.3 49.5 Radio films 35.2 9.5 24.1 Sports 17.0 7.9 13.1 Talk show 3.6 2.4 3.1 Educational programme 23.0 13.5 18.9 Documentary 1.8 0.0 1.0 Religion programme 49.1 67.5 57.0 Other 1.2 17.5 8.2 None 1.8 3.2 2.4 Don’t Know 12.7 2.4 8.2

Number of students who listen to the radio 165 126 291


4.1.4 Exposure to printed media Table 4.4 shows the percent distribution of students by the frequency of reading newspapers/magazines and percentage of students who read newspaper/ magazines by urban/rural school location. In general, 30 percent only of students reported reading newspapers/magazines in the 4 weeks preceding the survey. Reading newspapers/ magazines is more common among students in urban areas than those in rural areas; 42 percent of urban students read newspapers/magazines in the past 4 weeks compared to 12 percent only among those in rural areas. Bandes dessiness is the most printed materials that were read during the week prior to the survey (70 percent) followed by Lucky luke (35 percent) mickey (31 percent).

4.2 Communication about Health Hygiene

Mass communication channels should be used for health promotion through communicating health and sanitation messages. The school hygiene and sanitation survey collected data regarding the exposure of school children in Djibouti to general cleanliness or health hygiene. These data are shown in Table 4.5. Results show that 41 percent of school students received information about general cleanliness and health hygiene within the six months prior to the survey. The percentage is higher among urban students than rural ones (50 percent and 27 percent respectively).

Regarding the sources of information, mass media is the highest source of information (82 percent), followed by the school (73 percent), then family and relatives (51 percent). Health activities and community activities were the least sources for cleanliness and health hygiene information (20 percent and 10 percent respectively).

On individual basis, teachers recorded the highest percentages, where 53 percent of school students reported that teachers were the source of information, 51percent reported television, 44 percent reported the radio and 38 percent reported parents/caretakers. Moreover, school books was reported by 32 percent. Relatives were much more likely to be reported by rural students than urban students (33 percent and 4 percent respectively)

Table 4.4 Exposure to printed media Percent distribution of students by frequency of reading newspapers/magazines and among those who read newspaper/magazines during the last 4 weeks percentage by the most read newspaper/magazines, by urban-rural school location, Djibouti, SHSS 2009.

Urban Rural Total

Frequency of reading newspapers/ magazines

Everyday 11.2 7.4 9.7 At least once a week 21.9 3.4 14.5 At least once a month 9.1 1.3 5.9 Didn’t read any newspaper/magazine the past 4 weeks 57.9 88.0 69.9


Most read newspapers/magazine Lucky luke 37.9 19.3 34.9 Spirou (fr) 19.5 5.3 17.2 Mickey (fr) 29.9 38.6 31.3 Bandes dessinees 68.1 77.2 69.6 Other 19.1 22.8 19.7

Number of students who read newspaper/magazine 298 57 355

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Percentage whocleanness and he

Number of stud

Source of knowlMass media

T.V Radio Newspapers

Community Festival plays Meeting, activiMarathons

Schools Schools books Schools activitiDisplays in the Meeting Teachers

Health activitiesHealth providerPrograms and aPosters and flie

Family and relaParents/guardiaRelatives Friends

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Figure 4.1 Soclean

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707

84.2 65.7 36.5 0.3 11.0 7.9 2.8 0.3 68.9 34.0 14.9 0.8 0.6 46.9 20.1 2.2 4.5 13.5 42.9 38.5 3.9 3.1 0.6

ation 356

34

4

2

Schools b

ources of knownliness and he

Urban

udent’s exposu

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Rural Total

27.0 41.0

474 1181

75.8 82.0 11.7 51.4 64.1 43.8 2.3 0.8 5.5 9.5 0.8 6.0 3.9 3.1 0.8 0.4 85.2 73.2 25.8 31.8 13.3 14.5 0.0 0.6 1.6 0.8 69.5 52.9 20.3 20.1 0.0 1.7 2.3 3.9 18.0 14.7 71.9 50.6 35.9 37.8 32.8 11.6 5.5 3.7 0.0 4

128

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21

Student’s knowledge of proper hygiene habits 23


Student's knowledge of proper hygiene habits is the milestone for any health and sanitation school program. It is known that hand washing is one of the most important hygiene behaviors needed for reducing the incidence of infectious diseases especially diarrhea. This basic information must be known to students to help and support sanitation programs in schools. The aim of this chapter is to identify the knowledge of the students in Djibouti about the proper hygiene habits.

5.1 Student’s knowledge of ways to protect from illness The types of questions used in the questionnaires for this part were open ended questions, that may have more than one answer, and with the probing technique of the interviewers, they helped the students to mention all what they know about the possible answers. Table 5.1 shows the data about the children knowledge of what they should do to keep them clean and protect them from diarrhea according to different background characteristics. Ninety five percent of the students mentioned that they must wash their hands after going to toilets as one method to protect themselves against diarrhea and stomachache, 73 percent of students mentioned use clean water, 38 percent mentioned wash fruits and vegetables is a method to protect them from getting diarrhea, one-third mentioned use latrine as a method of protection, 31 percent reported eating well cooked food, and 25 percent reported drinking clean/boiled water.

Table 5.1 Knowledge of ways of protection from stomachache and diarrhea by background characteristics Percentage of primary school students by knowledge about ways of protection against getting stomachache and diarrhea, according to background characteristics, Djibouti, SHSS 2009


Wash hands after going to bathroom

Use clean water

Use latrine

Eat well cooked

foodDrink clean/ boiled water

Wash fruits and

vegetables Other

Percentage of who identified at least one correct way1

Number of

students

Age Less than 9 92.9 87.5 39.3 46.4 32.1 58.9 1.8 100.0 56 9-10 95.9 74.2 37.2 30.9 26.7 36.4 0.3 99.6 737 11-12 94.4 66.9 27.6 27.9 19.2 35.9 0.6 99.1 323 13+ 96.7 75.0 38.3 36.7 21.7 46.7 0.0 100.0 60 Sex Male 95.9 73.3 33.8 28.1 24.1 35.3 0.2 99.5 634 Female 94.9 72.6 35.6 34.6 25.4 40.4 0.7 99.5 547 Grade 4th grade 94.3 69.5 35.5 32.1 26.9 40.9 0.4 99.6 558 5th grade 96.5 76.2 33.9 30.2 22.8 34.9 0.5 99.4 622 Female guardian education No education 95.2 66.6 26.8 26.2 17.3 34.6 0.4 99.6 734 Primary/preparatory 93.5 78.1 47.9 43.2 37.9 47.9 0.0 99.4 169 Secondary (96.8) (80.6) (54.8) (54.8) (48.4) (67.7) (0.0) (100.0) 31 More than secondary * * * * * * * * 23 Don’t know 97.3 87.9 43.9 31.8 31.8 34.5 0.0 99.6 223 Male guardian education No education 94.4 66.6 24.9 23.6 16.1 31.2 0.3 99.8 590 Primary/preparatory 95.7 72.0 40.6 33.1 31.5 43.3 0.0 98.8 254 Secondary 98.2 75.0 48.2 48.2 41.1 57.1 0.0 100.0 56 More than secondary 98.3 80.0 61.7 58.3 56.7 66.7 1.7 100.0 60 Don’t know 96.4 88.7 43.0 37.1 27.1 35.7 0.9 99.1 221 Location Urban 95.3 73.8 43.0 43.0 29.7 45.7 0.6 99.4 707 Rural 95.6 71.7 22.2 13.3 17.3 25.7 0.2 99.6 474 Type of school Public 94.7 70.8 29.6 26.1 22.2 35.3 0.3 99.4 1006 Private 99.4 85.7 63.4 59.4 39.4 51.4 1.1 100.0 175 Total 95.4 73.0 34.6 31.1 24.7 37.7 0.4 99.5 1181

Includes primary school students who reported one of the following ways to protect themselves from stomachache and diarrhea: Wash hands after going to bathroom, use clean water, drink clean/boiled water, or wash fruits and vegetables. Note: Figures in parentheses are based on 30-50 unweighted cases, An asterisk indicates figure based on fewer than 30 unweighted cases and has been suppressed.


Data varied according to different background characteristics. By age, surprisingly, students less than 9 years old are more likely than all other students to report different ways for protecting themselves from getting stomachache and diarrhea (with the exception of washing hands after going to the bathroom). Moreover, students from urban schools are more likely than students from rural schools to report different ways for protecting themselves from getting stomachache and diarrhea (with the exception of washing hands after going to the bathroom).

Data also revealed that the type of school was an important factor in students’ knowledge about different ways for protecting themselves from getting stomachache and diarrhea. Students from private schools are by far likely than students from public schools to report different ways for protecting themselves from getting stomachache and diarrhea.

Table 5.2 presents student’s knowledge of protective measures against contracting stomachache or diarrhea by selected characteristics. The table shows that there are no variations in the percentage who identified at least one correct protective measure by selected characteristics. However, minor differentials are observed for each reported protective way. For example, students whose schools offer education on hygiene and environmental sanitation, those who participated actively in maintaining hygiene, those exposed to information about cleanness and health hygiene during the 6 months preceding the survey are more likely than their counterparts to reported drinking clean water or boiled water as a way to protect themselves against stomachache and diarrhea. Also, students whose schools reported that students participate actively in maintaining hygiene were twice as likely as those who didn’t participate to report washing fruits and vegetables as a method of protection against stomachache and diarrhea.

Table 5.2 Knowledge of ways of protection from stomachache and diarrhea by selected characteristics Percentage of primary school students by knowledge about ways of protection against getting stomachache and diarrhea, according to selected characteristics, Djibouti, SHSS 2009

Selected characteristics

Wash hands after

going to bathroom

Use clean water

Use latrine

Eat well cooked

food

Drink clean/ boiled water

Wash fruits and vegetables Other

Percentage of who identified

at least one correct way1

Number of

students

School offers education on hygiene and environmental sanitation

Yes 95.1 73.4 34.2 30.1 26.7 37.5 0.3 99.4 1007 No 96.6 71.1 34.9 34.2 14.8 43.6 1.3 100.0 149 Don’t know * * * * * * * * 25

School students participate actively in maintaining hygiene

Yes 95.1 75.2 37.2 31.7 29.1 40.3 0.3 99.4 874 No 95.5 61.7 14.3 19.5 11.3 19.5 0.0 99.2 133

Exposed to information about cleanness and health hygiene during the past 6 months

Yes 96.5 77.3 35.7 31.8 28.9 45.9 0.4 99.6 484 No 94.7 70.0 33.9 30.6 21.8 32.0 0.4 99.4 697 Total 95.4 73.0 34.6 31.1 24.7 37.7 0.4 99.5 1181

Includes primary school students who reported one of the following ways to protect themselves from stomachache and diarrhea: Wash hands after going to bathroom, use clean water, drink clean/boiled water, or wash fruits and vegetables. Note: An asterisk indicates figure based on fewer than 30 unweighted cases and has been suppressed.

5.2 Students’ attitude towards the importance of hand washing

Hand washing is very essential in prompted situations like before eating, after eating, after using toilets and after caring for animals. Table 5.3 shows the percentage of students by their opinion regarding the importance of hand washing at the four essential situations. Data showed that students know about the appropriate hand washing practices. Almost all students (98 percent) reported that it is important to wash hands with water and soap before eating or after using the toilet, 96 percent mentioned after eating. Surprisingly, only 64 percent reported that it is important


to wash hands with water and soap after taking care of home/farm animals. Differentials are very minor by background characteristics.

Table 5.3 Knowledge of appropriate hand washing practices by background characteristics Percentage of students who reported that washing hands with water and soap is important in prompted situations, according to background characteristics, Djibouti, SHSS 2009

Background characteristics Before eating

After eating

After using the

toilet

After taking care of home/ farm animals

Number of

students

Age Less than 9 98.2 98.2 98.2 62.5 56 9-10 97.4 96.3 98.8 63.4 737 11-12 97.8 96.9 96.6 65.3 323 13+ 98.3 98.3 96.7 61.7 60

Sex Male 97.6 96.1 97.6 64.8 634 Female 97.4 96.7 98.0 62.3 547

Grade 4th grade 97.3 96.1 99.1 65.9 558 5th grade 97.7 96.6 96.6 61.7 622

Female guardian education No education 97.1 96.5 97.5 65.9 734 Primary/preparatory 98.8 94.1 98.2 64.5 169 Secondary (100.0) (96.8) (100.0) (77.4) 31 More than secondary * * * * 23 Don’t know 97.3 97.3 97.8 54.3 223

Male guardian education No education 98.6 96.3 97.8 66.3 590 Primary/preparatory 96.9 94.5 98.8 64.6 254 Secondary 100.0 98.2 98.2 58.9 56 More than secondary 91.7 98.3 100.0 68.3 60 Don’t know 96.4 97.7 95.9 55.7 221

Location Urban 96.7 96.3 98.0 63.4 707 Rural 98.7 96.4 97.5 64.1 474

Type of school Public 97.2 95.9 97.5 61.1 1006 Private 99.4 98.9 99.4 78.3 175

Total 97.5 96.4 97.8 63.7 1181


Table 5.4 shows the relation between student’s knowledge of appropriate hand washing practices and exposure to hygiene related information, as well as school hygiene education or activities. The table indicates that there is no relation between student’s knowledge and the selected characteristics. For example, student’s whose school reported that students participate actively in maintaining hygiene were less likely than those whose schools reported that students don’t participate actively in maintaining hygiene to agree that it is important to wash hands with water and soap after taking care of home or farm animals.


Table 5.4 Knowledge of appropriate hand washing practices by selected characteristics Percentage of students who reported that washing hands with water and soap is important in prompted situations, according to selected characteristics, Djibouti, SHSS 2009

Selected characteristics Before eating

After eating

After using the

toilet

After taking care of home/ farm animals

Number of

students


Yes 97.2 96.3 97.5 60.2 1007 No 99.3 96.6 99.3 89.3 149 Don’t know * * * * 25


Yes 97.8 96.2 97.8 57.6 874 No 93.2 97.0 95.5 77.4 133


Yes 97.5 97.5 97.7 60.7 484 No 97.6 95.6 97.8 65.7 697

Total 97.5 96.4 97.8 63.7 1181

Note: An asterisk indicates figure based on fewer than 30 unweighted cases and has been suppressed.

Table 5.5 presents information about the percentage of students by their reported importance of washing hands with water and soap. Data shows that 96 percent of students reported that washing hands with water and soap reduces the chance of getting diarrhea, 60 percent reported that it reduces the chance of getting other diseases/infection, 54 percent reported that it reduces stomachache, and 49 percent reported that it keeps hands clean. Only 23 percent of students reported that washing hands with water and soap is a religious belief.

Differentials according to the different background characteristics are minor. However, students from urban and private schools were more likely than those from rural and public schools to report the importance of washing hands with water and soap. In addition, children aged 13 and over were more likely than those less than 9 years old to report that washing hands with water and soap is a religious belief (38 percent and 20 percent respectively). Moreover, student’s whose female or male guardian or parent has not attained any education were the least likely to report that hand washing is important to reduce the chances of getting other diseases/ infections, Keep hands clean and for religious beliefs.


Table 5.5 Knowledge of the importance of hand washing with water and soap by background characteristicsPercentage of students by their reported importance of washing hands with water and soap, according to background characteristics, Djibouti, SHSS 2009


Reduces the chances of

getting diarrhea

Reduces the chances of getting other

diseases/ infections

Keep hands clean

Reduces stomach-

ache Religious

beliefs Other Number of

students

Age Less than 9 100.0 83.9 60.7 60.7 19.6 0.0 56 9-10 96.1 63.5 52.8 56.4 21.8 0.3 737 11-12 95.7 48.6 40.6 50.2 23.5 0.0 323 13+ 95.0 60.0 41.7 45.0 38.3 0.0 60

Sex Male 95.9 57.6 47.3 54.7 21.3 0.3 634 Female 96.3 62.9 51.6 53.7 25.0 0.0 547

Grade 4th grade 95.9 60.6 50.4 57.7 24.0 0.2 558 5th grade 96.3 59.6 48.2 51.1 22.2 0.2 622

Female guardian education No education 95.1 51.2 42.9 50.4 20.8 0.3 734 Primary/preparatory 95.9 68.0 52.1 65.7 30.2 0.0 169 Secondary (96.8) (58.1) (51.6) (71.0) (32.3) (0.0) 31 More than secondary * * * * * * 23 Don’t know 99.1 81.2 67.3 54.7 22.0 0.0 223

Male guardian education No education 95.1 50.5 41.2 48.8 20.3 0.3 590 Primary/preparatory 94.9 63.8 52.8 60.2 28.7 0.0 254 Secondary 96.4 62.5 60.7 67.9 32.1 0.0 56 More than secondary 98.3 68.3 56.7 68.3 35.0 0.0 60 Don’t know 99.5 78.3 62.0 54.8 18.1 0.0 221

Location Urban 96.5 62.4 54.6 53.5 30.3 0.3 707 Rural 95.6 56.5 41.4 55.5 12.2 0.0 474

Type of school Public 95.7 57.8 47.4 54.9 20.3 0.2 1006 Private 98.3 73.1 60.0 50.9 38.9 0.0 175

Total 96.1 60.0 49.3 54.3 23.0 0.2 1181


Analysis of student’s knowledge of the importance of hand washing with water and soap has been carried by selected characteristics as well and are presented in Table 5.6. Results indicated that student’s whose school offers education on hygiene and environmental sanitation, student’s whose schools reported that students participate actively in maintaining hygiene, and those exposed to information about cleanness and health hygiene during the past 6 months were more likely than other students to report that hand washing is important to reduces the chances of getting other diseases/ infections, keep hands clean, and that it reduces stomachache.


Table 5.6 Knowledge of the importance of hand washing with water and soap by selected characteristics Percentage of students by their reported importance of washing hands with water and soap, according to selected characteristics, Djibouti, SHSS 2009

Selected characteristics

Reduces the chances of

getting diarrhea

Reduces the chances of getting other

diseases/ infections

Keep hands clean

Reduces stomach-

ache Religious

beliefs Other

Number of

students


Yes 96.7 61.5 50.1 57.6 21.4 0.2 1007 No 91.9 45.0 45.0 37.6 32.2 0.0 149 Don’t know * * * * * * 25


Yes 96.6 62.4 51.5 58.7 22.9 0.2 874 No 97.7 55.6 41.4 50.4 11.3 0.0 133


Yes 96.3 67.1 59.5 57.9 31.2 0.4 484 No 96.0 55.1 42.2 51.8 17.4 0.0 697

Availability of soap at school hand washing facilities

Bar soap 96.0 60.0 50.5 58.9 25.8 0.0 275 Liquid soap 98.0 73.3 54.0 44.0 18.7 0.0 150 Ash/mud/sand 100.0 78.7 40.0 45.3 4.0 0.0 75 None 96.1 58.4 49.0 53.9 23.0 0.2 831

Total 96.1 60.0 49.3 54.3 23.0 0.2 1181


5.3 Students’ knowledge towards specific hygienic practices

In order to assess the knowledge of the school students about the benefits of specific hygienic practices on their health, there were some statements mentioned to the students and they have to answer if they strongly agree, agree, neutral, disagree or strongly disagree with these statements. Table 5.7 shows the agreement of the students about these hygienic practices. Data show that overall, 91 percent of students agree that not washing hands with water and soap before eating can lead to serious diseases, and 86 percent agree that using an unclean toilet can lead to diseases. Students from public and rural schools and older students are more likely than other students to report agreement with both of these statements.

As shocking result, agreement with the two statements “It is ok to drink from the same glass with my friends” and “Washing hands with water only after using the bathroom is enough to protect from diseases” is quite high (65 percent and 63 percent respectively). Students from public and rural schools and male students are more likely than other students to report agreement with both of these statements.

Moreover, data showed that less than half of students agree with both statements “Playing near the garbage and waste water ponds is not danger” and “fruits that look clean do not need to be washed before eating”, however, percentages are still high (44 percent and 42 percent respectively). Younger students are the most likely to report agreement with these statements.

