KNOWLEDGE, ATTITUDE, AND PRACTICE OF HAND HYGIENE

AMONG JUNIOR HIGH SCHOOL STUDENTS

________________

A Baby Thesis presented to Dr. Antonio del Rosario

Bulacan State University

City of Malolos

________________

In partial fulfillment of the requirements

for Methods of Research in Education (E503)

By:

JOHN MEEK A. RODRIGUEZ

July 2020
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TABLE OF CONTENTS

CHAPTER I THE PROBLEM AND ITS BACKGROUND

Introduction……………………………………………………………………1

Statement of the Problem……………………………………………………...3

Significance of the Study……………………………………………………...3

Scope and Delimitations of the Study………………………………………...5

CHAPTER II THEORETICAL FRAMEWORK

Relevant Theories…………………………………………………………….6

Review of Related Literature………………………………………………..14

Review of Related Studies…………………………………………………..24

Conceptual Framework……………………………………………………..31

Hypothesis of the Study…………………………………………………….31

Definitions of Variables…………………………………………………….31

CHAPTER III METHODS OF RESEARCH

Research Design……………………………………………………………34

Population and Sample……………………………………………………..35

Research Instruments……………………………………………………….37

Data Gathering Procedure…………………………………………………..37

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Statistical Analysis of Data………………………………………………….38

CHAPTER IV PRESENTATION, ANALYSIS, AND

INTERPRETATION OF DATA

Part 1. What are the knowledge in hand hygiene of junior high school students of Frances

National High School?....................................................................................43

Part 2. What are the attitudes in hand hygiene of junior high school students of Frances

National High School?....................................................................................44

Part 3. What are the practices in hand hygiene of junior high school students of Frances

National High School?....................................................................................45

Part 4. Is there a significant relationship between the knowledge and attitude in hand

hygiene and practices in hand hygiene among junior high school students of Frances

National High School?....................................................................................47

CHAPTER V SUMMARY, CONCLUSIONS, AND

RECOMMENDATIONS

Summary………………………………………………………………………48

Conclusions……………………………………………………………………50

Recommendations……………………………………………………………..51

References…………………………………………………………………….53
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Appendices

KAP Survey…………………………………………………………………57

Google Form Photos………………………………………………….……..61

Curriculum Vitae……………………………………………………………63
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LIST OF TABLES AND FIGURES

Figure 2.1 Conceptual Framework………………………………………….32

Table 3.1 Distribution of Respondents by Representation………………….36

Table 3.2 Distribution of Respondents by Gender………………………….36

Table 3.3 Distribution of Respondents by Age……………………………..37

Table 3.4 Knowledge Scale…………………………………………………39

Table 3.5 Knowledge Scoring………………………………………………39

Table 3.6 Attitude Scale…………………………………………………….40

Table 3.7 Practices Scale…………………………………………………...40

Table 3.8 Table of Critical Value…………………………………………...41

Table 4.1 Presentation of Data: Knowledge in Hand Hygiene…………..…43

Table 4.2 Presentation of Data: Attitudes in Hand Hygiene………………..44

Table 4.3 Presentation of Data: Practices in Hand Hygiene……………...…45

Table 4.4 Correlation Table of Independent & Dependent Variable……..…47

 CHAPTER I

THE PROBLEM AND ITS BACKGROUND

Introduction

In an annual report conducted by Philippine Integrated Disease Surveillance

Response (PIDSR), it showed that acute bloody diarrhea is a prevalent illness to children

ages one to four years old wherein there were 12,058 cases of the said illness. In addition

to the report, influenza-like illnesses with 102,698 cases is also a threat for children from

the same age range. In addition to this, according to the National Health Interview Survey,

absenteeism due to diseases that are transferred by infections is one of the main issues in

families, academic institutions, and communities. In children ages 5 to 17 years old,

kindergarten up to the twelfth grade, there are more than 164 million absences per school

year due to the spread of viral and bacterial infections which affect the students’ academic

performance. Furthermore, about 88% of cases of diarrhea are attributable to unsafe water

and insufficient hygiene. These cases result in up to 1.5 million deaths among children

under the age of 5 each year. With this situation, it can be seen that the hand has its

primary role of transmitting many infectious diseases, particularly among children.

According to World Health Organization, hand washing is the simplest yet most

effective way to prevent the spread of infections caused by some infectious diseases. It has

been shown to decrease deaths caused by diarrhea by up to 50% and reduce the risk of

respiratory infections by 16%. It also reduces absenteeism. Thus, it improves a child’s

learning and teaching process. Children and adolescents are the most susceptible to

infections and thus it is crucial that they are able to develop the simple habit of hand
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washing. Though it may appear basic, many individuals still do not regularly wash their

hands. Despite health education campaigns in the community, hand washing remains to be

poorly practiced. In the 2016 global survey, about 90% have knowledge on washing hands

but only 59% profess confidence in performing it, and a low 18% report.

Poor hand washing practices among sponsored youth ages 12 and below is one of

the priority health problems that were identified in Children International Manila. Based

on the Electronic Medical Records System (EMRS), Acute Respiratory Infection (ARI) or

common cough and colds remain to be the most common illnesses experienced by

sponsored children and youth. Based on research, it was found that proper hand washing

with soap is one of the most effective interventions resulting to reduced number of people

getting sick with diarrhea by up to 31%. It was also found to be effective in reducing

incidence of acute respiratory infection (ARI) like colds in general population. Aside from

knowledge on proper hand washing, parental practice and supervision are also seen as

major factors in developing good hand washing behavior in children. Parental knowledge

on the critical times of hand washing as well as the value of using soap is indicators to their

practice of the behavior. Based on a recent Focus Group Discussions (FGDs) conducted in

the agency’s community centers 1 and 2, parents admit washing hands only after defecating

because they were not used to doing it often or forgotten it. The most frequently given

reasons for not washing hands were forgetfulness 78.2%, laziness 43.5%, and lack of time

21.7%. Other reasons cited were lack of clean water (18.9%) or soap (16.7%), bathroom

facilities that were dirty (16.5%) or unsafe (5.2%) and lack of interest (6.3%). If poor hand

hygiene among children will continue, it may lead to serious health concerns. Many studies

recognize the importance of hand hygiene especially in avoiding infections such as ARI,
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diarrhea and other illnesses due to infection. Thus, it is essential that sponsored children

and their families be equipped with the right knowledge and attitude to practice proper

handwashing at critical times.

Statement of the problem

The general problem of the study is: “How do knowledge and attitude in hand

hygiene relate to the practices of hand hygiene among junior high school students of

Frances National High School?”

Specifically, the study sought answers to the following questions:

1. What are the knowledge in hand hygiene of junior high school students of

Frances National High School?

2. What are the attitudes in hand hygiene of junior high school students of Frances

National High School?

3. What are the practices in hand hygiene of junior high school students of Frances

National High School?

4. Is there a significant relationship between the knowledge and attitude in hand

hygiene and practices in hand hygiene among junior high school students of

Frances National High School?

Significance of the Study

The result of this study is significant since knowledge, attitude, and practices on

hand hygiene plays a vital role in identifying health risk among students and other members

of the community, and promoting wellness and preventive measures in acquiring infections

or disease. Despite some limitations, the findings of the study will somehow provide
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important data and insights and will be beneficial to the following essentials of education

institution. The study would be of interest to:

Policy makers. The result of the study would be of great help to the policy makers

in creating or amending laws or policies related to Water, Sanitation, and Hygiene or

WASH program.

Department of Education. Through the findings of the study, the department, will

have a source of data or study to consider in implementing its own WASH in School or

WINS Program. Specifically, the result of the study would help Department of Education

in determining the frequency of handwashing program, and orientation activities to be

conducted for learners especially high school students.

School Administrators. It will indeed help the administration in ensuring the

health of its learners in identifying the needs and/or resources required for regular practice

of hand hygiene. Also, in directing concerned clubs and teachers for provision of

orientation and seminars to disseminate information to increase health knowledge of

learners.

Family. The study will provide an eye-opener data that a family plays a vital role

in enforcing children to practice the knowledge they have learned toward hand hygiene.

Through this, they will be able to monitor as well the healthy hand hygiene habits each

member of the family must observe.

Junior high school learners. The learners will be mindful in practicing healthy

hand hygiene in the school premises, inside one’s home, and in the community as a whole.
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Future researchers. This will serve as a guide to support their study for better

understanding regarding the scope, and scale of knowledge, attitude, and practices in hand

hygiene of students or their desired respondents.

Scope and Delimitations of the Study

This is a quantitative study that focuses on the knowledge, attitude, and practices

in hand hygiene among junior high school students of Frances National High School under

the school year 2019- 2020.

The method of study used is correlational research. To gather specific data

regarding the students’ knowledge, attitude, and practices in hand hygiene, survey was

used as the primary instrument of the study in data collection. The Knowledge, Attitude,

and Practices or KAP survey on Hand Hygiene utilized came from the research of Linda

Afia Mbroh of Minnesota State University of Mankato entitled “Assessing Knowledge,

Attitude, and Practices of Hand Hygiene among University Students.” Due to strict

implementation of physical or social distancing, and limiting social gatherings, google

form was used for fast distribution of the survey questionnaire and gathering of responses.

The study covered the responses of thirty (30) students from Frances National High School

and who are presently residing at Calumpit, Bulacan. Survey was conducted only from July

15- 17 of this year, 2020.

 CHAPTER II

THEORETICAL FRAMEWORK

This chapter presents the related theories, literatures, and studies which provide

relevant information on the problem under study. It also includes the conceptual

framework, the hypothesis of the study, and the definition of variables used in this study.

