KWAME NKRUMAH UNIVERSITY OF SCIENCE AND TECHNOLOGY

IMPROVING SANITATION AMONG LEARNERS’ IN KUMBUNGU D/A JUNIOR

HIGH SCHOOL BLOCK ‘B’ THROUGH HEALTH EDUCATION.

ABUTU DIYAUDEEN

9669219

A project in the Tamale College of Education, submitted in the Faculty of Educational

studies in partial fulfillment of the requirements for the award of the degree of Bachelor of

Education

July, 2023
 DECLARATION

CANDIDATE’S DECLARATION

I hereby declare that this project work is the result of my own original research and that no part

of it has been presented for another B. ED to the Institute of Education, Kwame Nkrumah

university of science and technology or elsewhere.

Candidate’s Name: ABUTU DIYAUDEEN

Signature: …………………………

Date: ……………………………….

SUPERVISOR’S DECLARATION

I hereby declare that the preparation and presentation of the project work were supervised in

accordance with the guidelines on supervision of project work laid down by the Kwame

Nkrumah University of Science and technology.

Supervisor’s Name. MR. MOHAMMED HAMID ABDUL AZIZ

Signature: ……………………………….

Date: …………………………………….

Coordinator’s Name…………………………………………………

Signature…………………………………………………………….

Date………………………………………………………………………..
 ABSTRACT

The study was undertaken to find out the effects of poor sanitation on the educational

development of pupils at Kumbungu D/A Junior High School Block ‘B’. The instruments used

for the study were questionnaire and observation. The study covers the entire school population

but forty (40) respondents were used in the study through purposive sampling. Tables and

percentages were used in analysis and discussions of the data obtained for the study. The results

indicated that poor sanitation was largely attributed to ignorance of pupils and lack of

encouragement from teachers to practice sanitation. Besides, pupils were unwilling to practice

sanitation because they thought it was a form of punishment. Finally, health education was

deficient in the school. The recommendations included the provision of waste bins and tools to

basic schools across the country by stakeholders in collaboration with basic school management

and organization of sensitization program by Ghana Education Service to enlighten teachers and

pupils to rally behind sanitation.

 ACKNOWLEDGEMENTS

My first thank goes to the Almighty Allah (SWT) for guiding me through this research

work. I also express my profound gratitude to my supervisor, Mr. Mohammed Hamid Abdul Aziz

my History lecturer of Tamale College of Education, for his objective advice and guidance given

to me during this research work. I learnt a lot through his committed and systematic valuable

comments on all aspects of the project work. My appreciation also goes to Kumbungu D/A

Junior High School Block ‘B’ Headteacher Mr. Sulemana Muftaw, the entire staff and learners’

for the space they granted me to undertake this study. Also, I would like the acknowledge my

colleague mentee’s Abdul Fatau Sa-eed (FT), Abubakari Mubarik, and Abudu’s Electricals (L

Prince) for their unflinching support throughout this research work. Finally, I appreciate all the

efforts of those who helped me in compiling this work. I am very grateful.

 DEDICATION

This project work is dedicated to my lovely Mom Yakubu Fati, my lovely Dad Kassim

Abutu (Buu), my brother’s, my sister’s and the entire Alhaji Kassim Family for their unflinching

support throughout my studies in school. Also, I dedicated this project work to anyone who has

contributed and supported me either cash or kind throughout my educational carrier, am forever

greatful.
TABLE OF CONTENT
 CHAPTER ONE (1)

Introduction

Sanitation in Ghana is a major issue and having access to improved sanitation is a

great Challenge. Kumbungu district and families do not have access to decent sanitary facilities

and the couple of accessible ones are not kept or made safe for human use along these

lines making local area individuals particularly learners of Kumbungu D/A Block ‘B’

defenseless against a wide scope of infections connected to poor sanitation. An action research is

therefore adopted to implement an intervention by way of instilling in learners the skills of

proper Health Education and to help improve poor sanitation if not completely eradicate it, but to

promote good life and maintain good health among learners in Kumbungu D/A Junior High

School Block ‘B’. This chapter will cover the background to the study, statement of the problem,

purpose of the study, research questions, significance of the study, Delimitations, Limitations

and Organization of study.

Background to the study

Sanitation plays a crucial role in promoting health and preventing the spread of

diseases. In many parts of the world, inadequate sanitation facilities and poor hygiene practices

pose significant challenges, especially among learners in educational institutions. Children and

adolescents spend a significant portion of their time in schools, making educational institutions

an ideal setting for implementing interventions to improve sanitation and hygiene practices.

Health education programs targeted at learners have the potential to create positive behavioral

changes, leading to improved sanitation practices and overall well-being.

 Sanitation includes use of latrine, personal hygiene, clean surrounding, proper disposal

of solid and liquid wastages and hygienic behavior. So basically, sanitation refers to having

access to facilities for the safe disposal of human waste (Faeces and urine), as well as having the

ability to maintain hygienic condition, through services such as garbage collection, industrial or

hazardous waste management and waste water treatment and disposal.

Furthermore, effective hygiene and Sanitation promotion is a major challenge for many

low income countries. Thus, there is a positive relationship between ill health, poor water

supply, sanitation and hygiene. This has been a major concerned of public health (Bartram &

Cairncross,2010). That is why, when sanitation improves, people's livelihood and health or

wellbeing will become better thereby enhancing economic productivity of the masses (Kumie &

Ali,2005). Due to this, World Bank Group (2000) estimate annual economic losses to the tune of

$260 billion in developing countries due to poor sanitation and it is estimated that about 2.5

million children lose their lives through diarrhea diseases that could have been simply prevented

by good sanitation (UNICEF/WHO, 2009).

Also, according to (WASH BCC,2011) there is growing awareness among public health

practitioners that, until proper hygiene is consistently practiced, both at home and in the

community as a whole, the desired impact of improved water and sanitation infrastructure in

terms of community health benefits cannot be realized. It is therefore important that sanitation is

treated as a major sector which encourages research, innovations and development as well as

professionalism (Patanayak, Poulos, Yang &Patil,2009

However, the Global Sanitation Crisis, despite significant progress made in recent years,

a global sanitation crisis persists, particularly in low- and middle-income countries. According to

the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF),
approximately 4.2 billion people worldwide lack access to safely managed sanitation facilities.

