Management of WASH Access in Elementary Schools to Support the Healthy School Program
DOI:
https://doi.org/10.54518/rh.6.4.2026.1511Keywords:
Academic Achievement, Elementary Schools, Environmental Management, Student Attendance, WASH AccessAbstract
Access to water, sanitation, and hygiene is essential for a healthy school environment and student learning. This study examined WASH access, its relationship with student attendance and academic achievement, and factors influencing its implementation. A mixed-methods approach with a sequential explanatory design involved 27 elementary schools in rural and urban areas selected through proportionate stratified random sampling. Quantitative data were analysed using Spearman’s rho and multiple linear regression, while qualitative data were analysed descriptively. Results showed disparities in WASH access. The findings revealed substantial disparities in WASH access between urban and rural elementary schools, with rural schools predominantly experiencing limited or no access. WASH access showed strong positive relationships with student attendance (ρ = 0.69) and academic achievement (ρ = 0.92). WASH access and student attendance simultaneously significantly influenced academic achievement (p < 0.001), explaining 84.3% of its variation, with WASH access as the dominant predictor (β = 0.873). Qualitative findings identified water availability, funding, and external collaboration as supporting factors, while limited infrastructure, budget constraints, and weak institutional capacity hindered implementation. Therefore, integrated WASH improvements are needed, particularly in rural schools.
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Abdulhadi, R., Bailey, A., & Van Noorloos, F. (2024). Access inequalities to WASH and housing in slums in low-and middle-income countries (LMICs): A scoping review. Global Public Health, 19(1), 23–36. https://doi.org/10.1080/17441692.2024.2369099.
Ahmed, J., Wong, L. P., Chua, Y. P., Hydrie, M. Z. I., & Channa, N. (2022). Drinking water, sanitation, and hygiene (WASH) situation in primary schools of Pakistan: The impact of WASH-related interventions and policy on children school performance. Environmental Science and Pollution Research, 29(1), 1259–1277. https://doi.org/10.1007/s11356-021-15681-w.
Andrade, A. E., Padilla, L., & Carrington, S. J. (2024). Educational spaces: The relation between school infrastructure and learning outcomes. Heliyon, 10(19), 1900-1918. https://doi.org/10.1016/j.heliyon.2024.e38361.
Apriyanti, I., & Lufar, N. (2024). Pemberian edukasi manajemen kebersihan menstruasi dengan alat bantu peraga pada siswi kelas VI sekolah dasar di SD Muhammadiyah Kota Serang. Jurnal Pelayanan dan Pengabdian Kesehatan untuk Masyarakat, 2(1), 8–16. https://doi.org/10.52643/jppkm.v2i1.4317.
Ardillah, Y., Septiawati, D., & Windusari, Y. (2021). Readiness of water sanitation hygiene (WASH) facilities and implementation of health protocols for teaching staff during the COVID-19 pandemic at Palembang state elementary schools. Jurnal Ekologi Kesehatan, 20(1), 1–11. https://doi.org/10.22435/jek.v20i1.4525.
Ashar, M. R. (2022). Improving student health through PHBS education: strategies, challenges, and future directions for better welfare. Jurnal Riset Kualitatif dan Promosi Kesehatan, 1(2), 42-56. https://doi.org/10.61194/jrkpk.v1i2.655.
Biswas, S., Adhikary, M., Alam, A., Islam, N., & Roy, R. (2024). Disparities in access to water, sanitation, and hygiene (WASH) services and the status of SDG-6 implementation across districts and states in India. Heliyon, 10(18), e37646. https://doi.org/10.1016/j.heliyon.2024.e37646.
Chirgwin, H., Cairncross, S., Zehra, D., & Sharma Waddington, H. (2021). Interventions promoting uptake of water, sanitation and hygiene (WASH) technologies in low-and middle-income countries: An evidence and gap map of effectiveness studies. Campbell Systematic Reviews, 17(4), 1182–1194. https://doi.org/10.1002/cl2.1194.
