ABSTRACT

Many developing countries including Kenya are struggling to provide proper sanitation to their population with most reporting less than 50 percent adequacy in sanitation. Different research works indicate sanitation is worse in schools compared to the general population despite the fact that schools hold a significant 26 percent proportion of the entire population. Provision of quality latrines in schools is critical in dealing with sanitation and health challenges. Healthy Environment for Children Alliance (HECA) program was rolled out in Transnzoia East Sub County with the aim of improving sanitation in the primary schools within the sub county by emphasising on community led school sanitation; however seven years after its roll out there had been no follow up study to find out its success or failures and hence the need for this study. Teachers were hypothesized to influence the latrine quality in schools due to their role in sanitation improvement as outlined in the national school health policy. The environment components were also studied to find out if they had significant influence in the quality of latrines in schools. A total of 301 teachers were sampled from 44 schools. These included schools that participated in the HECA program and those that did not. The head teacher from each school was sampled purposively while other teachers in the school were selected randomly. Questionnaires were used to collect quantitative data and qualitative data on teachers and environmental determinants affecting the latrine quality while a checklist was used to collect data on the quality of the latrines. The latrine quality was studied by looking at five major parameters which were latrine adequacy for pupils use, latrine structure, latrine privacy, availability of functional hand washing facilities and the cleanliness levels of the latrine. Results from the study indicated that there was no significant difference in latrine quality between schools that participated in the HECA program and those that did not participate (p value 0.280) except on the sub parameters; level of latrine fill up (p value 0.024), lockability of doors (p value 0.004) and accepted size of the latrine hole (p value <0.002).The HECA program failures were mainly attributed to lack of sustainability measures (52%) and lack institutionalization of the program (22%). Among the teachers and environmental related determinants found to be significant on the quality of latrines in schools  included knowledge on the national school health policy (p value <0.026), availability of local building materials (p value <0.0466) and teachers practice (p value <0.008). This information from the study will be key in informing the decision makers and stakeholders on issues of improvement of latrine quality in the schools and on future HECA program implementation. Some of the main recommendations from the study include implementation of measures that ensure continuous training on the national school health policy; adequate sustainability of future HECA program by ensuring more teachers are trained and ensuring adequate inclusion of the school health clubs to the program.