Examining Water Use and Sanitation Practices in Rural Schools of Chegutu District, Mashonaland West Province, Zimbabwe

Access to water, sanitation and hygiene (WASH) in schools is integral to the well-being of children and their right to quality education. The study examines water use and sanitation practices of selected rural secondary schools in Ward 11 and 29 of Chegutu District in Zimbabwe. Data were collected using questionnaires, interviews and published data. A total of 81 questionnaires investigating students’ hygiene practices, as well as their perceptions on service delivery, were issued to students. Data collected were analyzed using tables, graphs, pie chart, and descriptive statistics. The study concluded that the present WASH practices in many of the schools were not adequate. The reasons for low water and sanitation coverage included lack of a comprehensive policy and government will to effectively manage water and sanitation services, which to some extent affected the capacity of local authorities and schools to manage water and sanitation supply services in the past years. Despite support by community, civic society and Government, the impact of their contributions remains significant though insufficient. Inadequate capital to support and maintain WASH standards in schools, and lack of monitoring systems remain key challenges. Further support is required to meet international recommendations for healthy and gender-equitable schools.


Introduction
Water, sanitation and hygiene (WASH) in schools contributes to better health and educational outcomes among students.Water, sanitation and health are therefore very critical not only as a human right, but also as a step to national development and poverty reduction.World Health Organization has set a target of halving the proportion of people without safe access to improved water or sanitation by 2015 (UN, 2003).
The impact of WASH in schools is multi-faceted as it makes a crosscutting contribution to achievement of the Sustainable Development Goals (SDGs) through impacting universal primary education, gender equality and environmental sustainability.Although the world has progressed in the area of water and sanitation, more than 2 billion people still live without access to sanitation facilities and some are unable to practice basic hygiene (UN World Water Development Report, 2023).
In developing countries, there is mounting pressure from international agencies for schools to institute Water, Sanitation and Hygiene (WASH) facilities to reduce or eliminate water borne diseases.Inadequate water supply and sanitation are largely responsible for the high levels of water borne diseases in Southern Africa, where the majority of people live in rural areas and do not have appropriate sanitation systems (Hirji, 2001;Hirji, 2002).Not surprisingly, infectious water borne diseases, such as dysentery, cholera, and hepatitis are ommon in places where water is scarce.Providing drinking water free of disease-causing agents is the primary goal of all water supply systems (Faggle and Rabie, 1992).The inability of vulnerable populations to access safe water and basic sanitation has seen frequent diarrheal and cholera outbreaks in the Zimbabwe.The 2008 cholera outbreak was unprecedented, affecting urban and rural areas in all ten provinces.Results from the 2009 Multiple Indicator Monitoring Survey (MIMS) indicate that the proportion of people in rural areas with access to safe drinking water declined from 70% in 1999 to 61% in 2009, due to unfavorable economic conditions in the country (Sisimayi and Masuku, 2010).The majority of the cholera cases (68.6%) were reported from the provinces of Mashonaland West, Harare, Manicaland, and Masvingo (Waddington et al, 2009).Poor water and sanitation provisions in areas of Chegutu District (Mashonaland West Province) gave the outbreak a distinct rural preponderance at its outset.
Access to health services was a major challenge and one of the major reasons for the prolonged nature of the outbreak.
The programme component of WASH in schools supports countries in providing access to safe water and adequate sanitation for all in order to improve the health and well-being of the students, staff, as well as community.WASH provides guidance and tools for sustainability of water supply and sanitation facilities with focus on: operation and maintenance, community management, participatory health and hygiene education transformation as well as drinking water surveillance (WHO, 2012).WASH also assists countries in resource mobilization for the development of the water supply and sanitation sector.Since 1990, almost 2 billion people globally have gained access to improved sanitation, and 2.3 billion people have gained access to drinking water from improved sources (WHO Report, 2014).The report also highlights a narrowing disparity in access to cleaner water and better sanitation between rural and urban schools.
Southern African primary schools in rural areas are poor, linked to the high incidence of poverty, poor hygiene and sanitation practices (Dube and January, 2011).A study conducted in six Sub-Saharan African countries comprising Ethiopia, Kenya, Mozambique, Rwanda, Uganda and Zambia, found that 1% of rural schools in Ethiopia and Mozambique to 23% of rural schools in Rwanda, had improved water sources, improved sanitation and water and soap on school premises.Fewer than 23% of rural schools in the six countries met the WHO's recommended student-latrine ratios for boys and girls (Morgan et al., 2017).It is important to note that apart from the family, schools are important and stimulating learning environments for children and have the potential to significantly alter the behavior patterns of students leading to improved hygiene practices (UNICEF, 2009).According to Fewtrell et al ( 2005), these hygiene behaviors include proper hand washing, regular bathing and laundering, safe disposal of waste, and proper use of toilets which will help in enhancing effective learning, attracting large student enrolment in schools and ensuring a reduced burden on diseases.Very few studies have been carried out particularly in rural secondary schools to assess sanitation practices carried in these schools.It is against this back drop that this study sought to establish the extent of water use and sanitation practices in ensuring sustainable implementation of hygiene practices particularly in resettlement areas.
Results derived from the study provide a snapshot of the current status of water use and sanitation practices in rural  Before a school is registered by the Ministry of Education, it is Government policy that officials from MoHCW inspect and certify as satisfactory sanitary conditions at that school (GoZ, 2013).The national standards require an approved toilet facility for schools, that is, ventilated improved pits (VIP) for rural schools without reticulated water supply; or water-borne sanitation where reticulated water system is available, usually in urban areas.The ratio of pupils to toilet is 25:1 for boys and 20:1 for girls as a national policy (MoHCW, 2011).National standards on WASH in schools are specified in Minimum Functionality School Standards designed by Ministry of Primary and Secondary Education (Appendix A), while international standards for WASH in schools are specified by UNICEF Guidelines (Appendix B).