Inadequate sanitation infrastructure, coupled with poor hygiene behaviors, contribute to the

spread of diseases, such as diarrhea, illnesses, cholera, typhoid fever, and other waterborne

infections.

Also, the Impact on Learners, particularly children, are highly susceptible to the adverse

effects of poor sanitation and hygiene practices. Contaminated water sources, lack of clean

toilets, and improper waste management in schools can lead to increased absenteeism, reduced

concentration, and lower academic performance.

Moreover, learners often lack knowledge about proper hand washing techniques, the

importance of using clean toilets, and the significance of overall hygiene practices. Addressing

these issues through health education programs is crucial to ensuring a safe and healthy learning

environment for students.

In addition, Health Education and Behavior Change Health education serves as a

powerful tool to promote positive behavior change and improve sanitation practices among

learners. It involves imparting knowledge and skills to individuals, enabling them to make

informed decisions and adopt healthy behaviors. Effective health education programs focus on

raising awareness about the benefits of good sanitation and hygiene practices, such as regular

hand-washing, using clean toilets, and safe disposal of waste. These programs also emphasize the

importance of teamwork, social support, and community involvement in sustaining behavioral

changes
Statement of the problem

The main motive of writing on this topic is that, the learners including the occupants

dump waste whenever at the edge of the school compound. This has been observed by the

researcher countless times in the school premises.

Moreover, most of the learners doesn’t clean or wash their hands with soap and water

after nature’s call the learners equally are not used to dumping refuse into the few dust bins

available.

Additionally, the researcher further went on to few instructors and learners in the school

and they all confirmed that sanitation is a big issue to cope with. It is this light the researcher

needs to further develop and educate the learners of Kumbungu D/A Junior High School Block

‘B’, to dig into issues of sanitation to impact positively on the scene in the school.

Purpose of the study

The purpose of the study is to improve sanitation among pupils of Kumbungu D/A JHS

Block ‘B’ through health education. The study intends to:

examine the causes of poor sanitation, assess the effects of poor sanitation on academic work

and the use health education as an intervention to improve sanitation among learners in

Kumbungu D/A JHS Block ‘B’

Research Questions

Research questions formulated to guide the study includes;

1. What are the causes of poor sanitation among learners?

2. What are the effects of poor sanitation among learners?

3. What measures can be put in place to improve poor sanitation among learners?

Significance of the study

The researcher is aimed to educate the learners of Kumbungu D/A Junior High School

Block ‘B’ and the entire populace in the following ways;

Firstly, to help learners and members of staff to be aware of the causes and effects of poor

sanitation on the academic performance of learners, hence improving sanitation will curve to

improve academic performance of learners.

Also, the finding will enable Ghana Education Service (G.E.S) and district directorate

of education to come out with policies and programs that will sharpen the skills of the

teachers, community members, Parents Teachers Association(P.T.A), School Management

Committee (S.M.C) as stakeholders to aid improve proper sanitation among learners.

Finally, it will also help further researcher to do more findings on the concepts of

“sanitation” as it is a pertinent issue confronting learners’ in Kumbungu D/A Junior High

School Block “B” and Ghanaian at large.

Delimitation

The research has been restricted to only learners’ of Kumbungu D/A Junior High

School Block ’B’ because the duration for the research is less than a year. Even though, other

schools at the district may need this intervention to improve sanitation among learners in

their schools but research could not extend to them for the limited nature of the duration for
 the researcher.

Limitation

In carrying out the research, the researcher, faced the following challenges:

The researcher finds it difficult in incorporating the classroom workouts with the project

work.

Also, the out segment of the teaching practice brought about difficulty for the

researcher to get regular and consecutive assistance from the project work supervisor.

Moreover, insufficient resource materials and deprivation of library facility at

Kumbungu D/A Junior High School made it difficult for this task to be executed in the out

segment.

In addition, network problems and electricity power outage were also a challenge the

researcher faced due to the environment the research was conducted.

Finally, Financial problems were also faced by the researcher since he has to buy

research materials, search for information on the internet and move from one library to another

library and also from person to person to administer questionnaires and interviews about

sanitation.

Organization of the Study

This action research is organized into five (5) chapters.

In the first chapter talks about the introduction which includes the background of the study,

statement of the problem, purpose of the study, research questions, significance of the study,

limitations, delimitations as well as the organization of the study.

The second chapter also deals with the literature review. Here, the researcher

reviewed relevant literature of the study. In order words, what other people have said about
this particular work, their theories and suggestions to the study. Here, it highlights the

aspects, importance and solutions to the problem.

The third chapter contains the research methodology which describes the various

methods used by the researcher to collect data for the study. It also exposes its strength,

weakness and population instrument.

The fourth chapter talks about the analysis of data, the result of the study, discussion and

its summary.

The fifth chapter comprises the summary, conclusion and necessary

recommendations based on the outcome of the research. Then followed by the references of

the study and the appendices.

 CHAPTER TWO (2)

REVIEW OF RELATED LITERATURE

Introduction

Sanitation is a critical aspect of human life, encompassing a range of practices and

infrastructure aimed at maintaining hygienic living conditions. It plays a pivotal role in

preventing the spread of diseases, promoting public health, and fostering sustainable

development. This literature review examines the research conducted by prominent scholars in

the field, providing insights into the evolution of sanitation practices and its contemporary

significance.

Meaning of sanitation

Sanitation is a crucial aspect of public health and has been recognized as a fundamental human

right by the United Nations. It encompasses a range of practices and facilities aimed at

promoting hygiene, preventing the spread of diseases, and maintaining a clean and safe

environment. This literature review explores the meaning of sanitation, drawing upon the views

of various scholars and experts in the field. By examining their perspectives, we gain a

comprehensive understanding of the multifaceted nature of sanitation and its significance in

promoting health and well-being.

 However, The World Health Organization (WHO) defines sanitation as "the provision of

facilities and services for the safe disposal of human urine and feces" (WHO, 2019). According

to the WHO, sanitation also includes the promotion of personal hygiene practices, such as hand-

washing with soap, as well as the proper management of solid waste and wastewater. Curtis et al.