Relevant Theories

This section presents the related theories that enlighten the researcher to pursue this

research and to obtain knowledge on the subject of the study.

Self-Efficacy Theory. Self-efficacy is the belief in one’s own ability to

successfully accomplish something, achieve a goal. It is a theory by itself, as well as being

a construct of Social Cognitive Theory. Self-Efficacy Theory tells us that people generally

will only attempt things they believe they can accomplish and won’t attempt things they

believe they will fail. It makes sense— why would you try doing something you don’t think

you can do? However, people with a strong sense of efficacy believe they can accomplish

even difficult tasks. They see these as challenges to be mastered, rather than threats to be

avoided (Bandura, 1994 as cited in Hayden, J., 2019).

This theory introduces efficacy as something influenced by the factors such as

mastery of experience, vicarious experience, verbal persuasion, and somatic and emotional

state. Mastery of experience, as the most effective boost for self-efficacy, is the actual

doing of what you desire to happen and you are successful in your attempt. Vicarious
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experience, on the other hand, is learning from your chosen or close-to-yourself example.

This second factor uses ‘models’ to learn and develop his/her efficacy. Then, verbal

persuasion. This third factor covers the need of external lifters or someone that will keep

an eye on their progress. Lastly, somatic and emotional state is another factor focusing on

one’s emotion and anticipation of the outcome of what a person will try to do. Provision of

Water, Sanitation, and Hygiene in School or WINS Program of the Department of

Education caters such model preference in developing handwashing practices.

Health Belief Model or HBM Theory. The underlying concept of the HBM is that

health behavior is determined by personal beliefs or perceptions about a disease and the

strategies available to decrease its occurrence (Hochbaum, 1958). Personal perception is

influenced by the whole range of intrapersonal factors affecting health behavior, including,

but not limited to: knowledge, attitudes, beliefs, experiences, skills, culture, and religion.

The following four perceptions serve as the main constructs of the model: perceived

seriousness, perceived susceptibility, perceived benefits, and perceived barriers. Each of

these perceptions, individually or in combination, can be used to explain health behavior.

Over the years other constructs have been added to the HBM; thus, the model has been

expanded to include cues to action, motivating factors, and self-efficacy. (Hayden, 2019)

The health belief model theory gives emphasis to personal belief as primary factor

that influences health behavior. The constructs of the theory include perceived seriousness,

perceived susceptibility, perceived benefits, and perceived barriers. Individually or in

combination, these perceptions can be used to explicate health behavior. First, perceived

seriousness tackles the severity of a disease or its effect to one’s life. Second, perceived

susceptibility or simply known as personal risk heighten proper health behavior when there
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is a great chance in contacting a disease or infection. Then, perceived benefits deal with

the advantages and usefulness of new, and strengthened health behavior in decreasing the

possibility of contacting a disease. Another is perceived barriers. These barriers are actual

challenges a person encounter in his behavioral formation. Such perceptions are present in

forming healthy behavior in hand hygiene.

Attribution Theory. Simply put, this theory explains why people “attribute” or

assign cause to what happens to them. Think of it this way—when you work really hard in

a difficult course and get a good grade, what do you attribute the grade too? Perhaps you

attribute your good grade to the long hours you spent reading and studying, or working

with a tutor, or the way the professor taught the course. This theory explains why you

attribute those things to your success. Attributions are separated into two categories:

personal and environmental. Personal attributions include ability, personality, and other

factors internal to the person. Environmental attributions or factors are external to the

person (Strickland, 2006; Kearsely, 2006; Weiner, 1985, as cited in Hayden, J., 2019).

The third theory relevant to the study explains that preventive benefits of hand

hygiene against diseases are attributed to how frequent a person practice hand hygiene.

Commonly attribution in this theory are categorized as personal and environmental.

Personal attribution pertains to what you control and external attribution is what the

environment provided to you that you do not have any control at all and yet you are

benefited.

Protection Motivation Theory. Protection Motivation Theory (PMT) has its roots

in health communication and the fear appeal. Fear, remember, is an emotional state that

protects us from danger. When we’re afraid of something, we tend to avoid it or do

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something to counter the possible feared outcome. Fear appeals are based on this. They

change attitude, intention, or behaviors through the threat of impending harm. They are

intended to cause fear in order to motivate people to take protective action against the threat

(Rogers & Deckner, 1975, as cited in Hayden, J., 2019)

The protection motivation theory makes use of fear as a catalyst to positive

behavioral change. And to date, the world today exercises hand hygiene in all critical

moments because of COVID-19 pandemic. This fear of contacting the disease moved

people to observe hand hygiene as primary shield in preventing the transmission.

Social Cognitive Theory. SCT is based on the concept of reciprocal determinism

or the dynamic interplay among personal factors, the environment, and behavior (Bandura,

1977). The way in which people interpret their environment and their personal factors

affect their behavior (Parjares, 2004); their behavior affects their personal factors, which

can affect their environment, and so on. For example, in a school setting a teacher can work

with students to improve their personal factors—self-confidence, knowledge, and

cognitive skills—their behavior by improving their studying skills and the environment by

altering the classroom structures to enhance rather than undermine student success

(Parjares, 2004). The point being that changing one of the three factors changes all of them

and, therefore, changes behavior.

This theory gives importance to developing a setting or an environment itself

conducive to improving practical applications and mastery of the skill learned. As to

implementation of a well-structures WINS Program, it is necessary that schools develop

an environment that support hand hygiene practice. Theory such as this is relevant to the
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study in stressing the importance of school involvement and advocacy in support to hand

hygiene.

Diffusion of Innovation Theory. Diffusion of innovation is a communication

theory rooted in rural sociology (Valente & Rogers, 1995, as cited in Hayden, J., 2019). In

the 1920s, research supported by the U.S. Department of Agriculture was conducted to

determine the effectiveness of the different methods used to inform farmers of new

(innovative) farming practices (Wilson, 1927, as cited in Hayden, J., 2019). This type of

research continued into the 1930s with studies on how a variety of other innovations

(postage stamps, limits on municipal taxation rates, and compulsory school laws) were

shared and eventually accepted (Pemberton, 1936; Valente & Rogers, 1995, as cited in

Hayden, J., 2019). Building on this, research done in 1943 on the diffusion of hybrid corn

seed by Ryan and Gross (1943) laid the foundation for an understanding of how new

practices (innovation) were spread into society; that is, how innovation diffuses. What

prompted Ryan and Gross’s research was the unexpected reaction of farmers to hybrid corn

seed. Since the hybrid seed increased crop yield and produced hardier, drought-resistant

corn, farmers were expected to quickly switch to the new seed. However, this isn’t what

happened. Instead, it took seven years on average for a farmer to go from trying the hybrid

seed to planting 100% of his land with it. Obviously, something other than economics was

at the root of this seemingly irrational behavior (Rogers, 2004; Ryan & Gross, 1943, as

cited in Hayden, J., 2019). Diffusion of innovation is the process by which new ideas

(innovations) are disseminated (diffused) and adopted by a society. As new ideas are

adopted and integrated into the society—that is, they become the norm—behavior changes.

(Hayden, 2019).
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Primarily, diffusion of innovation theory concentrates on contemporary ways to

disseminate ideas and ways that can be acquired by the society. As such theory, hand

hygiene knowledge and practices underwent series of rebranding to suit the generation

being served and aroused active engagement in achieving a desired outcome. For this study,

desired outcome focuses on a search to prove relation between knowledge and attitude in

hand hygiene, and practices in hand hygiene. After that, providing recommendations

innovative and relatable for the benefactors of the study.

Social Ecological Model. The SEM also explains behavior using these factors but

differs in that it uses both internal and external factors, rather than one or the other. In

addition, the external environment is seen as being composed of both the social and

physical environments (Sallis & Owen, 1997, as cited in Hayden, J., 2019). Therefore,

when the SEM is used in health promotion, the intent is to change the environment (social

or physical), since changes in the environment change individual behavior (McLeroy,

Bibeau, Steckler, & Glanz, 1988, as cited in Hayden, J., 2019).

Socio-ecological model, as a health behavior theory, gives value both internal and

external factors with the idea that in order for a behavioral change to occur, it is necessary

to change the environment. As environment changes, individual behaviors differentiate. In

the context of hand hygiene practice, certain changes in the school setting or environment

is needed to bring the course of behavioral change to learners.

Social Capital Theory. From a public health or community perspective, the

concept of social capital refers to the networks, relationships, norms, and trust people need

to cooperate with each other, in a reciprocal fashion, for the benefit of all (Putnam, 2000;

Putnam, Leonardi, & Nanetti, 1993, as cited in Hayden, J., 2019). Social capital includes
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the resources (monetary and otherwise) we have available to us by virtue of our

connections with others. (Hayden, 2019)

This theory relevant to the study gives utmost significance to community partners

or stakeholders for the common good. This theory highlights the importance of partnership

in promoting the good attitude towards hand hygiene and religious practice of hand hygiene

from the acquired healthful knowledge. This theory is related to the study as school setup

of program and activities are partnered with stakeholders. And to every behavioral change

of learner, partnership is highly welcome and encouraged.

