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.

According to Rajiv et al (2011), 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 (Rheinlander, Samuelson, Dalsgaard and

Konradson,2010). 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 issues 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 was 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. (2004): 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 (2017) 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,

2017).

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 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
Polit and Hungler (1996) defined a 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

The process of selecting a portion of the population to represent the entire

population is known as sampling (LoBiondo-Wood & Haber 1998:250; Polit &

Hungler 1999:95). 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
According to Gay (1992), 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

According to Yin (2004), 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 depend

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.