title: Improving water, sanitation, and hygiene in schools in Indonesia: A cross-sectional assessment on sustaining infrastructural and behavioral interventions.
abstract: Water, sanitation, and hygiene (WASH) in schools are important for child health, development, and educational performance; yet coverage in Indonesian schools remains low. To address this deficiency, UNICEF and partners conducted a WASH intervention in 450 schools across three provinces in Indonesia. A survey evaluating the sustainability of infrastructure and behavioral interventions in comparison to control districts was conducted one year after completion of the intervention. The survey data were also compared with national government data to assess the suitability of government data to report progress on the Sustainable Development Goals (SDGs). Logistic regression was used to explore associations between WASH conditions and behaviors. Intervention schools were more likely to have handwashing stations with soap and water. In multivariable analyses, schools with a toilet operation and maintenance fund were more likely to have functional toilets. Students who learn hygiene skills from their teachers were less likely to defecate openly, more likely to share hygiene knowledge with their parents, and more likely to wash their hands. Survey data were comparable with government data, suggesting that Indonesian government monitoring may be a reliable source of data to measure progress on the SDGs. This research generates important policy and practice findings for scaling up and sustaining WASH in schools and may help improve WASH in schools programs in other low-resource contexts.
authors.affiliation: Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 135 Dauer Drive, CB#7431, Chapel Hill, NC, 27599, United States.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Karon
authors.affiliation: United Nations Children's Fund, Floor 10, World Trade Centre Block 6, Jalan Jenderal Sudirman Kav. 31, Jakarta 12920, Indonesia. Electronic address: acronin@unicef.org.
authors.forename: Aidan A
authors.initials: AA
authors.lastname: Cronin
authors.affiliation: Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 135 Dauer Drive, CB#7431, Chapel Hill, NC, 27599, United States.
authors.forename: Ryan
authors.initials: R
authors.lastname: Cronk
authors.affiliation: United Nations Children's Fund, Floor 10, World Trade Centre Block 6, Jalan Jenderal Sudirman Kav. 31, Jakarta 12920, Indonesia.
authors.forename: Reza
authors.initials: R
authors.lastname: Hendrawan
mesh_terms: D001519:Behavior; D002648:Child; D003247:Conservation of Natural Resources; D035082:Federal Government; D005260:Female; D006077:Government Agencies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006920:Hygiene; D007214:Indonesia; D016015:Logistic Models; D008297:Male; D012499:Sanitation; D012574:Schools; D011795:Surveys and Questionnaires; D014881:Water Supply
keywords: Hygiene; Indonesia; Sanitation; Sustainable Development Goals (SDGs); WASH in schools; Water