1.1 Background of the Study

The significance of handwashing has garnered increased attention, particularly in light of the emergence of COVID-19. It stands out as the most singularly efficacious method for averting infectious diseases (Raji et al., 2022). Handwashing, defined as the act of cleansing one's hands with either plain or antimicrobial soap and water, serves as the foremost preventive measure for curbing the dissemination of contagious ailments. In essence, the skin serves as the body's initial defense against bacterial intrusion, underscoring the indispensable role of meticulous hand care within the framework of hand hygiene (Buda et al., 2018).

Handwashing constitutes a fundamental and uncomplicated practice, wielding substantial influence on community health. The World Health Organization (WHO, 2015) has emphasized the pivotal role of hand cleanliness in shielding individuals from infections. Hands serve as a crucial vector in the transmission of infections stemming from feces (WHO, 2015), particularly given that fecal-oral transmission diseases are frequently propagated via hand-to-mouth contact.

Among the most efficacious and minimally disruptive practices for promoting hygiene is handwashing. Particularly when accompanied by soap, handwashing is recognized as one of the most economically efficient practices capable of enhancing both individual and public health. The simple act of washing hands with soap, with specific attention to critical moments, can interrupt the transmission of pathogens responsible for conditions like diarrhea and pneumonia (Ogwezzy-Ndisika and Solomon, 2019).

Research indicates that handwashing with soap can lead to a reduction of 28 to 47% in diarrheal episodes and a decrease of 20 to 50% in acute respiratory infections, such as pneumonia (Ejemot-Nwadiaro et al., 2021; Townsend et al., 2017). Handwashing also holds the potential to contain disease outbreaks, including cholera and Ebola, while diminishing healthcare-associated infections by over 50% (WHO and UNICEF, 2018). Furthermore, Global Handwashing Day is dedicated to heightening awareness and comprehension of the significance of handwashing with soap at critical junctures, recognizing it as a cost-effective and impactful measure for disease prevention (UNICEF, 2012).

Every community's growth relies on the academic achievement and overall health and well-being of its children and adolescents (Htun et al., 2013). In an average Nigerian community, the school-age population constitutes approximately 23% of the total population, making their health a reflection of the nation's developmental status (Odeyemi and Chukwu, 2015). In a developing country like Nigeria, which grapples with a high rate of infant morbidity and mortality, a school-aged child is one who has survived significant childhood diseases. Therefore, it is imperative that schools contribute to their holistic development through health promotion and the prevention of infectious diseases during their time in school, as these factors are essential for achieving maximum productivity (Raji et al., 2022).

Among the leading causes of child mortality worldwide, diarrheal diseases and acute respiratory infections collectively account for approximately 50% of such deaths (Wilches et al., 2011; Htun et al., 2013). The transmission of these diseases occurs through various means, including person-to-person contact during daily interactions, through the air, via skin contact, and environmental contamination (Assefa and Kumie, 2014).

In a school environment, one of the most significant vectors for the transmission of infectious diseases is the hand (Galiani et al., 2012). The hand becomes contaminated through various school-related activities such as using the restroom, handling food, handshakes, or after wiping the nose or sneezing, to name a few.

Concentrating on primary school children's health can significantly contribute to the achievement of sustainable development objectives pertaining to the improvement of healthcare, education, poverty alleviation, and the reduction of child mortality, as emphasized by Azuogu et al. (2016). Insufficient knowledge, practices, and attitudes regarding personal hygiene significantly contribute to the high incidence of communicable diseases, ultimately impacting a child's long-term overall development negatively (Assefa and Kumie, 2014).

Schoolchildren spend a significant portion of their formative years within educational institutions, exposing them to conditions that make them vulnerable to diseases. Consequently, educators, who serve as the primary custodians of students within schools, assume a pivotal role as authoritative figures responsible for promoting health in the school environment (Odeyemi and Chukwu, 2015).