Slightly more than one quarter of students agreed that “If hands look clean then you don’t need to wash them before eating”. Differentials by location and type of school are striking. Public school students are by far more likely than private school students to report agreement with this statement (31 percent and 5 percent respectively), and rural school students are more likely than urban school students to report agreement with this statement (41 percent and 18 percent respectively).


Table 5.7 Knowledge of specific hygiene habits by background characteristics Percentage of students who agree to prompted statements on specific hygiene habits, according to background characteristics, Djibouti, SHSS 2009

Background characteristic

Not washing hands with

water and soap before eating can lead to

serious diseases

Washing hands with water only after using the bathroom is

enough to protect from diseases

It is ok to drink from the same

glass with my friends

Fruits that look clean

do not need to be washed before eating

If hands look clean then you don’t

need to wash them before

eating

Number of

students

Age Less than 9 87.5 64.3 53.6 44.6 19.6 56 9-10 90.5 61.1 65.8 43.7 29.0 737 11-12 94.7 66.9 66.9 39.9 26.0 323 13+ 90.0 60.0 60.0 23.3 18.3 60

Sex Male 92.9 66.1 68.3 40.5 27.4 634 Female 89.4 58.3 61.4 42.8 27.1 547


Female guardian education No education 91.1 64.2 67.2 43.3 29.3 734 Primary/preparatory 96.4 62.1 64.5 37.9 21.9 169 Secondary (96.8) (61.3) (41.9) (32.3) (12.9) 31 More than secondary * * * * * 23 Don’t know 86.5 62.3 66.8 39.5 27.8 223

Male guardian education No education 92.2 63.1 68.1 42.2 30.7 590 Primary/preparatory 89.8 60.6 70.9 42.1 25.2 254 Secondary 94.6 67.9 58.9 37.5 16.1 56 More than secondary 91.7 48.3 26.7 43.3 20.0 60 Don’t know 89.6 65.6 62.4 39.8 25.3 221

Location Urban 87.3 59.0 56.6 42.0 18.0 707 Rural 97.3 67.7 77.8 40.9 41.1 474

Type of school Public 91.5 64.7 69.5 43.4 31.2 1006 Private 90.3 49.7 40.0 30.9 4.6 175

Total 91.3 62.5 65.1 41.6 27.3 1181


Table 5.8 illustrates the level of agreement of the students about some hygienic practices by selected characteristics. Students whose school students participate actively in maintaining hygiene were less likely to agree that washing hands with water only after using the bathroom is enough to protect from diseases than those in schools where students don’t participate actively in maintaining hygiene (63 percent compared to 74 percent). On the contrary, those whose school offers education on hygiene and environmental sanitation were more likely to agree to the same statement than students in other schools. Despite of the variations reported by selected characteristics in the level of agreement that “washing hands with water only after using the bathroom is enough to protect from diseases” yet it has to be noted that the level of agreement is generally high. Also, students who are exposed to information about cleanness and health hygiene in the 6 months prior to the survey are less likely than those who were not exposed to such information to agree that if hands look clean then they don’t need to wash them before eating (23 percent compared to 30 percent respectively).

3 Stud30

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Yes No

Expcleanduri

Yes No

Tota

Note

Source

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: An asterisk indica

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Not washing hands with

water and soap before eating can lead to

erious diseases

91.3 99.3

*

91.0 93.2

89.9 92.3

91.3

fewer than 30 unwe

general clea

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7.7

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Washing handswith water only after using the bathroom is

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64.3 53.0

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62.8 74.4

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It is ok to drink from the same

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lon

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66.3 51.0

*

64.5 78.2

53.9 72.9

65.1

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Fruits that ook clean do not need to be washed

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If hcy

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44.5 28.2

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43.0 54.1

40.7 42.2

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Nu

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22.9 430.3 6

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Table 5.9 Importance of cleanness by background characteristics Percentage of students by the reported importance of being clean, according to background characteristics, Djibouti, SHSS 2009

Background characteristic Health Smell

Status in family/ community

It is not good to be clean Other

Number of students

Age Less than 9 98.2 62.5 23.2 1.8 0.0 56 9-10 98.4 62.8 20.9 0.9 0.5 737 11-12 97.5 55.1 9.0 0.6 0.3 323 13+ 98.3 71.7 16.7 0.0 0.0 60

Sex Male 98.4 60.7 15.8 0.8 0.5 634 Female 97.6 62.0 19.7 0.9 0.4 547


Female guardian education No education 97.5 58.0 15.5 0.5 0.7 734 Primary/preparatory 99.4 72.8 13.0 1.2 0.0 169 Secondary (96.8) (64.5) (12.9) (0.0) (0.0) 31 More than secondary * * * * * 23 Don’t know 99.1 61.4 28.7 1.8 0.0 223

Male guardian education No education 96.8 56.6 13.7 0.5 0.8 590 Primary/preparatory 100.0 66.1 23.2 0.4 0.0 254 Secondary 98.2 71.4 16.1 0.0 0.0 56 More than secondary 100.0 78.3 11.7 1.7 0.0 60 Don’t know 98.6 61.1 23.5 2.3 0.0 221

Location Urban 98.4 67.6 16.4 1.3 0.3 707 Rural 97.5 51.9 19.4 0.2 0.6 474

Type of school Public 97.9 57.4 18.8 1.0 0.5 1006 Private 98.9 84.0 10.9 0.0 0.0 175

Total 98.1 61.3 17.6 0.8 0.4 1181


Table 5.10 presents the percentage of students by the reported importance of being cleaning by selected characteristics.

Table 5.10 Importance of cleanness by selected characteristics Percentage of students by the reported importance of being clean, according to selected characteristics, Djibouti, SHSS 2009

Selected characteristics Health Smell

Status in family/ community

It is not good to be clean Other

Number of students


Yes 97.8 60.2 18.9 1.0 0.4 1007 No 99.3 72.5 2.7 0.0 0.7 149 Don’t know * * * * * 25


Yes 98.4 61.8 17.8 0.9 0.1 874 No 94.0 49.6 25.6 1.5 2.3 133 Missing 14.9 16.3 8.7 0.0 20.0 174


Yes 98.3 66.9 22.9 0.6 0.6 484 No 97.8 57.4 13.9 1.0 0.3 697

Total 98.1 61.3 17.6 0.8 0.4 1181



When students were asked about from where do they usually learn about general cleanness and personal hygiene, three-quarter of them reported that they have learned about hygiene and cleanness from home, 56 percent have learned about it at school, and 36 percent have learned about it via radio or television. Only 8 percent of the students reported that they learn about general cleanness and personal hygiene at health facilities and 5 percent reported friends as their source of knowledge.

Looking at variations by background characteristics, it is clear that students in public schools are more likely than those in private schools to report that they learn about general cleanness and personal hygiene at school (58 percent and 42 percent respectively). By urban-rural residence, students residing in urban areas are more likely to report home as a source of knowledge than those in rural areas.

[

Table 5.11 Sources of knowledge about general cleanness and personal hygiene Percentage of students by source of knowledge about general cleanness and personal hygiene, according to background characteristics, Djibouti, SHSS 2009

Background characteristic Home School

Health facility Friends

TV/ Radio

Magazines Other

Don’t know

Number of students

Age Less than 9 83.9 75.0 7.1 .0 46.4 8.9 0.0 1.8 56 9-10 77.1 53.7 8.4 5.3 38.4 5.3 0.4 0.0 737 11-12 69.0 59.4 5.9 5.6 30.7 1.5 1.5 0.3 323 13+ 80.0 48.3 10.0 1.7 35.0 3.3 0.0 0.0 60

Sex Male 74.1 58.4 5.4 3.3 33.9 3.9 0.8 0.3 634 Female 76.4 53.4 10.4 6.8 39.1 4.8 0.5 0.4 547

Grade 4th grade 72.4 56.5 7.9 5.0 34.2 4.5 0.4 0.2 558 5th grade 77.7 55.8 7.6 4.8 38.3 4.2 1.0 0.5 622

Location Urban 77.4 56.6 11.7 7.5 42.6 5.9 0.6 0.1 707 Rural 71.9 55.3 1.7 1.1 27.0 1.9 0.8 0.6 474

Type of school Public 73.1 58.4 6.8 4.4 36.4 5.1 0.7 0.4 1006 Private 87.4 42.3 13.1 8.0 36.0 0.0 0.6 0.0 175

Total 75.2 56.1 7.7 4.9 36.3 4.3 0.7 0.3 1181

Table 5.12 shows the percentage of students who reported that their schools provide health hygiene activities/education, and percent distribution by the frequency of offering health hygiene activities and percentage by when are those activities provided. Overall, 94 percent of students reported that their schools provide health hygiene activities. Differentials are minor by background characteristics.

Regarding the frequency of receiving health hygiene activities, 42 percent reported that they get the health hygiene activities once per week, 28 percent reported once or twice per week, and 17 percent reported everyday. Students aged 9 years and less and students from public schools are the most likely to be given health hygiene activities everyday (25 percent and 19 percent respectively).

Students were asked about the timing of receiving health hygiene education. Data shows that65 percent receives it during classes, 13 percent receive it during breaks, and 11 percent receives it during school activities. In addition, 10 percent reported receiving it during sports activities. Some differentials exist by background characteristics. Fifteen percent of public school students reported receiving health hygiene education during breaks compared with only two percent of private school students. In addition, urban students are twice as likely as rural students to report receiving these activities during sports activities (15 percent and 7 percent respectively).


Table 5.12 Access to health hygiene education at school by background characteristics Percentage of students who reported that their schools provide health hygiene activities/education, and among those percent distribution by the frequency of offering health hygiene activities and percentage by when are those activities provided, according to background characteristics, Djibouti, SHSS 2009

Percentage

whose school provide health

hygiene activities

Frequency Timing of receive health hygiene

education


Every-day

Once per

week

Once or twice per

month

Less than once per month

During class

Morning assembly Activities Other

Number of

students

Age Less than 9 5.7 26.0 52.0 20.0 2.0 83.7 2.0 34.7 2.0 56 9-10 5.8 17.7 47.5 29.2 5.6 88.5 1.9 26.3 .9 737 11-12 6.0 16.7 38.0 29.5 15.8 90.0 1.7 15.4 4.2 323 13+ 2.7 16.7 41.7 33.3 8.3 89.2 .0 18.9 2.7 60 Sex Male 6.0 16.6 45.1 28.7 9.6 88.8 1.7 18.1 2.7 634 Female 5.4 19.2 44.3 29.8 6.7 88.6 1.8 29.6 1.0 547 Grade 4th grade 4.9 17.6 44.1 29.7 8.6 87.7 2.4 22.4 1.0 558 5th grade 6.5 17.9 45.3 28.7 8.0 89.6 1.1 24.2 2.9 622 Location Urban 6.9 17.8 39.0 35.5 7.6 88.0 1.8 29.5 1.6 707 Rural 4.0 17.8 52.4 20.6 9.2 89.8 1.7 14.7 2.5 474 Type of school Public 6.3 19.7 44.7 26.4 9.2 88.9 1.4 24.1 1.8 1006 Private 1.1 2.2 45.2 51.6 1.1 87.2 4.3 17.0 3.2 175 Total 5.7 17.8 44.7 29.2 8.3 88.7 23.4 1.7 2.0 1181

Table 5.13 shows the percentage of students who reported that their schools provide health hygiene activities/education by whether the school has committee or association responsible for school sanitation and hygiene education. Overall, 7 percent of the students whose school has committee or association responsible for school sanitation and hygiene education reported that their school provides health hygiene activities compared to 4 percent among those whose school does not have committee or association responsible for school sanitation and hygiene education. Looking at the frequency of offering health hygiene activities, students whose schools have committee or association responsible for school sanitation and hygiene education are twice as likely as those whose schools do not have such committee or association to report having health hygiene activities every day.

Table 5.13 Access to health hygiene education at school by selected characteristics Percentage of students who reported that their schools provide health hygiene activities/education, and among those percent distribution by the frequency of offering health hygiene activities and percentage by when are those activities provided, according to selected characteristics, Djibouti, SHSS 2009

Percentage whose school

provide health

hygiene activities

Frequency Timing of receive health hygiene

education

Selected characteristics Every-

day

Once per

week

Once or twice per

month

Less than once per month

During class

Morning assembly Activities Other

Number of

students

School has committee/ association responsible for school sanitation and hygiene education

Yes 6.8 22.0 43.4 27.0 7.6 89.1 1.1 21.6 0.9 683 No 3.9 10.9 46.9 32.8 9.4 88.1 2.8 26.3 3.8 498 Total 5.7 17.8 44.7 29.2 8.3 88.7 23.4 1.7 2.0 1181


5.4 Knowledge about general cleanliness and personal hygiene in school syllabus

School hygiene and sanitation survey aim to identify the school syllabus contents regarding cleanliness and personal hygiene from the students point of view. Table 5.7 presents the percentage of students who reported that school syllabus contain information about health hygiene and the type of materials used at school for promoting health hygiene. Data shows that only 42 percent of the students reported that the school syllabus contains information about health hygiene. The percentage is higher in urban schools than in rural schools (47 percent and 34 percent respectively) and in private school than in public schools (51 percent and 40 percent respectively).

Regarding the types of materials that are used by teachers for hygiene promotion in schools, about 49 percent of students mentioned poster, 23 percent mentioned books and 17 percent mentioned brochure/ pamphlets. More than quarter of students (29 percent) reported that no materials are used to promote health hygiene, with slightly higher percentage among private and rural students than public and urban students. Moreover, only 4 percent mentioned videos as a material used for promoting health hygiene and 2 percent mentioned games with higher percentage among younger students and urban ones.

Table 5.14 School syllabus and health hygiene Percentage of students who reported that school syllabus contain information about health hygiene and the type of materials used at school for promoting health hygiene, according to background characteristics, Djibouti, SHSS 2009

Percentage who reported that school syllabus

contains information on health hygiene

Materials used to promote health hygiene Number

of students


Brochures/pamphlets Games Videos Books Posters Other None

Age Less than 9 46.4 16.1 5.4 8.9 39.3 69.6 7.1 7.1 56 9-10 40.8 17.4 1.9 3.8 21.7 53.1 9.0 26.9 737 11-12 41.5 18.0 2.2 2.8 22.3 39.0 7.4 36.5 323 13+ 48.3 16.7 1.7 1.7 26.7 40.0 5.0 31.7 60

Sex Male 39.9 14.7 1.4 3.3 22.6 46.2 8.7 32.5 634 Female 43.5 20.5 2.9 4.0 23.6 52.7 7.7 24.7 547

Grade 4th grade 42.8 17.2 2.2 4.3 21.5 48.6 9.5 27.1 558 5th grade 40.5 17.5 2.1 3.1 24.4 49.8 7.1 30.4 622

Location Urban 46.7 19.9 2.4 6.1 30.3 53.7 7.2 26.7 707 Rural 34.0 13.5 1.7 .0 12.2 42.4 9.7 32.1 474

Type of school Public 39.9 16.8 2.4 3.1 22.1 50.0 9.3 26.8 1006 Private 51.4 20.6 .6 6.9 28.6 44.6 1.7 40.6 175

Total 41.6 17.4 2.1 3.6 23.0 49.2 8.2 28.9 1181

Student’s attitude towards proper hygiene habits 35


One of the main objectives of the School Sanitation and Hygiene Survey is to identify student’s attitude towards hygiene related habits. Thus, the survey has investigated student’s attitude towards proper hygiene habits. This chapter first presents information on student’s attitude towards using school toilet facilities followed by information on usage of these facilities. Second, attitude towards drinking water at school will be discussed. Finally, information on student’s attitude towards hand washing facilities at school will also be presented.

6.1 School Toilet Facilities

The Djibouti School Hygiene and Sanitation Survey collected information about the toilet facilities in schools. Table 6.1 presents the percentage of students who reported that they refuse to use school toilet, and among those percentage reporting reasons for refusing to use school toilet. Data shows that two-fifth of the students refuse to use the school toilet. These percentages are higher in schools that have simple latrine or bucket latrine (44 percent), among schools where dirt was observed on the toilet floor (59 percent), among students who reported that school toilets are not clean (58 percent), and among students who reported that use of toilet facility is difficult (58 percent).

Students who reported that they don’t use school toilet were asked about reasons for not using it. Overall, 68 percent reported that they don’t use it because it’s dirty, 38 percent reported that it smells bad, and 6 percent reported that there is no privacy.

There are differentials by school toilet characteristics. Dirt as a reason for not using the school toilet is more likely to be reported by students from schools whose toilet floor was observed to be dirty (86 percent), and in schools where many insects were observed in toilet (95 percent). Also, students in schools were it was observed that some toilets are not clean or smell bad were more likely than students in schools were all toilet facilities were found to be clean without too much smell to report that they refuse to use school toilet because it is dirty (85 percent compared to 50 percent respectively).


Table 6.1 Attitude towards using school toilets by school toilet characteristics Percentage of students who reported that they refuse to use school toilet, and among those percentage reporting reasons for refusing to use school toilet, according to school toilet characteristics, Djibouti, SHSS 2009

Percentage who refuse

to use school toilet

Number of students whose

schools have toilet

Reasons for refusing to use school toilet Number of

students who refuse to use school toilet

School toilet characteristics Dirty

Smells bad

No privacy Other

Type of toilet facilities Flush with seat 27.6 87 * * * * 24 Flush with slab 28.2 286 58.0 46.9 12.3 9.9 81 No flush 35.1 360 74.0 45.7 4.7 22.8 127 Urinals 31.8 279 67.4 58.4 4.5 15.7 89 Simple latrine1 43.9 621 71.1 33.0 5.9 26.0 273 Bucket latrine 43.7 482 66.5 52.8 5.7 10.4 212

Observed cleanness of toilet floor Clean and dry 27.6 647 48.9 39.8 10.8 28.0 186 Presence of dirt 59.2 390 85.7 36.8 2.6 20.8 231

Toilet clean without too much smell All 33.3 500 50.3 40.0 5.1 26.9 175 Most 27.2 124 (58.8) (5.9) (5.9) (32.4) 34 Some 46.0 259 88.3 52.5 9.2 15.8 120 None 57.1 154 85.2 27.3 4.5 26.1 88

Presence of insects in latrines None 28.8 473 44.4 42.4 9.7 29.9 144 Very few 45.7 304 76.3 33.1 4.3 30.9 139 Some 61.6 124 84.4 18.2 6.5 14.3 77 Many 41.9 136 94.7 66.7 1.8 5.3 57

Toilets have doors All 36.2 559 62.6 28.6 6.4 35.0 203 Some 40.3 428 72.1 39.9 6.6 15.8 183 None 62.0 50 (96.8) (90.3) (3.2) (0.0) 31

Bowl size suitable Suitable 37.8 827 63.8 35.0 6.8 27.9 323 Too large 51.6 93 (83.3) (18.8) (2.1) (20.8) 48 Too small 39.0 117 (93.5) (80.40 (6.5) (0.0) 46

Student perception of toilet cleanness

Clean 30.8 507 49.7 29.9 8.9 30.6 157 Sometimes clean 44.5 217 60.2 68.4 7.1 9.2 98 Not clean 58.2 372 85.3 29.5 5.1 26.7 217

Use of toilet Easy 29.1 505 46.3 36.1 7.5 38.1 147 Neutral 51.1 225 76.1 43.6 10.3 7.7 117 Difficult 58.4 306 78.9 36.7 2.8 26.1 180 DK/NA/missing (28.9) 37 * * * * 11

Total 40.2 1126 68.0 37.5 6.9 24.6 475

1 Includes cemented holes and simple holes in the ground Note: Figures in parentheses are based on 30-50 unweighted cases, An asterisk indicates figure based on fewer than 30 unweighted cases and has been suppressed.

Table 6.2 presents the percentage of students who reported that they refuse to use school toilet, and among those percentage reporting reasons for refusing to use school toilet by background characteristics. Refusal to use school toilets is higher among students in urban schools than rural schools (42 percent and 38 percent respectively). The gap is wider by type of school; 42 percent of students from public schools refuse to use the school toilet compared to 28 percent among those in private schools. It is clear from the table that dirt is the primary reason for not using toilet facility across background characteristics, followed by bad smells.