(2011): Curtis et al. argue that sanitation extends beyond the mere provision of infrastructure and

encompasses a broader socio-cultural context. They highlight the importance of behavioral

factors, such as the use of toilets and hand-washing facilities, as well as the acceptance and

adoption of good hygiene practices within communities. Their research emphasizes the need for

a holistic approach to sanitation that addresses both physical infrastructure and social behavior

(Curtis et al., 2004).

Also, Mara (2010) explores the meaning of sanitation from an environmental

perspective. He argues that sanitation should not only focus on individual health but also

consider the impact on the wider ecosystem. He highlights the importance of sustainable

sanitation systems that minimize water pollution, conserve resources, and promote

environmental sustainability. Mara emphasizes the need to move beyond basic sanitation

provision and towards more ecologically friendly solutions (Mara, 2010).

Furthermore, Fewtrell et al. (2007) emphasize the significance of sanitation in reducing

the burden of disease. Their research demonstrates the strong link between inadequate sanitation

and the transmission of waterborne diseases, such as diarrhea and cholera. They stress that

sanitation plays a vital role in preventing these diseases and protecting public health. Their

findings underscore the importance of improved sanitation infrastructure and practices in

achieving positive health outcomes (Fewtrell et al., 2007).

 Moreover, Bartram et al. (2012) highlight the social and economic benefits of sanitation.

They argue that improved sanitation facilities and practices contribute to enhanced dignity,

privacy, and gender equality, particularly for women and girls. Furthermore, they emphasize the

economic advantages of sanitation investments, including increased productivity and reduced

healthcare costs. Their research underscores the broader developmental impact of sanitation

beyond health considerations (Bartram et al.,( 2012).

In Conclusion, the literature review demonstrates that sanitation encompasses more

than just the provision of infrastructure and services for waste disposal. Scholars emphasize the

importance of considering behavioral, environmental, health, and socio-economic factors when

defining sanitation. It is clear that sanitation is a multifaceted concept that plays a critical role in

promoting public health, environmental sustainability, and social well-being. By adopting a

comprehensive approach to sanitation, policymakers and practitioners can effectively address the

complex challenges associated with sanitation provision and contribute to improved health

outcomes and quality of life for all.

Meaning of health

According to the World Health Organization (WHO), defines health as "a state of

complete physical, mental, and social well-being and not merely the absence of disease or

infirmity." This holistic definition emphasizes the comprehensive nature of health and recognizes

the interplay between various dimensions of well-being (WHO, 1946).

Moreover, Rene Dubos, a renowned microbiologist and humanist, highlighted the

importance of a person's ability to adapt and cope with their environment in defining health. He
argued that health is "a quality of adaptation and self-realization that enables an individual to

survive with dignity and to maintain a sense of well-being" (Dubos, 1965). Dubos' perspective

emphasizes the dynamic nature of health and its link to individual empowerment.

Health education encompasses a range of activities aimed at empowering individuals and

communities to take control of their health. According to Green and Kreuter (1999), health

education is "any combination of planned learning experiences based on sound theories that

provide individuals, groups, and communities with the information, skills, and opportunities to

make quality health decisions." It involves addressing knowledge gaps, fostering positive

attitudes, and promoting behavior change through education, communication, and advocacy

efforts (Naidoo & Wills, 2009).

However, Health education draws upon various theoretical frameworks to inform its

practice. The Health Belief Model (HBM), proposed by Rosenstock (1974), emphasizes

individuals' beliefs and perceptions about health threats and benefits, which influence their

likelihood of engaging in health-promoting behaviors. The Socio-Ecological Model (SEM),

developed by McLeroy et al. (1988), highlights the interaction between individual, interpersonal,

community, and societal factors in shaping health behaviors, providing a comprehensive

approach to health education interventions.

Moreover, on Goals and objectives, Health education aims to achieve several

overarching goals. The Ottawa Charter for Health Promotion, established by the World Health

Organization (WHO) in 1986, outlines three fundamental objectives of health education:

enabling individuals to gain control over their health, fostering supportive environments for

health, and strengthening community action for health promotion. Achieving these goals
involves enhancing health literacy, promoting healthy lifestyles, preventing diseases, and

empowering individuals to make informed decisions about their well-being (WHO, 1986).

Furthermore, on Approaches and Strategies, Numerous approaches and strategies are

employed in health education to effectively disseminate information and drive behavior change.

These include individual counseling, group discussions, community mobilization, mass media

campaigns, peer education, and digital technologies (Sørensen et al., 2012). The use of culturally

appropriate and tailored interventions, such as culturally sensitive health promotion materials and

language translation services, is crucial for reaching diverse populations and addressing health

disparities (Kreuter et al., 2003).

In addition, on Evaluation and Impact, Evaluating the effectiveness of health education

programs is vital for determining their impact on individuals and communities. Evaluation

frameworks, such as the RE-AIM model (Glasgow et al., 1999), assess program reach,

effectiveness, adoption, implementation, and maintenance. Studies have demonstrated the

positive impact of health education interventions on various health outcomes, including

increased knowledge, improved self-efficacy, behavior change, and reduced disease burden

(Nutbeam, 2000; Oldenburg et al., 2002).

Causes of poor sanitation

Access to proper sanitation facilities is crucial for promoting health, well-being and

overall educational outcomes among learners. Unfortunately, poor sanitation remains a persistent

challenge in many educational settings worldwide, negatively impacting the lives of students.

This literature review aims to explore the causes of poor sanitation among learners, drawing on

scholarly perspectives and research findings.

Firstly, Lack of Infrastructure, Insufficient infrastructure is a fundamental cause of poor

sanitation among learners. Inadequate provision of functional toilets, hand-washing facilities,

and proper wastewater disposal systems contribute to unsanitary conditions in schools.

According to Smith and Steinemann (2020), schools in low-income countries often lack basic

water and sanitation infrastructure, leading to compromised hygiene practices,

Secondly, Limited Access to Clean Water, Access to clean water is essential for

maintaining sanitation and hygiene practices. However, many educational institutions,

particularly in resource-constrained areas, face challenges in providing safe and sufficient water

supply. The study by Khushk and Khalique (2018) highlights the correlation between limited

access to clean water and poor sanitation in schools.

Moreover, Inadequate Maintenance and Management, Effective maintenance and

management of sanitation facilities are critical for ensuring their functionality and sustainability.

