Assessment of Hand Hygiene Practices and Their Association with School WASH Services among Secondary School Students in Al-Hilla City, Iraq
DOI:
https://doi.org/10.46649/8nzsw427Keywords:
Hand hygiene; WASH; School sanitation; Water quality; Hygiene practices.Abstract
Background: Hand hygiene is a main component of water, sanitation, and hygiene (WASH) services, which are fundamental requirements for healthy living, particularly for vulnerable populations across different age groups, including schoolchildren and adolescents. Handwashing with soap is among the most effective and inexpensive ways to prevent infectious diseases and is an essential component of infection control.
Objectives: This study aims to assess students’ hand hygiene practices and perceptions in relation to school WASH services among secondary schools in Al-Hilla City, Iraq
Methodology: A descriptive cross-sectional analytical study was conducted from 1 September 2025 to 10 April 2026 to assess students’ hand hygiene practices and perceptions of school WASH services. The study included 985 students from 17 secondary schools in Al-Hilla City, selected using multistage stratified sampling. Data were collected using a structured self-administered questionnaire covering sociodemographic characteristics, hand hygiene practices, and the use of water and sanitation services in schools. Data were analyzed using IBM SPSS version 29. Descriptive statistics summarized frequencies and percentages, while Pearson’s chi-square or Fisher’s exact test assessed associations between variables. A p-value of ≤ 0.05 was considered statistically significant.
Results: The findings demonstrate 64.8% of students had good hand hygiene practices, 32.3% had fair, and 2.9% had poor. 79.7% of students reported washing their hands with soap and water. Perceptions of students regarding water quality and toilet use indicated that 70.5% had poor practices and perceptions, 23.5% had fair, and 6.1% had good, and only 2.5% of students drank school water, and 9.2% used school toilets. The study reported a highly significant association between hand hygiene practices and water quality and toilet conditions.
Conclusion: Students demonstrated generally acceptable hand hygiene practices, significantly influenced by WASH infrastructure and perceptions of water and sanitation conditions. Strengthening hygiene education and ensuring consistent availability of soap and water are essential to improve student hygiene behavior.
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