Table 6.2 Attitude towards using school toilets by background characteristics Percentage of students who reported that they refuse to use school toilet, and among those percentage reporting reasons for refusing to use school toilet, according to background characteristics, Djibouti, SHSS 2009

Percentage who refuse

to use school toilet

Number of students

whose schools

have toilet

Reasons for refusing to use school toilet Number of

students who refuse to use school toilet

Background characteristics Dirty

Smells bad

No privacy Other

Age Less than 9 21.4 53 * * * * 12 9-10 38.5 703 67.3 38.4 7.4 25.0 284 11-12 44.0 308 69.0 32.4 6.3 25.4 142 13+ 53.3 57 (68.8) (53.1) (6.3) (15.6) 32

Sex Male 39.1 608 70.2 33.1 6.9 27.0 248 Female 41.5 518 65.6 42.3 7.0 22.0 227

Grade 4th grade 40.9 541 69.3 38.6 7.0 28.1 228 5th grade 39.7 584 66.8 36.4 6.9 21.5 247

Female guardian education No education 44.6 704 67.9 36.4 3.7 26.6 327 Primary/preparatory 39.1 166 63.6 48.5 4.5 25.8 66 Secondary (45.2) 31 * * * * 14 More than secondary * 23 * * * * 6 Don’t know 27.4 201 70.5 27.9 27.9 14.8 61

Male guardian education No education 44.2 565 69.3 38.3 3.8 25.7 261 Primary/preparatory 46.5 248 64.4 32.2 12.7 28.8 118 Secondary 50.0 54 * * * * 28 More than secondary 26.7 60 * * * * 16 Don’t know 23.5 199 61.5 36.5 15.4 17.3 52

Location Urban 41.7 704 69.8 41.0 5.8 22.0 295 Rural 38.0 422 65.0 31.7 8.9 28.9 180

Type of school Public 42.4 952 69.6 39.6 7.0 23.4 427 Private 27.4 174 (54.2) (18.8) (6.3) (35.4) 48

Total 40.2 1126 68.0 37.5 6.9 24.6 475


Students were also asked if they use toilets other than the school toilet for urination or defecation. Overall, about one-third of the students reported that they urinate/defecate outside school toilet. As expected, students whose schools have bucket latrine, those in schools with dirty toilets, and those in schools where toilets have no doors are the most likely to report urinating/defecating outside school toilet (43 percent, 52 percent, and 54 percent respectively). However, the highest percentage of urinating or defecating outside school toilet was observed among students who reported that use of toilet facilities is difficult (65 percent).

The primary reason for not using school toilet is that toilets are dirty (73 percent), followed by no water in toilets (51 percent), and that it smells bad (33 percent). Variations by schools toilet characteristics are also presented in Table 6.3. Ninety-three percent of students whose schools have many insects in toilet reported that they do not use toilets because of dirt compared to 61 percent among those whose schools have no insects present.

Concerning the place where students go to urinate/defecate, 29 percent reported that they urinate/defecate at home while 23 percent reported that they urinate/defecate in streets or yards.


Table 6.3 Usage of school toilet facilities by school toilet characteristics Percentage of students who urinate/defecate outside school toilets, and among those percentage reporting reasons by not using school toilet and location where they go to urinate/defecate, according to school toilet characteristics, Djibouti, SHSS 2009

Percentage who urinate/ defecate outside school toilet

Number of

students whose schools

have toilet

Reasons for not using school toilet Go to urinate/defecate at: Number of

students who urinate/

defecate outside

school toilet School toilet characteristics Dirty

Smells bad

No privacy

No water in toilets Other Home

Street/ yards

Mosque/ church Other

Type of toilet facilities Flush with seat 17.2 87 * * * * * * * * * 15 Flush with slab 9.1 286 * * * * * * * * * 26 No flush 16.3 360 84.7 39.0 8.5 27.1 0.0 50.8 45.8 0.0 3.4 59 Urinals 21.8 279 72.1 44.3 6.6 37.7 1.6 50.8 37.7 0.0 11.5 61 Simple latrine1 37.0 621 81.7 31.7 8.7 47.0 3.5 27.8 22.2 1.7 48.3 230 Bucket latrine 42.7 482 68.6 30.0 7.2 61.4 6.3 33.3 24.6 1.4 40.6 207

Observed cleanness of toilet floor

Clean and dry 19.6 647 57.6 27.3 12.9 63.6 3.8 22.0 32.6 0.0 45.5 132 Presence of dirt 52.1 390 88.2 37.4 6.9 41.4 5.4 32.0 17.2 2.5 48.3 203

Toilet clean without too much smell

All 14.7 500 58.4 29.9 6.5 58.4 1.3 49.4 45.5 0.0 5.2 77 Most 34.4 124 (83.7) (9.3) (2.3) (67.4) (0.0) (30.2) (18.6) (0.0) (51.2) 43 Some 52.9 259 83.3 48.6 10.1 52.9 5.8 24.6 4.3 2.2 68.8 138 None 50.0 154 76.6 23.4 14.3 27.3 9.1 11.7 37.7 2.6 48.1 77

Presence of insects in latrines

None 23.0 473 60.9 16.5 10.4 74.8 4.3 25.2 23.5 0.0 51.3 115 Very few 34.5 304 80.0 40.0 10.5 25.7 5.7 21.9 28.6 2.9 46.7 105 Some 45.6 124 82.5 22.8 8.8 36.8 5.3 29.8 35.1 0.0 35.1 57 Many 42.6 136 93.1 65.5 5.2 58.6 3.4 43.1 1.7 3.4 51.7 58

Toilets have doors All 24.4 559 73.7 38.7 11.7 37.2 5.1 38.7 32.8 .0 28.5 137 Some 37.7 428 74.9 21.1 8.2 67.8 5.3 19.9 19.3 1.2 59.6 171 None 54.0 50 * * * * * * * * * 27

Bowl size suitable Suitable 29.0 827 70.2 25.0 10.5 48.8 5.6 23.0 31.5 0.8 44.8 248 Too large 47.3 93 (88.6) (27.3) (6.8) (77.3) (4.5) (34.1) (0.0) (0.0) 65.9 44 Too small 36.4 117 (97.7) (88.4) (4.7) (30.2) (0.0) (51.2) (0.0) (7.0) (41.9) 43

Student perception of toilet cleanness

Clean 18.0 507 69.6 40.2 12.0 20.7 2.2 40.2 32.6 2.2 25.0 92 Sometimes clean 29.1 217 45.3 26.6 6.3 60.9 4.7 25.0 40.6 1.6 32.8 64 Not clean 54.2 372 82.7 34.7 11.9 56.4 10.9 27.2 15.8 1.0 55.9 202 Use of toilet Easy 8.9 505 (68.9) (35.6) (15.6) (13.3) (2.2) (33.3) (48.9) (2.2) (15.6) 45 Neutral 45.4 225 73.1 47.1 16.3 48.1 1.9 54.8 25.0 1.9 18.3 104 Difficult 64.6 306 74.4 26.1 5.0 56.8 10.1 17.6 20.1 1.0 61.3 199 DK/NA/missing (5.3) 37 * * * * * * * * * 2 Total 32.3 1126 73.0 33.0 11.0 50.5 7.3 28.5 23.0 1.3 47.1 382

1 Includes cemented holes and simple holes in the ground Note: Figures in parentheses are based on 30-50 unweighted cases, An asterisk indicates figure based on fewer than 30 unweighted cases and has been suppressed.

Looking at variations in urinating and defecating outside school toilet and reasons for that by background characteristics, students in public schools are 5 times more likely that those in private schools to report that they urinate/defecate outside school toilet. Also, male students are more likely to report that they urinate/defecate outside school toilets than female students (37 percent versus 27 percent respectively). Moreover variation is astounding by residence; 51 percent of students in urban schools reported that they urinate/defecate outside school compared to 20 percent among those in schools located in rural areas.

Concerning reasons for not using school toilets, students in schools in urban areas are more likely than those in rural schools to report that they do not use school toilets because they are either dirty


or smell bad. On the other hand students in schools located in rural areas are more likely than those in schools located in urban areas to report no privacy and no water in toilets as the reasons for not using schools toilets.

Table 6.4 Usage of school toilet facilities by background characteristics Percentage of students who urinate/defecate outside school toilets, and among those percentage reporting reasons by not using school toilet and location where they go to urinate/defecate, according to background characteristics, Djibouti, SHSS 2009

Percentage who

urinate/ defecate outside school toilet

Number of

students whose schools

have toilet

Reasons for not using school toilet Go to urinate/defecate at: Number of students

who urinate/ defecate outside

school toilet Background characteristics Dirty

Smells bad

No privacy

No water

in toilets Other Home

Street/ yards

Mosque/ church Other

Age Less than 9 33.9 53 * * * * * * * * * 19 9-10 30.5 703 71.6 32.9 15.1 57.3 7.1 27.6 22.2 0.4 49.8 225 11-12 35.9 308 76.7 31.0 4.3 40.5 6.9 29.3 25.0 0.9 44.8 116 13+ 28.3 57 * * * * * * * * * 17

Sex Male 36.8 608 74.7 30.5 10.3 48.1 6.9 25.8 24.5 1.3 48.5 233 Female 27.2 518 70.5 36.9 12.1 54.4 8.1 32.9 20.8 1.3 45.0 149

Grade 4th grade 34.6 541 76.2 35.8 12.4 51.8 3.6 28.5 25.4 1.0 45.1 193 5th grade 30.4 584 69.8 30.2 9.5 49.2 11.1 28.6 20.6 1.6 49.2 189

Female guardian education

No education 36.0 704 73.1 28.8 7.6 49.6 7.2 29.2 25.8 1.9 43.2 264 Primary/preparatory 28.4 166 (77.1) (35.4) (6.3) (45.8) (2.1) (37.5) (29.2) (0.0) (33.3) 48 Secondary (25.8) 31 * * * * * * * * * 8 More than secondary * 23 * * * * * * * * * 2 Don’t know 26.5 201 72.9 50.8 28.8 55.9 13.6 18.6 1.7 0.0 79.7 59

Male guardian education No education 36.9 565 72.0 29.4 6.0 47.2 9.2 28.9 25.7 2.3 43.1 218 Primary/preparatory 35.8 248 76.9 36.3 23.1 56.0 2.2 25.3 24.2 0.0 50.5 91 Secondary 32.1 54 * * * * * * * * * 18 More than secondary 8.3 60 * * * * * * * * * 5 Don’t know 22.6 199 70.0 38.0 16.0 64.0 12.0 24.0 8.0 0.0 68.0 50

Location Urban 19.8 704 85.7 41.4 8.6 32.1 0.7 50.7 27.9 2.1 19.3 140 Rural 51.1 422 65.7 28.1 12.4 61.2 11.2 15.7 20.2 0.8 63.2 242

Type of school Public 37.2 952 72.7 32.6 11.0 51.6 7.5 27.3 23.5 1.3 47.9 374 Private 4.6 174 * * * * * * * * * 8

Total 32.3 1126 73.0 33.0 11.0 50.5 7.3 28.5 23.0 1.3 47.1 382


6.2 Drinking Water Facilities at School

Drinking water facilities are very important especially for students in primary schools. Providing students with safe and clean water protects them from water born diseases especially diarrhea and intestinal infestation. Table 6.5 shows the percent distribution of students by their source of drinking water at school. One-third of the students (34 percent) reported that drinking water is never available in their schools. On the other hand, 43 percent of the students reported that they drink from water points at school with the highest percentage being reported among students in school where all water sources are child friendly (61 percent) and some water sources are child safe (74 percent). In addition, students who reported that use of water sources are easy were more likely than those who reported that they are difficult to report drinking water from water points at school (56 percent compared to 36 percent respectively).


Table 6.5 Source of drinking water at school by school water sources characteristics Percent distribution of students by their source of drinking water at school, according to school water sources characteristics, Djibouti, SHSS 2009

School water sources characteristics

From water points at school

From home

Never get drinking water

at school

Drinking water is never available at

school Other Total

Number of

students

Observed cleanness of source of water

Clean (No odor, color or taste) 60.7 17.4 5.0 13.9 3.0 100.0 735 Tastes bad/ colored/ bad odor 0.0 0.0 0.0 100.0 0.0 100.0 25 No source of drinking water 15.3 13.4 3.8 64.4 3.1 100.0 421

Water sources are child friendly All 60.9 17.2 6.1 14.2 1.5 100.0 586 Some 57.3 0.0 0.0 36.0 6.7 100.0 75 None 46.5 27.3 1.0 17.2 8.1 100.0 99 No source of drinking water

Water sources are child safe All 54.0 12.7 5.5 24.7 3.1 100.0 385 Some 74.9 5.7 1.7 17.1 0.6 100.0 175 None 53.5 34.5 6.5 1.0 4.5 100.0 200

Student perception of cleanness of source of water

Clean 49.5 14.3 4.0 29.8 2.4 100.0 923 Sometimes clean 23.4 21.3 2.1 41.5 11.7 100.0 94 Not clean 42.3 13.5 5.8 38.5 0.0 100.0 52

Student perception of cleanness of basins and places for drinking water

Clean 60.3 20.9 3.3 13.8 1.7 100.0 478 Sometimes clean 44.4 23.4 3.2 27.4 1.6 100.0 124 Not clean 40.7 14.2 6.2 38.1 0.9 100.0 113

Use of water facilities Easy 55.5 23.3 4.5 14.6 2.1 100.0 618 Neutral 51.1 12.8 3.8 32.3 0.0 100.0 133 Difficult 35.1 9.5 4.8 47.0 3.6 100.0 168 DK/NA/missing 28.1 3.5 1.8 66.7 0.0 100.0 57

Total 43.3 15.6 4.5 33.7 3.0 100.0 1181

Table 6.6 shows variations in sources of drinking water by background characteristics. Results show that rural students (54 percent) are more likely than urban students (20 percent) to report that drinking water is never available at school. Also, the percentage was higher among students in public schools (37 percent) than students in private schools (17 percent). On the other hand, the percentage of students who drink water from water points at school is higher in urban schools than in rural schools (50 percent and 33 percent, respectively). In addition, 16 percent of students get the drinking water from their home with the percentage being higher among urban students than rural students (23 percent and 4 percent respectively). As expected, the percentage of the students who get drinking water from their home is higher among students less than 9 years old (30 percent) than those 13 years or older (9 percent). Differences between male and female students are very minor.


Table 6.6 Source of drinking water at school by background characteristics Percent distribution of students by their source of drinking water at school, according to background characteristics, Djibouti, SHSS 2009


From water points at school

From home

Never get drinking water

at school

Drinking water never available at

school Other Total

Number of

students

Age Less than 9 28.6 30.4 1.8 37.5 1.8 100.0 56 9-10 45.0 14.8 3.7 34.1 2.4 100.0 737 11-12 42.1 16.4 7.4 30.0 4.0 100.0 323 13+ 44.1 8.5 1.7 40.7 5.1 100.0 60

Sex Male 44.7 15.2 3.6 32.7 3.8 100.0 634 Female 41.6 16.1 5.5 34.8 2.0 100.0 547

Grade 4th grade 45.2 14.0 5.9 32.6 2.3 100.0 558 5th grade 41.5 17.1 3.2 34.7 3.5 100.0 622

Location Urban 50.1 23.3 4.8 20.1 1.7 100.0 707 Rural 33.1 4.0 4.0 54.0 4.9 100.0 474

Type of school Public 42.2 12.9 5.2 36.6 3.1 100.0 1006 Private 49.1 30.9 .6 17.1 2.3 100.0 175

Total 43.3 15.6 4.5 33.7 3.0 100.0 1181

6.3 Hand Washing Facilities at School

The information about hand washing facilities in schools is shown in Tables 6.7 and 6.8. Slightly more than one- third of the students (36 percent) use the hand washing facilities at schools. The percentage of those students who use the hand washing facilities is highest among students who reported that hand washing facilities are easy to use (84 percent). In addition, 71 percent of those in schools were water is available all the time in hand washing places reported use hand washing place at school compared with 27 percent of those in school were water is not available at all in hand washing places.

Table 6.7 also shows the reasons for not using hand washing places at schools by hand washing facility characteristics. Overall, 18 percent of the students who do not use hand washing facilities in schools reported that they do not use it because it is very far, 35 percent reported lack of water and 52 percent reported lack of soap. Only 4 percent reported that they do not use hand washing places at schools because it is very crowded.


Table 6.7 Attitudes towards hand washing places at school by hand washing places characteristics Percentage of students who use hand washing places at school, and among those who don’t use hand washing places percentage reporting reasons for non use, according to hand washing places characteristics, Djibouti, SHSS 2009

Percentage who use hand

washing places at school

Number of students whose

schools have hand washing facilities

Reasons for not using hand washing facilities Number of students who do

not use hand washing places

at school

Hand washing places characteristics

Very far

Lack of

water

Lack of soap/ash

/mud Very

crowded Other

Availability of hand washing facility

Available 52.3 217 18.2 48.5 36.4 7.6 12.1 310 Available but far from toilet * 13 * * * * * 26 NA/missing 16.4 403 19.1 14.9 70.2 0.0 0.0 88 v Availability of soap at hand

washing facility Bar soap 61.5 79 18.5 37.0 44.4 14.8 14.8 169 Liquid soap (64.7) 35 44.4 27.8 22.2 11.1 5.6 97 Ash/mud/ sand * 26 (0.0) (0.0) (0.0) (0.0) (100.0) 48 v Availability of water at

hand washing facility In all 71.3 54 28.1 34.4 34.4 12.5 12.5 214 In some (48.3) 47 14.8 74.1 22.2 3.7 11.1 69 Not at all 26.5 129 0.0 27.8 77.8 0.0 5.6 53

Use of hand washing facilities

Easy (84.2) 35 45.5 31.8 36.4 4.5 0.0 303 Neutral (48.5) 39 20.7 34.5 44.8 10.3 6.9 64 Difficult 15.4 93 * * * * * 22 NA/missing 5.7 73 * * * * * 5

Total 35.9 633 17.7 34.7 51.6 4.0 6.5 424


Results on attitudes towards hand washing places at school are presented in Table 6.8 by background characteristics. The percentage of those students who use the hand washing facilities is higher in urban schools than in rural schools (47 percent and 19 percent respectively), and higher in private schools than in public schools (74 percent and 29 percent respectively). In addition, 39 percent of students aged 9 or 10 years old who reported that use of hand washing facility compared with 27 percent of those aged 11 or 12 years old (Figure 6.1).

Looking at reasons for not using hand washing facility by background characteristics, results show that students in schools located in rural areas are more likely than those in other schools to report lack of soap as a reason for not using hand washing facility (87 percent). Also, the percentage of students in school located in urban areas is quite high (47 percent). By type of school, students in private schools are more likely than those in private schools to report that hand washing facilities are far and that is why they do not use them (70 percent versus 13 percent).

Table 6.8 AttiPercentage of stupercentage repor


Age Less than 9 9-10 11-12 13+

Sex Male Female

Grade 4th grade 5th grade

Location Urban Rural

Type of school Public Private

Total

Note: Figures in pacases and has been

9-1

39

itudes towardsudents who use hrting reasons for n

Percentage who use hand

washing places at school

*

38.9 27.2

(25.0)

35.6 36.2

38.0 34.1

47.2 19.0

29.3

(73.7)

35.9

arentheses are based suppressed.

