Evaluating the impact of a school-based WASH intervention on household and community practices in Kuyu Woreda, Ethiopia

Inadequate water, sanitation, and hygiene (WASH) facilities remain a major barrier to child health, education, and gender equality in low-resource settings. A cross-sectional mixed-methods study was carried out in Kuyu woreda, Ethiopia, evaluating WASH conditions in schools and households of schoolchildren. Data included structured surveys, direct facility observations, and stakeholder interviews. School WASH conditions were poor: the student-to-water point ratio was 776:1, all schools depended on pit latrines (often unsanitary and unsafe), and only two had functioning handwashing stations. Solid waste was mainly burned or dumped in open fields. Household conditions reflected these issues, with only 36.6% having access to basic water services, 11.5% with basic hygiene facilities, and 9% with basic sanitation. Illnesses were common, with diarrhea reported in 7% of children, and strongly linked to inadequate WASH (OR for hygiene = 20.7). Menstrual hygiene management was severely neglected: only 18% of semi-urban and 4% of rural girls had private spaces for changing, and 25% missed school during menstruation. Rural–urban disparities further worsened inequalities. WASH deficiencies in schools and households reinforce each other, contributing to high child morbidity, poor educational outcomes, and persistent gender inequalities. Integrated efforts, including improved infrastructure, hygiene education, menstrual health support, and targeted rural investments, are crucial to achieving SDGs 5 and 6 and creating healthier, more equitable learning environments.