The Theory of Planned Behaviour (TPB) is a well-validated decision-making

model that has been applied to hand hygiene in hospital and other contexts [6-11]. The TPB

proposes that the best determinant of behaviour is intention which is influenced by three

factors: attitude, subjective norm, and perceived behavioural control. Attitude refers to

positive or negative evaluations of the behaviour (e.g., performing hand hygiene is good);

subjective norm refers to perceptions of pressure from others to perform the behaviour

(e.g., important others would want me to perform hand hygiene); and perceived

behavioural control refers to perceptions of the ease or difficulty of performing the

behaviour of interest (e.g., it would be easy for me to perform hand hygiene). Perceptions

of control are also considered to directly influence behaviour. The TPB’s belief base

proposes that attitudes are determined from the individual’s beliefs about the

advantages/disadvantages of performing the behaviour (behavioural beliefs; e.g.,

performing hand hygiene will result in a reduction of the spread of infections). Subjective

norms are determined by a person’s beliefs about whether important referents

approve/disapprove of them performing the behaviour (normative beliefs; e.g., other nurses
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would approve of me performing hand hygiene). Perceived behavioural control is based on

the individual’s beliefs about whether internal and external factors may prevent/assist in

the performance of the behaviour (control beliefs; e.g., a lack of time might prevent me

from performing hand hygiene [5]). The identification of beliefs can inform interventions

designed to encourage behavioural performance by altering existing beliefs or exposure to

new beliefs [12]. (White, K., Jimmieson, N., Obst, P., Graves, N., Barnett, A., Cockshaw,

W., Gee, P., Haneman, L., Page, K., Campbell, M., Martin, E., & Paterson, D., 2015)

In this theory, it presents that behavior is a concept based on intention. To define,

intention is an expanse by which someone is most likely to engage in a particular behavior.

It points out a setting where a person engaged in a behavioral activity when he planned it

or initiated to do it. Thus, it is a completely the same to a person who did not plan to engage,

that is why he did not.

Theory-practice-ethics gap. The author believes a ‘Homer Simpson’ mentality

persists, one of ongoing non- compliance. Therefore, an ethical problem exists on the non-

adherence of healthcare providers to hand hygiene recommendations. This becomes a

patient advocacy issue that the author calls the hand hygiene ‘theory-practice-ethics gap’.

Evidence from both the IPC literature and the author’s clinical experience suggests

indifference to recommendations based on evidence. We have all seen educated and

knowledgeable clinicians fail to practice their organization’s hand hygiene

recommendations. One possible explanation for this is that there is an ‘ethical gap’

(Mortell, 2009). For this theory, learned health knowledge essential for practice is not

religiously committed and forming practice-ethics-gap. It stresses that not all

knowledgeable practitioners in the field of medicine and health usually practice hand
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hygiene. This is even evident to learners who were taught of the importance of hand

hygiene in schools and homes.

Review of Related Literature

This section presents several literatures that facilitate the researcher valuable

insights in pursuance of this study.

According to Public Health England South West Health Protection Team (2017),

control of infection among children depends upon prevention, early recognition of each

case, and prompt action and follow up. Washing hands properly is one of the most

important things individuals can do to help prevent and control the spread of many

illnesses. Good hand hygiene will reduce the risk of illnesses like flu, stomach upsets and

other infections being passed from person to person. Alcohol hand gel can be used if

appropriate but should not replace washing hands if hands are visibly soiled or when there

is gastroenteritis (diarrhea and vomiting) cases in the school. Alcohol hand gel is not

effective against norovirus.

Hand washing is very essential for student to practice. It is a way of prevention

from any bacteria and viruses present. Then, it is very important for the students to know

proper hand hygiene. Substance, like alcohol hand gel will help to clean the hands but it is

more advisable to hand wash.

Human skin is colonized by a diverse range of organisms; their collective genetic

material is referred to as the skin microbiome. These include organisms that have a

beneficial role in human health as well as those that are relevant in the healthcare setting,
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either as potential infectious agents or as vehicles of transmission for antimicrobial

resistance determinants. Culture-independent (metagenomic) studies have provided recent

insights into factors that contribute to variation in the skin microbiome, including host

physiology (such as anatomic site) and genotype, environment and lifestyle, immune

system, and pathophysiology (Pittet, D., Boyce, J., Allegranzi, B., 2016).

Student's hand hygiene should always be present to make sure that their hands are

clean. In our environment there are many potential infectious agents that might affect our

body and can cause diseases, specially to the students. Students must have knowledge in

hand hygiene to prevent any infectious agents to enter in the skin.

Health-care associated infection affects hundreds of millions of people worldwide

and is a major global issue for patient safety. At both the level of the country and of the

health-care facility, the burden of HCAI is significant, although it may be difficult to

quantify at this stage. In general, and by their very nature, infections have a multifaceted

causation related to systems and processes of health-care provision as well as to political

and economic constraints on health systems and countries. They also reflect human

behaviour conditioned by numerous factors, including education. However, acquisition of

infection, and in particular cross-infection from one patient to another, is in many cases

preventable by adhering to simple practices. Hand hygiene is considered to be the primary

measure necessary for reducing HCAI. Although the action of hand hygiene is simple,

the lack of compliance among health-care workers continues to be a problem throughout

the world. Yet hand hygiene improvement is not a new concept within health care. Many

health-care facilities around the world already have well-established policies and

guidelines and undertake regular training programmes in this area. Increasingly, actions
 16

are being undertaken to introduce alcohol-based hand rubs at the point of care. However,

long-lasting improvements remain difficult to sustain, and many facilities worldwide have

not yet begun to address hand hygiene improvement in a systematic way. This is due to

numerous constraints, particularly those relating to the very infrastructures and resources

required to enable attention to turn to hand hygiene improvement (WHO, 2009).

Student's hand hygiene must practice at all times because it is considered as primary

measure to reduce any diseases. School management must have policies and guidelines for

students to practice regular proper hand hygiene. And, to improve the knowledge and

awareness of students in proper hand hygiene.

Six Myths of Hygiene Education. The way in which hygiene education used to be

carried out had very poor results. This was partly because it was founded on a number of

myths. Myth No 1. People are empty vessels into which new ideas can simply be poured

Hygiene Education rarely starts with what people already know. Every society already has

coherent explanations for disease (which may or may not include microbes). If we try to

pour new wine into these already full vessels then, the new wine will just spill over. The

new ideas create confusion and incomprehension. Some people even reject the new

teachings saying: “these doctors just don’t understand what makes my child sick!” Myth

No 2. People will listen to me because I’m medically trained Hygiene Education often

assumes that health personnel are automatically believed and respected. This is often untrue

in both developed and developing countries. There is no reason why the outsider with the

foreign ideas should be given higher credence than tried and tested local explanations of

disease. And a health worker who is thought to be saying “it’s your fault your kids get sick

and die, it’s because you are dirty” will gain little respect from the community (Nations).
 17

Myth No 3. People learn germ theory in a few health center sessions Everybody likes to

learn, but how responsive would you be if you were worrying about a sick child in a clinic

waiting room? Even in the best of circumstances, replacing old ideas about disease with

new ones is a long, slow process. Myth No 4. Health education can reach large populations

Major improvements in public health require interventions that cover large populations,

like vaccination or AIDS prevention programmes. But is it practical to give health

education classes about the germ theory of disease to all the childcarers in a region? Myth

No 5. New ideas replace old ideas Most people hold a variety of ideas about the origins of

disease in their heads at the same time. Folk models of illness co-exist with medical models

in all countries of the world, and few people anywhere explain child diarrhea by lapses in

stool hygiene. Hygiene education often just adds one more idea about disease without

erasing the old ones. Myth No 6. Knowing means doing. Even if we could convince large

populations that germs spread by poor hygiene cause disease, would this mean that they

would change their practices overnight? Though knowing about disease may help, new

practices may be too difficult, too expensive, take too much time, or be opposed by other

people. Fear of disease is not a constant preoccupation and is often not a good motivator

of behaviour change. (These myths are adapted from the useful booklet by Van Wijk &

Murre.) The best health education practice does not make all these mistakes. Unfortunately,

in the field of hygiene they are still very common. Of course, everybody has a right to know

as much as possible about health. In particular, every child in school should have the

opportunity to learn health science. (School hygiene programmes are a separate subject

which are not covered in this book). But we cannot assume that education about germs and
 18

diarrhea will lead directly to behaviour change, or have a major impact on diarrheal

diseases (UNICEF, 1999)

Now adays, students must be well aware in proper hand hygiene to prevent any

disease that may come. Student, just like a empty vessel must be poured with knowledge,

right attitude and practices about hand hygiene. Institution like school clubs must

encourage each student to have knowledge about proper hand hygiene. Not just merely

educating students but motivating them to do proper hand hygiene. And doing the hand

hygiene in a regular basis.

Why is it important to focus on schools? After the family, schools are most

important places of learning for children; they have a central place in the community.

Schools are a stimulating learning environment for children and stimulate or initiate

change. If sanitary facilities in schools are available, they can act as a model, and teachers

can function as role models. Schools can also influence communities through outreach

activities, since through their students, schools are in touch with a large proportion of the

households in a community. Why is it important to focus on children? A survey among

school children in India revealed that about half of the ailments found are related to

unsanitary conditions and lack of personal hygiene. Such survey results show the need for

a focus on children. Also, it is generally recognized that childhood is the best time for

children to learn hygiene behaviours. Children are future parents and what they learn is

likely to be applied in the rest of their lives. They have important roles in the household,

taking care of younger brothers and sisters, and depending on the culture, they may also

question existing practices in the household. If children are brought into the development

process as active participants, they can become change agents within their families and a
 19

stimulus to community development. They are eager to learn and help, and if they consider

environmental care and their role in this as important, they will take care of their own health

and the health of others. Being tomorrow’s parents, children are also likely to ensure the

sustainability of a programme’s impact. In reality, schools are often more than just places

for learning and behaviour change. If school sanitation and hygiene facilities are absent, or

are badly maintained and used, schools become risky places where diseases are transmitted.