0 11-

9

27

Percenta

Age

hand washinghand washing planon use, accordin

Number of students whose schools have hand washing

facilities

16 369 206 38

353 280

286 346

264 369

597 36

633

d on 30-50 unweigh

12 13

7 2

age who useby a

e

Stud

g places at schoaces at school, anng to background

Reasons for no

Very far

Lackof

wate

(14.3) (42.918.5 27.210.3 51.7

* *

10.9 29.123.2 39.1

18.3 43.317.2 26.6

17.4 37.620.0 13.3

13.2 36.070.0 20.0

17.7 34.7

hted cases, An asteri

3+

25

Figure 6.1e hand washage and locat

dent’s attitude

ool by backgrod among those wcharacteristics, D

ot using hand was

k

er

Lack of soap/ash

/mud V

cro

9) (42.9) (2 50.6 7 62.1

*

1 61.8 1 43.5

3 38.3 6 64.1

6 46.8 3 86.7

0 55.3 0 10.0

7 51.6

isk indicates figure b

U

ing places ation

e towards prop

ound characterwho don’t use hanDjibouti, SHSS 20

shing facilities

Very owded Other

(0.0) (14.3) 3.7 7.4 3.4 3.4 * *

5.5 5.5 2.9 7.2

1.7 6.7 6.3 6.3

3.7 7.3 6.7 0.0

4.4 7.0 0.0 0.0

4.0 6.5

based on fewer than

Urban R

47

at school

Location

per hygiene ha

ristics nd washing place009

Number of students who do

not use hand washing places

at school

33

287 88 15

226 198

212 212

334 90

295 129

424

n 30 unweighted

Rural

19

abits 4

s

o

43

Student’s hygiene practices 45


Information about personal health hygiene of students of primary school in Djibouti is important for health promotion activities that could be implemented in schools to improve the sanitation and health practices. This chapter contains the data collected in the school sanitation and health survey, Djibouti 2009 about the students’ hygienic practices.

7.1 Drinking water habits at school

Table 7.1 shows the percent distribution of students by the ways of drinking water at school. Data shows that 37 percent use their hands to drink water at school, 32 percent reported using unshared cup/bottle and 28 percent use cup/bottle shared with students. Differentials exist according to background characteristics. Using hands for drinking water is more common among students age 13 and older, male students, students in rural areas and students in public schools. Using a cup/bottle shared with students is more common among students age 13 and older, male students, students in rural areas and students in private schools. On the other hands, using an unshared cup/bottle is common among students less than 9 years old, female students, students in urban areas and students in private schools.

7.2 Hand washing habits at school

When students were asked about their washing hands habits at school, the majority reported washing their hands with water and soap before eating, after eating and after using the toilet with a mean score of 4, 4.2 and 3.8 respectively. The mean score of washing hands is highest among students in

Table 7.1 Drinking water habits at school Percent distribution of students by drinking water practices at school, according to background characteristics, Djibouti, SHSS 2009.

Drink water at school using

Number of

studentsBackground characteristic Hands

Cup/bottle shared with

studentsUnshared

cups/bottle Other

Age Less than 9 (28.6) (14.3) (57.1) (0.0) 35 9-10 34.4 28.6 35.6 1.4 486 11-12 43.8 29.2 22.6 4.4 226 13+ (44.4) (33.3) (13.9) (8.3) 36

Sex Male 40.0 29.3 28.6 2.1 427 Female 33.9 27.2 35.9 3.1 357




Total 37.2 28.3 31.9 2.6 784


Table 7.2 Washing hands at school by hand washing place characteristics Mean score of student’s frequency of washing hands with water and soap at school before eating, after eating and after using toilet, according to hand washing place characteristics, Djibouti, SHSS 2009.

Mean score of washing hands at school

Number of

students Hand washing place

characteristicsBefore eating

After eating

After using toilet

Availability of hand washing facility Available 4.1 4.3 4.0 593 Available but far from toilet 4.1 3.9 3.8 50 NA/missing 3.9 4.3 3.6 538 Availability of soap at hand washing

facility Bar soap 4.1 4.2 4.2 275 Liquid soap 4.2 4.3 4.3 150 Ash/mud/ sand 4.6 4.8 4.5 75 Availability of water at hand

washing facility In all 4.6 4.5 4.6 300 In some 4.0 4.0 3.8 143 Not at all 3.5 4.1 3.2 200 Use of hand washing facilities Easy 4.3 4.3 4.4 360 Neutral 4.5 4.6 4.2 132 Difficult 3.9 4.0 3.8 143 Don’t know 4.2 4.2 4.1 88 Total 4.0 4.2 3.8 1181

4 Stud46

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Table 7.4 shows also that almost all students (99 percent) reported that they take a bath at least once a week. Only 1 percent of students never use soap.

Table 7.4 Using soap and bathing habits by background characteristics Percentage of students who use soap when they wash their hands, wash complete body, percentage who never use soap and percentage who take a bath at least once a week, according to background characteristics, [country, year]

Percentage who use soap when they:

Never use soap

Take a bath at

least once a week

Number of

students


Wash hands

Wash complete body

Age Less than 9 98.2 100.0 0.0 100.0 56 9-10 91.9 93.1 0.3 100.0 737 11-12 78.3 88.2 1.5 100.0 323 13+ 85.0 91.7 0.0 100.0 60

Sex Male 85.6 91.8 1.1 100.0 634 Female 90.3 91.6 0.7 100.0 547


Female guardian education No education 84.1 89.6 1.4 100.0 734 Primary/preparatory 92.9 91.7 0.0 100.0 169 Secondary (96.8) (96.8) (0.0) (100.0) 31 More than secondary * * * * 23 Don’t know 93.7 97.3 0.4 100.0 223

Male guardian education No education 81.4 89.8 1.7 100.0 590 Primary/preparatory 92.9 91.3 0.4 100.0 254 Secondary 96.4 87.5 0.0 100.0 56 More than secondary 95.0 96.7 0.0 100.0 60 Don’t know 95.0 96.8 0.0 100.0 221



Total 87.8 91.7 0.9 100.0 1181


Table 7.5 illustrates variations in using soap and bathing habits among students by other selected characteristics. Students who were exposed to information about hand washing during the 6 months prior to the survey were more likely than other students to report using soap when washing hands (97 percent versus 82 percent). Also, 92 of students who participate actively in maintaining hygiene at school reported that they use soap when washing hands compared to 64 percent among those who do not participate in those activities.


Table 7.5 Using soap and bathing habits by other selected characteristics Percentage of students who use soap when they wash their hands, wash complete body, percentage who never use soap and percentage who take a bath at least once a week, according to other selected characteristics, [country, year]

Percentage who use soap when they:

Never use soap

Take a bath at

least once a week

Number

of students

Other selected characteristics

Wash hands

Wash complete body

Availability of hand washing facility Available 91.2 90.4 0.0 100.0 593 Available but far from toilet 100.0 92.0 0.0 100.0 50 NA/missing 82.9 93.1 2.0 100.0 538

Availability of soap at hand washing facility

Bar soap 98.5 95.3 0.0 100.0 275 Liquid soap 96.7 95.3 0.0 100.0 150 Ash/mud/ sand 98.7 96.0 0.0 100.0 75 NA/missing

Availability of water at hand washing facility

In all 98.7 94.0 0.0 100.0 300 In some 88.1 75.5 0.0 100.0 143 Not at all 84.5 96.0 0.0 100.0 200

Use of hand washing facilities Easy 98.1 97.8 0.0 100.0 360 Neutral 91.7 90.2 0.0 100.0 132 Difficult 86.0 88.1 7.0 100.0 143 Don’t know 97.7 92.0 0.0 100.0 88


Yes 88.3 91.1 1.1 100.0 1007 No 82.6 96.0 .0 100.0 149 Don’t know * * * * 25


Yes 92.0 89.7 1.3 100.0 874 No 63.9 100.0 0.0 100.0 133


Yes 96.5 92.8 0.2 100.0 484 No 81.8 91.0 1.4 100.0 697

Agree that washing hands with water only after using bathroom is enough to protect from diseases

Agree 97.9 89.7 0.0 100.0 97 Disagree 86.9 91.9 1.0 100.0 1084

Total 87.8 91.7 0.9 100.0 1181


7.3 Cleaning habits of school students

Teeth cleaning are important hygienic practice for school students as it prevents tooth decay and inflammations. Tables 7.6 and 7.7 present the percent distribution of students by frequency of cleaning their teeth, and among those who clean their teeth percent distribution by method of cleaning and percentage by when they clean their teeth. Overall, 83 percent of students reported that they clean their teeth everyday and 13 percent reported that they sometimes clean their teeth. Only minor percentage reported that they rarely or never clean their teeth (2 percent and 1 percent respectively). Minor differentials exist by background characteristics. The tendency of cleaning teeth is higher among students in urban and private schools than those in rural and public schools.


Table 7.6 shows also that the majority of students (85 percent) use water and brush/sewak to clean their teeth, while only 14 percent clean their teeth using toothpaste and brush. Differentials exist by background characteristics. For example, the percentage of students who use toothpaste and brush to clean their teeth is higher among students in urban areas than students in rural areas (20 and 6 percent respectively) and among students in private schools than students in public schools (29 and 12 percent respectively).

Table 7.7 shows also timing of cleaning tooth. Virtually all students (99 percent) reported that they wash their teeth when they wake up, 35 percent said that they clean their teeth before going to sleep and 38 percent mentioned that they clean they teeth after eating. The tendency of cleaning teeth before going to sleep and after eating is higher among students less than 9 years old, females, 4th grade students, and students from urban and private schools.

Table 7.6 Cleaning teeth practice by background characteristicsPercent distribution of students by frequency of cleaning their teeth, and among those who clean their teeth percent distribution by method of cleaning and percentage by when they clean their teeth, according to background characteristics, [country, year]

Frequency of cleaning teeth Number

of students

Clean teeth with: Timing of cleaning teeth Number of students who

clean their teeth

Background characteristic Always

Some-times Rarely Never

toothpaste and brush

Water and brush/ sewak

Water only Other

When I wake up

Before going to sleep

After I eat Other

Age Less than 9 76.8 21.4 1.8 0.0 56 23.2 75.0 1.8 0.0 98.2 55.4 58.9 1.8 56 9-10 85.6 12.1 1.1 1.2 737 15.5 83.9 0.5 0.0 99.0 37.6 39.7 0.1 728 11-12 79.3 14.6 4.3 1.9 323 10.4 88.0 1.3 0.3 98.1 27.1 28.7 0.6 317 13+ 86.7 11.7 0.0 1.7 60 5.1 94.9 0.0 0.0 100.0 22.0 37.3 0.0 59 Sex Male 81.1 15.0 2.4 1.6 634 12.3 86.4 1.1 0.2 98.6 33.8 35.1 0.3 624 Female 85.7 11.0 2.2 1.1 547 15.9 83.0 1.1 0.0 98.3 35.9 40.5 0.6 541 Grade 4th grade 85.5 11.1 2.0 1.4 558 14.4 85.1 0.5 0.0 98.7 39.5 39.5 0.2 550 5th grade 81.2 15.0 2.6 1.3 622 13.7 84.5 1.6 0.2 98.2 30.6 36.0 0.7 614 Female guardian education No education 83.2 13.4 2.3 1.1 734 10.3 88.6 1.0 0.1 98.2 26.3 28.9 0.7 726 Primary/preparatory 88.8 8.3 1.2 1.8 169 17.5 81.9 0.6 0.0 98.8 46.4 48.8 0.0 166 Secondary (96.8) (3.2) (0.0) (0.0) 31 (22.6) (77.4) (0.0) (0.0) (96.8) (54.8) (48.4) (0.0) 31 More than secondary * * * * 23 * * * * * * * * 22 Don’t know 76.2 18.8 3.1 1.8 223 21.5 76.3 2.3 0.0 99.1 47.0 54.3 0.0 219 Male guardian education No education 82.7 14.1 2.4 0.8 590 8.9 89.6 1.4 0.2 97.4 28.5 29.7 0.9 585 Primary/preparatory 85.8 8.7 3.1 2.4 254 15.3 84.3 0.4 0.0 99.6 36.3 39.5 0.0 248 Secondary 92.9 7.1 0.0 0.0 56 23.2 75.0 1.8 0.0 98.2 41.1 51.8 0.0 56 More than secondary 91.7 5.0 1.7 1.7 60 28.8 71.2 0.0 0.0 98.3 52.5 45.8 0.0 59 Don’t know 76.9 19.5 1.8 1.8 221 19.8 78.8 1.4 0.0 100.0 43.3 50.7 0.0 217 Location Urban 90.8 6.4 1.6 1.3 707 19.6 79.8 0.6 0.0 98.9 39.0 40.0 0.1 698 Rural 71.9 23.2 3.4 1.5 474 5.6 92.3 1.9 0.2 97.9 28.5 34.0 0.9 467 Type of school Public 80.6 15.4 2.7 1.3 1006 11.5 87.1 1.3 0.1 98.3 31.7 34.3 0.5 993 Private 98.3 0.0 0.0 1.7 175 28.5 71.5 0.0 0.0 99.4 52.3 56.4 0.0 172 Total 83.2 13.1 2.3 1.4 1181 14.0 84.8 1.1 0.1 98.5 34.8 37.6 0.4 1165


50 Student’s hygiene practices

Table 7.7 Cleaning teeth practice by other selected characteristics Percent distribution of students by frequency of cleaning their teeth, and among those who clean their teeth percent distribution by method of cleaning and percentage by when they clean their teeth, according to other selected characteristics, [country, year]

Frequency of cleaning teeth Number

of students

Clean teeth with: Timing of cleaning teeth Number of

students who clean their teeth

Other selected characteristics Always

Some-times Rarely Never

toothpaste and brush

Water and brush/ sewak

Water only Other

When I wake up

Before going to sleep

After I eat Other


Yes 82.1 14.1 2.4 1.4 1007 14.3 84.3 1.3 0.1 98.2 36.8 38.2 0.5 993 No 87.9 8.7 2.0 1.3 149 10.2 89.8 0.0 0.0 100.0 27.2 32.0 0.0 147 Don’t know * * * * 25 * * * * * * * * 25


Yes 84.0 12.0 2.5 1.5 874 14.9 83.7 1.4 0.0 98.4 35.5 37.4 0.6 861 No 69.9 27.8 1.5 0.8 133 10.6 87.9 .8 .8 97.0 44.7 43.2 0.0 132


Yes 90.9 7.6 0.4 1.0 484 17.5 81.8 0.6 0.0 99.2 42.6 43.8 0.4 479 No 77.9 16.9 3.6 1.6 697 11.5 86.9 1.5 0.1 98.0 29.3 33.2 0.4 686

Total 83.2 13.1 2.3 1.4 1181 14.0 84.8 1.1 0.1 98.5 34.8 37.6 0.4 1165




Table 7.8, and 7.9 show data about some general hygiene habits like cleaning hair and taking care of head, washing legs, cutting nails and bad habit like spitting on the ground. It is un believable to find that 56 percent of students never clean their hair. However, 43 percent of students clean hair and take care of their head monthly and only 1 percent do so weekly. Differentials exist by background characteristics. For example, as expected, the percentages of male students who never clean their hair or take care of their head is higher than female students (62 percent and 48 percent respectively).

Results show also that washing legs alone is not a habit among school students in Djibouti as 97 percent reported that they never wash their legs. On the other hand, 39 percent of students mentioned that they cut their nails weekly and 25 percent do so on monthly basis. Only 32 percent reported that they never cut their nails. The percentage of students who cut their nails weekly is higher among students less than 9 years old, students in rural areas t and students of public schools than other students.

Spitting on ground is a bad habits, but unfortunately one third of the students (35 percent) reported that they spit on ground daily with higher percentage among male students than female students (35 percent and 29 percent respectively) and among students in urban areas than students in rural areas (41 percent and 25 percent respectively). Moreover, 48 percent of the students reported that they never spit on the ground.

Table 7.9 shows that students who exposed to information about cleanness and health hygiene are less likely to report never cleaning hair than those who didn’t exposed to information.

Table 7.8 General hygiene habits by background characteristics Percent distribution of students by frequency of cleaning their hair and taking care of head, washing legs, cutting nails and spitting on the ground, according to background characteristics, [country, year]


Cleaning hair and taking care of head Washing legs: Cutting nails Spitting on the ground Number

of students Daily Weekly Monthly Never Daily Weekly Monthly Never Daily Weekly Monthly Never Daily Weekly Monthly Never

Age Less than 9 0.0 3.6 44.6 51.8 0.0 1.8 1.8 96.4 5.4 50.0 32.1 12.5 41.1 12.5 8.9 37.5 56 9-10 0.3 1.1 46.3 52.4 0.0 0.4 2.6 97.0 4.2 41.5 26.2 28.1 37.0 6.1 14.1 42.7 737 11-12 0.6 0.9 34.4 64.1 0.0 0.9 2.5 96.6 1.5 32.2 23.5 42.7 29.7 4.3 8.7 57.3 323 13+ 0.0 0.0 51.7 48.3 0.0 0.0 3.3 96.7 0.0 31.7 20.0 48.3 23.3 6.7 10.0 60.0 60 Sex Male 0.3 1.1 36.3 62.3 0.0 1.1 2.7 96.2 3.2 38.8 22.7 35.3 31.5 5.7 11.5 51.3 634 Female 0.4 1.1 50.8 47.7 0.0 0.0 2.4 97.6 3.5 38.9 28.5 29.1 37.8 6.2 12.8 43.1 547 Grade 4th grade 0.0 1.3 40.9 57.9 0.0 0.7 2.3 97.0 4.5 38.2 25.6 31.7 37.6 8.1 10.9 43.4 558 5th grade 0.6 1.0 45.0 53.4 0.0 0.5 2.7 96.8 2.3 39.5 25.2 33.0 31.7 4.0 13.2 51.1 622 Female guardian education No education 0.3 1.5 36.5 61.7 0.0 0.4 2.3 97.3 2.2 34.2 24.0 39.6 27.1 4.9 10.9 57.1 734 Primary/preparatory 0.0 0.0 41.4 58.6 0.0 1.8 3.6 94.7 2.4 39.6 32.0 26.0 45.0 9.5 11.8 33.7 169 Secondary (0.0) (3.2) (41.9) (54.8) (0.0) (0.0) (3.2) (96.8) (0.0) (35.5) (25.8) (38.7) (35.5) (12.9) (12.9) (38.7) 31 More than secondary * * * * * * * * * * * * * * * * 23 Don’t know 0.9 0.4 66.4 32.3 0.0 0.4 2.7 96.9 8.1 54.3 24.7 13.0 46.2 6.3 16.1 31.4 223 Male guardian education No education 0.3 0.8 37.5 61.4 0.0 0.5 2.2 97.3 2.2 35.8 22.7 39.3 26.9 4.9 11.7 56.4 590 Primary/preparatory 0.0 0.8 44.1 55.1 0.0 0.8 1.6 97.6 7.1 36.6 28.0 28.3 39.4 5.9 13.8 40.9 254 Secondary 0.0 3.6 44.6 51.8 0.0 0.0 3.6 96.4 1.8 32.1 37.5 28.6 37.5 10.7 8.9 42.9 56 More than secondary 0.0 0.0 36.7 63.3 0.0 1.7 0.0 98.3 0.0 25.0 35.0 40.0 58.3 5.0 8.3 28.3 60 Don’t know 0.9 1.8 57.9 39.4 0.0 0.5 5.0 94.6 3.2 55.2 24.0 17.6 41.6 7.7 13.1 37.6 221 Location Urban 0.6 0.7 38.3 60.4 0.0 0.8 2.8 96.3 1.6 30.3 35.5 32.7 41.2 6.9 15.0 36.9 707 Rural 0.0 1.7 50.0 48.3 0.0 0.2 2.1 97.7 5.9 51.7 10.3 32.1 24.5 4.4 7.8 63.3 474 Type of school Public 0.2 1.3 44.7 53.8 0.0 0.7 2.6 96.7 3.7 40.7 24.9 30.8 31.8 6.6 11.0 50.6 1006 Private 1.1 0.0 33.1 65.7 0.0 0.0 2.3 97.7 1.1 28.6 28.6 41.7 49.7 2.3 18.3 29.7 175 Total 0.3 1.1 43.0 55.5 0.0 0.6 2.5 96.9 3.3 38.9 25.4 32.4 34.5 5.9 12.1 47.5 1181



Table 7.9 General hygiene habits by other selected characteristics Percent distribution of students by frequency of cleaning their hair and taking care of head, washing legs, cutting nails and spitting on the ground, according to other selected characteristics, [country, year]

Other selected characteristics

Cleaning hair and taking care of head Washing legs: Cutting nails Spitting on the ground Number

of studentsDaily Weekly Monthly Never Daily Weekly Monthly Never Daily Weekly Monthly Never Daily Weekly Monthly Never


Yes 0.3 1.3 44.9 53.5 0.0 0.7 2.8 96.5 3.7 42.2 26.2 27.9 36.6 7.0 12.7 43.7 1007 No 0.7 0.0 21.5 77.9 0.0 0.0 1.3 98.7 0.0 20.8 11.4 67.8 16.8 0.0 3.4 79.9 149 Don’t know * * * * * * * * * * * * * * * * 25


Yes 0.3 0.7 44.1 54.9 0.0 0.6 2.1 97.4 2.6 43.4 28.4 25.6 37.0 7.6 13.5 42.0 874 No 0.0 5.3 50.4 44.4 0.0 1.5 7.5 91.0 10.5 34.6 12.0 42.9 34.6 3.0 7.5 54.9 133 Don’t know 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0


Yes 0.0 1.2 52.7 46.1 0.0 0.2 5.2 94.6 5.4 36.6 31.0 27.1 38.0 8.1 14.7 39.3 484 No 0.6 1.0 36.3 62.1 0.0 0.9 0.7 98.4 1.9 40.5 21.5 36.2 32.0 4.4 10.3 53.2 697

Total 0.3 1.1 43.0 55.5 0.0 0.6 2.5 96.9 3.3 38.9 25.4 32.4 34.5 5.9 12.1 47.5 1181




7.4 Discussion about hygienic practices with parents

Table 7.10 shows the percentage of students who discuss hygienic behaviors learned at school with parents/family, and among those who discuss hygienic behaviors percentage of each hygienic behavior discussed according to background characteristics. Only 35 percent of the students discuss hygienic behavior their learned at schools with their parents/family. The percentage is higher among students less than 9 years old, female students in urban areas and students in private schools.

