title: 'A child is also a teacher': exploring the potential for children as change agents in the context of a school-based WASH intervention in rural Eastern Zambia.
abstract: As part of water, sanitation and hygiene interventions in low-income settings, it is frequently assumed that pupils can disseminate information and catalyze change at home, yet this assumption has not been rigorously assessed. We employed qualitative research methods in two phases to assess the potential for children to be change agents in five schools in rural Zambia. Phase 1 included role-play and focus group discussions among pupils on their percieved ability to serve as change agents. Children were then given 'homework' that included information on health messages and on how to build a handwashing station, and were encouraged to engage their family. In Phase 2, we conducted separate focus group discussions with pupils and mothers on their experiences with the 'homework'. We found that, in general, pupils were enthusiastic about engaging with parents-typically male heads of household-and were successful at constructing handwashing stations. Mothers reported high levels of trust in children to relay health information learned at school. Pupils were able to enact small changes to behavior, but not larger infrastructure changes, such as construction of latrines. Pupils are capable of communicating knowledge and behaviors to family members; however, discrete activities and guidance is required.
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA sara.bresee@alumni.emory.edu.
authors.forename: S
authors.initials: S
authors.lastname: Bresee
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
authors.forename: B A
authors.initials: BA
authors.lastname: Caruso
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
authors.forename: J
authors.initials: J
authors.lastname: Sales
authors.affiliation: Schools Promoting Learning Acheivement through Sanitation and Hygiene (SPLASH), Lusaka, Zambia.
authors.forename: J
authors.initials: J
authors.lastname: Lupele
authors.affiliation: Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
authors.forename: M C
authors.initials: MC
authors.lastname: Freeman
mesh_terms: D000328:Adult; D002648:Child; D005260:Female; D017144:Focus Groups; D063373:Hand Hygiene / Q000379:methods; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010287:Parent-Child Relations; D015397:Program Evaluation; D012424:Rural Population; D012572:School Health Services; D055815:Young Adult; D015024:Zambia