Assessment of water, sanitation and hygiene interventions in primary schools: a case study of Uasin Gishu County, Kenya.

backgroundAccess to safe water, sanitation and hygiene (WASH) in schools is essential for children’s health, wellbeing and learning. However, data on school WASH in Kenya remain limited. This study aimed to assess the availability, functionality, and management of water, sanitation, and hygiene (WASH) interventions in primary schools in Uasin Gishu County to inform policy and practice.

methodsA mixed-methods case study was conducted in 51 proportionally sampled primary schools (24 rural, 27 urban) out of 498 in the county. Quantitative data were collected using structured questionnaires and observation checklists administered to head teachers or their representatives. Qualitative data were obtained through focus group discussions (FGDs) with teachers. Descriptive statistics were generated in R; qualitative data were thematically analyzed in NVivo.

resultsThe mean school population was 586 pupils. Sixty one percent of schools had access to piped water; 49% of schools relied on protected wells, and 24% of schools collected rainwater. Many schools used multiple water sources, so these percentages were not mutually exclusive. Seventy three percent of the schools lacked disability-friendly infrastructure for water supply access points. Median pupil toilet cubicles were 18 [IQR: 14–22]; 98% of schools had separate staff and pupil toilets. Two-thirds, 67% of schools reported availability of water for hand washing throughout the day, yet 59% of the schools lacked soap at hand washing points. Three-quarters, 75% of schools provided menstrual products. However, only 22% of schools had changing rooms and 25% of schools had sanitary disposal facilities. A WASH policy document was absent in 67% of the schools. Private schools generally showed better operation and maintenance indicators of WASH interventions than public schools.

conclusionsWASH interventions in the surveyed schools were inadequate and unevenly distributed, with notable gaps in disability inclusion, menstrual hygiene management and policy implementation. Strengthening routine water quality testing, upgrading sanitation infrastructure, ensuring soap availability, and implementing inclusive WASH and menstrual hygiene policies can significantly improve pupil health, reduce disease transmission, and promote equity in educational settings.