About three-quarter of the students, who said they discuss hygienic behavior learned at schools with parents and family, reported that they discuss with them wash hands with soap before eating and wash hands with soap after going to the toilets. These data was surprising because only less than 10 percent of the students said that wash hand by water and soap after using toilets is important, while more than 90 percent said that these habits are not important (table 5.2).

Other health issues that the school students discuss with their parents/families are build/improve health latrine (40 percent), not to eat unwashed fruits and vegetables (56 percent), prevent flies from approaching foods (57 percent), brush teeth (59 percent) and cut and clean nails (43 percent).

Table 7.10 Discussions about hygienic behaviors learned at school by background characteristicsPercentage of students who reported that they discuss the hygienic behaviors that they learned at school with parents/ family, and among those percentage by the hygienic behaviors discussed, according to background characteristics, [country, year]

Percentage who discuss hygienic behavior learned

at school with parents/ family

Hygienic behaviors discussed: Number of students who

discuss hygienic behavior learned at

school with parents/ family


Number of

students

Build/ improve sanitary latrine

Do not use un-composted

stools as fertilizers

Don’t eat unwashed fruits and

vege-tables

Do not drink un-

boiled water

Prevent flies from approach-ing food

Wash hands with soap

before eating

Wash hands with soap after going to the toilet

Brush teeth

Cut and

clean nails Other

Don’t know

Age Less than 9 62.5 56 42.9 34.3 62.9 37.1 62.9 65.7 71.4 71.4 40.0 0.0 2.9 35 9-10 35.5 737 44.7 32.8 56.9 34.4 61.1 73.3 73.7 60.3 43.5 0.0 0.0 262 11-12 30.7 323 29.3 24.2 48.5 19.2 44.4 69.7 68.7 50.5 39.4 1.0 2.0 99 13+ 35.0 60 * * * * * * * * * * * 21 Sex Male 33.4 634 34.0 26.9 58.0 25.5 59.4 74.1 72.6 59.0 46.2 0.5 0.9 212 Female 37.7 547 46.6 33.5 54.4 35.9 55.3 70.4 72.3 59.2 40.3 0.0 0.5 206 Grade 4th grade 36.7 558 42.9 29.8 59.0 33.7 62.9 73.2 75.6 54.1 40.5 0.0 0.5 205 5th grade 34.2 622 37.6 30.5 53.5 27.7 52.1 71.4 69.5 63.8 46.0 0.5 0.9 213 Female guardian education No education 28.2 734 37.2 19.8 49.3 20.3 46.9 67.1 65.7 57.0 38.6 0.5 1.0 207 Primary/preparatory 43.8 169 40.5 31.1 55.4 35.1 54.1 73.0 81.1 56.8 31.1 0.0 0.0 74 Secondary (45.2) 31 * * * * * * * * * * * 14 More than secondary * 23 * * * * * * * * * * * 12 Don’t know 49.3 223 40.9 41.8 61.8 40.0 71.8 77.3 74.5 57.3 50.0 0.0 0.9 110 Male guardian education No education 28.5 590 37.5 16.7 45.8 20.2 44.6 67.3 64.3 54.2 35.1 0.0 1.2 168 Primary/preparatory 39.8 254 37.6 30.7 52.5 30.7 56.4 76.2 79.2 47.5 40.6 0.0 0.0 101 Secondary 53.6 56 (36.7) (20.0) (66.7) (36.7) (66.7) (80.0) (86.7) (86.7) (63.3) (0.0) (0.0) 30 More than secondary 53.3 60 (62.5) (65.6) (84.4) (62.5) (84.4) (78.1) (84.4) (75.0) (71.9) (3.1) (0.0) 32 Don’t know 39.4 221 41.4 46.0 66.7 36.8 70.1 72.4 71.3 66.7 44.8 0.0 1.1 87 Location Urban 44.0 707 41.8 32.2 59.5 28.6 57.2 70.7 71.1 62.4 41.2 0.3 0.3 311 Rural 22.6 474 35.5 24.3 46.7 36.4 57.9 76.6 76.6 49.5 49.5 0.0 1.9 107 Type of school Public 34.2 1006 35.5 25.0 51.7 25.0 55.8 69.8 69.5 56.4 38.7 0.0 0.9 344 Private 42.3 175 62.2 54.1 77.0 56.8 64.9 83.8 86.5 71.6 64.9 1.4 0.0 74 Total 35.4 1181 40.2 30.1 56.2 30.6 57.4 72.2 72.5 59.1 43.3 0.2 0.7 418



Table 7.11 Discussions about hygienic behaviors learned at school by other selected characteristics Percentage of students who reported that they discuss the hygienic behaviors that they learned at school with parents/ family, and among those percentage by the hygienic behaviors discussed, according to other selected characteristics, [country, year]

Percentage who discuss hygienic

behavior learned at

school with parents/ family

Hygienic behaviors discussed: Number of students who

discuss hygienic behavior learned

at school with parents/ family

Other selected characteristic

Number of

students

Build/ improve sanitary latrine

Do not use un-composted

stools as fertilizers

Don’t eat unwashed fruits and

vege-tables

Do not drink un-

boiled water

Prevent flies from approach-ing food

Wash hands with soap

before eating

Wash hands with soap after going to the toilet

Brush teeth

Cut and

clean nails Other

Don’t know


Yes 38.2 1007 39.2 29.9 56.6 30.9 60.3 72.2 72.2 60.8 44.9 0.3 0.8 1007 No 6.0 149 44.4 11.1 55.6 33.3 55.6 55.6 66.7 55.6 44.4 0.0 0.0 0 Don’t know 96.0 25 * * * * * * * * * * * 0


Yes 41.0 874 39.7 31.0 57.0 31.0 61.2 75.1 75.1 63.1 46.9 0.3 0.3 877 No 20.3 133 33.3 14.8 51.9 29.6 48.1 33.3 33.3 29.6 18.5 0.0 7.4 133


Yes 52.5 484 29.1 26.0 56.3 29.5 60.2 74.8 78.0 63.4 47.6 0.4 0.4 437 No 23.5 697 57.3 36.6 56.1 32.3 53.0 68.3 64.0 52.4 36.6 0.0 1.2 570

School has committee/ association responsible for school sanitation and hygiene education

Yes 40.0 683 36.3 27.5 54.6 26.0 56.4 69.6 71.1 58.6 39.6 0.4 1.1 658 No 29.1 498 47.6 35.2 59.3 39.3 59.3 77.2 75.2 60.0 50.3 0.0 0.0 349 Total 35.4 1181 40.2 30.1 56.2 30.6 57.4 72.2 72.5 59.1 43.3 0.2 0.7 1007


Annex A list of targeted schools for the survey 59

ANNEX A LIST OF TARGETED SCHOOLS FOR THE SURVEY

Djibouti ville Urban Al hourya Public Balbala 6 Public Annexe 1 (gabode 2) Public Balbala 9 Public Arhiba Public Pk12 Public Einguella Public Pk20 Public Gachamale Public Ecole saoudienne primaire Private Quartier 5 Public Ileys Private Quartier 7 bis Public Notre dame de boulaos Private Stade Public La salle Private Ch. Osman (annexe 3) Public Osman ben affan Private Tour ousbo (bb4) Public Ecole yamenite Private Primaire nativite Private

ArtaUrban Arta Public Rural Dammerjog Public Douda Public

Ali sabiehUrban Ali sabieh 1 Public Ali sabieh 3 Public Saint louis (ali sabieh) Private Rural Assamo Public Goubetto Public Ali addeh Public

DikhilUrban Dikhil 2 Public Rural Gorabous Public Kontali Public Kouta-bouya Public Mouloud Public Yoboki Public Assa eyla 1&2 Public

ObockUrban Obock 1 Public Rural Alaili dadda Public Waddi Public

TadjourahUrban Tadjourah 1 Public Rural Adaillou Public Ardo Public Day Public Dorra Public Guirrori Public Kalaf Public Randa Public Sagallou Public Assa-gayla Public

Annex B sampling error 61

ANNEX B SAMPLING ERROR

List of selected variables for sampling errors

Variable Estimate Base population

Watching TV every day Proportion Number of students Watching TV at least once a week Proportion Number of students Watching TV at least once a month Proportion Number of students Did not watch TV in the past 4 weeks Proportion Number of students Don't own TV Proportion Number of students

Knowledge at least one correct way to protect yourself from stomachache and diarrhea Proportion Number of students

Washing hands with water and soap before eating Proportion Number of students Washing hands with water and soap after eating Proportion Number of students Washing hands with water and soap after using toilet/bathroom Proportion Number of students Washing hands with water and soap after caring for house/far Proportion Number of students

Drink water at school using hands Proportion Number of students Drink water water at school using cup/bottle shared with students

Proportion Number of students

Drink water at school using unshared cups/bottle

Proportion Number of students

Washing hands before eating Mean Number of students Washing hands after eating Mean Number of students Washing hands after using toilets Mean Number of students

Using soap when they Wash hands Proportion Number of students Using soap when they Wash complete body Proportion Number of students

Students always cleaning their teeth Proportion Number of students who clean their teeth Clean teeth with toothpaste and brush Proportion Number of students who clean their teeth

Discussing hygienic behavior learned at school with parents/ family Proportion

Number of students who discuss hygienic behavior learned at school with parents/ family

Annex B sampling error 62

List of selected variables for sampling errors

Estimate Standard error(se)

Unweighted count

Relative error

Confidence limit

Variable R-2SE R+2SE

Watching TV every day 0.414 0.036 572 0.0870 0.343 0.489 Watching TV at least once a week 0.068 0.013 752 0.1912 0.045 0.101 Watching TV at least once a month 0.003 0.002 752 0.6667 0.001 0.011 Did not watch TV in the past 4 weeks 0.097 0.017 752 0.1753 0.067 0.138 Don't own TV 0.419 0.042 752 0.1002 0.338 0.505

Knowledge at least one correct way to protect yourself from stomachache and diarrhea 0.995 0.002 1181 0.0020 0.987 0.998

Washing hands with water and soap before eating 0.975 0.008 1152 0.0082 0.954 0.987 Washing hands with water and soap after eating 0.964 0.012 1138 0.0124 0.931 0.981 Washing hands with water and soap after using toilet/bathroom 0.978 0.010 1155 0.0102 0.948 0.991 Washing hands with water and soap after caring for house/far 0.637 0.041 752 0.0644 0.551 0.715

Drink water at school using hands 0.372 0.045 784 0.1210 0.287 0.467 Drink water water at school using cup/bottle shared with students 0.283 0.047 784 0.1661 0.199 0.386 Drink water at school using unshared cups/bottle 0.319 0.042 784 0.1317 0.241 0.409

Washing hands before eating 4.0 0.091 1177 0.0228 3.85 4.21 Washing hands after eating 4.2 0.095 1177 0.0226 4.06 4.44 Washing hands after using toilets 3.8 0.100 1135 0.0263 3.59 3.99

Using soap when they Wash hands 0.878 0.026 1181 0.0296 0.815 0.922 Using soap when they Wash complete body 0.917 0.024 1181 0.0262 0.855 0.954

Students always cleaning their teeth 0.832 0.026 1165 0.0313 0.773 0.879 Clean teeth with toothpaste and brush 0.140 0.023 1165 0.1643 0.100 0.193

Discussing hygienic behavior learned at school with parents/ family 0.354 0.040 418 0.1130 0.278 0.438

ANNEX C QUESTIONNAIRES

Ministry of National Education and Higher EducationUNICEF

Annex C questionnaires

DJIBOUTI SCHOOL HYGIENE AND SANITATION (C4DS)

2009

SCHOOL QUESTIONNAIRE

63

This data is confidential and will be used only for scientific research purposes

PLACE NAME ...................................................................................

REGION/ DISTRICT ......................................................................... REGION/ DISTRICT

URBAN ............................... 1 RURAL ............................... 2 URBAN/RURAL

SCHOOL NAME: .......................................................................................

SCHOOL CODE/NO.: .................................................................... SCHOOL CODE

SCHOOL TYPE: 1 PRIMARY 2 BASIC EDUCATION SCHOOL TYPE

SCHOOL AFFILIATION: 1 PUBLIC 2 PRIVATE SCHOOL AFFILIATION3 COMMUNITY

RESPONDENTSRESPONDENT TO ADMIN PART

NAME: .................................................. POSITION: ...................... POSITION CODENAME: .................................................. POSITION: ...................... POSITION CODERESPONDENT TO SANITATION PART

NAME: .................................................. POSITION: ...................... POSITION CODENAME: .................................................. POSITION: ...................... POSITION CODE

SCHOOL'S QUESTIONNAIRE

IDENTIFICATION

DATE

TEAM TEAM

INTERVIEWER INTERVIEWER

SUPERVISOR SUPERVISOR

RESULT RESULT

NEXT VISIT:DATE: .......................... ..........................

TOTAL NUMBER OF VISITSTIME: .......................... ..........................

RESULTS CODE:1 COMPLETED2 REFUSED6 OTHER

(SPECIFY)

DATE / / 2009 / / 2009 / / 2009 / / 2009

SIGNATURE ــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــ

FIELD EDITOR OFFICE EDITOR CODER KEYER

NAME ــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــ

………………. ………………. ……………….

………………. ………………. ……………….

0

………………. ………………. ……………….

………………. ………………. ……………….

MONTH

INTERVIEWER VISITS FINAL VISIT

YEAR

………………. ………………. ………………. 2 0 9

1 2 3 DAY

Annex C questionnaires 65

My name is ________________. We are conducting a survey for (Name of organization) about sanitation and health hygiene practice in school. The information you give will be used to improve the school environment anddevelop better health program in your school. Please answer the questions based on what you really know or do. We deeply appreciate your cooperation.

Before you start the interview:If the school has 2 shifts under separate administration, make sure survey the school that isselected in the random sample.

How many levels are in this school? PRIMARY ...............................................................BASIC .....................................................

How many primary classes are there in this school? PRIMARY CLASSES ........................

and how many preparatory classes are there in thisschool? PREPARATORY CLASSES ..............IF NONE RECORD "000"

Are there more than one shift in this school? ONE SHIFT ...........................................................TWO SHIFT ...........................................................

IF YES: THREE SHIFT .......................................................How many shifts are there?

At what time, the school day start and finish? SHIFT ISTART TIME ..............

IF NONE RECORD "00" END TIME ....................SHIFT IISTART TIME ..............END TIME ....................

No. SKIP TOCODING CATEGORIES

SECTION 1: INFORMATION ABOUT SCHOOL

QUESTIONS AND FILTERS

103

101

2

AB

3

1

102

104 HOUR MIN

How many students are there in primary? BOYS GIRLSGRADE 1 ........

IF NONE RECORD "000" GRADE 2 ........GRADE 3 ........GRADE 4 ........GRADE 5 ........

How many students are there in preparatory?

IF NONE RECORD "000"

How many teachers are there in this school for each PRIMARYlevel? MALES .........................................

FEMALES .....................................IF NONE RECORD "000" BASIC

MALES .........................................FEMALES .....................................

How many workers other than teachers are there at the TOTAL .........................................school? MALES .........................................

FEMALES .....................................IF NONE RECORD "000"

How many people are employed by the school to clean TOTAL .........................................the sanitary facilities? MALES .........................................

FEMALES .....................................IF NONE RECORD "000"

In your school are there any committees or associations YES ........................................................................responsible for school sanitation, hygiene education NO ..........................................................................and environment where students, parents or communities are involved?

107

108

110 1

109

2 113

105

106 TOTAL BOYS TOTAL GIRLS

Annex C questionnaires66

No. SKIP TOCODING CATEGORIESQUESTIONS AND FILTERS

What kind of activities does committee/ association ADVOCATE LOCALLY FOR IMPROVEMENT INorganize to promote school sanitation, hygiene WATER SUPPLY, SANITATION AND HYGIENEeducation and environment? IN THE SCHOOLS ...............................................

SUPPORT MAINTENANCE OF FACILITIES ....BUILD NEW FACILITIES .....................................RAISE FUNDS .......................................................OTHER

How often does the committee meet? ONCE A WEEK.......................................................ONCE A MONTH .................................................ONCE A TERM .....................................................WHEN NEED ARISE .............................................

To what extent would you say that parents are involved VERY INVOLVED .................................................in improving school sanitation and hygiene INVOLVED .............................................................education? SOMEWHAT INVOLVED .....................................

NOT INVOLVED AT ALL .....................................

How often does the school promote the involvement of VERY OFTEN .........................................................parents in promoting hygiene education? OFTEN ....................................................................

SOMETIMES ...........................................................NEVER....................................................................