Schools can also pollute the natural environment in such a way that it causes health hazards

for the community at large. It is therefore important that schools have proper facilities.

However, improved facilities in themselves are not sufficient. If we want to reduce the

incidence of sanitation and hygiene-related diseases, and to protect the natural

environment, behavioural changes are also needed, leading to proper use of the facilities.

Three factors have to be addressed if lasting changes in hygiene behaviour are to occur.

These are: - predisposing factors - knowledge, attitude and belief; - enabling factors -

availability of resources like latrine facilities and safe water supply, enabling students to

transform newly acquired knowledge, attitudes and beliefs into desirable behaviours; -

reinforcing factors - factors affecting the students’ ability to sustain a certain behaviour,

like support and cooperation received from parents, guardians and peer groups. Increasing

students’ knowledge about health and disease prevention should therefore only be part of

the story. When knowledge is supported by enabling and reinforcing factors, desirable

changes may occur in the school setting and in the community. This stresses the importance

of combining hygiene education with the construction of water and environmental

sanitation facilities and involving the community and health institutions in SSH (UNICEF,

1998)
 20

School facilities plays a vital role in student's compliance in proper hand hygiene.

School as the second home of the students must be clean and well maintained. Also, the

teachers and school personnel must also be aware of proper hand hygiene because they

serve as the role model of student. Students must be aware of hygiene behaviors to prevent

any diseases.

Part 1: Do people really not wash their hands? According to the American Society

of Microbiology 97% of females and 92% of males say they wash but actually only 75%

of females and 58% of males wash. Fifty percent of middle and high school students wash,

and of these only 33% of females and eight percent of males use soap. Part 2: Why is

handwashing important? 229,000 germs per square inch on frequently used faucet

handles 21,000 germs per square inch on work desks about 400 times more than the

average toilet seat More germs at the kitchen sink than at the toilet 1,500 on each

square centimeter of hands Prevents spreading germs to food or to another person

Germs are invisible on your hands Germs can make you very sick Hands are most

exposed part of the body to germs Washing hands regularly can keep a person healthy

A 1996 Wirthlin research study of 305 school students reported that students who

washed their hands four times a day had 51% fewer lost days to stomach upset. Part 3:

When is handwashing important? Ask students to list things touched in one day, use any

of the following to reinforce: Before eating, preparing or serving food Whenever

hands look, feel, or smell dirty After using the toilet After handling raw meat, fish,

poultry and before touching any other food After changing a diaper When sick, after

blowing your nose Cough or sneeze: Germs get on hands from a sneeze (sneezing into

the hands is not a good idea) – important to sneeze into sleeve After using common
 21

objects money, doorknobs, computer keyboard, telephone, lockers, keys After touching

pets or any animals After taking out the trash (Toney-Butler, T., Gasner, A., Carver, N.,

2020).

There are many objects that can be a home for bacteria and germs. Though it is not

visible in our naked eyes, we must learn how to kill and sanitize our belongings. Specially,

students must be well informed to wash their hands every time to prevent any harmful

germs and bacteria. The researcher of this study informs us that, there is a low percentage

of students who wash their hands after doing their thing. Then, it is very important for the

students to be well informed and be aware of the proper hand hygiene.

Hygiene and sanitation are essential to good health. Adequate water supply and

adequate toilet and proper handwashing facilities are required to achieve good hygiene and

sanitation. The lack of access to these facilities poses risk to people’s health. However, the

mere presence of these facilities is not enough to achieve better hygiene and sanitation

among the community members. Proper and correct practices in the use of these facilities

must be practiced to maximize the benefits and achieve the impact to the well-being of the

community. Hygiene and sanitation challenges have caused many children in developing

countries to fall ill and even die from infection with intestinal parasites, abdominal pain,

and diarrhea. This situation also leads to anemia, stunted growth, and higher incidence of

absenteeism which consequently impede a child’s learning and ability to stay in school. In

the Philippines, some 24 million Filipinos lack improved sanitation even as the Department

of Health (DOH) has made significant strides in this regard over the last two decades. Poor

sanitation practices among the almost 20 million poorest Filipinos have been linked

directly to poverty, thus bringing to the fore the vital role of government in breaking the
 22

cycle of poverty and ensuring access to improved drinking water and sanitation. The lack

of access to safe and clean water and poor sanitation and hygiene practices among the

nation’s poorest families have led to an estimated 43.7 percent and 44.7 percent of pre-

school age and school-age Filipino children, respectively, having soil-transmitted helminth

infections. To help address this challenge, the Department of Education (DepEd) has been

conducting semi-annual deworming of kindergarten and elementary school children in all

public schools nationwide under its Integrated Helminth Control Program (IHCP). In the

last six years, it has combined deworming with daily tooth-brushing and proper

handwashing under one program. Department Order (D O.) No. 56, s. 2009 titled

“Immediate Construction of Water and Hand Washing Facilities in All Schools for the

Prevention of Influenza A (H1NI)” and D O. No. 65, s. 2009 titled “Implementation of the

Essential Health Care Program (EHCP) for the School Children’’ were issued in an effort

to institutionalize good health and hygiene practices among students. Under the EHCP,

pupils have been taught simple, basic, and doable health interventions to promote

cleanliness and prevent sickness. As of 2014, the program was able to cover 16 of the

country’s 17 regions in partnership with a number of government organizations (GOs) and

non-government organizations (NGOs) that have continuously sponsored health

kits/packages for more than three (3) million pupils nationwide. This meant coverage of 68

out of 220 Schools Divisions, with 9,366 EHCP-implementing schools out of a total of

38,689 public schools. In consonance with the EHCP, the Department has endeavored to

bridge the gap in the pupil-to-bowl ratio in the country’s public elementary and secondary

schools which, as of 2015, was 1:36 in the elementary level and 1:53 in high school. The

Department also partnered with stakeholders to vigorously promote correct handwashing

 23

practices among school children. Best practices around the world have shown that

improving access to and use of water and sanitation facilities within schools and enhancing

hygiene and sanitation practices can effectively halt water and sanitation-related diseases.

This will also help bring the Philippines closer to realizing its 2015 MDG commitment on

the reduction of infectious diseases and improving sanitation coverage. To expand the

EHCP’s reach and transform it into a more comprehensive program, the Department has

crafted this holistic program for personal health care and environmental sanitation through

a set of standards for proper and correct health practices in schools. It goes beyond

handwashing, tooth brushing, and deworming – which are the key programs of the EHCP

– to cover water, sanitation including food handling and preparation, hygiene including

menstrual hygiene management, deworming, health education, and capacity building. In

crafting this set of guidelines, thus, the Department, in partnership with agencies and

stakeholders, hopes to address the gaps in the areas of hygiene and sanitation and keep

more children healthy and in school (DepEd, 2016).

Proper use of facilities is required to meet the full potential of it. The Government

together with NGO's here in the Philippines works together to inform the students in proper

hand hygiene. Correct handwashing practices was been informed to the students to prevent

any virus or harmful bacteria. Also, sanitation facilities is been constructed in school.

Hand cleaning and basic hygiene habits are generally learned during early

childhood. But it needs to be reinforced for them to wash them as often and thoroughly as

they should. • Research suggests that it is important for hygiene lessons to be repeated

during the K-12 school curricula. • Using a coordinated approach, teachers, school nurses,
 24

administrators, and students can all take part in a campaign. Student involvement especially

can boost its impact. (Columbus Public Health, 2009)

Students must be aware in proper hand hygiene. They must have knowledge to

practice frequent hand washing. Teachers must guide and instruct them on how proper hand

hygiene is being used.

Hands are warm, moist parts of the body that come into frequent contact with germs

that cause communicable illnesses. Young children have not yet learned healthy personal

habits. They suck their fingers and/or thumbs, put things in their mouths, and rub their

eyes. These habits can spread disease, but good handwashing can help reduce infection due

to these habits. Caregivers who teach and model good handwashing techniques can reduce

illness in childcare settings and schools. Handwashing is the single most effective way to

prevent the spread of infections. Handwashing is the single most effective way to prevent

the spread of infections (Wolkoff, B., Grim, A., Marx Jr., H., 2011).

Students must have knowledge on proper hand washing because it is an effective

way to prevent any harmful bacteria. Also informed students some techniques to wash their

hands well.

Review of Related Studies

A study on hand hygiene knowledge and practice among university students:

evidence from Private Universities of Bangladesh indicated that “widespread insufficient

hand hygiene in the university-going population. Moreover, low scores related to

participants’ handwashing knowledge and practice may indicate a need for an extensive
 25

public health education program on the topic. The hand hygiene awareness and compliance

among the university students were found to be relatively low. The study shows the need

for further improvement in the existing hand hygiene behavioral change communication

programs to address the gaps in knowledge, attitudes, and practices. Furthermore,

multifaceted and dedicated efforts must be undertaken to rectify this attitude and behavior

from early on. Therefore, supporting quantity and/or quality of the available campus-based

public health education programs and development of hand hygiene promotion programs

for the general public based on the findings of this study are recommended” (Sultana, M.,

Mahumud, R., Sarker, A., Hossain, S., 2016)

The knowledge of students in Bangladesh about proper hand hygiene is relatively

low and may cause a high risk in spreading of bacteria and disease. Therefore, public health

education programs must be created to give awareness to the students in proper hand

hygiene behavior.

