Publication:

Effect of school-led total sanitation intervention on school attendance among pupils in primary schools within Baringo County, Kenya

Background School attendance critically determines educational outcomes, especially in resource-constrained settings. Poor sanitation and hygiene cause illness-related absenteeism in primary schools. This study evaluated the impact of school-led total sanitation (SLTS) intervention on pupil attendance in Baringo County, Kenya.

Methods A pre-post quasi-experimental design with non-equivalent control groups was conducted in six primary schools across two sub-counties in Baringo County. Three Mogotio Sub-County schools received SLTS intervention; three Baringo South Sub-County schools served as controls. Using multistage sampling, 440 pupils from grades 4-7 were enrolled. SLTS intervention included health club establishment, triggering, and health education. Data were collected at baseline and post-intervention using questionnaires and headteacher key informant interviews. School attendance was measured as absence in the previous two weeks, with chi-square analysis at p 70%), with no significant differences in illness-related absences or specific conditions, such as diarrhoea and respiratory diseases, between groups. School feeding programs strongly motivated attendance, while cultural practices, gender roles, and environmental factors acted as barriers.

Conclusions School-led total sanitation intervention did not significantly improve attendance in the study. School absenteeism is multifaceted with multiple contributing factors. While SLTS may create enabling environments, comprehensive approaches addressing multiple absenteeism determinants are needed for meaningful attendance improvements.