Neglected or poorly maintained facilities can deteriorate over time, leading to unhygienic

conditions. Cairncross et al. (2018) argue that inadequate maintenance and management

contribute significantly to the persistence of poor sanitation in schools.

 Also, Cultural and Societal Factors, Cultural beliefs, attitudes, and societal norms can

influence sanitation practices among learners. In some communities, sanitation may be given

lower priority compared to other pressing needs, leading to a lack of investment and resources in

improving sanitation infrastructure. The study by Freeman (2018) emphasizes the role of cultural

factors in perpetuating poor sanitation practices in educational settings.

In addition, Lack of Awareness and Education, Insufficient knowledge and awareness

about proper sanitation and hygiene practices contribute to poor sanitation among learners.

Education campaigns focusing on hygiene promotion and behavior change are crucial for

addressing this issue. WaterAid (2020) suggests that comprehensive hygiene education programs

can help empower learners with the knowledge and skills necessary for maintaining good

sanitation practices.

Lastly, Poverty and Inequality, Poverty and socio-economic inequalities often

exacerbate poor sanitation conditions in schools. Low-income households may lack resources to

invest in adequate sanitation facilities or to maintain them over time. Furthermore, marginalized

communities and those in remote areas may face additional challenges due to limited access to

services and infrastructure. McIntyre et al. (2019) highlight the link between poverty, inequality,

and inadequate sanitation among learners.

In Conclusion, Poor sanitation among learners is a complex issue influenced by

various factors, including inadequate infrastructure, limited access to clean water, poor

maintenance, cultural beliefs, lack of awareness, and poverty. Addressing these underlying

causes requires a comprehensive approach involving policy interventions, infrastructure

development, behavior change initiatives, and education campaigns. By understanding the causes
of poor sanitation, policymakers, educators, and stakeholders can work together to create

sustainable solutions and promote a healthy learning environment for all learners.

Effects of Poor Sanitation

Sanitation is a fundamental aspect of human well-being and plays a crucial role in

maintaining public health and preventing the spread of diseases. In educational settings, poor

sanitation can have significant implications for learners, affecting their overall health,

educational outcomes, and socio-economic development. This literature review aims to explore

the effects of poor sanitation among learners, highlighting the viewpoints of various scholars.

First and foremost, Impact on Health, Poor sanitation facilities in schools can lead to a

range of health problems among learners. According to Cairncross et al. (2010), inadequate

sanitation increases the risk of waterborne diseases such as diarrhea, cholera, and parasitic

infections. These diseases can result in frequent absences from school, decreased concentration,

and compromised cognitive development among learners (O'Reilly and Louis, 2014).

Furthermore, a study by Freeman et al. (2012) emphasized that poor sanitation facilities

contribute to the prevalence of neglected tropical diseases (NTDs) like soil-transmitted helminth

infections, which can impair physical growth and lead to malnutrition among learners.

Secondly, Educational Outcomes, the impact of poor sanitation on educational

outcomes is well-documented. Scholars have highlighted that learners in schools with inadequate

sanitation facilities are more likely to miss classes due to illness (Guiteras et al., 2015). This

absenteeism disrupts their learning continuity, leading to poor academic performance and

reduced educational attainment (Dreibelbis et al., 2013). Moreover, the lack of proper sanitation
amenities, such as separate toilets for boys and girls, can pose challenges for menstrual hygiene

management among female learners, contributing to their school dropout rates (Sommer et al.,

2016).

Moreover, Psychosocial Effects, the psychosocial consequences of poor sanitation

among learners should not be underestimated. Several scholars have explored the psychological

and social implications of inadequate sanitation facilities. Travers et al. (2018) highlighted that

learners often experience feelings of shame, embarrassment, and low self-esteem due to the lack

of privacy and cleanliness in sanitation facilities. These negative emotions can have long-lasting

effects on learners' mental well-being, leading to social isolation and reluctance to attend school

(Perez et al., 2017).

Furthermore, Socio-economic Impact, Poor sanitation has broader socio-economic

implications for learners and their communities. Several studies have demonstrated that

improved sanitation facilities in schools positively contribute to increased enrolment rates and

higher retention rates (Hathi et al., 2017). On the contrary, the absence of adequate sanitation

infrastructure can perpetuate the cycle of poverty and hinder economic development by limiting

learners' access to quality education (Hulland et al., 2015). Scholars argue that investing in

improved sanitation facilities can yield substantial economic benefits in the long run by reducing

healthcare costs, increasing productivity, and breaking the intergenerational transmission of

poverty (Gross et al., 2018).

In Conclusion, the literature review highlights the multifaceted effects of poor

sanitation among learners. It emphasizes the detrimental impact on health, educational outcomes,

psychosocial well-being, and socio-economic development. Scholars consistently argue that

investments in adequate sanitation facilities are essential to promote a conducive learning

environment, prevent disease transmission, and enhance educational opportunities for learners.

Addressing the issue of poor sanitation requires a comprehensive approach involving

infrastructure development, hygiene promotion, and policy interventions to ensure the well-being

and future prospects of learners.

Considering the literature on effects of poor sanitation, one can conclude that the health

and livelihood of the learners in the school is in danger as long as they continue in the filthy

environment of Kumbungu D/A JHS. Also, the environment is threatened while social and

economic development is retarded. These numerous effects of poor sanitation either takes

children out of school or make them inattentive due the filthy environment or the pain they may

be going through as a result of the disease they are infected with hence hindering effective

teaching and learning.

Solution to Poor Sanitation

Access to adequate sanitation facilities is crucial for promoting the health, well-being,

and educational outcomes of learners. However, poor sanitation remains a pressing issue in many

educational settings, particularly in low- and middle-income countries. This literature review

aims to explore various solutions proposed by scholars to address the problem of poor sanitation

among learners. By examining a range of scholarly views and insights, this review provides

valuable recommendations for policymakers, educators, and stakeholders involved in improving

sanitation conditions for learners.

Also, Access to adequate sanitation facilities is a fundamental human right and a

critical component of public health and education. Unfortunately, many learners around the

world face the challenge of poor sanitation conditions, leading to increased health risks,
absenteeism, and decreased educational achievement. This literature review synthesizes

scholarly research to identify potential solutions and interventions to address the issue of poor

sanitation among learners.