Another study entitled ‘An Institution-Based Assessment of Students’ Hand

Washing Behavior’ revealed that the majority of the students had poor hand washing

practice score and the prevalence of hand washing with soap is low. The study also

highlights that the physical environment of hand washing needs to be conducive, especially

in the public institution. In line with this, the provision of soap, regular availability of clean

running water, and regular hygienic sanitation of wash room facilities are a necessity.

These could encourage students to wash hands frequently. Random visits to the wash

rooms and observations of hand washing could help in understanding the hand hygiene

behavior of students in future studies. Also, educational interventions need to be

implemented to enhance the hand washing knowledge, practices, and skills of the students
 26

(Teumta,G., Niba, L., Ncheuveu, N., Ghumbemsitia, M., Itor, P., Chongwain, P., Navti, L.,

2019)

Poor hand washing is relatively prevalent in schools because of student’s lack of

awareness in proper hand hygiene. School management must encourage student to practice

proper hand hygiene and improve the facilities to motivate student to do proper hand

hygiene.

From the study ‘Knowledge, Attitude, and Practice on Hygiene and Morbidity

Status among Tertiary Students: The Case of Kotebe Metropolitan’, the leading diseases

prevailing in KMU are preventable by some level of hygiene practices. Based on this study,

there exists a considerable gap in KAP on hygiene among KMU students. These gaps are

significant to trigger intervention either on awareness raising sessions or other supervision

activities. Regarding attitude-related responses, the students showed significant disparity

between gender, and somehow there also existed difference in practice and knowledge.

Therefore, the progress towards hygiene solutions has to consider this gender disparity in

order to be effective. Further detailed studies including the sanitary service adequacy and

hygiene information communication is recommended (Gebreeyessus, G., Adem, D., 2018).

Proper hand hygiene is necessary to prevent diseases. Student's awareness about hand

washing is so important for the intervention of spreading any disease.

In assessing of hand-washing habits among school students aged 6–18 years in

Jordan, findings obtained showed that a low percentage of school students ignored hand-

washing after different critical situations, and this figure decreased with age. Nevertheless,

the practice should be improved further. Health promotion and health education

programmes should be implemented for students and their families in the community or in
 27

school settings. School nurses and school staff also have a crucial role in teaching and

encouraging good hand-washing practice (ALBashtawy, M., 2017).

School management must create programs to promote proper hand washing to the

students. Because of low percentage in student's awareness, the school must encourage the

student to do good hand- washing practice.

Another research study is related is the hand hygiene knowledge of college students

conducted year 2010, it illustrated that there is a link between a general knowledge of

science and hand washing; science majors were significantly more likely to wash their

hands than non-science majors. This would indicate that the general information on

bacteria, pathogens, and the immune system received in general biology courses is

influencing a students’ hygiene behavior outside of the class room. Other studies have

found that an increase in the understanding of the benefits of hand hygiene increases the

likelihood of hand washing 21-23 and it is interesting to speculate that students that are

educated in the sciences have a general knowledge of bacteria and the immune system, and

therefore the benefits of handwashing. This is somewhat supported by survey data,

indicating that science majors know more about hand hygiene than non-science majors. In

class information may lead to a greater appreciation for the need to wash their hands during

the day and a general understanding of the link between hand washing and illness.

Although there are no other studies that look expressly at major and hand washing habits,

Anderson et al. reported that students in academic buildings are more likely to wash their

hands than those that used the rest room in the recreational center.12 The major for these

students is unknown, but it lends support to the hypothesis that a greater understanding of
 28

biology and/or science may lead to a greater incidence of handwashing (Taylor, J., Basco,

R., Zaied, A., Ward, C., 2010)

In this study, science major students are more aware of how proper hand hygiene

is and its benefits to prevent diseases than non- science major students because of their

knowledge about bacteria and diseases. Then, it is better for the students to become aware

of doing proper hand hygiene and its benefits.

A local study on the Impact of a school-based Water, Sanitation and Hygiene

Intervention on knowledge, practices, and diarrhea rates in the Philippines found out that

global effort to achieve sanitation and water for all by 2030 extends beyond the household

to include institutional settings such as schools [6]. WASH in Schools seeks to improve

student health, increase access to inclusive and effective education and learning, and

contribute to health equity. The WHO and UNICEF established the Joint Monitoring

Programme (JMP) for Water Supply, Sanitation, and Hygiene, which has developed global

norms and indicators to benchmark and compare WASH progress, including in schools [6].

Nevertheless, there is no universal blueprint for effective WASH in Schools interventions

and there remains a need to better understand the impacts of school-based WASH

programmes, particularly in developing country contexts. Specific goals are to understand

health and educational outcomes, to identify opportunities and challenges within program

implementation, and assess intervention fidelity, to understand the extent to which students

operate as WASH change agents in wider communities, and to consider the broader

environmental and socio-political contexts that shape intervention outcomes [2,7,27].The

PRC has contributed to efforts to address and improve WASH in schools. The findings

presented here suggest that students in intervention schools, compared to comparison

 29

schools, had improved WASH knowledge, hygiene behaviour-including handwashing after

toilet use, and reduced absence due to diarrhea. Students also appear to have played some

role as change agents at the household level, with self-reported handwashing at critical

times found to be significantly higher among household members from intervention

schools. It needs to be acknowledged that this evaluation represents an assessment of a

particular intervention, rather than of the potential for WASH in Schools to have an impact

in any context. However, we feel that given the extent of the interventions that these

findings are relevant to other low to middle income country settings. The results of this is

evaluation suggest that school children are ready, reachable, and important targets for

WASH in Schools intervention (Vally, H., McMichael, C., Doherty, C., Li, X., Guevarra,

G., Tobias, P., 2019)

Second local study labeled related to the study resulted that private and public

grades 4, 5, and 6 students from selected elementary schools in Batangas City, Philippines

manifest high level of knowledge in hand hygiene, practice it frequently but the facilities

although available are not utilized. Furthermore, school type which is being public or

private has highly significant relationship. In fact, public schools showed higher level of

hand hygiene knowledge, greater frequency in practice, better facilities utilization as well

as greater interest in proposed hand hygiene health activities. On the other hand, grade level

has no significant relationship (Asilo, M., Berberabe, J., Ramos, A., 2018).

Aside from school programs about proper hand washing, it is also important that

students must practice proper hand hygiene in their household as well. To prevent any

harmful bacteria and diseases. The Student serves as change agent for the community and

in their household.
 30

Then, study about hand hygiene instruction decreases illness-related absenteeism

in elementary schools: a prospective cohort study demonstrated that regular hand hygiene

instruction may be useful in reducing illness-related absences during the flu season. Flu

season is a critical time for attendance improvement, as illness-related absences are

traditionally highest during these months [18, 19]. Consistent with past research, our

findings demonstrate the importance of instruction in improving efficacy of hand hygiene

practices at schools [9–15]. As observed, interventions to change hygiene behaviour are

plausible among children [20]. Data from teachers suggest that hand hygiene standards

vary greatly from school to school, with one exception: hand hygiene is not performed

properly among students. Additional barriers to hand hygiene were consistent with those

reported in other studies and included time constraints and limited access to

materials/facilities [21, 22]. Such findings underscore the importance of compulsory

instruction in hand washing and sanitizing techniques as well as uniform distribution and

access policies. We accordingly recommend a two-part hand hygiene policy in public

elementary schools: (1) We advise schools to ensure that all common areas are well-

stocked with hand sanitizer and that all bathrooms are well-stocked with hand washing

materials throughout the school day. (2) We urge schools to provide a short hand hygiene

lesson for students at the beginning of each academic year, as well as refresher lessons

throughout the year. (Lau, C., Springston, E., Sohn, M., Mason, I., Gadola, E., Damitz, M.,

Gupta, R., 2012)

Students from Batangas showed high level of knowledge in hand hygiene. It is

important to have facilities for the students to do the hand hygiene. Also, hand hygiene

programs help the student to become aware of the benefits of hand hygiene.
 31

Korean students, who were respondents and subjects of a study during H1N1

outbreak, increased their frequency of hand hygiene practices during the pandemic, with

significant gender differences existing in the attitudes and behaviors related to the use of

hand hygiene as a means of disease prevention. Here, the factors that affected hand washing

behavior were similar to those identified at the beginning of the H1N1 or SARS pandemics,

suggesting that public education campaigns regarding hand hygiene are effective in altering

individual hand hygiene habits during the peak periods of influenza transmission (Park, J.,

Cheong, H., Son, D., Kim, S., Ha, C., 2010)

Hand hygiene standards vary from school to another; however, student must

practice proper hand hygiene because it helps to decrease illness- related absenteeism in

schools. Students must be aware of proper handwashing and sanitizing techniques.

Conceptual Framework

This study utilized the correlation model between independent and dependent

variables of the study. As shown in the figure, the independent variable is comprised of the

knowledge and attitude in hand hygiene of junior high school students in Frances National

High School. On the other hand, frame two represents the dependent variable which is

practices in hand hygiene of junior high school students in Frances National High School.
 32

Figure 2.1. Research Paradigm

SUBJECT
Junior students of Frances
National High School

INDEPENDENT VARIABLES DEPENDENT VARIABLES

• Knowledge in hand hygiene

• Practices in hand hygiene
• Attitude in hand hygiene

Hypothesis of the study

There is a significant relationship between knowledge and attitude in hand hygiene,

and practices in hand hygiene among junior high school students in Frances National High

School.

Definition of Variables

For the purpose of having an accurate, clear, adequate understanding and

comprehensive presentation of the context, the following terms are conceptually and/or

operationally defined based on how they are used in the study.

Subject. A person or thing that is being discussed, described, or dealt with.