What do you think about the physical condition of school THE CONDITION IS O.K. ................................. A

building? IT IS NOT SAFE ..................................................... BIT IS NOT CLEAN ................................................. C

PROBE: STAIRS NOT SAFE ............................................... D

Anything else? OTHER X

DON’T KNOW Z

1

23

34

1132

1142

34

112

4

1

111

ABCD

1

(SPECIFY)

X(SPECIFY)

115

DON’T KNOW ................................................... Z

What do you think about the physical THE CONDITION IS O.K. ..................................... Acondition of classrooms? IT IS NOT SAFE ..................................................... B

IT IS NOT CLEAN ................................................. CPROBE: LACK OF LIGHTING ............................................. D

Anything else? LACK OF SPACE ................................................... EDESKS ARE IN A BAD CONDITION .................. FLACK OF DESKS ................................................... GCHAIRS ARE IN A BAD CONDITION ................ HLACK OF CHAIRS ................................................. IBAD VENTILATION ........................................... JWINDOWS IN BAD CONDITION BROKEN ...... KTHERE ARE VERMIN ......................................... LOTHER X

DON’T KNOW ....................................................... Z

116

(SPECIFY)


No. SKIP TOCODING CATEGORIESQUESTIONS AND FILTERS

What do you think about the condition of toilets and THE CONDITION IS O.K. ..................................... A

hand washing facilities? IT IS NOT SAFE ..................................................... BIT IS NOT CLEAN ................................................. C

PROBE: LACK OF LIGHTING ............................................. D

Anything else? LACK OF SPACE ................................................... ENO SUFFICIENT TOILETS FOR SCHOOLCHILDREN ........................................................... F

TOILET DOOR DON’T HAVE LOCKERS ........ GHAND WASHING FACILITIES ARE NOTSUITABLE TO SMALL CHILDREN ................ H

FULL OF EXCRETA ........................................... IBAD VENTILATION ........................................... JWINDOWS IN BAD CONDITION/BROKEN .... KTHERE ARE VERMIN ......................................... L

OTHER X

DON’T KNOW ....................................................... Z

What do you think about school canteen? THE CONDITION IS O.K. ..................................... A

IT IS NOT SAFE ..................................................... B

PROBE: IT IS NOT CLEAN ................................................. C

Anything else? BAD VENTILATION ........................................... D

WINDOWS IN BAD CONDITION/BROKEN .... E

THERE ARE RODENTS ....................................... F

OTHER X

118

(SPECIFY)

117

THERE IS NO CANTEEN ..................................... Y

DON’T KNOW ....................................................... Z

Are there street food sellers outside the school? YES ........................................................................ 1

NO .......................................................................... 2

DON’T KNOW ....................................................... 8

What are the types of foods that is sold by the street BAIGNETS ................................................................. A

sellers? CATTEAU ................................................................. BJUICE .......................................................................... CICE CANDY ............................................................. DSWEETS AND BISCUTS ......................................... EOTHER X

In your opinion, what percentage of school students buy LESS THAN 10% ................................................... 1

food from street sellers outside school? FROM 10% TO LESS THAN 25% ...................... 2FROM 25% TO LESS THAN 50% ...................... 350% OR MORE ....................................................... 4

119

120

121

201

(SPECIFY)

(SPECIFY)


What is the main source of drinking water in PIPED WATERthe school? PIPED INTO SCHOOL BULDINGS .................... 11

PIPED TO PLAYGROUND ................................... 12PIPED TO NEIGHBOUR ..................................... 13PIPED TO WATER KIOSK ................................... 14PUBLIC TAP/STANDPIPE ................................... 15

TUBE WELL OR BOREHOLE .............................. 21DUG WELLPROTECTED WELL ............................................... 31UNPROTECTED WELL ......................................... 32

WATER FROM SPRINGPROTECTED SPRING ........................................... 41UNPROTECTED SPRING ..................................... 42

RAINWATER COLLECTION .............................. 51TANKER- TRUCK ............................................... 61CART WITH SMALL TANK/DRUM/BEAST OF BURDEN ......................................... 71

SURFACE WATER (RIVER, STREAM, DAM,LAKE, POND,CANAL, IRRIGATION CHANNEL) 81

BOTTLED WATER VIA COMPANY ................ 91OTHER 96

Is this water treated in any way to make it safer YES ........................................................................to drink? NO ..........................................................................

What does the school usually do to the water to ��

2

SECTION 2: SANITATION AND HYGIENE No. QUESTIONS AND FILTERS CODING CATEGORIES SKIP TO

201

(SPECIFY)

202 1204

203 AWhat does the school usually do to the water to �� ........................................................................make it safer to drink? �� .....................................

�� ..........��

�� !" ................................�� .......................................

�� ..............................OTHER

�� #��$ �� .........................................................

During the last two weeks, was there any time YES ........................................................................ 1when water was not available from (READ NO .......................................................................... 2SOURCE IN 201) ? DON’T KNOW ..................................................... 8

Did this happen on a daily or almost daily basis, DAILY/ALMOST DAILY ..................................... 1

or only a few times per week, or less frequently? FEW TIMES PER WEEK ....................................... 2LESS FREQUENTLY ............................................. 3DON'T KNOW ....................................................... 8

Does school store drinking water? YES ........................................................................ 1NO .......................................................................... 2DON’T KNOW ..................................................... 8

�� ALL COVERED ................................................... 1�� SOME COVERED ............................................... 2

%&�'��%&��%(�)��(��*��*%��+��,��"��%& NONE COVERED ............................................... 3

��%,��(+��,� NOT ABLE TO OBSERVE ................................ 8��

�,��*%��+��,��"�*%-�,�'�

�� NARROW MOUTH(S) ......................................... 1

�%��"��*%��+��,��"��+-��+��+,,%(�%, WIDE MOUTH(S) ................................................. 2

(�'��)%&��"� BOTH TYPES ......................................................... 3

Are water container(s) washed from inside? YES 1

209

Z

208

209

X

203

(SPECIFY)

F

204206

205

ABC

DE

206

211

207

Are water container(s) washed from inside? YES ........................................................................ 1NO .......................................................................... 2


209211

69

No. QUESTIONS AND FILTERS CODING CATEGORIES SKIP TO

How are the container(s) washed? BY WASHING THOROUGHLY WITH WATER .... 1BY WASHING WITH WATER AND SOAP .......... 2OTHER 6

How would you describe the availability of MOREwater in the school , is it more than enough, THANenough, or insufficient: ENOUGH ENOUGH INSUFFICIENT DN/NA

a. Water for drinking? 1 2 3 8b. Water for sanitation? 1 2 3 8c. Water for personal hygiene? 1 2 3 8d. Water for cleaning? 1 2 3 8

Has the water ever been tested? YES ...................................................................... 1NO .......................................................................... 2DON’T KNOW ..................................................... 8

Who tested the water? MINISTRY OF HEALTH .......................................NATIONAL OFFICE OF WATER AND SANITATION IN DJIBOUTI ................................

OTHER

DON’T KNOW .....................................................

What were the results of the last test of water ..........................................................................undertaken? ..........................................................................................

..........................................................................................

Are their toilets/latrines at school? YES ...................................................................... 1NO ........................................................................ 2

How many latrines are there for:* Teachers TEACHERS ...................................................* Female students FEMALE STUDENTS .................................

230

(SPECIFY)

214

216

212

211

BX

215

215

210

213 A

(SPECIFY)

Z

* Male students MALE STUDENTS .....................................IF NONE RECORD "00"

What is the distance in meters from the METERS .................................................classrooms to toilets/ latrines? DON’T KNOW .....................................................

All students, most of them, half of them, some ALL ........................................................................of them, or none of them use the school toilets/ MOST OF THEM ...................................................latrine to urinate? HALF OF THEM ...................................................

SOME OF THEM ...................................................NONE ......................................................................

All students, most of them, half of them, some ALL ........................................................................of them, or none of them use the school toilets/ MOST OF THEM ...................................................latrine for defecation? HALF OF THEM ...................................................

SOME OF THEM ...................................................NONE ......................................................................

CHECK 218 & 219CODES 2 - 5 IN CODES "1" IN

218 OR 219 218 AND 219

Where do students who do not use school toilets/ OUTSIDE .................................................................latrines go? HOME ....................................................................

OTHER

Why don't all students use toilets/latrines NO WATER AVAILABLE IN LATRINES ........when they need to urinate or defecate? LATRINES ARE NOT SAFE .................................

LATRINES ARE DIRTY.........................................MIXED LATRINES FOR BOYS AND GIRLS ......LATRINE DOORS DON'T CLOSE ........................OTHER

DON’T KNOW .......................................................

Are the number of toilets/latrine suitable for the ENOUGH FOR ALL THE STUDENTS ................number of students? ONLY ENOUGH FOR THE BOYS BUT NOT

FOR THE GIRLS .................................................ONLY ENOUGH FOR THE GIRLS BUT NOTFOR THE BOYS ...................................................

43

3

X(SPECIFY)

5

219

220

222

D

221 126

223

(SPECIFY)

1

218 1

BC

3

E

Z

223

A

217

2

2

12

4

998

5

NOT ENOUGH .....................................................


4

70


Into where does school toilets/latrine flush PIPED SEWER SYSTEM ..................................... 01drain? VAULT (BAYARA) ............................................... 02

SEPTIC SYSTEM ................................................... 03PIPED CONNECTED TO CANAL ........................ 04PIPED CONNECTED TO GROUNDWATER ............................................................... 05

EMPTIED (NO CONNECTION) .......................... 06OTHER 96

DON'T KNOW WHERE ......................................... 98

Are there any personnel responsible for cleaning YES ........................................................................ 1and maintenance of school latrine/toilets? NUMBER ...................................IF YES: NO ........................................................................ 2

How many?Is there a schedule the school follows when YES ........................................................................ 1cleaning the latrines? NO .......................................................................... 2

DON'T KNOW ....................................................... 8

How frequently are school toilets/latrine TIMES PER DAY ................................... 1cleaned? TIMES PER WEEK ................................. 2

TIMES PER MONTH .............................. 3LESS THAN ONCE PER MONTH ........................NEVER....................................................................DON'T KNOW .......................................................

What do you think about the sanitary condition THE CONDITION IS O.K ................................... Aof student's toilets/latrine at school? IT IS NOT CLEAN ............................................. B

IT IS NOT SAFE ................................................. CPROBE: IT IS NOT ENOUGH ........................................... D

Anything else? THERE IS NO WATER ..................................... EOTHER X

227

(SPECIFY)

224

228

225

(SPECIFY)

993995998

227

226

How frequently does maintenance of school ONCE EVERY MONTH ..................................... Atoilets/latrine take place? ONCE EVERY TWO MONTHS .......................... B

ONCE EVERY THREE MONTHS ...................... CONCE EVERY STUDYING PERIOD (TERM) .. DONCE AT THE BEGINNING OF STUDYING YEAR ............................................. E

NEVER.................................................................. YDON'T KNOW ................................................... Z

How often are classrooms cleaned? TIMES PER DAY ................................... 1TIMES PER WEEK ................................. 2TIMES PER MONTH .............................. 3LESS THAN ONCE PER MONTH ........................NEVER....................................................................DON'T KNOW .......................................................

How often is the school yard cleaned? TIMES PER DAY ................................... 1TIMES PER WEEK ................................. 2TIMES PER MONTH .............................. 3LESS THAN ONCE PER MONTH ........................NEVER....................................................................DON'T KNOW .......................................................

How often does solid waste get collected from TIMES PER DAY ................................... 1classrooms and offices? TIMES PER WEEK ................................. 2

TIMES PER MONTH .............................. 3LESS THAN ONCE PER MONTH ........................NEVER....................................................................DON'T KNOW .......................................................

How does the school get rid of rubbish and ASSEMBLED AND REMOVED BYwaste products? CLEANING COMMITTEE ................................. A

BURRIED ............................................................... BBURNED ............................................................... CTHROWN IN THE ROAD ..................................... DOTHER X

Is there a school canteen in this school? YES ........................................................................ 1NO .......................................................................... 2 246

234

993995

(SPECIFY)

998

993

233

995998

993995

230

229

998

231

232

DON’T KNOW ..................................................... 8


246

71


What are the types of foods offered in the school READY "PACKED FOOD" ................................... Acanteen? READY "NON-PACKED FOOD" .......................... B

FOOD PREPARED IN THE CANTEEN .............. C

Is there a basin for washing hands in canteen or YES ........................................................................ 1near the canteen? NO .......................................................................... 2

DON’T KNOW ..................................................... 8

Do food handlers wash their hands when YES ........................................................................ 1necessary? NO .......................................................................... 2

DON’T KNOW ..................................................... 8

Are food storage and preparation areas kept YES ........................................................................ 1clean? NO .......................................................................... 2

DON’T KNOW ..................................................... 8

Are food storage and preparation areas YES ........................................................................ 1protected from insects and rodents? NO .......................................................................... 2

DON’T KNOW ..................................................... 8

Are cooking facilities adequate for heating YES ........................................................................ 1food sufficiently? NO .......................................................................... 2

DON’T KNOW ..................................................... 8

Is there a fridge at the school? YES ........................................................................ 1NO .......................................................................... 2FOOD IS NOT STORED ....................................... 7DON’T KNOW ..................................................... 8

Is dry food stored appropriately at the school? YES ........................................................................ 1NO .......................................................................... 2DIDN'T STORE DRY FOODS .............................. 7DON’T KNOW ..................................................... 8

Have food handlers been trained in basic food YES ........................................................................ 1

237

235

236

241

240

239

238

243

242

Have food handlers been trained in basic food YES ........................................................................ 1safety? NO .......................................................................... 2

DON’T KNOW ..................................................... 8

Are eating utensils washed immediately after YES ........................................................................ 1each use with hot water and detergent, and air NO .......................................................................... 2dried? DON’T KNOW ..................................................... 8

Are fruits and vegetables washed with safe YES ........................................................................ 1water? NO .......................................................................... 2

DON’T KNOW ..................................................... 8

Does the school offer education on hygiene and YES ........................................................................ 1environmental sanitation to the student? NO .......................................................................... 2

DON’T KNOW ..................................................... 8

How often? TIMES PER DAY ................................... 1TIMES PER WEEK ................................. 2TIMES PER MONTH .............................. 3LESS THAN ONCE PER MONTH ........................NEVER....................................................................DON’T KNOW .....................................................

What teaching aids are used to promote personal BOOKS ................................................................. Ahygiene activities among the student in your MODELS ................................................................. Bschool? POSTERS/CHARTS ............................................... C

VIDEO PROGRAMMES ..................................... DRADIO PROGRAMMES ..................................... EOTHER X

Do school children participate actively in YES ........................................................................ 1maintaining hygiene? NO .......................................................................... 2

DON’T KNOW ..................................................... 8

Who provide teaching about sanitation and TEACHERS ............................................................. Ahealth hygiene? STUDENTS ............................................................. B

PEER EDUCATION ............................................. COTHER X

(SPECIFY)

301

993995998

250

246

245

244

243

249

247

248

(SPECIFY)


(SPECIFY)

To Interviewer:This part is based on your observation inside the school. You must observe and recordwithout interaction from any school personnel.

Existence of fences in the school. FENCES EXIST AND COMPLETE ............................ 1FENCES EXIST BUT NOT COMPLETE/BROKEN.... 2NO FENCES AT ALL ................................................. 3

Area outside school. CLEAN FROM SOLID AND NON-SOLID WASTE .. ASOLID AND NON-SOLID WASTE ARE PRESENTAROUND SCHOOL ................................................... B

STAGNANT WATER ARE FOUND IN THESURROUNDING AREA ............................................. C

The physical condition of the school building. VERY GOOD ............................................................... 1GOOD .......................................................................... 2MEDIUM .................................................................... 3BAD .............................................................................. 4VERY BAD .................................................................. 5

SOURCES OF DRINKING WATER:

Drinking water in school. WATER AVAILABLE WITH NO ODOURS,COLOR OR TASTE ................................................... 1

WATER TASTE IS BAD/COLOURED/BAD ODOUR 2NO SOURCE OF DRINKING WATER .................... 5

Number of water points for drinking water. WORKING WATER POINTS ........................NO WORKING WATER POINTS ..............

Sources of drinking water. ALL SOURCES ARE PROPERLY COVERED .......... 1NOT ALL SOURCES ARE COVERED 2

310

SECTION 3: SCHOOL OBSERVATION No. QUESTIONS AND FILTERS CODING CATEGORIES SKIP TO

301

302

303

304

305

306NOT ALL SOURCES ARE COVERED ........................ 2WATER SOURCES NOT COVERED AT ALL .......... 3

The water sources are child-safe (not slippery, YES................................................................................ 1water well covers, convenient water SOME ............................................................................ 2collection tools). NO ................................................................................ 3

The water drinking points are child friendly (size, YES .............................................................................. 1height & tap kind…etc.). SOME .......................................................................... 2

NO ................................................................................ 3

How do children drink? WITH THEIR OWN CUPS ......................................... 1WITH APERSONNAL GOURD ................................... 2WITH ONE SINGLE CUP ......................................... 3WITH THEIR HANDS ............................................... 4WITH THEIR MOUTHS ............................................. 5

TOILETS/LATRINES:

TEACHERS TEACHERS

YES NO YES NO1- Flush toilet with seat2- Flush toilet with slab3- Toilet with slab /no flush4- Urinal (males)5- Simple latrine (cemented hole)6- Simple latrine (hole in ground)7- Bucket latrine8- No latrine/defecated in nature

YES

310

308

309

NO YES NO1 2 1 2 1 2 1

307

2

2

( A ) ( B ) ( C ) ( D )

BOYS GIRLSMALE FEMALE

1 2

1 2 1 2 1

1 2 1 2 1 2

1 2 1 2

2 1

1 2

1 2 1 2 1 2

1 2

2 1 2

1 2

1 2

11

2 1 2 11

12

1 2 1 2 1

2

2

21

2


No. QUESTIONS AND FILTERS CODING CATEGORIES SKIP TOCHECK 310:

AT LEAST ONE "NO" ALL "YES"IN ITEM "8" IN ITEM "8"

Presence of insects in the latrines. NONE ............................................................................ 1VERY FEW .................................................................. 2SOME .......................................................................... 3MANY .......................................................................... 4

The size of the toilet bowls. SUITABLE .................................................................. 1TOO LARGE ............................................................... 2TOO SMALL ............................................................... 3

Latrines with adequate light. YES FOR ALL OF THEM ........................................... 1MOST OF THEM ....................................................... 2SOME OF THEM ....................................................... 3NONE ............................................................................ 4

Are the toilets/latrines located near enough to YES .............................................................................. 1the classes/buildings? NO ................................................................................ 2

Is anal cleansing material available (water tap, YES FOR ALL OF THEM ........................................... 1container, water pipe for cleansing etc.)? MOST OF THEM ....................................................... 2

SOME OF THEM ....................................................... 3NONE ............................................................................ 4

Are toilets/latrines clean and without too much YES FOR ALL OF THEM ........................................... 1smell? MOST OF THEM ....................................................... 2

SOME OF THEM ......................................................... 3NONE ............................................................................ 4

Do all toilets/latrines have doors ? NOT ALL HAVE DOORS ........................................... 1

311

312

317

313

314

315

316

310a325

YES ALL HAVE DOORS ............................................. 2NONE ............................................................................ 3

How many toilets/latrines don't have doors? HAVE DOORS ...............................................DON’T HAVE DOORS .................................

Door bolts are at height suitable for the children? YES FOR ALL OF THEM ........................................... 1MOST OF THEM ....................................................... 2SOME OF THEM ....................................................... 3NONE ............................................................................ 4

Number of latrines/toilets have doors with NO. OF TOILETS WITH CHILD FRIENDLY

suitable and working bolts? BOLTS .....................................................NO. OF TOILETS WITH NON-CHILD FRIENDLYBOLTS .....................................................

NO. OF TOILETS WITHOUT BOLTS ..

Cleanliness of latrines/toilets floor? CLEAN AND DRY ....................................................... 1PRESENCE OF DETRITUS (DIRT, URINE,STOOLS, STAGNANT WATER) .............................. 2

VERY DIRTY (DIRT, URINE, STOOLS, STAGNANTWATER) .................................................................... 3

How many toilet have poor drainage? NO. OF TOILETS WITH POOR DRAINAGE

Cleanliness of latrines/toilets walls? CLEAN ........................................................................ 1PRESENCE OF DIRT, URINE OR STOOL ................ 2VERY FILTHY – IMPORTANT PRESENCE OFDIRT, URINE OR STOOL ......................................... 3

Are there cleaning materials and a disposal CLEANING MATERIALS ........................................... Asystem for girls menstruation? DISPOSAL MECHANISM ........................................... B

NONE ............................................................................ Y

323

320

324

318

322

321

319

321


No. QUESTIONS AND FILTERS CODING CATEGORIES SKIP TOHAND WASHING FACILITIES:

Where are the hand washing facilities located? INSIDE THE TOILET ................................................. 1OUTSIDE THE TOILET ............................................. 2FAR FROM TOILET ................................................... 3NOT AVAILABLE ....................................................... 4

OBSERVE:Are the hand washing facilities of boys separate YES .............................................................................. 1

than girls? NO ................................................................................ 2

Number of hand washing facilities are available TOTAL NUMBER OF HAND WASHING

in school for boys and girls? FACILITIES IN SCHOOL ..........................NO. FOR BOYS ...........................................

IF NOT AVAILABLE RECORD "00" NO. FOR GIRLS ...........................................NO. FOR MIXED .......................................

Distance between toilets and hand washing DISTANCE IN METERS FOR BOYS M

facilities? DISTANCE IN METERS FOR GIRLS MIF LOCATED IN SAME ROOM RECORD "00" DISTANCE IN METERS FOR MIXED M

What is the condition of these hand washing NOTfacilities for students? FUNCTIONING FUNCTIONING LEAKING

* Tub with several taps? 1 2 3* Washstand with tap? 1 2 3* Movable washstand? 1 2 3* Pitcher and basin? 1 2 3* Other ? 1 2 3

325

326

327

328

329

(Specify)

336

Are there hand washing facilities especially for YES .............................................................................. 1

teachers? NO ................................................................................ 2

How many hand washing facilities are there for NO. OF HAND WASHING FACILITIES ......

teachers?

