Sustainability of Use of Point-of-Use Water Treatment among Students and Households in a School Program — Nyanza Province, Western Kenya, 2007

Background: To prevent diarrhea, in May 2007, we installed drinking water and handwashing stations in 17 schools and trained teachers to promote these behaviors to pupils. We gave schools PuRŪ flocculent-disinfectant powder for drinking water treatment and WaterGuard hypochlorite solution for handwashing water treatment. We evaluated this program on parental knowledge and behaviors, and pupil absentee rates, in September 2007 and July 2008.

Methods: We conducted a baseline survey of water handling knowledge and practices in parents of pupils from 17 schools and tested household stored water for chlorine. To implement the program, we engaged local Ministry of Education officials, conducted teacher trainings, created safe water clubs for student-to-student teaching, installed water stations, and distributed instructional comic books, encouraging students to read and discuss them with their parents. We conducted follow-up surveys and repeat household chlorine testing at 3 and 13 months post-implementation.

Results: We enrolled 662 student-parent pairs at baseline. From baseline to 3-month follow-up, awareness of PuRŪ (49-91%, p<0.0001) increased, WaterGuard awareness remained high (93%-92%), and there was a significant increase in household use of PuRŪ (<1-7%, p<0.0001) and WaterGuard (6-13%, p<0.0001). Household use of PuRŪ (6%) and WaterGuard (11%) was maintained after 13 months. Following program implementation, pupil absentee rates were 26% lower in 2007 than in 2006 (p<0.001) and 2005 (p<0.001); lower rates were maintained in 2008.

Conclusions: This school-based program resulted in knowledge transfer from pupil to parent and significant increases in household water treatment practices that were sustained for over one year.