Dreibelbis, R., Winch, P. J., Leontsini, E., Hulland, K. R., Ram, P. K., Unicomb, L., & Luby, S. P. (2013). The integrated behavioural model for water, sanitation, and hygiene: A systematic review of behavioural models and a framework for designing and evaluating behaviour change interventions in infrastructure-restricted settings. BMC Public Health, 13(1), 1015–1025. https://doi.org/10.1186/1471-2458-13-1015.
Grigg, N. (2026). Water management across the SDGs: Gaps and needs. Sustainability, 18(11), 5481-5490. https://doi.org/10.3390/su18115481.
Gunamantha, I. M., & Dantes, I. N. (2025). Cultivating environmental literacy in the classroom: A study of knowledge, attitudes, and behavior toward 3R in Indonesian elementary education in support of SDG 4.7. Journal of Lifestyle and SDGs Review, 5(6), 1-21. https://doi.org/10.47172/2965-730X.SDGsReview.v5.n06.pe06779.
Karon, A. J., Cronin, A. A., Cronk, R., & Hendrawan, R. (2017). Improving water, sanitation, and hygiene in schools in Indonesia: A cross-sectional assessment on sustaining infrastructural and behavioral interventions. International Journal of Hygiene and Environmental Health, 220(3), 539–550. https://doi.org/10.1016/j.ijheh.2017.02.001.
Kusumaningtiar, D. A., Veronika, E., Azteria, V., & Anggara, T. R. (2024). Water, sanitation, and hygiene in Indonesia school: Facilities and infrastructure availability. Journal of Research and Health, 14(3), 291–296. https://doi.org/10.32598/JRH.14.3.2255.2.
Lawal, N., Aliyu, D. G., Habila, M. I., Aliyu, A. S., & Khotimatul, B. (2025). Enhancing water sanitation and hygiene standards in secondary schools of developing countries: A review and conceptual framework. Fudma Journal of Sciences, 9(12), 178–187. https://doi.org/10.33003/fjs-2025-0912-4254.
Leone, N. S., & Kamara, M. B. (2025). The impact of water sanitation and hygiene in public primary schools. In International Student Science Congress (pp. 227–233). Turkey: Manisa. https://doi.org/10.52460/issc.2025.029.
Lestari, P., Komarulzaman, A., & Pitriyan, P. (2026). Evaluating the gender gap in academic achievement: The role of household WASH access in Indonesia. Jurnal Ekonomi Pembangunan, 23(2), 135–147. https://doi.org/10.29259/jep.v23i2.23370.
Logan, J. R., & Burdick-Will, J. (2017). School segregation and disparities in urban, suburban, and rural areas. The ANNALS of the American Academy of Political and Social Science, 674(1), 199–216. https://doi.org/10.1177/0002716217733936.
Ndum, A. C., Ako, S. E., & Nicholas, T. (2025). Water availability, sanitation and hygiene practices in primary schools in the Buea Municipality, Cameroon: A cross-sectional study. Central African Journal of Public Health, 11(5), 285–298. https://doi.org/10.11648/j.cajph.20251105.17.
Ngcongo, M. T., & Tekere, M. (2026). Evaluating knowledge, attitudes and practices related to water, sanitation and hygiene (WASH): A case study of Durban high schools in South Africa. International Journal of Environmental Research and Public Health, 23(1), 61-78. https://doi.org/10.3390/ijerph23010061.
Nisa, I., Thohari, I., & Nurmayanti, D. (2024). Gambaran kualitas lingkungan sekolah dasar di Desa Dalegan. Jurnal Higiene Sanitasi, 4(1), 6–12. https://doi.org/10.36568/hisan.v4i1.86.
