Purpose: Improving hygiene behaviors and sanitation practices among youth in Ghana, West Africa, is a national priority. In 2004, Ghana Education Service (GES) and the Danish International Development Assistance (DANIDA) initiated a hygiene program (School Sanitation and Hygiene Education, SSHE). It focuses on improving hygiene behaviors and providing sanitation facilities for schools in 4 regions in Ghana. Until now, no comprehensive national level data were available on the prevalence level of hygiene behaviors and sanitation at the basic education level. In 2007, the Ghana GSHS (Global School-Based Student Health Survey) was administered. In this presentation we examined baseline data collected on hygiene behaviors and sanitation to evaluate SSHE among junior-secondary school students.

Methods:  In the 4 targeted regions, 600 school health committees were trained to support hygiene promotion activities. In addition, teachers and school-health coordinators were trained to carry out planned activities. Materials on school hygiene promotion (posters/stickers) with key messages, a calendar with health messages and a teaching/activity booklet were also distributed throughout the schools. 34 schools were selected from the 4 target regions to participate in the 2007 Ghana GSHS.  Participation was voluntary and anonymous. For this study, 11 questions asking about hygiene behaviors and sanitation were selected for analysis.

Analysis/Results: 70.2% of students who were taught in class how to wash hands during the past 30 days. Students attending school in SSHE regions (75.1%) were significantly (p < .001) more likely than students in non- SSHE regions (64.6%) to have been taught in class how to wash hands during the past 30 days. Overall, 24.8% of students never or rarely used soap when washing hands during the past 30 days. Students attending school in SSHE regions (19.3%) were significantly (p < .001) less likely than students in non-SSHE regions (31.4%) to never or rarely used soap when washing hands during the past 30 days. Overall, in schools with a place to wash hands, 14.7% of students never or rarely washed hands after using the toilet or latrine. Students attending school in SSHE regions (11.7%) are significantly (p < .001) less likely than students in non- SSHE regions (18.9%) to never or rarely wash hands after using the toilet or latrine.

Conclusions: The SSHE program markedly improved hygiene behaviors and sanitation among students in the 4 target regions. Since positive changes in hygiene behaviors and sanitation leads to lower morbidity and mortality, the SSHE should be implemented nationwide.