Impact of Inadequate WASH Facilities in Rural schools
Although it is a worldwide trend to prioritise provision of good quality drinking water over good sanitation, experience has shown that good health requires three essential components, that is, water, sanitation and hygiene (Water Aid, 2012).
Inadequate water and sanitation undermines immune functioning and increases vulnerability to infections.This is particularly significant given the prevalence of AIDS in Africa.Inadequate water and sanitation services in schools frequently results in the loss of privacy and dignity, and increases risks to children's safety when toilets are placed at a distance from the schools' premises (Enviro Loo, 2010).This is particularly true for girls when it comes to menstrual hygiene management (MHM).Poor sanitation and unusable facilities in many schools may contribute to absenteeism and an uncongenial learning environment, and is cited as an important reason why many girls drop out of school (UNICEF, 2002).Further studies can also look into the impact of sanitation aspects on girls' participation and attendance in schools   techniques were employed in this study.Although each method collects specific type of data, the methods are complementary; one method confirms, verify and reinforce the findings obtained by the others (Mills et al, 2010).

Methodology
Data collection techniques used in this study were self-administered questionnaires and interviews.The adoption of these techniques was meant to have these methods augment each other in soliciting data from different units of analysis.
Combining these methods also facilitate verification of data.

Questionnaires
Questionnaires were distributed to students since they are the most affected by water supply and sanitary conditions in public schools.Questionnaires were used to collect data from respondents with cognisance that the data would be easy to convert into figures for comparative analysis (Gray, 2009).
Both closed and open-ended questions were used for respondents to express themselves where necessary.The questionnaires with simple-tick response administered to students included 5-point Likert scale seeking information on water, sanitation, and hygiene-related issues.

Interviews
Interview guides were used to solicit information from School Health Masters, School Development Committee (SDC) Chairpersons, Rural District Council, District Education Office, Ministry of Health (Chegutu District Hospital), and UNICEF coordinator in the district.The role of school health master in the survey was to examine the consistency of the students' view concerning the state of the WASH in their schools.The methodology was preferred for its strength in giving detailed explanations of a phenomenon (Babbie, 2008) and in this case, explanation on progress of WASH in schools, challenges and future plans.The above mentioned authorities were interviewed to assess their contribution towards attainment of WASH objectives in the district, including future plans.

Secondary data
Secondary data is data already collected for other purposes.The secondary data sources included WASH reading material, School Development Plan (SDP), records of enrolment from 2016 to 2022, Health education schedules, school WASH campaign schedules, as well as internet sources.This method was favourable for its fewer costs compared to other methods like which required more resources (Gray, 2009).

Sampling
Sampling is the process of taking any portion of the population as representative of that population (Otero, 1999).For this research, combinations of sampling techniques were used to gather data.These were purposive sampling and stratifiedsystematic random sampling.Purposive sampling was used to select schools in geographical area under study.Schools from Ward 11 and 29 of Chegutu East Constituency were consciously and purposively selected to be representative of secondary schools in resettlement areas.Stratified-systematic random sampling was used to select students.The students were aggregated by gender (stratified sampling) and systematic sampling was used to select every second student using school registers.Stratified sampling permits the researcher to identify sub-groups within a population and create a sample which mirrors these sub-groups by randomly choosing subjects from each stratum (Babbie, 2008).

