Who is responsible for soap in Pakistani school toilets?

Hand-washing with soap could potentially avert around a million diarrhoea deaths a year (Curtis and Cairncross, 2003). Some 10-15% of Pakistani children suffer from an episode of diarrhoea every month (PSLM, 2004-07). Several hygiene promotion projects are targeting schoolchildren in Pakistan. Soap companies have also launched hygiene campaigns. Yet there are knowledge gaps in precisely what initiates and sustains habit change among Pakistani schoolchildren, especially in schools in low-income urban wards. Meta-analysis suggests that focused hand-washing promotion may be more effective than hygiene education measures (Fewtrell and Colford, 2004). Another view is that hygiene promotion is appropriate for primary schoolchildren, and hygiene education for secondary schoolchildren. However, there are questions about the scalability and sustainability of both approaches. PIEDAR has conducted a study comparing the observed and student- and teacher-reported hygiene practices in government and privately run schools of Rawalpindi and Islamabad that cater to children from low- and middle-income families to assess: sources of hygiene information of the children; reported hygiene practices of children, teachers, and parents; and how the reported practices compare with observed behaviors? A suite of tools, including sample surveys, semi-structured interviews with students, teacher; focused group discussions with parents, and direct observation, have been used to assess actual hygiene behaviour and perceptions about it. The study shows that hygiene knowledge is common among the students owing to general communications and media campaigns along with change messages from family, friends or community, yet hand washing with soap is not consistently practiced. School administrations often fail to provide the simple basic necessities for convenient hand washing and latrine maintenance. School hygiene programmes need to address the key deficiencies, such as teacher training, strengthening school management and reform of Education Departments.