1. SCALE- UP BASELINE SURVEY UNILEVER SCHOOL OF FIVE COAST PROVINCE SEPTEMBER, 2013 1

2.  Methodology  Study tools  Baseline results –Background characteristics –Hand washing in school –Hand washing at home –General hand washing information –Pupil observation –Health group assessment –School School observation Key informant information  Discussions and recommendations  Questions? Outline 2

3.  Study area Primary schools in Coast Province Expanded baseline results 70 schools– Kisauni (27), Changamwe (22), Mvita (13), Mtwapa (8) districts Type of schools (Public (15), Private (52) and Special schools (3)) Representative sample at Baseline- 70 schools from the three categories (Public, private and special) All 70 schools participated in baseline survey Methodology 3

4.  Study design A descriptive cross sectional studies- Before intervention activities Quantitative and structured qualitative data collected  Study population 3,227 pupils participated from the three school types in Likoni county Public (723), Private (2,372) and Special (132) Methodology 4

5.  Selection criteria Registered schools by the Ministry of Education Primary schools in the 4 districts  Sampling procedure Stratified random sampling Random selection of 70 schools from the 3 types Random selection of pupils (Boys and girls) of class 5, 6, 7 and 8 from the class registers Methodology 5

6.  Sampling procedure 3,227 pupils from the 70 schools randomly selected for quantitative component An average of 44 pupils from each school selected Observation of hand washing after visiting the toilet Selection of boys and girls per class (5-8) proportionate to population within class Methodology 6

7. Unilever School of Five questionnaire –Pupil hand washing practices Pupil Observation tool –To observe hand washing behavior after visiting toilet School Observation –To observe school infrastructure and hygiene behavior from interviewer observation Group assessment –To assess pupil participation in health behavior club’s activities Key informant survey –To assess school infrastructure and hygiene behavior from knowledgeable person Study tools 7

8. Training of Research Assistants: –Team of 12 RAs trained on research ethics and all data collection tools (including Unilever tools) Quality control: –Piloting study tools and corrections before actual data collection; in-field data checks and corrections; regular call-backs Data management: –Data captured using Android’s tools through phone and central server –Cleaning, coding and analysis using STATA 12.1 Research processes 8

9. Baseline Results 9

10. Background characteristics 10 PublicPrivateSpecialAll Baseline Sample Study sample (n)7232,3721323,227 Study sample (%)22.473.54.1100.0 Total number of pupils Total number of Boys49.950.152.350.2 Total number of Girls50.149.947.749.8 Age Age (<10 Years) %0.81.40.01.2 Age (11-12 Years)%33.943.229.540.6 Age (13+ years) %65.355.370.558.2

11. Hand washing in school 11

12. Do you wash hands in school? 12 PublicPrivateSpecialAll Kisauni72.294.9100.088.7 Changamwe36.070.397.768.4 Mvita89.097.875.093.2 Mtwapa69.697.8-90.6 All Baseline71.086.990.983.5

13. What do you use to wash hands in school? 13 PublicPrivateSpecialAll KisauniWater only73.261.29.162.0 Water with soap18.633.090.931.8 ChangamweWater only93.877.658.177.1 Water with soap6.322.141.922.6 MvitaWater only85.478.884.881.1 Water with soap14.620.815.218.7 MtwapaWater only71.964.9-66.3 Water with soap26.632.8-31.6 All BaselineWater only77.669.047.569.7 Water with soap17.728.052.527.2

14. Where do you get soap for hand washing in school? 14

15. Hand washing at home 15

16. Do you wash hands at home? 16

17. Occasions for hand washing at home 17

18. Hand washing at home- All 5 occasions 18

19. Do other people wash hands at home? 19

20. Who washes hands at home? 20

21. General hand washing information 21

22. Do you belong to any health/hygiene club? 22 PublicPrivateSpecialAll Kisauni 6.3 6.4 24.1 6.8 Changamwe 6.9 3.6 20.5 4.7 Mvita 5.7 1.7 6.8 3.4 Mtwapa 4.0 6.1 - 5.5 All Baseline 5.9 4.6 16.2 5.4

23. Is there a proper way to wash hands?- Yes 23

24. Who taught you how to wash your hands? 24

25. Have you heard of School of Five? 25

26. From whom did you hear School of Five? 26

27. Observation 27

28. Hand washing behaviour observed 28

29. Availability of soap 29 PublicPrivateSpecialAll Kisauni - 26.3 - Changamwe - - - - Mvita - - - - Mtwapa - - - All Baseline - 13.2 -

30. Cleanliness status of toilet or hand washing facility 30 KisauniPublicPrivateSpecialAll Clean toilet/latrine 28.6 63.2 100.0 55.6 Clean hand washing facility 57.1 73.7 100.0 70.4 Changamwe Clean toilet/latrine - 42.1 100.0 40.9 Clean hand washing facility - 52.6 100.0 50.0 Mvita Clean toilet/latrine 50.0 100.0 - 76.9 Clean hand washing facility 50.0 100.0 84.6 Mtwapa Clean toilet/latrine - 50.0 - 37.5 Clean hand washing facility 50.0 33.3 - 37.5 All Baseline Clean toilet/latrine 26.7 59.6 66.7 52.9 Clean hand washing facility 46.7 65.4 100.0 62.9

