Assessment of Hand Hygiene Knowledge, Attitudes and Practices among Primary School Pupils in the Achiase District, Ghana
Gideon Kwakye
Eastern Regional Health Directorate, Ghana Health Service, Koforidua, Ghana and School of Public Health, University of Port Harcourt, Port Harcourt, Nigeria.
Oscar Vetsi *
School of Public Health, University of Port Harcourt, Port Harcourt, Nigeria and Ada West District Health Directorate, Ghana Health Service, Sege, Ghana.
Best Ordinioha
School of Public Health, University of Port Harcourt, Port Harcourt, Nigeria.
Hubert Amu
University of Health and Allied Sciences, Ho, Ghana.
*Author to whom correspondence should be addressed.
Abstract
Aims: To describe hand hygiene knowledge, attitudes, self-reported behaviours and school WASH support among primary school pupils in Achiase District, Ghana.
Study Design: School-based cross-sectional survey.
Place and Duration of Study: Selected public primary schools in Achiase District, Eastern Region, Ghana, September–October 2025.
Methodology: A multistage sample of 389 pupils aged 6–12 years completed interviewer-administered questionnaires, and a school-facility checklist was used. Questionnaire responses were summarised descriptively. Associations with an overall questionnaire practice category were explored using chi-square tests and logistic regression.
Results: Good knowledge was reported for 93.1% and positive attitudes for approximately 93% of pupils. However, only 13.1% identified the recommended minimum hand-rubbing duration, 1.8% reported handwashing after toilet use and 8.5% reported consistent soap-and-water use. Functional school handwashing facilities were reported by 10.3% of pupils. A separate overall practice summary classified 13.9% as good; this category does not represent confirmed adherence to every individual practice. Very large residence-related adjusted odds ratios were recorded, but the semi-urban subgroup was small (n = 7) and the estimates require cautious interpretation.
Conclusion: Knowledge of handwashing benefits was generally high, but several self-reported hygiene behaviours and enabling school conditions were limited. Practical instruction and improved access to handwashing facilities warrant consideration alongside further evaluation of behaviour and school WASH provision.
Keywords: Hand hygiene, handwashing with soap, knowledge, attitudes and practices, primary school pupils, school sanitation and hygiene, rural health, Ghana