Water, Health and WASH

Address a range of global health issues in our online course Geo-Health

COVID-19 and Water, Sanitation and Hygiene in Schools
Implications, Challenges, Solutions

(Source: Newsletter 1/2021 |  Arbeitskreis Medizinische Geographie und Geographische Gesundheitsforschung in der Deutschen Gesellschaft fur Geographie)

The role that children play in the transmission pathways of COVID-19 remains unclear. What we know is that children have always played a significant role in disease outbreaks and epidemics (e.g. influenza pandemics), as they are potential carriers and spreaders (Mansourian et al., 2021; Bhuiyan et al., 2021). Taking into account that most of the children infected with COVID-19 are asymptomatic or usually develop mild symptoms, infants have the potential to become superspreaders of SARS-CoV-2 (Mansourian et al., 2021; Dufort et al., 2020). In the face of this problem, most governments around the world have temporarily closed educational institutions in an attempt to contain the spread of the COVID-19 pandemic.

Photo: Source: UNICEF and WHO, 2020
Figure 1: Hygiene services in schools in India

UNICEF estimates that the imposed countrywide school closures in 188 nations during the pandemic so far affected over 1.6 billion students (UNICEF, 2020). School closures carry several adverse impacts not only on children but also on other stakeholders (parents, teachers etc.) as well (UNESCO, 2021). Therefore, the reopening of schools is starting in some places, and considered in others. Some countries, especially in Asia (e. g. China, Taiwan, South Korea) and Europe (e. g. Denmark, Germany, Norway) have already begun the process by implementing different COVID-19 prevention strategies such as reduction of class size, mandatory wearing of masks, installation of plastic dividers, among others (Ezeonu et al., 2021). However, WHO and UNICEF through the WHO/UNICEF Joint Monitoring Programme (JMP) points out that worldwide, especially in low- and middle-income countries (LMICs) most of the schools lack the necessary water, sanitation and hygiene (WASH) infrastructure to ensure the safety of students and school staff during the school reopening (UNICEF and WHO, 2020).

Therefore, our ongoing study aims to identify and describe WASH conditions in LMICs prior to, during, and beyond the COVID-19 pandemic and possible barriers, enablers and solutions related to the necessary improvement of WASH under the perception of the different schools stakeholders, such as parents, school staff, teachers, government and students. Moreover, the results of this study will be used to showcase best WASH practices for safe reopening of schools in LMIC during COVID-19 pandemic as also to improve schools resilience against future waterborne and hygiene-related pandemics.

We seek to understand:

  1. How are the WASH conditions in schools in LMICs;
  2. What are the factors that influence / interfere in WASH conditions in schools in LMICs, such as location (urban, peri-urban, rural), type of school (primary, secondary, public or private school), among others;
  3. If there is a difference of the WASH conditions in schools in LMICs between the worst and less affected areas by COVID-19;
  4. What are the school stakeholders’ perceptions of the challenges, hurdles, enablers and solutions related to the necessary improvement of WASH in schools in LIMCs in order to provide the safe reopening of the schools during COVID-19 pan-demic;
  5. What are the lessons learnt for future unprecedented crises or pandemics.

In order to address these questions, a mixed qualitative and quantitative methods approach is going to be employed. Quantitative analysis will comprise spatial and non-spatial statistic analysis of WASH in schools in LMICs using secondary data retrieved by dif-ferent datasets, such as from UNESCO, UNICEF and National Surveys. Qualitative research will comprise multiple qualitative methods (e.g. community-based participatory research and arts-based qualitative research, i. e. focus groups, interviews and photovoice), employed in one or two LMICs. Hitherto we are considering to conduct the research in Brazil, however the research areas are still to be defined.

This research is in the stage of conceptualization and will be implemented over the course of the next four years (2021-2015) as a doctoral project in GeoHealth. It is being carried out by Kasandra Poague (MSc in Sanitation, Environment and Water Resource), under the supervision of Carmen Anthonj, at the Department of Earth Observation Science (EOS), Faculty of Geo-Information Science and Earth Observation (ITC), Univertsity of Twente, The Netherlands. The first step is a systematic review on WASH in schools in LMICs, which the research team is currently conducting (PROSPERO protocol registration number CRD42021248831).

Contact us

If you are interested in learning more about this project, in collaborating, or in contributing to this project, e.g. as a key informant or interviewee representing the public health, WASH or educational sector, or by sharing relevant data you are kindly invited to contact us.

  • References

    Bhuiyan, M.U., Stiboy, E., Hassan, M.Z., Chan, M., Islam, M.S., Haider, N, Jaffe, A., Homaira, N., 2021. Epidemiology of COVID-19 infection in young children under five years: A systematic review and meta-analysis. Vaccine 39(4), 667–77.

    Dufort, E.M., Koumans, E.H., Chow, E.J., Rosenthal, E.M., Muse, A., Rowlands, J., Barranco, M.A., Maxted, A.M., Rosenberg, E.S., Easton, D., Tomoko, U., Kumar, J., Pulver, W., Smith, L., Hutton, B., Blog, D., Zucker, H., for the New York State and Centers for Disease Control and Prevention Multisystem Inflammatory Syndrome in Children Investigation Team, 2020. Multisystem Inflammatory Syndrome in Children in New York State. N Engl J Med. 383(4),347–58.

    Ezeonu, C., Uneke, C., Ezeonu, P., 2021. A rapid review of the reopening of schools in this COVID-19 pandemic? How ready are we in Nigeria? Nigerian Journal of Medicine 30 (1), 8-16.

    Mansourian, M., Ghandi, Y., Habibi, D., Mehrabi, S., 2021. COVID-19 infection in children: A systematic review and meta-analysis of clinical features and laboratory findings. Arch Pediatr 28(3), 242-248.

    United Nations Children’s Fund (UNICEF), 2020. COVID-19 and Children. UNICEF data hub. https://data.unicef.org/covid-19-and-children

    United Nations Children’s Fund (UNICEF) and World Health Organization (WHO), 2020. Progress on drinking water, sanitation and hygiene in schools: Special focus on COVID-19. New York: WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene. https://www.unicef.org/media/74011/file/Progress-on-drinking-water-sanitation-and-hygiene-in-schools-focus-on%20covid-19.pdf

    United Nations Educational, Scientific and Cultural Organisation (UNESCO), 2021. Adverse consequences of school closures. https://en.unesco.org/covid19/educationresponse/consequences