Department of Environmental Health, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
BMC Public Health. 2012 Feb 21;12:140. doi: 10.1186/1471-2458-12-140.
In Vietnam, efforts are underway to improve latrine use in rural and remote areas with particular focus on increasing coverage of sanitation in schools. However, there is a lack of information on how the school program affects latrine use by schoolchildren and at community level. This paper analyzes sanitation use among schoolchildren in a multi-ethnic area to inform future school-based sanitation promotion programmes.
A combination of quantitative and qualitative methods was applied during a 5 months period in six primary and secondary schools and in the homes of schoolchildren in four different ethnic villages in Northern rural Vietnam. Using a structured questionnaire, 319 children were interviewed face-to-face to collect quantitative data. Qualitative methods included extensive observations at schools and in the homes of 20 children, a single day's diary writings of 234 children, in-depth interviews with children (20), their parents (20) and school staff (10), and focus group discussions with parents (4) and teachers (6), and picture drawing with children (12).
All surveyed schools had student latrines. However, the observed schoolchildren most commonly urinated and defecated in the open. Main barriers for latrine use included inadequate number of latrines, limited accessibility to latrines, lack of constant water supply in latrines and lack of latrine maintenance by school management. Programs promoting latrine use for children were not conducted in either schools or communities and were not established as a preferred social norm in such settings. Children perceived existing school latrines as unappealing and expressed a wish to have basic, functional, clean, and colorful school latrines with privacy.
The paper shows that the current school based sanitation promotion is insufficient to change sanitation behavior of school children irrespective of their ethnicity. It is important that schools, households and communities work more closely together to increase use and uptake of latrine use among schoolchildren. Also, the contractors of latrine facilities must work more closely with local school management when constructing latrines, including identifying location, design and appropriate systems of water supply. A separate budget needs to be allocated to allow the school to maintain the sanitation infrastructure and keep it hygienic and appealing for users.
在越南，正在努力改善农村和偏远地区的厕所使用情况，特别注重增加学校的卫生设施覆盖率。然而，关于学校计划如何影响学童和社区层面的厕所使用情况，信息还很缺乏。本文分析了多民族地区学童的卫生使用情况，为今后基于学校的卫生促进方案提供信息。
在越南北部农村的四个不同民族村庄的六所小学和中学以及学童家中，进行了为期五个月的定量和定性相结合的研究。使用结构化问卷，对 319 名儿童进行了面对面访谈，以收集定量数据。定性方法包括在学校和 20 名儿童的家庭中进行广泛观察、234 名儿童进行为期一天的日记写作、对 20 名儿童、20 名儿童家长、10 名学校工作人员进行深入访谈、对 4 名家长和 6 名教师进行焦点小组讨论以及对 12 名儿童进行图画绘制。
所有被调查的学校都有学生厕所。然而，观察到的学童最常见的是在户外小便和排便。阻碍使用厕所的主要因素包括厕所数量不足、厕所难以进入、厕所供水不足以及学校管理层缺乏厕所维护。促进儿童使用厕所的计划既没有在学校也没有在社区开展，也没有在这些环境中确立为首选的社会规范。儿童认为现有的学校厕所没有吸引力，并表示希望有基本的、功能性的、干净的、色彩鲜艳的、有隐私的学校厕所。
本文表明，目前基于学校的卫生促进措施不足以改变学童的卫生习惯，不论他们的种族如何。学校、家庭和社区更紧密地合作，增加学童使用和接受厕所的比例非常重要。此外，厕所设施的承包商在建造厕所时，必须与当地学校管理层更紧密地合作，包括确定位置、设计和适当的供水系统。需要单独分配预算，以便学校维护卫生基础设施，保持其卫生和对使用者的吸引力。
