Water, sanitation and hygiene (WASH) in schools in Brazil pre-and peri-COVID-19 pandemic: Are schools making any progress?

The previous paucity of data and research on water, sanitation and hygiene (WASH) in schools in Brazil have been preventing an assessment of how safe and healthy schools are to reopen during the COVID-19 pandemic. This study aimed first to assess the current situation of WASH in schools in Brazil and, second, to evaluate to what extent Brazilian schools have been making any progress in providing WASH since the beginning of the COVID-19 pandemic. Data on WASH conditions in schools in Brazil was retrieved from the 2020 and 2021 Brazilian National School Census (BNSC). For the first objective, frequencies of 31 variables were calculated for the whole country and regions, considering all 173,700 schools from BNSC of 2021. Five main variables were considered as indicators of adequate WASH infrastructure in schools. T-test and ANOVA were used to assess differences in these five variables according to the locality, management model and regions. For the second objective only schools presented in both datasets (n = 170,422) were considered to compare WASH in schools pre- and peri-COVID-19 pandemic. Frequencies of 31 variables were calculated for the whole country and regions before and during the pandemic. Paired t-tests were conducted when differences in variables across the years were observed. At the present moment, the majority of schools in Brazil have bathrooms (97%), drinking water with quality suitable for human consumption (95%), improved sanitation facilities (78%) and solid waste collection (70%). Between 2020 and 2021, there was a mix of improvements and deterioration in the school's WASH infrastructure in all regions of the country. Overall, solely considering the WASH infrastructure, schools in the South and Southeast regions of the country are better prepared for the safe reopening. Nevertheless, public schools, schools located in rural areas and the North and Northeast regions of the country, are more in need of WASH interventions. Results indicate that little progress was achieved, and schools in Brazil are still in need of improvements.

Water, Sanitation and Hygiene in Schools in Low- and Middle-Income Countries: A Systematic Review and Implications for the COVID-19 Pandemic.

The global COVID-19 pandemic has revealed the extent to which schools are struggling with the provision of safe drinking water, sanitation and hygiene (WASH). To describe the WASH conditions in schools and discuss the implications for the safe reopening of schools during the ongoing COVID-19 pandemic, a systematic review of peer-reviewed literature on WASH in schools in low- and middle-income countries was performed. In April 2021, five databases, including MEDLINE (via PubMed), Web of Science, Scopus, AJOL, and LILACS, were used to identify studies. Sixty-five papers met the inclusion criteria. We extracted and analyzed data considering the Joint Monitoring Programme (JMP) definitions and the normative contents of Human Rights to safe drinking water and sanitation. Publications included in this systematic review considered 18,465 schools, across 30 different countries. Results indicate a lack of adequate WASH conditions and menstrual hygiene management requirements in all countries. The largely insufficient and inadequate school infrastructure hampers students to practice healthy hygiene habits and handwashing in particular. In the context of the COVID-19 pandemic, being hindered to implement such a key strategy to contain the spread of SARS-CoV-2 in the school environment is of major concern.

Kenyan school book knowledge for water, sanitation, hygiene and health education interventions: Disconnect, integration or opportunities?

BACKGROUND: Schools, depending on their access to and quality of water, sanitation and hygiene (WASH) and the implementation of healthy behaviours, can be critical for the control and spread of many infectious diseases, including COVID-19. Schools provide opportunities for pupils to learn about the importance of hygiene and WASH-related practice, and build healthy habits and skills, with beneficial medium- and long-term consequences particularly in low- and middle-income countries: reducing pupils' absenteeism due to diseases, promoting physical, mental and social health, and improving learning outcomes. WASH services alone are often not sufficient and need to be combined with educational programmes. As pupils disseminate their acquired health-promoting knowledge to their (extended) families, improved WASH provisions and education in schools have beneficial effects also on the community. International organisations frequently roll out interventions in schools to improve WASH services and, in some cases, train pupils and teachers on safe WASH behaviours. How such interventions relate to local school education on WASH, health promotion and disease prevention knowledge, whether and how such knowledge and school books are integrated into WASH education interventions in schools, are knowledge gaps we fill. METHODS: We analyzed how Kenyan primary school science text book content supports WASH and health education by a book review including books used from class 1 through class 8, covering the age range from 6 to 13 years. We then conducted a rapid literature review of combined WASH interventions that included a behaviour change or educational component, and a rapid review of international policy guidance documents to contextualise the results and understand the relevance of books and school education for WASH interventions implemented by international organisations. We conducted a content analysis based on five identified thematic categories, including drinking water, sanitation, hygiene, environmental hygiene & health promotion and disease risks, and mapped over time the knowledge about WASH and disease prevention. RESULTS: The books comprehensively address drinking water issues, including sources, quality, treatment, safe storage and water conservation; risks and transmission pathways of various waterborne (Cholera, Typhoid fever), water-based (Bilharzia), vector-related (Malaria) and other communicable diseases (Tuberculosis); and the importance of environmental hygiene and health promotion. The content is broadly in line with internationally recommended WASH topics and learning objectives. Gaps remain on personal hygiene and handwashing, including menstrual hygiene, sanitation education, and related health risks and disease exposures. The depth of content varies greatly over time and across the different classes. Such locally available education materials already used in schools were considered by none of the WASH education interventions in the considered intervention studies. CONCLUSIONS: The thematic gaps/under-representations in books that we identified, namely sanitation, hygiene and menstrual hygiene education, are all high on the international WASH agenda, and need to be filled especially now, in the context of the current COVID-19 pandemic. Disconnects exist between school book knowledge and WASH education interventions, between policy and implementation, and between theory and practice, revealing missed opportunities for effective and sustainable behaviour change, and underlining the need for better integration. Considering existing local educational materials and knowledge may facilitate the buy-in and involvement of teachers and school managers in strengthening education and implementing improvements. We suggest opportunities for future research, behaviour change interventions and decision-making to improve WASH in schools.

Risk Perception and COVID-19.

The call for articles for the International Journal of Environmental Research and Public Health Special Issue "Research about risk perception in the Environmental Health domain" was proposed at the beginning of 2020 as part of multidisciplinary efforts to understand the complex interactions between people and the environment [...].