Abstract:
Background: Hand washing is the single most important and cost-effective method for
prevention of diseases such as diarrhea among children and adults. Many interventions have
been done in Tanzania focusing on primary care takers. Nevertheless, hand washing
proportion is still low. Hence more hand washing promotion interventions are needed and for
the behavior to be effective, proper hand washing must be learnt from childhood so that it
becomes a routine habit throughout life. Since, school children are good behavior change
agents, this study focused on primary school children's hand washing practice. Objective: The
aim of this study was to determine factors influencing hand washing practice among primary
school children. Materials and methods: A cross- sectional analytical study based on
quantitative research methods was conducted from June to July 2010 involving 527 grade five
to seven primary school children of both sexes in Arusha rural district council using a pre-
tested self administered questionnaire. Data analysis: Frequency distributions, Chi-square and
multiple logistic regression analyses were performed by SPSS version 13.0. Results: Only
18.8% of participants fulfilled the criteria of washing hands with soap, before eating, after
using the toilet by using the required time. More than half (55.7%) of the children were aware
of issues related to hand washing practice. Only one school had hand washing stations and
none of the schools provided soap for hand washing. Bivariate analysis indicated that;
significantly (p<0.001) higher proportion of children who perceived pressure from important
referents (42.1 %) washed hands as compared to those who did not perceive pressure (11.5%).
Whereas, self efficacy and attitude were not significantly associated with children's hand
washing practice. Controlling for age, sex, grade and school location multiple logistic
regression further indicated that; pressure from important referents continued to be highly
associated with hand washing [Adjusted OR= 0.2, 95% CI;0.1,0.3; p<O.OOI]. Likewise,
children of lower grades were more likely to wash hands than those of higher grades [AOR=
2.4, 95% Cl; 1.3, 4.6; p=0.007]. Conclusion: The findings of this study demonstrated
important referents and grade of school children were significantly associated with their hand
washing practice.
