The Hygiene Hub: Theory-Driven School Hand Hygiene and Sanitation  Program in Chikwawa District

The project reached 178 primary schools in Chikwawa District, training one School Health and Nutrition (SHN) teacher from each school and 14 Primary Education Advisors (PEAs).

The intervention also engaged the Chikwawa District Health Office (DHO) and other district stakeholders, including five Environmental Health Officers (EHO), six Assistant EHOs, and four Senior Health Surveillance Assistants (SHSAs), who were oriented on the intervention.

Following the training, teachers were provided with an implementation manual to guide delivery of the intervention to learners. The intervention aimed to increase the adoption of hygiene and sanitation behaviours in primary schools through participatory, practical and engaging activities.

The intervention covered COVID-19 transmission and prevention, with particular emphasis on handwashing with soap, respiratory hygiene, physical distancing, appropriate mask use, and cleaning frequently touched surfaces.

Rather than relying on knowledge-based messages alone, teachers used games, demonstrations, visual materials, discussions and hands-on activities to help learners understand how germs spread and how appropriate hygiene behaviours can interrupt transmission.

Practical and Participatory Learning

Germ-transmission activities demonstrated how contamination could spread through hand contact and surfaces, followed by practical demonstrations of handwashing with soap.

To make the intervention feasible in resource-constrained school settings, activities encouraged the use of locally available materials, including mud, charcoal powder, wild fruits and coloured chalk as alternatives to PVA paint.

Teachers also adapted activities to what was locally available; for example, chalk dust was used in place of pepper in the pepper game, while still demonstrating how easily contamination can spread and reinforcing the importance of effective handwashing.

These adaptations helped make the intervention practical, affordable and easy for schools to continue using.

Unannounced supportive monitoring visits conducted by the research team, with support from Primary Education Advisors (PEAs), indicated good uptake of handwashing with soap among learners.

A WhatsApp group was also established for School Health and Nutrition (SHN) teachers, providing a platform for schools to share experiences, implementation challenges, lessons learned and practical solutions.

Addressing Implementation Challenges

Monitoring identified several barriers to sustained practice, particularly inadequate numbers of handwashing facilities, which resulted in congestion at peak times such as during school breaks.

In response to this implementation challenge, the project developed and piloted a group handwashing facility in two schools. The facility was designed to enable multiple learners to wash their hands simultaneously, reduce congestion and make routine handwashing with soap more feasible within the school setting.

When Malawi experienced a cholera outbreak in 2022, this established relationship provided an opportunity to broaden the programme’s focus beyond COVID-19 to address cholera and other WASH-related infections.

WASHTED engaged selected primary schools in Chikwawa District to strengthen school sanitation clubs, equipping learners with practical knowledge and skills to prevent cholera and other WASH-related infections.

The approach recognised learners as agents of change, supporting them to promote good WASH practices not only within their schools but also in their homes and communities.