Water, sanitation, and hygiene interventions in schools for effective pandemic response in low- and middle-income countries: a systematic scoping review

Abstract

In low- and middle-income countries, inadequate water, sanitation, and hygiene (WASH) services in schools pose significant challenges to controlling infectious disease outbreaks. The aim of conducting this review is to assess school WASH interventions to give guidance in the formulation of WASH improvement strategies in schools. A systematic review of peer-reviewed articles that reported on WASH interventions in primary schools was conducted. Five databases were systematically searched. Inclusion and exclusion criteria yielded 69 studies reporting on WASH interventions being included. The review is organized based on four school WASH intervention categories: water, sanitation, hygiene, and a combination of water, sanitation, and hygiene. Behavioral change therapy (BCT), peer education based on the Health Believe Model, introduction and promotion of hand hygiene curriculum, group handwashing station, and better menstrual management for schoolgirls are long-term and cost-effective school-based interventions that can contribute to better WASH outcomes in schools. The review recommends the adoption of cost-effective interventions and other strategies by governments and other stakeholders. Further research needs to be conducted on the long-term impact of school-based behavioral change interventions and on practical, acceptable, and cost-effective disease prevention strategies for school children.