Study Sample size
According to Otero (1999), a sample is a set of data collected and selected from a statistical population by a defined procedure.Generally, a sample is a subset of the population.The study's sample frame comprised of 81 students (40%) from a target population of 201 students.In all statistical analysis, the objective is to minimise error and maximise the true measure.Gay (1987) suggests 10% of large populations and 20% of small populations as minimum population samples.
The sample that was chosen constituted 40% of the form four student populations.The population sample was set above the minimum of 20% suggested by Gay to minimise error.According to Gray ( 2009), as the sample size increases, the random extraneous errors tend to cancel each other out, leaving a better picture of the true measure of the population.
The survey was carried out in the winter season, between the months of October and November 2022.

Data analysis
Data collected were compiled and analysed using descriptive statistics (graphs and tables).

Results and Discussion
Data collected from four school sites in Chegutu District was presented and analyzed.The researcher used the findings that have been reviewed in the literature section and those from the field survey.General characteristics of staff and student population were also identified.Heads of schools and students responded to self-administered questionnaires.To assess water use and sanitation practices by students, 5-point Lickert scale (strongly agree, agree, neutral, disagree and strongly disagree) was used to determine level of agreement.Students were asked for their perceptions pertaining services delivered to them.The schools from which data were acquired were coded as A, B, C, and D following the order of visits from day one.Coding was spurred by the idea of maintaining anonymity of the respondents.Health masters (one per school) and SDC chairpersons were interviewed on the assumption that some of them would not respond to selfadministered questionnaires well and that the researcher required qualitative data from people directly involved in school WASH programmes.The findings revealed the actual sanitation practices in rural secondary schools of Chegutu District.

General Characteristics of Students and Staff Population
This section identifies populations of male and female staff, as well as trends in student enrolment statistics of schools A,

Staff Characteristics by Gender
The study revealed that all schools were headed by male acting heads, with 6 to 11 years work experience.All school heads were holders of Bachelor of Education degree in subject area.From the schools visited, the number of male teachers range from 2 to 6 teachers, while females range from 3 to 5 teachers.On average there were 4 male and 4 female teachers per school.Equal average numbers entail the need for equity in terms water supply and sanitation to meet the needs of both male and female teachers.Research findings (Figure 2) show that there were more female (71%) than male (29%) teachers in school D. School C had equal numbers of male (50%) and female (50%) teachers.School A and B had more male than female teachers.Figure 2 below shows staff population classified by gender.The research revealed that both staff and students used the same water source.Sanitation facilities for staff were adequate ranging from two to four toilets.The research showed that hand-washing for teachers and washing water for female staff is still lacking in schools.The results showed that school D had more female staff, more than double male teacher population.
This condition implies that more washing water for female staff, and the need for privacy is required.unclear; the head revealed that the school experienced quite significant numbers of dropouts from 2020 to 2022. Figure 3 shows a summary of student enrolment statistics from 2017 to 2022.The trends in figure 3) revealed that enrolment for schools A, C and D was increasing each year from 2017 to 2022, except for school B when it declined in 2020 and 2021 then rose sharply in 2022.Generally, enrolment for schools A, B, C and D were higher in 2022 than in 2017 by 116%, 74%, 81% and 157% respectively, which suggests that enrolment rate was on the rise.