Firstly, Integrated Infrastructure Development, Scholars have emphasized the need for

integrated infrastructure development to improve learner sanitation. This includes the

construction and maintenance of clean, accessible, and gender-segregated toilet facilities within

educational institutions (Gelaw et al., 2019). Additionally, water supply systems, hand-washing

stations, and waste management mechanisms are crucial components of improved sanitation

infrastructure (O'Reilly et al., 2017). These infrastructure improvements not only promote better

hygiene practices but also contribute to a conducive learning environment.

Secondly, Behavior Change Interventions, Behavior change interventions play a vital

role in promoting good hygiene practices among learners. Scholars argue that education

programs should focus on raising awareness about the importance of sanitation, hand-washing

techniques, and proper toilet usage (Snel et al., 2018). Such interventions should employ

participatory and interactive approaches, engaging learners, teachers, parents, and community

members to foster sustainable behavior change (Caruso et al., 2020). Furthermore, incorporating

sanitation and hygiene education into the curriculum can help instill long-term habits and

knowledge.

Moreover, Policy Support and Collaboration, Scholars emphasize the significance of

policy support and collaboration among stakeholders to address the challenges of poor sanitation

among learners effectively. Governments should prioritize sanitation in national policies, allocate
sufficient budgets, and establish regulatory frameworks to ensure compliance and monitoring

(Moe et al., 2019).

Additionally, partnerships between governments, non-governmental organizations

(NGOs), educational institutions, and communities are crucial for implementing comprehensive

sanitation programs (Wilbur et al., 2021). Collaboration enables the pooling of resources,

knowledge sharing, and leveraging of expertise for sustainable solutions.

Finally, solutions are paramount. Scholars highlight the need for regular maintenance,

repair, and monitoring of sanitation facilities (Parker et al., 2019). Engaging the school

community, including learners, teachers, and parents, in the maintenance and management of

sanitation infrastructure promotes ownership and responsibility (Muyanja et al., 2021).

Sustainable financing models, such as public-private partnerships, can also contribute to the

long-term viability of sanitation interventions.

In Conclusion, addressing poor sanitation among learners requires a multifaceted

approach that integrates infrastructure development, behavior change interventions, policy

support, and collaboration. Scholarly research emphasizes the importance of gender-segregated

sanitation facilities, water supply systems, hygiene education, and sustained efforts for

maintenance. By implementing these solutions, policymakers, educators, and communities can

create an enabling environment that promotes better sanitation practices among learners and

contributes to their overall health and educational outcomes.

Importance of health education to learners

This literature review explores the significance of health education in addressing poor

sanitation among learners. It highlights the views of scholars on the subject matter, with a focus

on the role of health education in promoting hygiene practices, preventing diseases, and

improving overall well-being. The review underscores the need for comprehensive health

education programs to empower learners with the knowledge and skills necessary for

maintaining proper sanitation and hygiene practices. By examining various scholarly

perspectives, this review aims to shed light on the importance of health education in ensuring the

well-being of learners in relation to sanitation.

Poor sanitation poses significant challenges to the health and well-being of learners.

The lack of access to clean water, proper toilets, and adequate hygiene practices in educational

settings contributes to the spread of infectious diseases and undermines the educational outcomes

of students. Health education plays a crucial role in addressing these challenges by imparting

knowledge, raising awareness, and promoting positive behaviors related to sanitation and

hygiene. This literature review delves into the views of scholars regarding the importance of

health education in mitigating poor sanitation among learners.

First and foremost, Health Education and Hygiene Practices, Health education serves

as a powerful tool for promoting and sustaining proper hygiene practices among learners.

Scholars emphasize the role of health education in providing learners with essential knowledge

about personal hygiene, hand-washing, and environmental sanitation. By instilling these

practices, health education cultivates a culture of cleanliness, reduces the transmission of

diseases, and fosters a healthy learning environment. Furthermore, research shows that health
education interventions have led to significant improvements in hand-washing behavior and

sanitation practices among learners (Biran et al., 2012; Curtis et al., 2011).

Secondly, Disease Prevention and Control, one of the primary benefits of health

education in relation to poor sanitation is disease prevention and control. Scholars argue that

health education equips learners with information about the causes, symptoms, and preventive

measures of waterborne and sanitation-related diseases. By understanding the consequences of

poor sanitation, learners are motivated to adopt safe practices and take proactive measures to

protect themselves and others. The implementation of health education programs has been

associated with reduced rates of diarrheal diseases and other sanitation-related illnesses (Fewtrell

et al., 2005; Esrey et al., 2008).

Moreover, Empowerment and Behavior Change, Health education empowers learners

to become agents of change by enabling them to take responsibility for their own health and the

health of their communities. Scholars highlight the transformative potential of health education

in promoting behavior change among learners regarding sanitation practices. By fostering critical

thinking, encouraging dialogue, and engaging learners in participatory activities, health

education programs facilitate the adoption of sustainable behaviors and the creation of healthy

habits (Dreibelbis et al., 2013; Scott et al., 2008). Moreover, health education empowers learners

to advocate for improved sanitation infrastructure and policies in their communities.

In Conclusion, the literature review underscores the crucial role of health education in

addressing poor sanitation among learners. Scholars consistently emphasize the significance of

health education in promoting hygiene practices, preventing diseases, and empowering learners

to become agents of change. By imparting knowledge, raising awareness, and fostering behavior
change, health education equips learners with the tools necessary to maintain proper sanitation

and hygiene practices. Further research and implementation of comprehensive health education

programs are essential to ensure the well-being and educational success of learners in relation to

sanitation.
 CHAPTER THREE

METHODOLOGY

Having reviewed literature in the previous chapter, certain key issues have been identified

in relation to the objectives of the study which are relevant to the study of hygiene in the school.

This chapter presents the procedures that were used in collecting data and the tools for analysis

that was used in interpreting the data. This covers the research design, strengths and weaknesses

of the design, population, sample and sample selection, questionnaires and observation were

used as the research instruments, data collection procedure and data analysis plan.

