Epidemiology and Infection

Original Papers

The impact of a school-based safe water and hygiene programme on knowledge and practices of students and their parents: Nyanza Province, western Kenya, 2006

C. E. O'REILLYa1a2 c1, M. C. FREEMANa3, M. RAVANIa3, J. MIGELEa4, A. MWAKIa4, M. AYALOa4, S. OMBEKIa4, R. M. HOEKSTRAa2 and R. QUICKa2a3

a1 Epidemic Intelligence Service, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA

a2 Enteric Diseases Epidemiology Branch, Division of Foodborne, Bacterial and Mycotic Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA

a3 Center for Global Safe Water at Rollins School of Public Health, Emory University, Atlanta, GA, USA

a4 CARE Kenya, Homa Bay, Kenya


Safe drinking water and hygiene are essential to reducing Kenya's diarrhoeal disease burden. A school-based safe water and hygiene intervention in Kenya was evaluated to assess its impact on students' knowledge and parents' adoption of safe water and hygiene practices. We surveyed 390 students from nine schools and their parents at baseline and conducted a final evaluation of 363 students and their parents. From baseline to final evaluation, improvement was seen in students' knowledge of correct water treatment procedure (21–65%, P<0·01) and knowing when to wash their hands. At final evaluation, 14% of parents reported currently treating their water, compared with 6% at baseline (P<0·01). From 2004 to 2005, school absenteeism in the September–November term decreased in nine project schools by 35% and increased in nine neighbouring comparison schools by 5%. This novel programme shows promise for reducing school absenteeism and promoting water and hygiene interventions in the home.

(Accepted January 09 2007)

(Online publication February 19 2007)


Use of trade names is for identification only and does not constitute endorsement by the Centers for Disease Control and Prevention or by the Department of Health and Human Services.

The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.