Water Use in Schools
Among many factors which influence the quality of service delivery, water availability is one of them (UN, 2011).In order to assess the regularity of supply of water in schools under study, it was important to first identify the common water sources used.A student questionnaire was used to identify the main source of water in the schools.It was found that the majority of the students in all the four schools are supplied with borehole water.It was noted that these sources of water do not go through any form of treatment before use and this does not make it totally safe for drinking.Even though majority of the students indicated that water was safe for drinking (60%) as shown in figure 4, 34% disagreed.From student assessment in school D, 96% of respondents said borehole water usually contained some visible suspended substances.
Supporting evidence through observations by researcher revealed that suspended substances and rust were seen in borehole water during morning when people start to fetch water.The school health master from school D confirmed that students had raised concern on quality of water, but had not investigated the issue to verify the sentiments.Students from school C also reported that the water had an unpleasant taste.To determine the significance of responses the researcher tested the water and it had an unpleasant taste.The school health master, the head and the SDC chairman also said the same thing, and emphasised on the need for water test to ensure microbiological safety.However, borehole and tap water is considered acceptable provided it has undergone necessary treatment that meets national standards (UNICEF, 2014).Instead, microbial water tests by trained individuals at schools could provide more accurate information on water quality.While boreholes for schools C and D provided a needed source of potable water 4 and 5 years ago, respectively, they have not been maintained by experts, and no inspections have been done by Government health officials for the past 5 years.All heads of schools reported that neither Ward health officials nor Chegutu Rural District Council have visited schools on WASH related issues but for other reasons.This shows lack of commitment on part of Ministry of Health and Rural District Council despite the fact that the results from key informants interviewed indicated lack of resources and overdependence on donor aid as main challenges being faced by these institutions.However there has been to a larger extent the intervention of the private sector and community in ensuring availability of water in all schools.Increased resources or alternative actors for water quality monitoring should be addressed.
Majority of the students from school C indicated water scarcity as the main challenge in the school especially when the borehole is not functioning.To handle such challenges, students bring their drinking water from home while a few depend on water sold in school.The school in this category dedicates a day during the week to fetch water from boreholes from nearby farms and store in large drums.Since the water supplied is not treated before storage, majority of the students bring their drinking water from home. Figure 4 below shows the results on water related matters from the students.It could be inferred that all schools had their water sources functional as indicated by 77% of students.Despite similarities in terms of pumping out water, the states of boreholes were different due to age.Aging water systems are vulnerable to continued breakdown, burst pipes and leaks leading contamination problems (DWAF, 2003b).Observations showed that boreholes in schools A and B were newer than of other schools.The heads of schools and SDC chairmen also indicated that donor intervention and community involvement provided boreholes for schools A and B, respectively.The boreholes for these schools were replaced after series of break downs due to use of old equipment.In addition, students from these schools did not mention any problems related to water quality other than long queues and long waiting time at water points during break and lunch time.Figure 4 below shows students' responses on provision of water services as well as hygiene practices by students.The results showed lack of investment in hand-washing facilities and soap among schools studied.Majority of students disagreed on provision of soap (89%) and availability of hand-washing water (63%).Observations also revealed that there were neither hand-washing facilities nor soap during school visits.Only a few students indicated bringing soap for handwashing to school.Majority of students (76%) indicated that they do not wash hands with soap; this is a clear indication of lack of commitment in terms of investment in school WASH components.Majority of students did not agree on provision of washing water for girls (78%), while 17% agreed.Students also revealed that lack of hand-washing facilities and soap made it difficult for them to practice hygiene at school.Washing water for girls were only provided in school B; water was stored in open drums and a small bucket was used to fetch water.Open water is prone to contamination and its use poses potential health risk.According to MoHCW (2009), water quality is an important consideration in rating the performance of a water supply system.The quality of water required for either personal or domestic use must be safe, that is, free from micro-organisms and chemical substances that constitute a threat to a person's health.The need for clean protected water for use by students should be considered seriously.Findings support the view that girls who are menstruating face numerous challenges when attending school and these include; lack of appropriate disposal facilities for sanitary pads, inadequate water supply, lack of sufficient toilets and little provision for hand washing (UNICEF, 2012).

Frequency of Water Use
Students were asked on frequency of water use during school hours.Figure 5 below shows frequency of water use by male and female students per day.The results showed that frequency ranged from "once a day" to "four times a day".
Majority of male students (40%) use water source twice a day, followed by 29% using water source three times a day.
16% and 14% of male students use water source once a day and four times a day, respectively.The study also revealed that majority of female students (52%) use water source three times a day, followed by a significant number of 34% using water source four times a day.From the study findings, it is noted that small percentages of female students use water source once (5%) and twice (9%) a day.The results reveal that female students use water source more frequently that male students, hence renewed investments in school WASH need to consider consistent provision of water for girls and all students in the long run.Water access and good latrine conditions at school were found to be important aspects of school environment for menstruating girls in Tanzania, Kenya and South Asia (Blanton et al, 2007)

