Hand Washing for Children, by Children

Hand Washing for Children, by Children

Written by Sarah Lebu, CFK Africa 2022 Peacock Fellow and Ph.D. student in Environmental science and Engineering at the University of North Carolina, Chapel Hill.

This story begins with the dong of a school bell. Immediately after, young learners, aged between six to thirteen years fill the school compound. Playgroups begin to form, lunch boxes are popped open, and happy shrieks are heard. Not too far away, a few children are washing their hands at a handwashing station by the school administration building.  

Handwashing is one of the most effective ways to help prevent diarrheal-related diseases among children. In Kenya, the prevalence of diarrhea among children under 5 is 15%. The rate is even higher (18.7%) among children who live and go to school in informal settlements 1. Educating children about the importance of hand hygiene as well as how and when to wash your hands is a key factor in promoting good health and wellbeing. 

Students washing hands at CFK Africa hand washing station.
Students washing their hands in school (Photo Credit, Sarah Lebu).

Behavior Change Communication is an approach to hygiene promotion that uses an in-depth understanding of people’s behavior to design persuasive communication. At CFK Africa, children are engaged as equal and active participants in designing messaging around handwashing in schools. The design process starts by trying to understand on a deeper level how children think and feel and what motivates them to practice or not practice a behavior. 

A Collaborative Design Process

Through focus group discussions with five to six children each, we created a research experience that is respectful, safe, and allowed children to share their views without fear. The groups had a varied composition: mixed-gender, mixed-age, and mixed-grade. We asked children to share their perspectives, needs, and motivations around handwashing. The process also captured nuances in design preferences around color, fonts, and choice of images used. As a CFK Peacock Fellow, I had the opportunity to facilitate two focus group discussions.  

We learned that having mural designs with simple messaging, bright colors, and playful images of children were appealing to children and created a positive learning environment. The color white and sparkling hands were associated with cleanliness, while some children thought the color brown was akin to dirt and germs. The responses from children were compiled and shared with the design team to produce a child-friendly mural design. 

CFK Africa focus group discussion with students
Leading a focus group discussion with students on hand washing murals (Photo Credit, Sarah Lebu).

Children as Agents of Change  

To date, CFK Africa has facilitated the painting of collaboratively designed, child-friendly murals in 10 schools across two counties. The reception of the message on the murals has been positive so far. In the schools with the mural paintings, children are washing their hands more often, as often as required. We are also seeing evidence of children becoming agents of change. Young learners in schools are sharing positive hygiene messages with their near-peers (e.g., siblings and friends in the same age group). These messages are further cascading to households and communities. Such is the power of child-centered design. 

Hand washing mural in school commissioned by CFK Africa.
Hand washing mural commissioned by CFK Africa in a school (Photo Credit, Sarah Lebu).

However, the challenge is far from over. CFK Africa plans to work with public health officers and education officers from county governments to encourage more conversations around proper handwashing among children. For example, a training was held for members of school health clubs, dubbed WASH champions, to equip them with tools and knowledge to create more awareness among their peers on handwashing. Educators and partners working to improve hygiene among children can learn some valuable lessons from this process.  

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Sarah Lebu leading a focus group with students.
Hand Washing for Children, by Children
This summer, CFK Africa Peacock Fellow Sarah Lebu incorporated elements of child-centered design to help improve hand washing behaviors and demonstrate how children can be powerful agents of change in their schools, households, and communities.
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