Research Design

The research design in this study is "Action Research". Kenneth A. Gyimah and Eric

Anane (2013, p 91) research methods on education noted that ‘Action research or participatory

action research is a research initiated to solve an immediate problem or a reflective process of

progressive problem solving led by individuals working with others in teams or as part of a "

community of practice " to improve the way they address issues and solve problems'. Action

research aims at improving a problem with its related situation through a change. This action

research assists the researcher with recognition of what really persists or continues in the school

compound. Additionally, it seeks to get new information and empowering the researcher to foster

a proper intercession to find an answer to the issue recognized in the school, and more

particularly the school compound. Besides, Action Research has some lapses because it cannot

be used in general case study, and a particular project work that has been carried out and also, it

cannot be used to solve another problem.

Population

Population as the entire aggregation of cases that meet designed set of criteria. In this

case, the population of students at Kumbungu D/A junior high school where the study is

undertaken is four hundred and fifty-six (456) pupils, 240 being girls and 216 being boys. Also,

the school has 14 teachers 4 being females and 10 males. Thus, the entire population in the

school is 470.

Sample and sample technique

A sample is a subset of a population selected to participate in the study, it is a fraction of

the whole, selected to participate in the research project (Brink 1996:133; Polit & Hungler

1999:227).

The Sampling Procedure

Sample Procedure is process of selecting a portion of the population to represent the

entire population. In this case, Purposive sampling was the method used. Purposive sampling,

also known as judgemental, selective, or subjective sampling, is a form of non-probability

sampling in which researchers rely on their own judgement when choosing members of the

population to participate in their study.

Purposively a total of forty (40) key informants were chosen to participate in the

research. In purposive sampling, as the above definition suggest, the researcher handpicks both

the Teacher’s and pupil’s to be included in the sample on the basis of his own judgement of the

performance and knowledge possessed by individuals about the issues under study thus in

purposive sampling, also known as judgemental sampling, the researcher purposely chooses

subjects who in his opinion are thought to be relevant to the research topic (Kenneth.A. G & E.
Annane 2013, p 66).

Those included in the sample are as follows: the headmaster, three (3) form teachers and six

(6) pupils each from six (6) classes making a total of 40 pupils.

The headmaster was picked in light of the fact that he manages the entire school whiles

the form masters were picked because they oversee their various forms classes, the class prefect

and his collaborator with four others learner’s each from the classes were picked due to their

ability to express themselves.

Research Instrument

All research studies involve data collection. In gathering information, the researcher used

questionnaire and observation to obtain information for the research. The level of pupil’s

knowledge on sanitation was the main thing the researcher considered in choosing the instrument

for the study. Also the researcher was mindful of greater assurance of anonymity and

respondent's convenience as far as classes were concern and questionnaires endorsed by the

mentor and headteacher.

Data Collection Procedure

A qualitative data collection must be flexible and carefully planned, well executed and

appropriately controlled in order to gain respect as a researcher. That is why the researcher

carefully designed the pre-intervention, intervention and post- interventions to solve the problem.
Pre-Intervention

Pre-intervention served as the foundation of the data collection procedure. It was a

technique the researcher adopted in order to find solution the perceived problem before the actual

intervention. The researcher, after observing the pupil’s behavior towards sanitation in the school

especially during recreational hours realized learners’ behavior towards sanitation was bad, then

the researcher sought permission from the headmaster to carry out some activities. Thus, the

researcher instructed each class to bring two empty frytol gallons to the school, he helped the

pupil to cut-opened each gallon to serve as waste bins in other to reduce the filthy nature of the

school compound. Upon the researcher's improvisation of the waste bins, more than 70% of the

pupils still litter about during recreational hours neglecting the idea employed by the researcher.

He also administered questionnaire to the respondents during their silence hour and break hours

over a period of a week. The respondents were administered on class basis thus a class at a time

hence the others in different classes will not know what was carried out in another class. After

administering questionnaire to pupils successfully, it was revealed that even though poor

sanitation has many causes, ignorance is the major cause of poor sanitation as in the case of

Kumbungu D/A JHS.

Also, the teachers always admonished the learners to keep the environment clean but the

learners’ always thought it was a form of punishment to them. Due to that, the learners’ do not

keep the school compound clean but they do not know the health hazard it may cause to them.

Finally, health education and provision of waste bins as suggestions for improving sanitation,

majority of the learners’ have no idea about the impact of health education in improving
sanitation

Intervention Activities

Intervention is the method that the researcher employed to enable the pupils understand

and solve the problem. The success of any intervention depends enormously on a combination of

structural, behavioral, individual as well as community components (Parker et al, 2012). The

researcher took the pupils through the following activities:

The researcher carefully organized the learners’ and gave them health educational talk on

the meaning, causes, effects and possible solutions to the problem "Poor Sanitation" using three

consecutive days, always during their silence hour thus, from 6:30-7:30AM each day. This was

done to improve their knowledge of understanding about sanitation and its related problems in

Kumbungu D/A Junior High School.

Also, the researcher took the pupils through some interesting activities to improve their

understanding on sanitation. The activities undertaken by the researcher and the learners include:

folding of empty pure water sachets, turning empty gallons into waste bins, using collection of

polythene to form a football, stitching of empty water sachets to form dust covers for computers

and other activities to aid in their knowledge of understanding.

It is observed that, the filthy nature of the school compound has improved day in day out,

which means that, the pupils have gotten the concept of Health Education clearly.

Post Intervention

This stage of the methodology evaluates the outcome of the actions taken. At the end of

the intervention, there was the need for the researcher to evaluate the learner’s knowledge to
determine the improvement level of the learners.

A questionnaire was administered again at the same level. The results of the questionnaire

showed that, the researcher had achieved his aims. That is there was a drastic improvement of

sanitation in the school indicating about 80% that practice good sanitation. Also, after the

intervention, it was observed that pupils’ attitudes towards sanitation changed. The learners’

now use the improvised bins and they no longer litter the school compound and the health and

progress of the learner’ are now better-off thereby enhancing teaching and learning.

Data Analysis plan

According to Mara et al., (2010) states that complexity of sanitation demands a clear

analysis of the situation at hand and developing the required strategies that can help achieve

success.

The analysis of data was based on the research questions for the study. As a result, the

data was gathered and organized under the stated research questions. Information under each

were interpreted and explained in line with how it contributes to academic performance of

learners’

In conclusion, the instruments employed by the researcher to record and analyze the data

gathered from the research work are: observation, questionnaire and percentage of responses

from both pre-intervention and post-intervention results using filled data tables. Details of the

analysis are presented in the next chapter.