Is water available in the hand washing facilities? YES IN ALL.................................................................. 1SOME OF THEM ....................................................... 2NONE OF THEM ....................................................... 3

What water source is used for the hand washing PIPE .............................................................................. 1stand? WATER BOUGHT TO A BARREL .............................. 2

OTHER 6

NO HANDWASHING STAND ................................. 7

At the hand washing facility, are the following YES IN SOME OF NONE OF available: ALL THEM THEM* Bar soap? BAR SOAP ............ 1 2 3* Liquid soap? LIQUID SOAP ...... 1 2 3* Ash/mud/sand? ASH/MUD/SAND .. 1 2 3

Are hand washing facility easy to clean? YES................................................................................ 1NO ................................................................................ 2

CLEANING AND WASTE DISPOSAL:

How does the school dispose solid wastes? COLLECTED ON THE FLOOR ................................. 1IN A CEMENT BUILT AREA ..................................... 2CONTAINER ............................................................... 3

School yard /playground? VERY CLEAN ............................................................... 1CLEAN ........................................................................ 2DIRTY .......................................................................... 3VERY DIRTY ............................................................... 4

332

337

(SPECIFY)

334

335

336

331

330

333

332


No. QUESTIONS AND FILTERS CODING CATEGORIES SKIP TOAre waste bins available in classrooms? AT ALL CLASSROOMS ........................................... 1

AT SOME CLASSROOMS ....................................... 2IN THE PLAYGROUND/AROUND THE SCHOOL .. 3NONE ............................................................................ 4

SCHOOL CANTEEN:

Condition of school canteen? VERY CLEAN ............................................................... 1CLEAN ........................................................................ 2DIRTY .......................................................................... 3VERY DIRTY ............................................................... 4NONE .......................................................................... 5

Was there a washing basin in canteen? YES AND WORKING ................................................. 1YES BUT NOT WORKING ......................................... 2NO ................................................................................ 3

Cleanliness of utensils, plates, glasses? VERY CLEAN ............................................................... 1CLEAN ........................................................................ 2DIRTY .......................................................................... 3VERY DIRTY ............................................................... 4NOT APPLICABLE ..................................................... 5

Places for food storage? VERY CLEAN ............................................................. 1CLEAN ........................................................................ 2DIRTY .......................................................................... 3VERY DIRTY ............................................................... 4NOT APPLICABLE ..................................................... 5

Places for food preparation? VERY CLEAN ............................................................... 1343

338

339

340

342

341

p pCLEAN ........................................................................ 2DIRTY .......................................................................... 3VERY DIRTY ............................................................... 4NOT APPLICABLE ..................................................... 5

EDUCATION MATERIALS:

During your visit, did you observe any posters YES .............................................................................. 1

or other educational materials for promotion of NO ................................................................................ 2

sanitation/ hand washing/ health hygiene?

What type and what subject? ....................................................................................................................................................................................................................................................................................................................................................................

344401

345


Thank the respondent for his cooperation in completing questionnaire. Complete questions401 and 402. Review the questionnaire for completion before leaving the school

Degree of cooperation Weak .......................................Fair ..........................................Good ........................................Very good ................................

INTERVIEWER OBSERVATIONS:------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

FIELD EDITOR OBSERVATIONS------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

SUPERVISOR OBSERVATIONS------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

OFFICE EDITOR OBSERVATIONS------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------


OBSERVATIONS

401 1234

77

402

403

404

405




79


2009

STUDENT'S QUESTIONNAIRE

PLACE NAME ...................................................................................

REGION/ DISTRICT ......................................................................... REGION/ DISTRICT


SCHOOL NAME: .......................................................................................

NO./SCHOOL CODE: .................................................................... SCHOOL CODE



STUDENT NAME: ..............................................................................

STUDENT CODE: .............................................................................. STUDENT NO.

DATE

TEAM TEAM



RESULT RESULT

NEXT VISIT:DATE: .......................... ..........................


RESULTS CODE:

1 COMPLETED

2 REFUSED

6 OTHER(SPECIFY)


0

ــــــــــــــــــــــــــــــــــــ

………………. ……………….

………………. ……………….

2 3

……………….

NAME

……………….

ــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــ

……………….



90………………. ……………….

CODER

……………….

FIELD EDITOR OFFICE EDITOR


MONTH1

……………….……………….

……………….

DATE / / 2009 / / 2009 / / 2009

SIGNATURE ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــ

81

/ / 2009

KEYER

STUDENT'S QUESTIONNAIRE

IDENTIFICATION

2

………………. ……………….

YEARDAY

My name is ________________. We are conducting a survey for (NAME OF ORGANIZATION) about your healthand the impact of what you do and your school do that may affect your health.The information you give will beused to develop better health program in your school. Please answer the questions based on what you really knowor do. There are no right or wrong answers, and all your answers will be kept confidential. Your school mark or grade will never be affected by this survey. We deeply appreciate your cooperation.

Sex? MALE ................................................................................ 1FEMALE .......................................................................... 2

Current School Grade attended? GRADE ....................................................................

How old are you? AGE IN COMPLETE YEARS .................................

How many brothers and sisters live with you NO. OF BROTHERS .............................................in the household? NO. OF SISTERS ...................................................

What is the Educational attainment of your DID NOT ATTENDED SCHOOL AT ALL .............. 01

father/male guardian? PRIMARY ........................................................................ 02SECONDARY FIRST STAGE ........................................... 03SECONDARY SECOND STAGE....................................... 04HIGHER ............................................................................ 05DIED/SEPARATED FROM FAMILY .............................. 95DON’T KNOW ............................................................... 98

What is the Educational attainment of your mother DID NOT ATTENDED SCHOOL AT ALL........................ 01

/ female guardian? PRIMARY ........................................................................ 02SECONDARY FIRST STAGE ........................................... 03SECONDARY SECOND STAGE....................................... 04HIGHER ............................................................................ 05DIED/SEPARATED FROM FAMILY .............................. 95DON’T KNOW ............................................................... 98

What is the main source of drinking water for PIPED WATERmembers of your household? PIPED INTO DWELLING ............................................... 11

PIPED TO COMPOUND, YARD OR PLOT .................... 12PIPED TO NEIGHBOUR ................................................. 13PIPED TO WATER KIOSK ........................................... 14PUBLIC TAP/STANDPIPE ............................................. 15

TUBE WELL OR BOREHOLE ..................................... 21DUG WELLPROTECTED WELL......................................................... 31UNPROTECTED WELL................................................... 32

WATER FROM SPRINGPROTECTED SPRING ................................................... 41UNPROTECTED SPRING ............................................. 42

RAINWATER COLLECTION ..................................... 51TANKER- TRUCK ........................................................... 61CART WITH SMALL TANK/ DRUM ............................ 71SURFACE WATER (RIVER, STREAM, DAM,LAKE, POND,CANAL, IRRIGATION CHANNEL).......... 81

BOTTLED WATER VIA COMPANY ............................ 91OTHER 96

DON’T KNOW ............................................................... 98


(SPECIFY)

105

QUESTIONS AND FILTERSNO. CODING CATEGORIES

103

104

SECTION 1: STUDENT BACKGROUND

SKIP TO

101

102

106

107

80

QUESTIONS AND FILTERSNO. CODING CATEGORIES SKIP TO

What kind of toilet facility in your household? FLUSH OR POUR FLUSH TOILETFLUSH TOILET WITH SEAT ....................................... 11FLUSH TOILET WITH SLAB ....................................... 12TOILET WITH SLAB /NO FLUSH ................................ 13

PIT LATRINESMIPLE LATRINE (CEMENTED HOLE) ...................... 21SMIPLE LATRINE (HOLE IN GROUND) ...................... 22

BUCKET LATRINE ....................................................... 31

NO LATRINE/DEFECATED IN NATURE...................... 51OTHER 96

Do you have in your dwelling a place for hand YES .................................................................................... 1

washing (tap, basin..etc)? NO ...................................................................................... 2

Do you have in your dwelling soap for hand YES .................................................................................... 1

washing or bathing? NO ...................................................................................... 2

Do you have in your dwelling towels for each YES FOR EACH PERSON ............................................. 1

household member? YES BUT SHARED ......................................................... 2NO ...................................................................................... 3


(SPECIFY)

83

109

110

111

108

Now we would like to talk about T.V, Radio and other communication channels and what do you liketo watch and listen on them.

During the past 4 weeks how often did you EVERY DAY ...................................................................... 1watch TV : every day, at least once a week, at least AT LEAST ONCE A WEEK ............................................... 2once a month or did not watch TV in the past AT LEAST ONCE A MONTH ........................................... 34 weeks? DID NOT WATCH TV IN THE PAST 4 WEEKS .............. 4

DON'T OWN TV ............................................................... 5

How many hours on average do you watch the NO. OF HOURS PER DAY .................................television each day? LESS THAN ONE HOUR ...........................................

NOT SURE/ DON’ T KNOW .....................................

When do you usually watch T.V? MORNING (6 AM : 9 AM) .................................................FORENOON (9 AM: 12 PM) .............................................

PROBE: NOON (12 PM: 3 PM) .......................................................Any other time? AFTER NOON (3 PM: 6 PM) .............................................

EVENING (6 PM: 9 PM) .....................................................NIGHT (AFTER 9 PM) .......................................................NO SPECIFIC TIME ...........................................................

During the last week which were the 3 T.V RTD TV ..............................................................................channels that you watched the most? TV5 ....................................................................................

MBC ..................................................................................PROBE: 2M (MAROC) ..................................................................

Anything else? ZEE AFLAM (AR.) .............................................................ETN (SOM) ........................................................................ERTV (ERYTHREE) .........................................................LBC (LIBAN)......................................................................FRANCE 24 ......................................................................CANAL + HORIZONS

206

Y

201

203

204

ABCD

9398

F

202

SKIP TONO. CODING CATEGORIESQUESTIONS AND FILTERS

E

SECTION 2: EXPOSURE TO MASS MEDIA AND SOURCES OF INFORMATION

ABCDEFGKLMCANAL + HORIZONS .......................................................

NESSMA (FILMS) .............................................................OTHER X

Could you tell me what type of T.V programme 1stOPT 2ndOPT 3rdOPTyou watched the most during the last week? CARTOON ......................

T.V SERIES ......................And what is the second? And what is the third? FILMS ................................

SPORTS ............................TALK SHOW ..................EDUCATIONAL

(MAKE SURE YOU RECORD THE ORDER PROGRAM ....................APPROPRIATELY) DOCUMENTARY ..........

RELIGION PROGRAMHUMOR PROGRAM ......MUSIC PROGRAMS ......OTHER ............................

(SPECIFY) (SPECIFY) (SPECIFY)NONE ................................DON'T KNOW/ DON'TANSWER ........................

During the past 4 weeks how often did you listen to EVERY DAY ...................................................................... 1the radio : every day, at least once a week, at least AT LEAST ONCE A WEEK ............................................... 2once a month or did not listen to the radio in the AT LEAST ONCE A MONTH ........................................... 3past 4 weeks? DID NOT LISTEN TO THE RADIO IN THE PAST

4 WEEKS .......................................................................... 4DON'T OWN RADIO ......................................................... 5

When do you usually listen to the radio? MORNING (6 AM : 9 AM) .................................................FORENOON (9 AM: 12 PM) .............................................

PROBE: NOON (12 PM: 3 PM) .......................................................Any other time? AFTER NOON (3 PM: 6 PM) .............................................

EVENING (6 PM: 9 PM) ...................................................NIGHT (AFTER 9 PM) .......................................................

210

01 01 01

97

0910 10

05

1096 96 96

98 98 98

08 08 08

97 97

09 09

05

06 06 0607 07 07

(SPECIFY)

02030304 04

05

02 02

BC

205

0304

206

EF

207 A

D

MN

N G ( 9 ) .......................................................NO SPECIFIC TIME .........................................................


Y

84


During the last week which were the 3 radio RTD ..................................................................................channels that you listened the most? SAWA (AR.) ....................................................................

VOICE OF AMERICA .......................................................PROBE: BBC (SOM.-AR.) ...............................................................

Anything else? OTHER

Could you tell me what type of radio programme 1stOPT 2ndOPT 3rdOPTyou listened the most during the last week? RADIO SERIES/THEATRE

NEWS ................................STORIES ............................

And what is the second? And what is the third? SPORTS ............................TALK SHOW ..................EDUCATIONAL PROGRAM ....................

(MAKE SURE YOU RECORD THE ORDER DOCUMENTARY ..........APPROPRIATELY) RELIGION PROGRAM ....

HUMOR PROGRAM ......MUSIC PROGRAMS ......OTHER ............................

(SPECIFY) (SPECIFY) (SPECIFY)NONE ................................DON'T KNOW/ DON'TANSWER ........................

During the past 4 weeks how often did you EVERY DAY ...................................................................... 1read other things different from school books AT LEAST ONCE A WEEK ............................................... 2such as comics, magazines or newspapers: every AT LEAST ONCE A MONTH ........................................... 3day, at least once a week, at least once a month or DID NOT READ ANY MAGAZINES IN THE PASTdid not read in the past 4 weeks? 4 WEEKS .......................................................................... 4

During the last week which were the 3 other things LUCKY LUKE A

97 97

10 10

98

09 09 09

97

98 98

96 96

07 0708 08 08

04 04 0405 05 05

02 02 0203 03

01

208

209

(SPECIFY)

210

212

211

06 06 06

1096

07

ABCDX

01 01

03

During the last week which were the 3 other things LUCKY LUKE .................................................................. Adifferent from school books such as comics, SPIROU (FR) .................................................................. Bmagazines or newspapers that you read the most? MICKEY (FR) .................................................................. CPROBE: BANDES DESSINEES ..................................................... D

Anything else? OTHER X

During the past six month, have you seen/read or heard any information or advice about general YES .................................................................................... 1cleanliness or health hygiene from any source? NO ...................................................................................... 2

What was the source of these information about MASS MEDIAgeneral cleanliness or health hygiene? T.V ..................................................................................

RADIO ..............................................................................NEWSPAPERS .................................................................

COMMUNITY FESTIVAL PLAYS ...........................................................MEETING, ACTIVITIES .................................................MARATHONS ..................................................................

SCHOOLS SCHOOLS BOOKS (TEXT BOOK) .................................SCHOOLS ACTIVITIES ...................................................DISPLAYS IN THE SCHOOL...........................................MEETING ......................................................................TEACHERS ......................................................................

HEALTH ACTIVITIESHEALTH PROVIDERS .....................................................PROGRAMS AND ACTVITIES INSIDE THE HEALTHFACILITIES ..................................................................

POSTERS AND FLIERS .... .............................................FAMILY AND RELATIVESPARENTS/CARETAKER .... ...........................................RELATIVES ....................................................................FRIENDS ........................................................................

OTHER

What type of information do you need to know ................................................................................about cleanliness or health hygiene?

214

DE

QX

F

I

G

(SPECIFY)

O

L

P

H

K

M

J

N

214

212

213A

C

211

(SPECIFY)

B

about cleanliness or health hygiene? ......................................................................................................................................................................................................


What should you do to keep clean and protect WASH HAND AFTER GOING TO BATHROOM TO

yourself from stomachache, and diarrhea disease? PASS MOTION/URINE .............................................USE CLEAN WATER .......................................................USE LATRINE ..................................................................

PROBE: EAT WELL COOKED FOOD ...........................................Anything else? DRINK CLEAN/BOILED WATER ...................................

WASH FRUITS, VEGETABLES AND PEEL ..............OTHER

When should you wash your hands with water BEFORE EATING .............................................................and soap? AFTER EATING ...............................................................

AFTER USING THE TOILET ...........................................PROBE: AFTER TAKING CARE OF HOME/FARM ANIMALS ..

When else? WAKING UP ......................................................................BEFORE COOKING/CHANGING BABY ........................AFTER COUGHING/SNEEZING .....................................AFTER CLEANING HOME/UTENSILS ........................ALL THE ABOVE ...........................................................OTHER

Why is it important to wash your hands with water REDUCES THE CHANCES OF GETTINGand soap? DIARRHEA ......................................................................

REDUCES THE CHANCES OF GETTINGPROBE: OTHER DISEASES/INFECTION (EYE

NO.

SECTION 3: KNOWLEDGE OF CORRECT HYGIENE HABITS

FG

SKIP TOQUESTIONS AND FILTERS CODING CATEGORIES

C

EFX

301A

DE

DCB

302 AB

HIX

(SPECIFY)

(SPECIFY)

303A

PROBE: OTHER DISEASES/INFECTION (EYEAnything else? INFECTION, FLU, COLD..ETC) ...................................

KEEP HANDS CLEAN .....................................................REDUCES STOMACHACHE .........................................RELIGIOUS BELIEFS .......................................................OTHER

Now I will read to you some actions, and I wantyou to tell me its degree of importance

* Washing hands with water and soap before eating.* Washing hands with water and soap after eating.* Washing hands with water and soap after using

toilet/bathroom.* Washing hands with water and soap after caring

for house/farm animals.

Where do you usually learn about general HOME ................................................................................cleanliness and personal hygiene? SCHOOL ............................................................................

HEALTH FACILITY .......................................................PROBE: FRIENDS ..........................................................................

Somewhere else? T.V/RADIO ......................................................................MAGAZINE ......................................................................OTHER

DK/DA ................................................................................

IMPORTANT IMPORTANT NEUTRAL

FX

(SPECIFY)

BCDE

CDE

X(SPECIFY)

304

305

3 2

A

NOTVERY NOT IMPORTANT

IMPORTANT AT ALL

Z

5 4 1

5 4 3 2 1

B

1

5 4 3 2 1

5 4 3 2


NO. SKIP TOQUESTIONS AND FILTERS CODING CATEGORIES

When do you receive messages on cleanliness and DURING CLASS .................................................................hygiene in your school? DURING BREAKS ...........................................................

SCHOOL ACTIVITIES ...................................................SPORT ACTIVITIES. .......................................................MORNING ASSEMBLY ...................................................OTHER

I DIDN'T RECIEVE ANY MESSAGES ............................

How often cleanliness and personal hygiene EVERY DAY ...................................................................... 1

activities/lessons are conducted in your school? ONCE PER WEEK ............................................................. 2TWICE PER MONTH ..................................................... 3ONCE PER MONTH ....................................................... 4LESS THAN ONCE PER MONTH ................................. 5NEVER................................................................................ 7

Is there any information about general cleanliness YES .................................................................................... 1

or health hygiene in the school syllabus you study? NO ...................................................................................... 2DON'T KNOW ................................................................. 8

What type of materials are used by teachers for BROCHURES/PAMPHLETS .............................................hygiene promotion? GAMES ..............................................................................

VIDEOS ..............................................................................PROBE: BOOKS ..............................................................................

Anything else? POSTERS/STUDENTS WALL POSTERS ....................OTHER

NONE ................................................................................

(SPECIFY)

308

Y

CDEX

309

307

BCDE

Y

306

X

(SPECIFY)

AB

308

A

Why do you think is it good to be clean? HEALTH ............................................................................SMELL ................................................................................

PROBE: STATUS IN FAMILY/COMMUNITY ............................Anything else? IT IS NOT GOOD TO BE CLEAN ...................................

OTHER

I will read to you some statements and I would likeyou to tell me whether you strongly agree, agree, STRONGLYneutral, disagree, strongly disagree :* If some one does not wash his hands with waterand soap before eating it can lead to serious diseases.

* Washing hands with water only after using thebathroom is enough to protect from diseases.

* It is ok to drink from the same glass with myfriends.

* Using an unclean toilet can lead to diseases.* Playing near the garbage and waste water pondsis not dangerous for the health.

* Fruits that look clean don't need to be washedbefore eating them.

* If your hands look clean then you don’t need towash them before eating.