Sanitation Practices in Rural Schools
In the study area, all schools had improved functional sanitation structures (VIP toilets) on premises.School directors reported that facilities had waterless latrines, and all were functional.From figure 6, majority of the students (67%) reported bad odour in toilets, while 33% disagreed.Observations revealed that toilets in schools C and D had "bad smell" compared with toilets in schools A and B which were in good state.Additionally, the study found that 40% of the students (majority from school A and B) agreed that cleaning schedules were available in schools, while a significant number also disagreed (38%).Observations showed that only schools A and B had cleaning schedules pasted on notice boards.The state of sanitation facilities in schools C and D is an indication that little is being done to ensure that facilities are kept in good state.To support that, 63% of students, with majority from schools C and D, indicated that sanitation facilities were not cleaned and disinfected.It can be noted that there is need for schools to put written schedules into practice in order to promote a healthy learning environment.This shows lack of commitment on part of the school staff.The research revealed that all heads of schools were holders Bachelor of Education degree, but they failed to embark on at least one fundraising project, yet they have the potential to design, plan and manage income generating projects.Although the conditions of sanitation facility of schools A and B were better than those of schools C and D, their adequacy remains an issue.Table 1 shows the current ratios of toilet to students for schools A, B, C and D.

Source: Research findings
It was observed that there were insufficient toilets in all the secondary schools.Latrine construction in all the schools had not kept pace with the increase in enrollment which has resulted in schools having more than 25 pupils per drop-hole.The study revealed that for the past 5 years, no toilets were added to keep pace with increase in enrolment.The population of the schools visited range between 196 and 302 students, with number of toilet facilities that ranges between 3 and 5 latrines.The ratio of toilet to student in all schools ranged from 1: 28 for boys and 1: 30 for girls to 1: 36 and 1: 34 respectively.The study also found that students find it difficult to use toilets especially the female students, who require more privacy.Both female and male students prefer using the toilets before leaving their various homes and also at the close of the day since school toilets are not always clean even though there were schedules for cleaning of toilets.The study revealed that cleaning of toilets were done by students as schools under study were low income schools and could not afford to employ ancillary staff as specified by all heads of schools.Proper use of the toilet facility can only be possible when the toilet facilities are well cleaned and disinfected (UN, 2003).Some students could not use the toilets because they were always dirty.No urinals are provided in all the schools assessed.Through thorough observation and investigation, it was revealed that cleaning materials were only provided in school A and B, Heads of schools C and D indicated that school cash inflow rates were not favourable, the reason being that only a few students were paying fees.
They also added that most parents live in farm compounds, and their monthly wages are low, ranging between US$40 and US$60.As a result, the little income each school get is channeled towards administrative issues and the purchase of Qeios, CC-BY 4.0 • Article, October 17, 2023 Qeios ID: W5DKO4 • https://doi.org/10.32388/W5DKO41/25 Qeios, CC-BY 4.0 • Article, October 17, 2023 Qeios ID: W5DKO4 • https://doi.org/10.32388/W5DKO45/25 3.1.Study Area The study was conducted in Ward 11 and 29 of Chegutu District, Mashonaland West Province in Zimbabwe.The area falls under Agro-ecological Region 2B where rainfall ranges from 750 to 1000 mm per year.The study area which is located in Selous resettlement area, was considered for purpose of the study.Four secondary schools were selected, namely; Chengeta Secondary School, Naemoor Secondary School, Benbank Senior School and Saruwe Secondary School (figure 3.1).The schools were coded A, B, C and D respectively, for confidentiality.The schools are dispersed throughout the study site area as shown in figure 1.

Figure 1 .
Figure 1.Map showing the location of study area (Arc GIS Version 10.1) WASH components in schools were assessed using Minimum Functionality School Standards designed by Ministry of Primary and Secondary Education to promote WASH in schools, and UNICEF guidelines.The Minimum Functionality School Standards document draws information from various Government and Ministry instruments.Both documents set the basic measures or benchmarks of expected performance and achievement for effective teaching, learning and institutional management of schools.The documents also specify expected standards for WASH in schools.The student-latrine ratios were also used to assess adequacy of sanitation facilities in schools.It was obtained by dividing number of students by the number of observed functional latrines per school.

Figure 2 .
Figure 2. Staff Population by gender (Source: Research Findings)

Figure 4 .
Figure 4. Students' response on water use in schools (Source: Research findings)

Figure 5 .
Figure 5. Water use by Male and Female Students per day.(Source: Research findings)