 CHAPTER FOUR (4)

RESULTS, FINDINGS AND DISCUSSION

This study aims at finding out the effects of poor sanitation on the academic work of

learners in Kumbungu D/A Junior High School. As a result, the researcher conducted three

questions to assist him in the study.

The data collected under study was analyzed using simple frequency and percentages in

relation to the answers the respondents gave. The framework for qualitative data analysis by

Miles and Huberman (1994) explains that at the reduction phase, data collected is simplified and

transcribed for easy manageability. The analysis includes all the pupils, form teachers and

headmaster and discussion of the result to answer each research question.

Meanwhile, this chapter give the social characteristics of the respondents and the

responses of the respondents as per the questionnaire administered to them.

Ages of Respondents

The respondents’ age between 13 years to 16 years, 15% were 13 years and also 15%

were 14years meanwhile 12% were 16years representing the oldest.

Sex of Respondents

The respondents were made up of 17 males representing 42.5% and 23 females

representing 57.5%.

Research Questions

Research Question 1: What are the causes of poor sanitation?

Table 1 shows the perception of respondents on the research question.

Table 1: what are the causes of poor sanitation among learners ?

Views of learners Frequency Percentages (%)

Ignorance 22 55%

Laziness 8 20%

Lack of waste bins and tools 10 25%

Total 40 100

Source: Field data

From table 1, it is clear that 8 respondents representing 20% affirmed laziness as

cause of poor sanitation. However, 22 respondents representing 55% said ignorance causes

poor sanitation. On the other hand, 10 of the respondents also said lack of tools and waste

bins.

Through Keen observation, this research question and responses from

respondents showed that the cause of poor sanitation is mainly attributed to ignorance.
Research Question 2: What are the effects of poor sanitation in the school?

Table 2: What are the effects of poor sanitation among learners?

Effects of Poor Sanitation Frequency Percentages %)

Contamination of food and 9 22.5

water

Increase health problems 7 17.5

Filthy environment 24 60

Total 40 100

Source: Field data

Table 2 is an illustration of how pupils perceive the effects of poor sanitation. Among the

respondents 17.5% said there is outbreak of diseases affecting them and 60% said poor sanitation

makes the environment filthy while 22.5% said poor sanitation contaminates of food and water.

It can clearly be seen from the table above that a great number of the pupils were only

aware of the filthy nature of the environment accompanied poor sanitation in the school despite

health problems and contamination of food and water which could lead to absenteeism and
sickness among learners.

Research Question 3: What measures can be put in place to improve poor sanitation?

The researcher posed this question to enable him gather information on the possible

solutions to poor sanitation.

Table 3: Suggestions for improving poor sanitation

Ways to improve poor sanitation Frequency Percentages (%)

Punishment 20 50

Health Education 6 15

Provision of waste bins 14 35

Total 40 100

Source: Field data

From table 3, 50% of the respondents suggested that, culprits should be punished to

serve as a deterrent. Also, 15% Suggested health education while 35% said the school authority

should provide waste bins.

From table 3, it can be deduced that majority of the respondents have no idea about the

impact of using health education in improving sanitation.

Post-Intervention

Then the researcher after taking the respondents through health education during the

intervention designed and administered a similar questionnaire to them. The researcher realized

that, the responses vary from the previous one though the same questions to the same respondents.
Research Question 1: What are the causes of poor sanitation?

Table 4: Learner’s opinions on causes of poor sanitation.

Learners opinion Frequency Percentages (%)

Ignorance 32 80

Laziness 2 5

Lack of waste bins 6 15

Total 40 100

Source: Field data

From the table 4 above, it can be seen that 5% said it was laziness, 15% said lack of

waste bins while 80% said ignorance. It is obvious that majority of the pupils opined that, it is

ignorance on the part of the pupils that brought about the poor sanitation.

Research Question 2: W h a t a r e t h e e ff e c t s o f p o o r s a n i t a t i o n i n school?

Table 5: Learner’s opinion on the effects of poor sanitation

Learners Opinion Frequency Percentages (%)

Contamination of food and water 10 25

Increased health problem 18 45

Filthy environment 12 30

Total 40 100
 From the table 5 above, it is seen that 45% of the respondents said that, increment in health

problem was a major effect, 30% said it can lead to filthy environment and 25% said poor sanitation

attracts contamination of food and water. It is clearly seen that, majority of the respondents

(45%) said they are faced with health problem which means we need to improve health

education.

Research Question 3: What measures can be put in place to improve poor sanitation.

Table 6: Suggestions for improving poor sanitation

Views of Learners Frequency Percentages (%)

Punishment of learners 2 5

Health Education 34 85

Provision of waste bins 4 10

Total 40 100

Source: Field data

From table 6, 5% said punishment to culprits, 85% responded to health education and

10% said, provision of waste bins.

It is obvious that, majority of the pupils said that, if health education is given to pupils, they
would get the concept and practice sanitation everywhere. Also, when pupils are educated on

the consequences of poor sanitation, they will now use waste bins and other tools to maintain

and practice good sanitation in their surroundings.

Summary of Findings

The results of the findings indicate that before the intervention; poor sanitation is

mainly attributed to ignorance, great number of the pupils were only aware of the punishment

that accompanied poor sanitation in the school despite their health and lack of waste bins in

the school compound. Majority of the respondents had no idea about the impact of using

health education in improving sanitation.

Also after the intervention, it was clear that, many of the pupils agreed that it is

ignorance on the part of the pupils that brought about the poor sanitation, many of the

respondents (85%) said they lacked health education about the causes and effects of poor

sanitation. Finally, health education is a vital aspect in ensuring good health hence affirming

the validity of the intervention.

 CHAPTER FIVE (5)

SUMMARY, CONCLUSIONS AND RECOMMENDATIONS

This chapter provides a summary, conclusion and recommendations of the topic under

study towards making future directives and policies. The main aim of the study was to find out

the effects of poor sanitation on the academic performance of pupils in Kumbungu D/A Junior

High School.

Summary Overview of the Study

The study aimed at finding out the effects of poor sanitation on the academic work of

pupils in Kumbungu D/A Junior High School, which serves as the population of the study. An

action research was used and respondents were sampled using purposive method. Data was

collected from 40 respondents using observation and questionnaire.