31. Values and life skills 31 KisauniPublicPrivateSpecialAll Advertisements 28.6 15.8 - 18.5 Privately owned kiosks 57.1 57.9 - 55.6 Changamwe Advertisements 100.0 5.3 - 13.6 Privately owned kiosks - 63.2 - 54.5 Mvita Advertisements 25.0 12.5 100.0 23.1 Privately owned kiosks 50.0 37.5 100.0 46.2 Mtwapa Advertisements - 16.7 12.5 Privately owned kiosks 100.0 66.7 75.0 All Baseline Advertisements 33.3 11.5 33.3 17.1 Privately owned kiosks 53.3 57.7 33.3 55.7

32. Water and hygiene 32 KisauniPublicPrivateSpecialAll School has a source of drinking water 85.7 89.5 100.0 88.9 All classrooms have litter bins 14.3 36.8 - 29.6 Changamwe School has a source of drinking water - 63.2 100.0 59.1 All classrooms have litter bins - - - - Mvita School has a source of drinking water 75.0 87.5 100.0 84.6 All classrooms have litter bins 50.0 87.5 100.0 76.9 Mtwapa School has a source of drinking water 100.0 66.7 - 75.0 All classrooms have litter bins - 16.7 - 12.5 All Baseline School has a source of drinking water 73.3 76.9 100.0 77.1 All classrooms have litter bins 20.0 28.8 33.3 27.1

33. Values and life skills 33

34. School- Life skills and values 34 KisauniPublicPrivateSpecialAll School community anti-drug campaign 78.6 86.8 100.0 85.2 Evidence of counseling children fond with drugs 21.4 52.6 100.0 46.3 Changamwe School community anti-drug campaign 25.0 84.2 100.0 79.5 Evidence of counseling children fond with drugs - 18.4 - 15.9 Mvita School community anti-drug campaign 100.0 50.0 100.0 69.2 Evidence of counseling children fond with drugs 25.0 6.3 50.0 15.4 Mtwapa School community anti-drug campaign 50.0 84.6 - 76.5 Evidence of counseling children fond with drugs 25.0 23.1 - 23.5 All Baseline School community anti-drug campaign 73.3 80.0 100.0 79.4 Evidence of counseling children fond with drugs 20.0 29.5 50.0 28.4

35. Schools and gender issues 35

36. Water, sanitation and hygiene 36 KisauniPublicPrivateSpecialAll Observed hygiene education every term 57.1 57.9 - 55.6 Existence of hand washing water 57.1 89.5 100.0 81.5 Observed water quality inspection - 31.6 - 22.2 Changamwe Observed hygiene education every term 25.0 39.5 - 36.4 Existence of hand washing water 75.0 63.2 50.0 63.6 Observed water quality inspection - 7.9 - 6.8 Mvita Observed hygiene education every term 37.5 56.3 50.0 Existence of hand washing water 100.0 Observed water quality inspection 37.5 6.3 - 15.4 Mtwapa Observed hygiene education every term 25.0 7.7 - 11.8 Existence of hand washing water 100.0 69.2 - 76.5 Observed water quality inspection 25.0 7.7 - 11.8 All Baseline Observed hygiene education every term 43.3 44.8 16.7 43.3 Existence of hand washing water 76.7 79.0 83.3 78.7 Observed water quality inspection 13.3 16.2 - 14.9

37. Knowledge of pupils who have used drugs 37

38. Knowledge of harmful gender-related practices discouraged in school and at home 38

39. Knowledge of child protection rights 39

40.  The practice of hand washing in school remains a challenge as it contrasts reported hand washing practice at home.  Hand wetting still a common practice among Public and Special schools  Most schools have a source of drinking water ; – from rainwater harvesting, piped water, and boreholes among others.  School compounds were found free from injurious materials –Some abandoned pits, dis-used buildings and timber in few public schools.  Special schools have conducive and barrier-free environments which are good for learning. –Not true especially in Private schools  Most of the schools teach life skills and there are no advertisements on drugs around and near the schools.  Marked use of drugs among pupils; –Tobacco, alcohol, cannabis and Khat among others. Discussions 40

41.  Discouragement of early marriage and child labour was low.  Most of the Pupils know their survival rights; – However, some do not know most of their responsibilities and rights except that of respecting their family members/elders & education as their development right.  Most pupils in Private and Public schools had shoes; –Few in Special schools.  Pupils are knowledgeable on type of parasite and diseases prevented by wearing shoes.  There was no any organized school feeding programmes in most of the school –Only in some Private and Special schools.  Very few pupils belonged to a health club in school and significant number of schools lacked health clubs. Discussions 41

42.  Need to strengthen school health clubs –health champions at school level  Pupils to be taught more on values and life skills, gender issues, child rights and protection  Need for adequate latrines, drinking water points and desks in all schools  Girls provided with sanitary towels and sanitary towels disposal facilities  Hand washing (with soap) facilities should be provided and strategically placed for easy access by pupils. Programmatic Implications 42

43.  Need for sensitization among pupils, parents and the communities at large on dangers of drug abuse.  School management committees to work closely with the teachers in order to appreciate new skill being introduced to them by the pupils  Need for household involvement in creating long-lasting influence on hand washing behavior among pupils. Programmatic Implications (Cont.) 43

44. Questions? 44