Figure 6 .
Figure 6.Sanitation Practices and Hygiene (Source: Research Findings) schools of Chegutu District based on available local data and from research studies.This research seeks primarily to support raising the profile of WASH in schools by providing the current available data, and a baseline from which progress in the sector may be tracked.The results from the study would be used by Chegutu District Public Health Department and other related organisations that are involved in the prevention of diarrheal diseases to come up with appropriate diarrheal prevention interventions.The findings of the research help schools to avail financial resources and time in areas of water use and sanitation practices, hence improving and reinforcing hygienic conditions.The study provides information for the development of better policy regarding implementation strategies for the rural schools by the Government of Zimbabwe from district to national level.2.Literature Background: Overview on Water and SanitationHuman health depends on the quality of our immediate surroundings, in which water and sanitation services and their management have a key role.In September 2000, the United Nations General Assembly adopted a number of Millennium Development Goals (MDGs) that challenged the global community to reduce poverty and increase the health and wellbeing of all peoples.In September 2002, the World Summit on Sustainable Development in Johannesburg reaffirmed these goals and added specific targets on sanitation and hygiene(UN, 2003).By Water Supply and Sanitation Programmes in Developed CountriesImproved sanitation practices that produce the desired results have been studied in the developed world.WHO (2009)notes that, in the developed world, only the sanitation technologies which operate in an environmentally responsible manner are chosen.The implementation of eco-sanitation (eco-san) to manage excreta has been realized in Romania.
Morgan et al (2017)r table is high and pollution problems very real, VIP latrines may not be considered(Enviro Loo, 2010), especially for schools in Eastern and Western Cape in South Africa, and part of the Eastern Highlands of Zimbabwe where water table is relatively high.According toWHO (2009), cholera, dysentery and trachoma are diseases spread by a combination of poor sanitation and poor hygiene practices associated with water scarcity and poor water quality, as well as lack of education and understanding of how easily the infection can spread in public institutions and between people.Between August 2008 and If there are no latrines and hand-washing facilities at school, or if they are in bad repair, many children would rather not attend school than use the alternatives(WHO, 2008).It is particularly important that girls who are old enough to menstruate have adequate facilities at school that are separate from those of boys.According to Sayed (2013), if facilities are not separate, students, especially girls may miss school monthly, finding it difficult to catch up, and ultimately being more likely to drop out of school altogether.A study conducted byMorgan et al (2017)notes that fewer than 20% of the rural schools were observed to have at least four to five recommended menstrual hygiene services Qeios, CC-BY 4.0 • Article, October 17, 2023 Qeios ID: W5DKO4 • https://doi.org/10.32388/W5DKO44/25sinceliterature is still lacking.Poorly designed sanitation facilities or inappropriate location may lead to migration of waste matter and contamination of local water supplies putting the school and surrounding community at risk (MoHCW, 2011).Groundwater pollution problems associated with on-site sanitation systems have given rise to concern in terms of its potential negative impact on the environment in rural schools.May 2009, Zimbabwe suffered the most severe cholera epidemic ever recorded in Africa, resulting in 98,440 cases and 4,130 deaths (CARE, 2012).In response to the cholera crisis Zimbabwe has experienced, CARE International UK has implemented a successful project in Bikita district, one of the areas worst affected by Cholera.With funding from the Isle of Man Overseas Aid Committee, technical assistance from CARE and the active involvement of government departments and local authorities, a project has been implemented to improve WASH situation in schools and surrounding rural communities in Bikita (CARE, 2012).Alongside improving education around WASH issues, the project also saw the construction of latrines, hand washing facilities and water points for a community in dire need.Affordable services should be promoted to ensure the broadest coverage within the shortest time frame.As a minimum basic requirement, sanitation services and potable water within 500m of a school should be provided and upgraded when feasible (UNICEF, 2011; MSS, 2013).In addition, good hygiene practices such as hand washing, safe water storage, as well as solid waste management, should be promoted through implementation of appropriate awareness campaigns.The research focuses on how such practices are being achieved in rural schools, and the challenges being faced in service delivery.Lack of facilities and poor hygiene affect both girls and boys, although poor sanitation conditions at schools have a stronger negative impact on girls.All girls should have access to safe, clean, separate, and private sanitation facilities in their schools(WSP, 2004).(separatesex latrines with doors and locks, water for use and waste bin).
. However, a recent study in Malawi found no impact of school WASH conditions on girls' absenteeism(RWSSI Project Briefs, 2014).A number of qualitative studies (UK Aid, 2014; UNICEF, 2011; WHO, 2014) provide reports of the adverse impact poor WASH conditions have on girls' privacy and comfort at school, and lack of menstrual hygiene management (MHM) resources may affect girls' participation in school activities due to fear of leakage.Current findings reveal that insufficient resources are available for menstruating girls in rural schools of developing countries; however reviews indicate insufficient research to clarify the impact of improved MHM on school or health parameters.Generally there is lack of privacy and places to wash or dry (reusable) sanitary materials, and lack of water for washing.

Table 1 .
Current Ratio of Toilet to Students for Schools A, B, C and D