| Objective:Through the collection of the conditions of water and sanitation in schools,as well as the status quo of personal health knowledge,attitude and behavior of students,to evaluate the implementation status of water,sanitation and hygiene promotion projects in Chongqing,which provide reference basis and advice for the establishment of the next period project and provide theoretical basis for the Ministry of Education to plan related projects in the future.Methods:A mixed method of quantitative,qualitative and field observation has been used in this study.1.Quantitative research:A questionnaire survey on the basic situation of schools is conducted for all the project schools.A total of 3067 students from 10 project schools were selected to conduct a questionnaire survey on students'personal hygiene knowledge,attitude and behavior.2.Qualitative research:qualitative data were obtained through 5 key figures interviews,11 in-depth interviews and4 groups of focus group discussions.3.Field observation:in order to know the hygienic status of water supply,toilet,canteen,dormitory in schools,field observation was conducted in 9 project schools.Results:1.Quantitative results(1)Hygiene and food safety of school canteens:68.6%of schools have standard canteens;The canteen area is concentrated between 200~500square meters(50.8%);95.7%of schools hold"catering service license";The number of employees in the canteen is concentrated in 1-5(48.6%);77.1%of the canteens reported that their facilities and equipment fully met the standards.The on-site investigation found that all the canteen location was reasonable.Seven(77.8%)canteens were divided into functional areas.There are still 6(66.7%)pantries without wash basins and sink.The holding rate of catering service license,canteen hygiene management and health certificates of canteen employees are all 100%.The qualified rate of personal hygiene of employees was 88.9%.Only one of the nine schools had provided disinfection records for food(cooking)utensils.(2)water supply:the coverage rate of centralized water supply in schools is 100%;The main drinking way for teachers and students is purified water(42.4%).The on-site investigation found that 11.1%of the schools still didn't arrange drinking water points in the teaching area.Only66.7%of the schools met the requirement of"at least one tap for every 45people".88.9%of the schools set up waiting spaces at drinking places,but33.3%of the waiting spaces occupied the emergency evacuation passageway.77.8%of schools have established the water supply sanitation management system.88.9%of the schools are equipped with water supervisors,but 22.2%of the water supervisors cannot provide valid health certificate.Only 77.8%of schools provided the water quality inspection report;Only 11.1%of the schools have provided health permits for wading products.77.8%of schools provided drinking water hygiene monitoring data.(3)The results of the sanitary survey of school toilets:61.4%of schools have harmless sanitary toilets;54.3%of toilet hand washing faucets meet the requirements;96.9%of hand washing faucets were equipped with soap or hand sanitizer;The percentage of men squatting in toilets(95.4%)is much higher than that of women(33.8%).(4)Health survey and evaluation of school dormitories:Of the 70schools,34(48.6%)are boarding schools;5.9%of the dormitory buildings are not separated from the main body of the teaching building.Only 17.6%of the schools meet the requirement of"no more than 6 people per room in the dormitory";There are still 38.2%of schools that cannot guarantee"one bed per person".52.9%of school dormitories have toilets;26.5%of school dormitories have shower facilities;82.4%of schools have established dormitory health management system.(5)Prevention,control and management of infectious diseases,common diseases and frequently-occurring diseases:97.1%of schools have established an infectious disease reporting system.90.0%of schools insisted on the registration of infectious diseases;98.6%of schools insisted on working in morning inspection every day.94.3%of schools insisted on tracing and registering the causes of absenteeism due to illness every day.75.7%of the schools had complete registration records for absenteeism due to illness.91.4%of the schools had carried out the vaccination certificate examination for freshmen.There were still 20%schools that didn't have clinics or infirmaries.Only 32.9%of schools were equipped with health professionals or health teachers.All schools(100%)had regular physical examinations for students and kept the data on file.(6)Health education classes:97.7%of schools had health education classes;94.6%of the schools had classes in week or two weeks.56%of the schools were taught by full-time teachers.85.6%of schools are equipped with special teaching materials.The establishing rate of health education classes(?~2=246.845,P=0.000),the teaching rate of full-time teachers(?~2=35.506,P=0.000)and the allocation rate of special teaching materials(?~2=7.785,P=0.004)in urban schools are higher than those in rural schools.The teaching rate of full-time teachers(?~2=8.990,P=0.003)and special teaching materials(?~2=153.947,P=0.000)in senior grades are higher than those in junior grades.(7)Students'personal hygiene knowledge,attitude and behavior:(1)Multiple linear regression found that students with girls,living with several generations,and father with higher education level had higher personal hygiene knowledge level;When the school health education class starts at least once in week and was equipped with special teaching materials,students'personal health knowledge level was higher.The students in the schools with both men's and women's toilet squatting numbers up to the standard and sufficient hand washing taps had a higher level of personal hygiene knowledge.The higher the score of students'personal hygiene attitude,the higher their knowledge level.(2)Girls and senior students scored higher in personal hygiene attitude;Schools with both men's and women's toilet squatting numbers up to the standard scored higher in students'personal hygiene attitudes.The higher the score of students'personal hygiene knowledge,the better their attitude.(3)Girls and father with higher education level did better in personal hygiene behavior.Schools equipped with full-time teachers and special teaching materials in health education classes had higher scores on students'personal hygiene behaviors.Schools with sufficient drinking water and hand-washing taps scored higher on students'personal hygiene behavior.Students with higher scores in personal hygiene knowledge and attitude had better personal hygiene behaviors.2.Qualitative resultsQualitative data found that school teachers generally didn't understand enough about the national and Chongqing standards,policies and guidelines for school health work.The implementation of WASH project in various schools was very similar,mainly focusing on water and toilet improvement,school building construction,playground renovation,canteen renovation and school infrastructure renovation,etc.Both the leaders and teachers said that the school environment had improved greatly after the implementation of the project,especially the toilet sanitation and drinking water sanitation,and the behavior habits of the students in the school had also changed,mainly focusing on hand washing after defecation,personal hygiene maintenance,drinking water habits,public health maintenance,etc.The successful implementation of the WASH project in Chongqing cannot be separated from the attention and initiative of the government,the education commission and the school,and cannot be separated from the coordination and linkage of the three parties.Conclusion:1.In view of the problems existing in the hygiene and food safety of studentcanteens,suggestedthatschoolsshouldimprovethe self-examination ability of canteen management and should run the canteen by themselves as much as possible;The educational administrative departments shall incorporate the sanitation of the school canteen into the school assessment system.2.In view of the problems existing in the water supply and drinking water sanitation in schools,suggested that the education department should increase the investment in the hardware facilities for drinking water supply in schools,strengthen the supervision of drinking water sanitation in schools,and schools should also improve their self-examination ability in drinking water management.3.In view of the problems existing in the sanitation of toilets and dormitories in schools,suggested that educational department should continue to increase the investment in infrastructure,improve the hardware facilities of toilets and dormitories,establish and improve the sanitation management system,and improve the operation and maintenance capability of sanitation facilities and equipment.4.In view of the problems existing in the prevention,control and managementofinfectiousdiseases,commondiseasesand frequently-occurring diseases in schools,suggested that the education department and the health administrative department should work together to solve the problems of insufficient professional health technicians,low salaries and low professional competence in the clinic of primary schools and to strengthen the training and professional guidance of existing health teachers.5.In view of the problems existing in students'personal hygiene knowledge,attitude and behavior,suggested that schools should continue to improve school environmental hygiene facilities and to construct students'personal hygiene education ability.When carrying out health education,schools should be different from person to person,seize the differences in population classification,and strengthen the education of boys,lower grades and groups lacking family education. |
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