In the context of health promotion, educational initiatives play a pivotal role in averting the occurrence or recurrence of health issues through the advocacy of personal hygiene practices. A study conducted in Zaria, as demonstrated by Ahmadu et al. (2013), underscores that this goal is achieved through the implementation of educational programs, the formulation of policies, the provision of services, and the execution of research activities within the school setting. Effective adherence to principles of personal hygiene among primary school children holds significant potential for mitigating the spread of infectious diseases. Such diseases, when left unaddressed, not only jeopardize the well-being of students and staff but also underscore the legal obligation of school boards to establish policies in compliance with relevant laws that guide responses to communicable diseases in public schools (Raji et al., 2022).

It is against this background that this study seeks to investigate the attitudes of primary school pupils towards hand washing in Nigeria, with a specific focus on Aylward Schools in Uyo.


1.2 Statement of the Problem

        Globally, infectious diseases continue to pose a significant threat to childhood well-being and survival. UNICEF has underscored the widespread prevalence of diarrhea among children, identifying it as a global health concern responsible for the daily loss of 2,195 young lives worldwide. UNICEF underscores that a staggering 842,000 fatalities could be averted on a global scale through the consistent provision of enhanced access to clean water and improved sanitation. This lack thereof contributes to one in nine child deaths worldwide, establishing it as the second leading cause of mortality among children under the age of five (Tyessi, 2018).

It has been observed that school-aged children often neglect to practice proper hand hygiene at critical junctures, such as after using the restroom, before meals, and prior to food preparation (Biswas et al., 2015). Furthermore, due to the close proximity of children in school settings, there exists a heightened risk of infectious disease transmission. Consequently, safeguarding the health and well-being of children necessitates the prevention of infectious maladies, including diarrhoea, pneumonia, and other communicable diseases, and handwashing stands acknowledged as an economical and efficacious strategy for averting such ailments (UNICEF, 2012).

Nonetheless, despite the acknowledged importance of handwashing, the prevailing body of literature reveals deficiencies in comprehending the attitudes of primary school students toward this practice, a critical determinant of its successful implementation. This research endeavors to address these lacunae by investigating the attitudes of primary school pupils regarding handwashing, with a particular emphasis on Aylward Schools in Uyo, Nigeria.


1.3 Aim of the Study

The aim of this study is to investigate the attitudes of primary school pupils towards hand washing in Nigeria, with a specific focus on Aylward Schools in Uyo.


1.4 Objectives of the Study

To achieve the aim of this study, the following objectives will be pursued:

  1. To assess the attitudes of primary school pupils at Aylward Schools in Uyo, Nigeria, towards the practice of handwashing.
  2. To determine if there is a significant relationship between the sociodemographic factors of students and their attitudes towards handwashing practices


1.5 Research Questions

This study will address the following research questions:

  1. What are the attitudes of primary school pupils at Aylward Schools in Uyo, Nigeria, towards the practice of handwashing.
  2. Is there a significant relationship between the sociodemographic factors of students and their attitudes towards handwashing practices?


1.6 Research Hypothesis

The research hypothesis for this study is:

H0: There is no significant relationship between the sociodemographic factors of students and their attitudes towards handwashing practices.

H1: There is a significant relationship between the sociodemographic factors of students and their attitudes towards handwashing practices.

1.7 Justification of the Study

This study is important for several reasons. First, it addresses a critical issue in public health, which is the prevalence of preventable diseases due to poor hand hygiene practices among schoolchildren. Second, it contributes to the body of knowledge about hygiene education in Nigeria, particularly in the context of primary schools. Understanding the attitudes of primary school pupils towards hand washing will provide valuable insights for designing and implementing effective hygiene education programs. Lastly, this study has the potential to benefit the health and well-being of primary school pupils, not only at Aylward Schools but also in other schools with similar challenges in Nigeria.

1.8 Scope of the Study

This research will primarily focus on primary school pupils at Aylward Schools in Uyo, Nigeria. It will investigate their attitudes related to hand washing and assess the effectiveness of existing hand hygiene education and awareness programs. The study will involve data collection from pupils within the school community.