Independent Variable. It is generally conjectured that an independent variable is

one that influences the dependent variable in either a positive or negative way.
 33

Dependent Variable. The dependent variable is the variable of primary interest to

the researcher. The researcher’s goal is to under- stand and describe the dependent variable,

or to explain its variability, or predict it. In other words, it is the main variable that lends

itself for investigation as a viable factor.

Hand Hygiene. It is a proper way of cleaning one's hands that significantly reduces

or prevents potential pathogens or harmful microorganisms on the hands.

Knowledge. An awareness or familiarity gained by experience of a fact or situation.

Attitude. A settled way of thinking or feeling about someone or something,

typically one that is reflected in a person's behavior.

Practices. Perform (an activity) or exercise (a skill) repeatedly or regularly in order

to improve or maintain one's proficiency.

 CHAPTER III

METHODS OF RESEARCH

This chapter presents the methods and techniques of research used in this study, the

population and sample of the study, the research instruments, data gathering procedure,

and data processing and statistical treatment.

Research Design

This study is a quantitative research and will utilize correlational research method.

To put simply, correlational research method tests and finds out the relationship

significance between variables. According to the reference book of our class in Methods

of Research, correlational research involves collecting data to determine whether, and to

what degree, a relation exists between two or more quantifiable variables. A variable is a

placeholder that can assume any one of a range of values; for example, intelligence, height,

and test score are variables. At a minimum, correlation research requires information about

at least two variables obtained from a single group of participants. The purpose of a

correlational study may be to establish relations or use existing relations to make

predictions. Correlation refers to a quantitative measure of the degree of correspondence.

The degree to which two variables are related is expressed as a correlation coefficient,

which is a number between +1.00 and - 1.00 (Gay, L., Mills, G., Airasian, P., 2012).

Educational Research: Competencies for Analysis and Applications, pp10-11.

In this study, correlational method of research will be used for the relationship of

variables, description and quantification of variables and assessment of knowledge, attitude

 35

and practices in hand hygiene among junior high school students of Frances National High

School.

Population and Sample

Quantitative researchers generally do not gather data from the entire population—

it’s rarely necessary and even more rarely feasible, especially if the population of interest

is large or geographically scattered. If a sample is well selected, the results of a study testing

that sample should be generalizable to the population. That is, the results of the re- search

will be applicable to other samples selected from the same population. (Gay, L., Mills, G.,

Airasian, P., 2012) Educational Research: Competencies for Analysis and Applications,

pp130.

The respondents of this study are thirty junior high school students form Frances

National High School; a nonrandom sampling was chosen as it gives the researcher a

benefit of time in gathering data from students amid the pandemic situation. Specifically,

convenience sampling was used and made use of the responses of the junior high school

students of Frances National High School that were available during the conduct of the

survey via google form.

Convenience sampling, also referred to as accidental sampling or haphazard

sampling, is the process of including whoever happens to be available at the time. Two

examples of convenience sampling are seeking volunteers and studying existing groups

“just because they are there.” (Gay, L., Mills, G., Airasian, P., 2012)
 36

Another sampling method was used by the research to solicit varied responses. That

method is intensity sampling, though qualitative, actual respondents are 15 students

considered as Red Cross Youth Council or students engaged in the school-based program

of Red Cross in secondary public schools and 15 nonpartisan students of the council or

students taking part in other club activities or no particular club membership at all. The

population of the study is present in Table 3.1 to 3.3.

Table 3.1

Distribution of Respondents per Representation

Representation Number of Respondents Percentage

Red Cross Youth - JHS 15 50.00

Nonpartisan students - JHS 15 50.00

Total 30 100.00%

Table 3.2

Distribution of Respondents per Gender

Gender Number of Respondents Percentage

Male 9 30.00

Female 21 70.00

Total 30 100.00%
 37

Table 3.3

Distribution of Respondents per Age

Age Number of Respondents Percentage

17 years old 1 3.30

16 years old 4 13.30

15 years old 6 20.00

14 years old 15 50.00

13 years old 2 6.70

12 years old 2 6.70

Total 30 100.00%

Research Instruments

A Knowledge, Attitude, and Practices or KAP survey used in this study is based on

the related study “Assessing Knowledge, Attitude, and Practices of Hand Hygiene Among

University Students” by Linda Afia Mbroh (2019). Some items were modified for there are

numbers lacking. In order to be treated statistically, Likert scale was utilized. The survey

was used to collect data from junior high school students of Frances National High School.

Data Gathering Procedure

The respondent’s profile was added to the Knowledge, Attitude, and Practices or

KAP survey but disclosed that their personal information would be dealt confidentially.

Before administering the survey, the researcher converted the survey into google form to

easily cascade the questionnaire and to solve the limit of strict compliance to physical
 38

distancing during this pandemic. The questionnaire was sent via messenger in a form of a

link that students just need to click to access the form. Group chats of Red Cross Youth

Council of Frances, and other group chats per section received the link directly and

indirectly from the researcher. It was conducted from July 15 until 17th day of this year,

2020. As the number of students answering the survey reached 30, the researcher already

set the form to ‘no longer accept responses.’

Statistical Analysis of Data

The data gathered using the research instruments are summarized on the 4th chapter

in tabular form, analyzed, and measured statistically. Simple descriptive statistical tool like

frequency (f), and mean were used to describe the profile of the student-respondents in

terms of: representation, age, and gender.

For hand hygiene knowledge scale as the first, hand hygiene knowledge was

assessed using 10 questions which includes “True” or “False” questions on general hygiene

knowledge. A scoring system was used where one point was given for each correct

response to knowledge and 0 was given for an incorrect answer. A total score was

calculated on the knowledge items called KSCORE. The higher the value of the variable

KSCORE the more knowledge a student had in relation to hand hygiene. A score of more

than 75% was considered very good, 50-74% good and less than 50% poor. The cut off

values to determine good, moderate and poor levels will be adapted from previously

published study (Kudavidanage, Gunasekara, & Hapuarachch, 2011, as cited by Mbroh,

2019).
 39

Table 3.4

Knowledge score per Response

Response Score

Correct 1

Incorrect 0

Table 3.5

Knowledge Scale

Percentage Range Description

75- 100 Very Good

50- 74 Good

49 and below Poor

Second, for attitude scale toward hand hygiene was assessed using a seven-point

semantic differential scale using seven different descriptors about participants feeling of

practicing hand hygiene. The individual items measured the degree of inconvenience,

irritation, frustration and practicality involved in practicing hand hygiene at the appropriate

times, as well as whether hand hygiene is considered optional or beneficial. Attitude was

calculated by adding the summated items: the higher the score, the better the attitudes

toward hand hygiene. A score of more than 75% was considered very good, 50-74% good

and less than 50% poor. The cut off values to determine good, moderate and poor levels
 40

will be adapted from previously published study (Kudavidanage, Gunasekara, &

Hapuarachch, 2011, as cited by Mbroh, 2019).

Table 3.6

Attitude Scale

Percentage Range Description

75- 100 Very Good

50- 74 Good

49 and below Poor

Then, for elf-reported hand hygiene practices were measured using 30 questions

where respondents were asked to choose from four options- always, sometimes, never and

not applicable. In the evaluation of self-reported practices of hand hygiene, ‘always’

response received 3 points, “sometimes” received 2 points, “never” received 1 point and

“not applicable received 0 point for all questions (Mbroh, 2019).

Table 3.7

Practices Scale

Description Rating/Points

Always 3

Sometimes 2

Never 1
 41

Lastly, to obtain data on the correlation of the independent and dependent variable,

Pearson Product Movement Correlation was used, and referred to table of critical values

for Pearson’s r level of significance for two-tailed test under 0.05 following the rule:

1) If the computed value is greater than the critical value, the relationship is significant &

2) If the computed value is less than the critical value, the relationship is not significant.

Table 3.8
 CHAPTER IV

PRESENTATION, ANALYSIS, AND INTERPRETATION OF DATA

This chapter covers the presentation, analysis, and interpretation of the data of the

study. To restate, the problem of the study is: “How do knowledge and attitude in hand

hygiene relate to the practices of hand hygiene among junior high school students of

Frances National High School?” The study seeks to prove that there is a significant

relationship between knowledge and attitude in hand hygiene, and practices in hand

hygiene among junior high school students of Frances National High School.

Accordingly, the chapter is divided into four parts:

Part 1. What are the knowledge in hand hygiene of junior high school students of

Frances National High School?

Part 2. What are the attitudes in hand hygiene of junior high school students of

Frances National High School?

Part 3. What are the practices in hand hygiene of junior high school students of

Frances National High School?

Part 4. Is there a significant relationship between the knowledge and attitude in

hand hygiene and practices in hand hygiene among junior high school students of Frances

National High School?

The following are the presentation, analysis and interpretation of data according to

the data gathered from the responses of the junior high school students of Frances National

High School in the Knowledge, Attitude, and Practices or KAP survey in Hand Hygiene:
 43

Part 1: What are the knowledge in hand hygiene of junior high school students of Frances

National High School?

