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Factors associated with pupil toilet use in kenyan primary schools.

Garn JV, Caruso BA, Drews-Botsch CD, Kramer MR, Brumback BA, Rheingans RD, Freeman MC - Int J Environ Res Public Health (2014)

Bottom Line: We found a piecewise linear relationship between decreasing pupil to toilet ratio and increasing pupil toilet use (p < 0.01).We found some evidence suggesting facility dirtiness may deter girls from use (p = 0.06), but not boys (p = 0.98).Our study is the first to rigorously quantify many of these relationships, and provides insight into the complexity of factors affecting pupil toilet use patterns, potentially leading to a better allocation of resources for school sanitation, and to improved health and educational outcomes for children.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology, Rollins School of Public Health and Laney Graduate School, Emory University, Atlanta, GA 30322, USA. jgarn@emory.edu.

ABSTRACT
The purpose of this study was to quantify how school sanitation conditions are associated with pupils' use of sanitation facilities. We conducted a longitudinal assessment in 60 primary schools in Nyanza Province, Kenya, using structured observations to measure facility conditions and pupils' use at specific facilities. We used multivariable mixed regression models to characterize how pupil to toilet ratio was associated with toilet use at the school-level and also how facility conditions were associated with pupils' use at specific facilities. We found a piecewise linear relationship between decreasing pupil to toilet ratio and increasing pupil toilet use (p < 0.01). Our data also revealed significant associations between toilet use and newer facility age (p < 0.01), facility type (p < 0.01), and the number of toilets in a facility (p < 0.01). We found some evidence suggesting facility dirtiness may deter girls from use (p = 0.06), but not boys (p = 0.98). Our study is the first to rigorously quantify many of these relationships, and provides insight into the complexity of factors affecting pupil toilet use patterns, potentially leading to a better allocation of resources for school sanitation, and to improved health and educational outcomes for children.

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(a) Proportion of pupils who used a toilet at each school as a function of pupil to toilet ratio, fit with an ordinal pupil to toilet ratio variable. (b) Proportion of pupils who used a toilet at each school as a function of pupil to toilet ratio, fit with a piecewise quadratic spline (knots shown by vertical lines).
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ijerph-11-09694-f003: (a) Proportion of pupils who used a toilet at each school as a function of pupil to toilet ratio, fit with an ordinal pupil to toilet ratio variable. (b) Proportion of pupils who used a toilet at each school as a function of pupil to toilet ratio, fit with a piecewise quadratic spline (knots shown by vertical lines).


Factors associated with pupil toilet use in kenyan primary schools.

Garn JV, Caruso BA, Drews-Botsch CD, Kramer MR, Brumback BA, Rheingans RD, Freeman MC - Int J Environ Res Public Health (2014)

(a) Proportion of pupils who used a toilet at each school as a function of pupil to toilet ratio, fit with an ordinal pupil to toilet ratio variable. (b) Proportion of pupils who used a toilet at each school as a function of pupil to toilet ratio, fit with a piecewise quadratic spline (knots shown by vertical lines).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4199044&req=5

ijerph-11-09694-f003: (a) Proportion of pupils who used a toilet at each school as a function of pupil to toilet ratio, fit with an ordinal pupil to toilet ratio variable. (b) Proportion of pupils who used a toilet at each school as a function of pupil to toilet ratio, fit with a piecewise quadratic spline (knots shown by vertical lines).
Bottom Line: We found a piecewise linear relationship between decreasing pupil to toilet ratio and increasing pupil toilet use (p < 0.01).We found some evidence suggesting facility dirtiness may deter girls from use (p = 0.06), but not boys (p = 0.98).Our study is the first to rigorously quantify many of these relationships, and provides insight into the complexity of factors affecting pupil toilet use patterns, potentially leading to a better allocation of resources for school sanitation, and to improved health and educational outcomes for children.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology, Rollins School of Public Health and Laney Graduate School, Emory University, Atlanta, GA 30322, USA. jgarn@emory.edu.

ABSTRACT
The purpose of this study was to quantify how school sanitation conditions are associated with pupils' use of sanitation facilities. We conducted a longitudinal assessment in 60 primary schools in Nyanza Province, Kenya, using structured observations to measure facility conditions and pupils' use at specific facilities. We used multivariable mixed regression models to characterize how pupil to toilet ratio was associated with toilet use at the school-level and also how facility conditions were associated with pupils' use at specific facilities. We found a piecewise linear relationship between decreasing pupil to toilet ratio and increasing pupil toilet use (p < 0.01). Our data also revealed significant associations between toilet use and newer facility age (p < 0.01), facility type (p < 0.01), and the number of toilets in a facility (p < 0.01). We found some evidence suggesting facility dirtiness may deter girls from use (p = 0.06), but not boys (p = 0.98). Our study is the first to rigorously quantify many of these relationships, and provides insight into the complexity of factors affecting pupil toilet use patterns, potentially leading to a better allocation of resources for school sanitation, and to improved health and educational outcomes for children.

Show MeSH
Related in: MedlinePlus