Evaluating W.A.S.H. (Water, Sanitation and Hygiene) Interventions in Rural Schools Of West Bengal, India

Poor sanitation exacerbates adverse health outcomes such as infectious disease, diarrhea and childhood stunting. People of India suffer from disproportionately high rates of poor sanitation. Diarrheal diseases are preventable and better sanitation can reduce disease transmission through improved access to latrines, hygiene education and clean water. A significant concentration of behaviors related to poor sanitation occurring in India requires sustainability and an assessment of programs working towards improving water access, sanitation and hygiene (WASH). We assessed the health and environmental impact of Non-Governmental Organizations (NGOs) such as Sarboday Sangha and Water for People which implemented WASH projects in about 141 schools in the East Medinipur district of West Bengal, India. In addition, we evaluated 18 of these schools for their sustainability by collecting cross-sectional observational data by surveying school headmasters and photographing between December 29th, 2016 and January 2nd, 2017. The survey was divided into five sections: (1) Health behavior/knowledge; (2) Social-school hygiene education; (3) Hardware resources; (4) Costs; and (5) Governance tracking. Interviews were aided by a translator. Data were analyzed using summary statistics and ranking sustainability. All 18 schools reported zero open defecation and improved school attendance largely due to latrines and female sanitary napkins. All but one of the schools reported a hygiene education program. Monthly WASH maintenance costs ranged from 800 INR to 5000 INR. Maintenance funding was reported as the largest need. The school WASH interventions improved sanitation knowledge and behavior, but more funding is needed for maintenance costs to sustain the interventions.