Improving children’s environmental health in Metro Manila, Philippines, through a school water, sanitation, and hygiene intervention

Abstract

Millions of children are exposed to inadequate water, sanitation, and hygiene (WaSH) in schools globally. Diarrhoea is a leading cause of disease, while dehydration impairs cognitive performance and malnutrition hinders physical growth. To determine the most effective school WaSH interventions, the WaSH in Metro Manila Schools (WMMS) study assessed the association between WaSH and children’s health in a cross-sectional study of 15 schools, and evaluated an intervention, developed by the author, through a cluster-randomised controlled trial. The intervention consisted of policy recommendations, health and hygiene education, WASH hardware, and “software”. Health education was found to reduce the prevalence of stunting, overnutrition, and severe dehydration, and to improve children’s handwashing behaviour.