Key Findings

Firstly, Poor sanitation is largely attributed to ignorance of pupils and lack of

encouragement from teachers to practice sanitation.

Secondly, Teacher’s and learner’s were unconcerned about the health of themselves
which sometimes leads to absenteeism and sickness among both teachers’ and learners’ in the

school and at home.

In addition, Learners’ were unwilling to practice sanitation because they thought it was a

form of punishment.

Finally, Health education is deficient in the school which need solution.

Conclusions

The conclusion made from the study included: ignorance and lack of encouragement

from teachers resulted in the poor sanitation in the school, learners’ were only compelled to

practice sanitation of which the learners’ thought it was form of punishment to them. Also, the

learners’ were not focused on health hazard of sanitation to their studies because sanitation was

of no concern to them which causes a lot of illness hence preventing learners from going to

school regularly and posing negative effect on the academic performance of Kumbungu D/A

Junior High School learners’.

Recommendations

Throughout the study conducted, the researcher realized that, there is the need for more

improvement in carrying out activities of sanitation in the schools and even beyond hence the

following recommendations are made based on the research findings and observation:

Stakeholders should implement sanitation projects in all basic schools across the country

and ensure its effectiveness.

Stakeholders in collaboration with basic schools’ management should provide waste bins

and tools for basic schools across the country. Schools and teachers who do their best in good

sanitation should be rewarded with incentives.

The Ghana Education Service should organize sanitation sensitization programs to

enlighten teachers and learners’ to rally behind sanitation.

Suggestions for Further Research

Further studies should be carried out on the effects of poor sanitation on the academic

performance at all levels of education to help prevent the havoc sanitation has on the academic

performance of learners across all level of education in Ghana, Africa and the World at large.

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 APPENDIX A

Sample questionnaire for a Head Teacher on sanitation:

I am currently a student of Tamale College of Education studying for a Degree in Basic

Education. In relation to this, I am conducting research on the topic "Improving sanitation in

Kumbungu D/A Junior High School. You are however ensured of confideciality.

Name of Headteacher:

School: Kumbungu D/A Jumior High School Block ‘B’

1.What measures are currently in place to ensure proper sanitation within the school premises?

2.Are there designated personnel responsible for maintaining cleanliness and hygiene in the

school? If yes, please provide their roles and responsibilities.

3.How frequently are the school toilets and washrooms cleaned and sanitized?

4.Are there any specific guidelines or protocols followed for waste disposal within the school?
5.What steps have been taken to promote hand hygiene among students and staff?

6.Are there adequate facilities for hand washing, such as hand washing stations or hand

sanitizers, available throughout the school?

7.Are the toilet facilities easily accessible to all students, including those with disabilities?

8.How do you ensure the availability of clean and safe drinking water for students and staff?

9.Are there any initiatives or programs in place to educate students about proper sanitation

practices and the importance of cleanliness?

10.Have you encountered any challenges or issues regarding sanitation within the school? If yes,

how have you addressed them?

11.Are there any plans for future improvements or upgrades in terms of sanitation facilities

within the school?

12.Are there any specific policies or regulations enforced to maintain sanitation standards within

the school?

13.How do you involve the school community, including parents and students, in promoting and

maintaining a clean and hygienic environment?

14.Are there any partnerships or collaborations with external organizations or agencies to

support sanitation initiatives within the school?

15.How do you monitor and evaluate the effectiveness of sanitation practices within the school?
 APPENDIX B

Sample of questionnaire on poor sanitation for Teachers

I am currently a student of Tamale College of Education studying for a Degree in Basic

Education. In relation to this, I am conducting research on the topic “Improving sanitation in

Kumbungu D/A Junior High School’’. You are however assured of complete confidentiality.

1.How would you rate the overall sanitation facilities in your school?

 Excellent [ ]

 Good [ ]

 Fair [ ]

 Poor [ ]

 Very poor [ ]

2.Are there sufficient and clean toilet facilities available for both students and teachers?

 Yes [ ]

 No [ ]

If no, please specify the issues you have observed regarding the toilet facilities.
3.How often are the toilets cleaned and maintained in your school?

 Daily [ ]

 Weekly [ ]

 Monthly [ ]

 Irregularly [ ]

 Not sure [ ]

4.Are there enough hand washing stations available in your school?

 Yes [ ]

 No [ ]

If no, please provide reasons for the lack of hand washing stations.

5.Are the hand washing stations regularly supplied with soap and water?

 Always [ ]

 Sometimes [ ]

 Rarely [ ]

 Never [ ]

6.Have you noticed any instances of improper waste management in your school?

 Yes [ ]

 No [ ]
If yes, please describe the specific waste management issues you have observed.

7.Are there any unpleasant odors or unhygienic conditions present in or around the school

premises?

 Yes [ ]

 No [ ]

If yes, please specify the areas or situations where you have noticed such conditions.

8.How do you think poor sanitation affects the overall health and well-being of students and

teachers in your school?

9.Have you received any training or information on promoting proper sanitation practices in your

school?

 Yes [ ]

 No [ ]

If yes, please describe the type of training or information you have received.

10.What suggestions or improvements would you propose to enhance sanitation facilities in your

school?
 APPENDIX C

Sample of questionnaires for learners

I am currently a student of Tamale College of Education studying for a Degree in Basic

Education. In relation to this, I am conducting research on the topic "Improving sanitation in

Kumbungu D/A Junior High School.

Gender…………

Date………………………………. Basic…………

Please thick [? ] only one to show your assessment

1. The causes of poor sanitation are:

A. Ignorance Agree [ ] Disagree [ ] None[ ]

B. Laziness Agree [ ] Disagree [ ] None[ ]

C. Lack of waste bins and tools Agree [ ] Disagree[ ] None [ ]

2. Poor sanitation has the following effects:

A. Contamination of food and water Agree [ ] Disagree[ ] None[ ]

A. Health problem Agree [ ] Disagree [ ] None[ ]

b. Attracts punishment Agree [ ] Disagree[ ] None[ ]

3. Ways of improving poor sanitation

A. Punishment to pupils Agree[ ] Disagree[ ] None[ ]

B. Health education Agree [ ] Disagree[ ] None[ ]

C. Provision of waste bins and tools Agree [ ] Disagree [ ] None[ ]