Odagiri, M., Thomas, A., Listyasari, M., Mills, F., Bain, R. E. S., Muhammad, Z., … Willetts, J. (2021). Safely managed on-site sanitation: A national assessment of sanitation services and potential fecal exposure in Indonesia. International Journal of Environmental Research and Public Health, 18(15), 8204-8214. https://doi.org/10.3390/ijerph18158204.
Pradhan, S., Pradhan, B., & Joshi, A. (2025). Leveraging geographic information systems (GIS) in water, sanitation, and hygiene (WASH) research: A systematic review of applications and challenges. Spatial Information Research, 33(2), 111–121. https://doi.org/10.1007/s41324-025-00613-4.
Quinan, M. D. (2025). WASH in school (WinS): A mixed-methods assessment of program implementation in rural Philippines. Asian Journal of Education and Social Studies, 51(6), 1022–1033. https://doi.org/10.9734/ajess/2025/v51i62054.
Rahmat, M. R., Ariffin, F. D., Othman, H., Ishak, I., & Shamsuddin, A. (2026). Advancing WASH interventions in Malaysia: A systematic review of strategic approaches, behavioural outcomes and implementation challenges. Hygiene, 6(1), 39-49. https://doi.org/10.3390/hygiene6030039.
Raswati, D., Purnamaningsih, I. R., & Abduloh. (2025). Implementation of classroom management and infrastructure management in improving learning achievement. Research Horizon, 5(6), 3127–3138. https://doi.org/10.54518/rh.5.6.2025.962.
Rosemiarti, T., Sunardi, D., & Putri, N. M. (2026). Safe drinking water and its impact on children’s growth and development: A systematic review. International Journal of Environmental Research and Public Health, 23(3), 313-324. https://doi.org/10.3390/ijerph23030313.
Sapriana, S., Maryam, & Arianty, R. (2020). Pengaruh ketersediaan sarana terhadap praktik cuci tangan pakai sabun (CTPS) siswa sekolah dasar. Poltekita: Jurnal Ilmu Kesehatan, 14(1), 24–29. https://doi.org/10.33860/jik.v14i1.58.
Satriani, S., Ilma, I. S., & Daniel, D. (2022). Trends of water, sanitation, and hygiene (WASH) research in Indonesia: A systematic review. International Journal of Environmental Research and Public Health, 19(3), 1617-1625. https://doi.org/10.3390/ijerph19031617.
Shalshabilla, A. T., Mukhtarudin, K. A. H., Pamudji, R., Ghiffari, A., Tusadiah, H., Antoni, A., … Muchsiri, M. (2023). Clean and healthy lifestyle behavior education program to improve personal hygiene in elementary school. Indonesia Berdaya, 4(4), 1271–1276. https://doi.org/10.47679/ib.2023544.
Sharma, M. K., Adhikari, R., Khanal, S. P., Acharya, D., & van Teijlingen, E. (2024). Do school water, sanitation, and hygiene facilities affect students’ health status, attendance, and educational achievements? A qualitative study in Nepal. Health Science Reports, 7(8), 2293-2300. https://doi.org/10.1002/hsr2.2293.
Sharma, M. K., Khanal, S. P., & Adhikari, R. (2022). School water, sanitation, and hygiene: A systematic review of an effect on health, attendance, regularity, and educational achievements. Scholars’ Journal, 5(1), 1–21. https://doi.org/10.3126/scholars.v5i1.55744.
Sommer, M., Caruso, B. A., Sahin, M., Calderon, T., Cavill, S., Mahon, T., & Phillips-Howard, P. A. (2016). A time for global action: Addressing girls’ menstrual hygiene management needs in schools. PLoS Medicine, 13(2), 100-116. https://doi.org/10.1371/journal.pmed.1001962.
Valcourt, N., Javernick-Will, A., Walters, J., & Linden, K. (2020). System approaches to water, sanitation, and hygiene: A systematic literature review. International Journal of Environmental Research and Public Health, 17(3), 702–715. https://doi.org/10.3390/ijerph17030702.
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