Handwashing Knowledge, Practices, And Associated Factors Among Selected Basic School Children at the Lower Manya Krobo Municipality in the Eastern Region of Ghana

Abstract

Background: Hand hygiene is a fundamental public health intervention for preventing communicable diseases, particularly among school-aged children. This study aimed to evaluate the knowledge, practices, and enabling conditions related to handwashing among basic school children at the Lower Manya Krobo Municipality in the Eastern Region of Ghana. Methods: A quantitative cross-sectional study design was employed among 390 pupils selected from three basic schools using a multistage sampling technique. Data was collected using a structured questionnaire administered through KoboCollect. Descriptive statistics were used to summarize variables, while chi-square tests and logistic regression analyses were conducted to assess associations and predictors of handwashing practices at a 5% level of significance. Results: The study found that 90.3% of respondents had good knowledge of handwashing, while 57.8% demonstrated good handwashing practices, showing a substantial knowledge-behaviour gap. A majority of pupils reported washing their hands at critical moments such as before eating and after toilet use; however consistent use of soap was lower. Majority of respondents reported access to handwashing stations, however, availability of soap and water was not always consistent. Class level, availability of soap and water, and the presence of hygiene posters were significantly associated with handwashing practices (p<0.05), while on the other hand; sex, school location, and knowledge level were not. Behavioral factors including forgetfulness, were also identified as barriers to proper hand hygiene. Conclusion: In conclusion, although basic school children in the Lower Manya Krobo Municipality demonstrate high levels of handwashing knowledge, this does not consistently translate into proper handwashing practices, highlighting a significant Knowledge-behaviour gap. The study establishes that enabling conditions, particularly consistent availability of water and soap, along with hygiene promotion tools such as posters, play a more critical role in influencing handwashing behaviour that knowledge alone. Addressing both behavioral and infrastructural barriers through strengthened school-based WASH interventions, improves child health outcomes in the municipality.