Table 4.1

Distribution and percentage of correct and incorrect answers on the knowledge questions

Questions Correct n (%) Incorrect n (%)

1. Cold water should be used for handwashing. (c) 14 (46.70%) 16 (53.30%)

2. Medium hot water should be used for 26 (86.70%) 4 (13.30%)

handwashing. (c)

3. Hot water should be used for handwashing. (i) 28 (93.30%) 2 (6.70%)

4. There is no need to remove watches and bracelets 28 (93.30%) 2 (6.70%)

when washing hands. (i)

5. There is no need to remove rings when washing 28 (93.30%) 2 (6.70%)

hands. (i)

6. There is no need to wash wrists. (i) 29 (96.70%) 1 (3.30%)

7. Hands need to be washed at least 15 seconds. (i) 17 (56.70%) 13 (43.30%)

8. Hands need to be dried after washing. (c) 30 (100%) 0

9. Handwashing prevents an individual getting 25 (83.30) 5 (16.70%)

infection. (c)

10. Handwashing is part of personal hygiene. (c) 30 (100%) 0

Mean 8.50 (85%) 1.50 (15%)

 44

As shown in the table, a mean of 8.5 from the responses of the students are

actually correct. The thirty respondents (100%) correctly believed that hands need to be

dried after washing and handwashing is part of personal hygiene. However, 16 among them

(53.30%) had a misconception that washing the hands using cold water is incorrect

contradictory to what some studies revealed that cold water is as beneficial as the use of

warm water in handwashing. Hence, there is a need to stress out that both should be running

water. Knowledge of student-respondents is under very good description.

Part 2: The attitude in hand hygiene of junior high school students in Frances

National High School.

Table 4.2

Descriptive statistics for total attitude scores

I feel practicing hand hygiene is:

No.
Negative attitude Negative n (%) Positive Attitude Positive n (%)

1 Inconvenient 1 (3.30%) Convenient 29 (96.70%)

2 Frustrating 3 (10.00%) Not frustrating 27 (90.00%)

3 Not practical 4 (13.30%) Practical 26 (86.70%)

4 Troubling 6 (20.00%) Reassuring 22 (80.00%)

5 Irritating 1 (3.30%) Soothing 29 (96.70%)

6 Optional 2 (6.70%) Necessary 28 (93.30%)

7 Harmful 2 (6.70%) Beneficial 28 (93.30%)

Negative Attitude Mean 0.70 (10.00%) Positive Attitude Mean 6.30 (90.00%)
 45

The table shows that 90% or 27 of the student respondents have a positive attitude

towards hand hygiene. It is good to note that according to their high responses, hand

hygiene practice for them is soothing and convenient. Attitudes of respondents toward hand

hygiene is notably very good.

Part 3: What are the practices in hand hygiene of junior high school students of Frances

National High School?

Table 4.3

Frequency of responses for practices in hand hygiene

No. Practices Always Sometimes Never

I wash my hands: n (%) n (%) n (%)

1 before meal. 25 (83.30%) 0 5 (16.70%)

2 after meal. 29 (96.70%) 0 1 (3.30%)

3 before using the restroom. 14 (46.70%) 14 (46.70%) 2 (6.70%)

4 after using the restroom. 29 (96.70%) 0 1 (3.30%)

5 when I come home. 15 (50.00%) 15 (50.00%) 0

6 after handshaking. 7 (23.30%) 20 (66.70%) 3 (10.00%)

7 before going to bed. 18 (60.00%) 11 (36.70%) 1 (3.30%)

8 after using public 13 (43.30%) 16 (53.30%) 1 (3.30%)

transportation.

9 after waking up in the 18 (60.00%) 11 (36.70%) 1 (3.30%)

morning.

10 after touching animals. 25 (83.30%) 0 5 (16.70%)

 46

…continued Always Sometimes Never

n (%) n (%) n (%)

11 after handling animal waste. 27 (90.00%) 2 (6.70%) 1 (3.30%)

12 after handling animal food. 27 (90.00%) 2 (6.70%) 1 (3.30%)

13 only if they are soiled. 15 (50.00%) 7 (23.30%) 8 (26.70%)

14 before preparing meals. 27 (90.00%) 3 (10.00%) 0

15 after money exchange. 12 (40.00%) 18 (60.00%) 0

16 after blowing my nose. 20 (66.70%) 8 (26.70%) 2 (6.70%)

17 after sneezing. 16 (53.30%) 14 (46.70%) 0

18 after coughing. 15 (50.00%) 15 (50.00%) 0

19 after touching garbage. 25 (83.30%) 5 (16.70%) 0

20 before touching sick people. 14 (46.70%) 15 (50.00%) 1 (3.30%)

21 after touching sick people. 21 (70.00%) 9 (30.00%) 0

22 after combing my hair. 7 (23.30%) 18 (60.00%) 5 (16.70%)

23 after cleaning my home. 24 (80.00%) 5 (16.70%) 1 (3.30%)

24 after washing dishes. 27 (90.00%) 2 (6.70%) 1 (3.30%)

25 after doing laundry. 21 (70.00%) 5 (16.70%) 4 (13.30%)

26 before preparing food. 27 (90.00%) 3 (10.00%) 0

27 after preparing food. 28 (93.30%) 2 (6.70%) 0

28 before using gadget. 9 (30.00%) 17 (56.70%) 4 (13.30%)

29 after using gadget. 8 (26.70%) 18 (60.00%) 4 (13.30%)

30 before handling babies. 18 (60.00%) 12 (40.00%) 0

Mean 19.37 (64.57%) 8.9 (29.66%) 1.73 (5.77%)

Weighted Mean 2.59

 47

The researcher found out that after preparing food respondents most likely

religiously practice handwashing and followed by before preparing food and meal.

Students self-reported practices in hand hygiene are considered good under the given

categorial description having obtained a percentage of 65 when rounded off in whole

number.

Part 4. Is there a significant relationship between the knowledge and attitude in

hand hygiene and practices in hand hygiene among junior high school students of Frances

National High School?

Table 4.4

Correlation of Variables

Variables Computed Value (r) Critical Value Relationship

(0.05)

Knowledge and Practices 0.065 (<) 0.349 Not significant

in Hand Hygiene

Attitude and Practices 0.085 (<) 0.349 Not significant

in Hand Hygiene

As for this study with the available respondents, it is revealed that there is no

significant relationship between knowledge and attitude in hand hygiene, and practices in

hand hygiene among junior high school students of Frances National High School.
 CHAPTER V

SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS

This final chapter presents the summary, conclusions, and recommendations of the

study.

Summary

The main problem of this study is: How do knowledge and attitudes in hand hygiene

relate to the practices in hand hygiene among junior high school students of Frances

National High School?” In the conduct of the study, the following theories were considered

relevant such as self- efficacy theory, health-belief model, attribution theory, protection

motivation theory, social cognitive theory, diffusion of innovation theory, social ecological

model, theory of planned- behavior, and theory-practice-ethics-gap. To restate, the

hypothesis of the study is there is a significant relationship between the knowledge and

attitudes in hand hygiene relate to the practices in hand hygiene among junior high school

students of Frances National High School. The researcher conducted a Knowledge,

Attitude, and Practices Survey on Hand Hygiene via google form to available junior high

school students of the said secondary public school. Respondent were categorized as Red

Cross Youth Council with 15 participants and nonpartisan students of the school, 15

participants as well.

The findings of the study revealed without manipulation or bias the following

truthful facts about the respondents and their valuable responses with truthfulness and

honesty to every section of the survey:

 49

1. The knowledge of the respondents in hand hygiene are very good, noting a

percentage of 85% correct responses. The thirty respondents (100%) correctly

believed that hands need to be dried after washing and handwashing is part of

personal hygiene. However, 16 among them (53.30%) had a misconception that

washing the hands using cold water is incorrect contradictory to what some

studies revealed that cold water is as beneficial as the use of warm water in

handwashing. Hence, there is a need to stress out that both should be running

water.

Same with the study of Mbroh (2019), where the findings showed that although

the overall knowledge of hand hygiene was high which was a positive finding.

Table 3 shows that respondents have good knowledge on basic hand hygiene

where more than 80.9% answered 8 out of 10 questions correctly. This was

perhaps due to their usual understanding on personal and hand hygiene,

obtained from formal and informal learning processes. This could be considered

to be a positive influence to students at large, mid-western university. P29

2. The attitude of the respondents toward hand hygiene shows that 90% or 27 of

the student respondents have a positive attitude towards hand hygiene. It is good

to note that according to their high responses, hand hygiene practice for them

is soothing and convenient. Attitudes of respondents toward hand hygiene is

notably very good.

Similarly, Mbroh’s study (2019) shows that 90% or 27 of the student

respondents have a positive attitude towards hand hygiene. It is good to note

that according to their high responses, hand hygiene practice for them is
 50

soothing and convenient. Attitudes of respondents toward hand hygiene is

notably very good. P.30

3. The researcher found out that after preparing food respondents most likely

religiously practice handwashing and followed by before preparing food and

meal. Students self-reported practices in hand hygiene are considered good

under the given categorial description having obtained a percentage of 65 when

rounded off in whole number.

In comparison to Mbroh’s study, self - reported practices were highest after

handling animal waste (89.7%) and after using the restroom (87.4%). The next

highest hand hygiene practices reported were before preparing meals (83.1%)

and after touching sick people (79.8%). Practices were lowest before using the

restroom and after combing my hair.

4. Though the high percentage of results were obtained from the study, on the

other hand, as for this study with the available respondents, it is revealed that

there is no significant relationship between knowledge and attitude in hand

hygiene, and practices in hand hygiene among junior high school students of

Frances National High School.

Conclusions

Hand hygiene is vital to the health of the school community. This study gathered

the knowledge, attitude and practices of hand hygiene junior high school students of

Frances National High School. Overall, the study showed that levels of knowledge,
 51

attitude and practices of hand hygiene among student- respondents were high. Although

the results of this study indicated that participants had high levels of knowledge, attitude

and practices of hand hygiene, the information provided in this study regarding current

hand hygiene knowledge, attitudes and practices among high school students will help

identify the gaps in knowledge, poor attitudes and substandard practices. This will also be

valuable to the design and implementation of the hand hygiene intervention.