2

DISAGREENEUTRAL

1

2

(SPECIFY)

DISAGREE

4

1

5 4 3 2

2 1

5 3 2 1

1

1

12

5 4 3 2

3

45

5

AGREE

3

3

5 4

4

AGREE

5 4 3

STRONGLY311

310

X

ABCD


Do you ever refuse to use school toilet and wait NEVER .............................................................................. 1until you are home? SOMETIMES .................................................................... 2

OFTEN .............................................................................. 3ALWAYS ............................................................................ 4NO TOILET IN SCHOOL ................................................. 5

Why? TOILETS ARE DIRTY .......................................................TOILETS SMELLS ARE BAD ...........................................NO PRIVACY ....................................................................OTHER

When you are at school, do you ever urinate/ NEVER .............................................................................. 1defecate outside the toilet/latrine? SOMETIMES .................................................................... 2

OFTEN .............................................................................. 3ALWAYS ............................................................................ 4

Why? TOILETS ARE DIRTY .......................................................TOILETS SMELLS ARE BAD ...........................................NO PRIVACY ....................................................................NO WATER IN TOILETS .................................................OTHER

Where do you go to urinate or defecate when you HOME ................................................................................don’t use the toilet? STREET/YARDS ...............................................................

MOSQUE/CHURCH .........................................................OTHER

(SPECIFY)

401

(SPECIFY)

(SPECIFY)

403

403

402 ABC

406

D

404

405 12

C

X

AB

SECTION 4: SCHOOL ENVIRONEMENT AND ATTITUDES TOWARD CORRECT HYGIENE HABITS

CODING CATEGORIESNO. QUESTIONS AND FILTERS SKIP TO

406

X

36

Is drinking water always available in school? NEVER................................................................................ 1SOMETIMES .................................................................... 2OFTEN .............................................................................. 3ALWAYS ............................................................................ 4

From where do you get drinking water at school? FROM WATER POINTS IN SCHOOL ..............................I GET WATER FROM MY HOME .................................I NEVER GET DRINKING WATER FROM SCHOOL ....OTHER

When you are at school how do you usually drink WITH HANDS .................................................................water? WITH PLASTIC CUPS SHARED WITH STUDENTS ....

WITH OTHER SHARED CUPS .......................................WITH SHARED BOTTLE ...............................................WITH UNSHARED PLASTIC CUPS ................................WITH OTHER UNSHARED CUPS .................................WITH UNSHARED BOTTLE ...........................................OTHER

In your school are you able to get water by yourself BY MYSELF ...................................................................... 1or you need to ask for it? HELP FROM OTHERS ..................................................... 2

I DID NOT DRINK WATER AT SCHOOL ...................... 3DON’T KNOW .................................................................. 8

Do you use the hand washing place at school? YES .................................................................................... 1NO ...................................................................................... 2NO PLACE FOR HAND WASHING .............................. 3

Why not? VERY FAR ........................................................................LACK OF WATER .............................................................LACK OF SOAP/ASH/MUD .............................................VERY CROWDED .............................................................OTHER

(SPECIFY)

CDX

0607

406

410

411

412

A

0304

96

409

412

(SPECIFY)

410

(SPECIFY)

12

6

408 01

407

02

05

(SPECIFY)

B

3


(SPECIFY)

CODING CATEGORIESNO. QUESTIONS AND FILTERS SKIP TO

When you are at school do you clean your handswith water and soap always, often, sometimes, APPLICABLE

rarely, or never:

* Before eating ?

* After eating ?

* After using the toilet or latrine?

I would like to ask you about the cleanliness of some places at the school, and how much would NOTyou rate it: extremely clean, clean, some times CLEAN CLEANclean, not clean, or not clean at all:* School latrines/toilets.* Source of water.

* Basins and places for drinking water.

* School playground.* Classrooms.* Streets surrounding the school.

How do you describe the following places in your school: easy to use or sometimes difficult or SOME-difficult to use? EASY TIMES DIFFICULT DK NA

* Water facilities? 1 2 3 8 7* Toilets/latrines? 1 2 3 8 7* Hand washing facilities? 1 2 3 8 7

Now I will ask you about some actions, and I want

7

4 3 2 1

2

412 SOME-

5 4 3

ALWAYS

5

EXTRE-

5

RARELY

1

APPLICABLEAT ALLNOT

5

NOT

73 2

7

3

7

3 2

7

1

7

OFTEN TIMES NEVER

NOT

414

5

1

5

2

24

7

CLEAN

1 7

3

3

4

4

7

1

CLEAN

3

SOME-

1

1

4

4 3

415

2

4

5

5

413TIMES

2

4

2

5

CLEANMELY

1

y ,you to tell me whether this happen in school or not: YES NO

* Do you help in bringing water to school. BRINGING WATER TO SCHOOL .......... 1 2

* Do you help in cleaning drinking places. CLEANING DRINKING PLACES .......... 1 2

* Do you help in cleaning latrine. CLEANING LATRINE .......................... 1 2

* Do you help in cleaning classrooms. CLEANING CLASSROOMS .................... 1 2

* Do you help in cleaning the school. CLEANING THE SCHOOL ...................... 1 2

* Students help in cleaning the surrounding CLEANING THE SURROUNDINGenvironment. ENVIRONMENT ................................... 1 2

* Do you provide financial support for cleaning/ PROVIDE FINANCIAL SUPPORT health activities in the school. FOR CLEANING ................................... 1 2


When do you use soap? WASH HANDS ............................................................... AWASH COMPLETE BODY ....................................... BWASHING CLOTHES ................................................... CCLEANING HOUSE ....................................................... DOTHER X

I NEVER USE SOAP ..................................................... Y

How do you apply what you learn on cleanliness USE SANITARY LATRINE ...............................................and hygiene from schools when you are out of the WASH FRUITS AND VEGETABLE BEFORE EATING .school? DON'T DRINK UN-BOILED WATER ............................

PREVENT FLIES APPROACHING FOOD ......................PROBE: WASH HANDS WITH SOAP BEFORE EATING ..........

Anything else? WASH HANDS WITH SOAP AFTER URINATING/DEFECATING ...............................................................

BRUSH TEETH .................................................................DON'T EAT FOOD SOLD IN THE STREET ..................BATHE ..............................................................................CUT AND CLEAN NAILS ...............................................OTHER

NEVER ..............................................................................

Do you talk to your parents and family about YES .................................................................................... 1hygienic behaviors that you have learned from NO ...................................................................................... 2school?

505

DE

FG

X

H

J

Y

I

(SPECIFY)

(SPECIFY)

ABC

501

503

502

SECTION 5: PRACTICES OF HYGIENE HABITS

NO. CODING CATEGORIES SKIP TOQUESTIONS AND FILTERS

What type of hygiene behaviors do you tell your BUILD/IMPROVE SANITARY LATRINE ......................parents and family? DO NOT USE UNCOMPOSTED STOOLS AS

FERTILIZER ....................................................................DON'T EAT UNWASHED FRIUTS AND VEGETABLEDON'T DRINK UNBOILED WATER ..........................PREVENT FLIES APPROACHING FOODS ....................WASH HANDS WITH SOAP BEFORE EATING ............WASH HANDS AFTER URINATING/DEFECATING ..BRUSH TEETH .................................................................CUT AND CLEAN NAILS ...............................................OTHER

DON’T KNOW ..................................................................

Do you clean your teeth every day? ALWAYS .......................................................................... 1SOMETIMES .................................................................. 2RARELY .......................................................................... 3NEVER .............................................................................. 5

How do you clean your teeth? WITH TOOTHPASTE AND BRUSH ............................ 1WITH WATER AND BRUSH/SEWAK ........................ 2WITH WATER ONLY ..................................................... 3OTHER 6

When do you clean your teeth? WHEN I WAKE UP ......................................................... ABEFORE GOING TO SLEEP ........................................... BAFTER I EAT FOOD ....................................................... COTHER X

504

507

(SPECIFY)

GH

Z

505

(SPECIFY)

508

X(SPECIFY)

A

BCDEF

I

506


NO. CODING CATEGORIES SKIP TOQUESTIONS AND FILTERS

Do you usually wash vegetables and fruits before ALWAYS .......................................................................... 1

you eat them ? SOMETIMES .................................................................. 2RARELY .......................................................................... 3NEVER .............................................................................. 7

Usually how often do you take a bath? EVERY DAY ...................................................................... 1EVERY 2 DAYS ................................................................. 2EVERY WEEK ................................................................. 3EVERY MONTH ............................................................... 4RARELY ............................................................................ 5NEVER .............................................................................. 7

Now I will ask you about some actions and habitsand I would like you to tell me if you do it daily orweekly or monthly:

* Cleaning hair and taking care of head ?

* Washing legs ?

* Wearing shoe ?

* Cutting nails ?

* Spitting on the ground?

* Covering mouth and nose while coughing andsneezing?

1

1

3

3

3

NEVER

2

WEEKLY MONTHLY

2

2

5

5

DAILY

3

2

1

1

510

5

5

509

508

5 3 2 1

5 3 2 1


Thank the student for his cooperation in completing questionnaire. Complete questions601 and 602. Review the questionnaire for completion before leaving the school

Degree of cooperation Weak ..........................................Fair .............................................Good ...........................................Very good .................................


FIELD EDITOR OBSERVATIONS:------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

SUPERVISOR OBSERVATIONS:------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

OFFICE EDITOR OBSERVATIONS:------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------


OBSERVATIONS

601 123

605

4

602

603

604




2009

PRIMARY TEACHER'S QUESTIONNAIRE

93


PLACE NAME ..................................................................................

REGION/ DISTRICT ......................................................................... REGION/ DISTRICTREGION/ DISTRICT


SCHOOL NAME: .......................................................................................

NO./SCHOOL CODE: .................................................................... SCHOOL CODE



TEACHER NAME: ..............................................................................

TEACHER NUMBER : .................................................................... TEACHER NUMBER

DATE

TEAM TEAM



RESULT RESULT

NEXT VISIT:DATE: .......................... ..........................


RESULTS CODE:

1 COMPLETED

2 REFUSED

6 OTHER(SPECIFY)

SIGNATURE


………………. ……………….

………………. ……………….

3

……………….

95


………………. ………………. ……………….

PRIMARY TEACHER'S QUESTIONNAIRE

IDENTIFICATION

2

………………. ……………….

MONTH1 2

……………….

DATE / / 2009 / / 2009 / / 2009

ــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ

90

YEARDAY

FIELD EDITOR


/ / 2009

……………….

0……………….

NAME

OFFICE EDITOR CODER KEYER


………………. ……………….

ــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــ

My name is ________________. We are conduction a survey for (NAME OF ORGANIXATION) about sanitation and health hygiene practice in school. The information you give will be used to develop better health program in your school. Please answer the questions based on what you really know or do. We deeply appreciate your cooperation.

Sex? MALE ................................................................................ 1FEMALE .......................................................................... 2

How old are you? AGE IN COMPLETED YEARS ..........................

Years of experiences as a teacher at this school? YEARS ..................................................................

What is your position in the school? PRINCIPLE ........................................................................ 1VICE PRINCIPLE ............................................................... 2SENIOR TEACHER ........................................................... 3SUBJECT TEACHER ....................................................... 4CLASS TEACHER ........................................................... 5OTHER 6

(SPECIFY)

What subject do you teach ? MATH ................................................................................ ASCIENCE ............................................................................ BLANGUAGE ...................................................................... CRELIGION .......................................................................... DHISTORY .......................................................................... EOTHER X

104

102

103

105

106

SECTION 1: TEACHER BACKGROUND

SKIP TO

101

CODING CATEGORIESQUESTIONS AND FILTERSNO.

(SPECIFY)

Had you recieve training on: YES NO

* Communication? COMMUNICATION ...................... 1 2* First aid? FIRST AID ..................................... 1 2* Hygiene? HYGIENE ......................................... 1 2* Disease/health? DISEASE/HEALTH .......................... 1 2* Environment? ENVIRONMENT ............................ 1 2* Training of trainers? TOT ................................................... 1 2

Were you responsible of any school activities out YES .................................................................................... 1of the official curriculum last year? NO ...................................................................................... 2

What activities did you implement last year? ...........................................................................................................................................................................................................................................................................................................................................................................................

Are you involved in any committee in school? YES .................................................................................... 1NO ...................................................................................... 2

What committees are you involved in? ...........................................................................................................................................................................................................................................................................................................................................................................................

What activities were implemented by the ..................................................................................committee last year? ...................................................................................................

...................................................................................................

.....................................................................................................

110

111

201

109

109

108

106

107


Is there any information about general cleanliness YES .................................................................................... 1or health hygiene in the school syllabus you teach? NO ...................................................................................... 2

DON'T KNOW ................................................................. 8

Are there any activities on hygiene, environment, YES .................................................................................... 1health issues being implemented in school ? NO ...................................................................................... 2

DON'T KNOW ................................................................. 8

What are the activities being implemented on CLEAN CAMPAIGNS INSIDE THE SCHOOL ................hygiene, environment, health issues in school ? SCHOOL GARDENING .....................................................

HEALTH EDUCATION SEMINARS IN SCHOOL ..........PROBE: HOUSEKEEPING ...............................................................

Anything else? IMPLEMENTING HEALTH CAMPAIGNS ....................PRODUCING WALL MAGAZINES/POSTERS ..............ACTIVITIES DURING MORNING ASSEMBLY ..........OPEN DAY ........................................................................PEER EDUCATION ACTIVITIES ...................................OTHER

In your opinion: are the toilets available enough YES, ENOUGH FOR ALL ................................................. 1and adequate to the number of students at the YES, ENOUGH FOR BOYS ONLY ................................... 2school? YES, ENOUGH FOR GIRLS ONLY ................................. 3

NOT ENOUGH FOR ALL ................................................. 4

I would like to ask you about the cleanliness of some places at the school, and how much would

t it out of scale of 5 (5 t l l d NOT NOT

204

205EXTRE- SOME- NOTMELY TIMES CLEAN

CDE

G

X(SPECIFY)

F

HI

201

202

204

203 AB

SECTION 2: KNOWLEDGE OF CORRECT HYGIENE HABITS


you rate it out of scale of 5 (5= extremely clean and NOT1= not clean at all) CLEAN CLEAN

* School latrines.* Basines and places for drinking water.

* School play ground.* Classrooms.* Streets surrounding the school.* School canteen.

5 4 3 2 1 7

5 4 3 2 1 7

5 4 3 2 1 7

7

5 4 3 2 1 7

NOTCLEAN CLEAN AT ALL APPLICABLE

5 4 3 2 1

MELY TIMES CLEAN

5 4 3 2 1 7


During last school year, have you participated YES .................................................................................. 1in any activities or events to promote NO .................................................................................. 2students’ health?

What are the activities or events that you participate CLEAN CAMPAIGNS INSIDE THE SCHOOL ................to promote students’ health run at school last year ? SCHOOL GARDENING .....................................................

HEALTH EDUCATION SEMINARS IN SCHOOL ..........PROBE: HOUSEKEEPING ...............................................................

Anything else? IMPLEMENTING HEALTH CAMPAIGNS ....................PRODUCING WALL MAGAZINES/POSTERS ..............ACTIVITES DURING MORNING ASSEMBLY ..........OPEN DAY ........................................................................PEER EDUCATION ACTIVITES .....................................OTHER

Why didn't you participate in any activities or NO SUCH ACTIVITIES RUN IN OUR SCHOOL ............ Aevents? I DON'T HAVE TIME TO PARTICIPATE ...................... B

I DON'T BELIEVE IN SUCH ACTIVITIES ...................... COTHER X

(SPECIFY)

During the last year, were you teach the students about any of the following issues in school (in any DON'Tof the classes)? YES NO KNOW

* Students’ health in general? STUDENTS’ HEALTH IN GENERAL .. 1 2 8

* Worm infections? WORM INFECTIONS ............................ 1 2 8

* Healthy eating habit? HEALTHY EATING HABIT ................ 1 2 8

303

A

SECTION 3: SCHOOL HEALTH ACTIVITIESNo. QUESTIONS AND FILTERS CODING CATEGORIES SKIP TO

301

304

302

X(SPECIFY)

GHI

304

BCDE

303

F

Healthy eating habit? 1 2 8

* Benefit of Personal hygiene (clean body, oralhygiene, healthy eyes, skins…etc.)? BENEFIT OF PERSONAL HYGIENE .... 1 2 8

* Environmental issues (safe water, waste disposalglobal warming…etc. )? ENVIRONMENTAL ISSUES .................. 1 2 8

CHECK Q 304

IF ALL ANSWERS ARE "NO" ELSE

Why students weren't taught the previous SCHOOL DOESN'T CARE ABOUT STUDENTmentioned topics last year? PERSONAL HYGIENE ............................................... A

SCHOOL CURRICULM DOESN'T CONTAINPROBE: THESE SUBJECTS ....................................................... B

Anything else? I DON'T BELIEVE IN SUCH ACTIVITIES .............. C 308TEACHERS AREN'T TRAINED TO THESE

SUBJECTS .................................................................... DOTHER X

(SPECIFY)

Who participated in teaching such health issues? SCHOOL DOCTOR ........................................................... APlease tell me all the persons. SCHOOL NURSE ............................................................... B

SCHOOL TEACHER ......................................................... CPROBE: PARENTS .......................................................................... D

Anything else? STUDENTS ........................................................................ EIT IS A TOPIC PREPARED BY TEACHER ...................... FOTHER X

(SPECIFY)

307305

306

307



In your school, do you have the following DON'Teducational materials to teach health issues ? YES NO KNOW

* Guidelines for teachers GUIDELINES FOR TEACHERS ............ 1 2 8

* Textbooks TEXTBOOKS ......................................... 1 2 8

* Flip Charts FLIP CHARTS ....................................... 1 2 8

* Posters POSTERS ................................................. 1 2 8

* Pamphlets PAMPHLETS ......................................... 1 2 8

* Slides SLIDES ..................................................... 1 2 8

* Videos VIDEOS ................................................... 1 2 8

* Educational Games EDUCATIONAL GAMES ...................... 1 2 8

* Others OTHERS ................................................. 1 2 8(specify)

I will read to you some statements and I would likeyou to tell me whether you strongly agree, agree, A N D SDneutral, disagree, strongly disagree :

* It is not teacher's responsibility to ensure thecleanliness of latrine, Playground, Classroom,Drinking water point and Canteen. 5 4 3 2 1

* The government has a complete responsibility tosupport water facilities and sanitation in school 5 4 3 2 1

* Teacher could help in supervising andfollowing up the toilets at school 5 4 3 2 1

* Parents and students should not be responsible for supporting the cost of cleaning toilets inschool 5 4 3 2 1

SA309

308

* Social and school activities aren’t important to promote hygiene and health 5 4 3 2 1

In the future, if we want to improve the health PEER EDUCATION ........................................................... Ahygiene practices among school students, what VIDEO ................................................................................ Bare the best channels? DEMONSTRATION ......................................................... C

PLAYS ................................................................................ DCOMPETITION ................................................................. EGROUP DISCUSSION ..................................................... FOTHER X

(SPECIFY)

What is needed to encourage a teacher to participate TRAINING PROGRAM ..................................................... Ain such activities? PROMOTIONS ................................................................. B

INCENTIVES .................................................................... COTHER X

(SPECIFY)

What type of training do teachers require to be able ..................................................................................to implement hygiene,enviroment and health issues? ...................................................................................................

...................................................................................................

What supporting material do you require to help ..................................................................................you? ...................................................................................................

...................................................................................................

What are the 3 priorities you would like to see ..................................................................................happening that would improve access to water toilet ..................................................................................and soap in your school ? ..................................................................................

312

313

314

311

310


Thank the teacher for his cooperation in completing questionnaire. Complete questions401 and 402. Review the questionnaire for completion before leaving the school

Degree of cooperation Weak .......................................Fair ..........................................Good ........................................Very good ................................


FIELD EDITOR OBSERVATIONS:------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

SUPERVISOR OBSERVATIONS:------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

OFFICE EDITOR OBSERVATIONS:------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------


4

100

402

403

404

405

OBSERVATIONS

401 123

Documents

DJ IBOUT I SCHOOL HYGIENE A ND SANITATION SURVEY 2009washinschoolsmapping.com/wengine/wp-content/... · NITAT 09 I HYGI ION S ENE A ... a Certificate of Fundamental Education is required