Recommendations

With the result of the study conducted by the researchers, the following

recommendations are hereby solicited:

1. For policy makers, provide extensive multimodal hand hygiene improvement

strategies which have been implemented by local and national health care

agencies and schools in the Philippines. Start by initiating a big population-

sized sampling research to address issue related herewith.

2. For the Department of Education, adopt existing guides to implementing hand

hygiene improvement strategies, such as those published by the WHO that can

serve as a structure when planning hand hygiene education on college

campuses. Key interventions for the implementation of hand hygiene strategies

may include frequent training sessions and education; evaluation and

performance feedback to encourage students to follow correct hand hygiene

practices; and reminders on the learning areas. These interventions would help

identify gaps in knowledge and practice and also help to ensure that students
 52

develop habits consistent with what is required to curb the incidence contracting

infectious diseases.

3. School administrators should religiously follow and implement the directives

and guidelines provided by its department in dealing with hand hygiene most

especially that today a lot of diseases are spreading and one of the weapons that

a learner can use to prevent active transmission of these is handwashing or hand

hygiene.

4. Family is the first school of every individual. Parents and guardian are

encouraged to attend to teaching and monitoring a child’s behavior towards

hand hygiene. The best way is the family can be a good example for every child

to imitate proper hand hygiene and behavior, including thorough practical

application of the skill to form a habit. And, from habit to lifestyle.

5. Junior High School Students should start an active application of what

knowledge they acquired. Use peer influence to encourage or persuade friends

in practicing hand hygiene even if there no one watching.

6. Lastly, future research should try studying this research problem with a larger

population to really gain a more substantial and heavy data regarding the

relationship of knowledge and attitudes, and practices in hand hygiene among

junior high school students.

 53
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Disease Surveillance and Response. Retrieved from www.doh.gov.ph

Hayden, J., (2019). Introduction to Health Behavior Theory, 51- 53. Retrieved from

www.scribb.com

Hayden, J., (2019). Introduction to Health Behavior Theory, 154- 157. Retrieved from

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Hayden, J., (2019). Introduction to Health Behavior Theory, 464- 468. Retrieved from

www.scribb.com

Hayden, J., (2019). Introduction to Health Behavior Theory, 483- 484. Retrieved from

www.scribb.com

Hayden, J., (2019). Introduction to Health Behavior Theory, 691- 695. Retrieved from

www.scribb.com
 54

White, K., (2015) A theory of planned behaviour framework to explore hand hygiene

beliefs at the ‘5 critical moments’ among Australian hospital-based nurses, 2. Retrieved

from BMC Health Services Research, https://bmchealthservres.biomedcentral.com/

Mortell, M., (2012). Hand hygiene compliance: Is there a theory-practice-ethics gap?

Retrieved from https://www.researchgate.net/

Public Health England (2018). Spotty Book: Notes on Infectious diseases in Schools and

nurseries, 8 & 12, Retrieved from https://www.england.nhs.uk/south/wp-

content/uploads/sites/6/2019/09/spotty-book-2019-.pdf

Pittet, D., Boyce, J., Allegranz, B., (2016). Hand Hygiene: A Handbook for Medical

Professionals, 19. Retrieved from

https://nitroflare.com/view/02D4B31E827ADAE/02397408234X10.pdf

WHO (2009). A Guide to the Implementation of the WHO Multimodal Hand Hygiene

Implemented Strategy, 6. Retrieved from www.who.int

UNICEF (1998). A Manual on School Sanitation and Hygiene, 13-14. Retrieved from

www.unicef.org

UNICEF (1998). A Manual on School Sanitation and Hygiene, 1-3. Retrieved from

www.unicef.org

Toney-Butler, T., Gasner, A., Carver, N. (2020). Handwashing: Prevent Disease &

Outbreak Intervention. Retrieved from

https://www.ncbi.nlm.nih.gov/books/NBK470254/
 55

Department of Education (2016). DepEd Order No.10 S. 2016 – DepEd WASH in

Schools (WINS) Program. Retrieved from www.deped.gov.ph

Wolkoff, B., Grim, A., Marx, Jr., H. (2011). Preventional & Control of Common

Diseases. Retrieved from www.health.mo.gov

Sultana, M. Mahumud, R., Sarker, A ,Hossain, S. (2016). Hand hygiene knowledge and

practice among university students: evidence from Private Universities of Bangladesh,

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L., (2019). An Institution-Based Assessment of Students’ Hand Washing Behavior, 7.

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Among University Students, 17-19. Retrieved from www.cornerstone.lib.mnsu.edu

 57

KNOWLEDGE, ATTITUDE, AND PRACTICES (KAP) SURVEY ON HAND HYGIENE

Please read the statements carefully before answering. Answer all items
with truthfulness/honesty. Your personal information and answers will be
kept confidential.

I. Personal Information
Age:
Gender:
 Male
 Female
Birthday:
Representation:
 FNHS Red Cross Youth
 Non-FNHS RCY

Address (Barangay, Municipality, Province):

Received hand hygiene training in the last 2 years:

 Yes
 No

II. Knowledge Questions

1. Cold water should be used for handwashing
 Correct
 Incorrect
2. Medium hot water should be used for handwashing
 Correct
 Incorrect
3. Hot water should be used for handwashing
 Correct
 Incorrect
4. There is no need to remove watches and bracelets when
washing hands
 Correct
 Incorrect
5. There is no need to remove rings when washing hands
 Correct
 Incorrect
6. There is no need to wash wrists
 58

 Correct
 Incorrect
7. Hands need to be washed atleast 15 seconds
 Correct
 Incorrect
8. Hands need to be dried after washing
 Correct
 Incorrect
9. Handwashing prevents an individual getting infection
 Correct
 Incorrect
10. Handwashing is part of personal hygiene
 Correct
 Incorrect

III. Attitude Questions

I feel practicing hand hygiene is:
1. Convenient or Inconvenient
2. Not frustrating or frustrating
3. Not practical or practical
4. Troubling or reassuring
5. Irritating or soothing
6. Optional or necessary
7. Harmful or beneficial

IV. Hand Hygiene Practices

No. Practices Always Sometimes Never

1 I wash my hands before meal.
2 I wash my hands after meal.
3 I wash my hands before using the
restroom.
4 I wash my hands after using the
restroom.
5 I wash my hands when I come
home.
6 I wash my hands after handshaking.
7 I wash my hands before going to
bed.
 59

8 I wash my hands after using public

transportation.
9 I wash my hands after waking up in
the morning.
10 I wash my hands after touching
animals.
11 I wash my hands after handling
animal waste.
12 I wash my hands after handling
animal food.
13 I wash my hands only if they are
soiled.
14 I wash my hands before preparing
meals.
15 I wash my hands after money
exchange.
16 I wash my hands after blowing my
nose.
17 I wash my hands after sneezing.
18 I wash my hands after coughing.
19 I wash my hands after touching
garbage.
20 I wash my hands before touching
sick people.
21 I wash my hands after touching sick
people.
22 I wash my hands after combing my
hair.
23 I wash my hands after cleaning my
home.
24 I wash my hands after washing
dishes.
25 I wash my hands after doing
laundry.
26 I wash my hands before preparing
food.
27 I wash my hands after preparing
food.
28 I wash my hands before using
gadget.
29 I wash my hands after using
gadget.
 60

30 I wash my hands before handling

babies.
 61
Google Forms
62
JOHN MEEK A. RODRIGUEZ
#364 San Juan, Hagonoy, Bulacan 3002
cherjmar@gmail.com
+639358899551

Teaching Profession
A graduate of secondary education and has served public schools during my field work and practicum, with
hands- on experience in presentations, module writing and innovations, facilitating trainings and people
management.
Core Strengths: Education- Science and Health- Programs Support Presentations- Communications-
Facilitation- MS Office- Paper works

Summary of Qualifications
• Profound knowledge of English language
• Strong experience handling diverse group of young individuals
• Has a persevering nature
• Goal oriented
• Good leader

Civil Service Eligibility

Licensure Examination for Teachers (LET)

Rating: 78.20

License Number: 1520005

Education
Bachelor of Secondary Education
Bulacan State University|BulSU- city of Malolos
Work Experience
July 2018 - Present Teacher I, Frances National High School
October 6, 2015 -
Sponsorship Relations Assistant
December 22, 2016
Children International Manila Inc.--Barangay Kaligayahan, Novaliches, QC
Handling the processing of basic letter requirement (Participation Letter) and periodic
letter requirements such as Welcome Letters and 19-year old Final Thank You Letter, and
communication between the sponsors and beneficiaries, creation of visit itineraries.
2013 – 2015 Field Study and Practicum
Sta. Monica, National High School-- HagonoyBulacan
Iba National High School--Hagonoy, Bulacan
- taught Science and MAPEH subjects for Grade 7 and 8 student
- handled 8 sections of diverse learners and provided assessment tools for students' learning

Character References
MICHELLE P. BALDEMORO

Sponsorship Relations Manager

Children International Manila Inc.

+639357055943

CHRISTINA S. TENORIO

Public School Science Teacher

Children International Manila Inc.

+639328630984

MA. VERONICA ALVAREZ

Community Center Coordinator (Team 4)

Children International Manila Inc.

+639333534047
 I declare under oath that this Resume has been accomplished by me, and is a
true, correct and complete statement pursuant to the provisions of pertinent laws, rules
and regulations of the Republic of the Philippines.
I also authorize the agency head / authorized representative to verify / validate
the contents stated herein. I trust that this information shall remain confidential.

JOHN MEEK A. RODRIGUEZ