Knowledge, attitudes, and practices of safe drinking water, sanitation, and hygiene among pre-adolescent students in public and private schools in Jordan: cross-sectional school-based study.

BACKGROUND: Maintaining good hygiene, which is easily applied with access to safe and adequate water, is an important preventive step against various infectious disease transmissions that might spread as a result of unclean water and inadequate sanitation. Jordan is one of the world's most water-stressed countries, and only one in three schools has basic sanitary facilities, which poses severe health risks to students. Assessing WASH-related knowledge, attitudes, and practices provides valuable evidence to guide interventions that promote healthy behaviors and reduce these risks. PURPOSE: This study aimed to assess the level of WASH knowledge, attitudes, and practices among preadolescent schoolchildren and to examine the relationship between student knowledge, attitudes, and practices with selected socio-demographics, as well as to investigate differences between public and private schools' students in Jordan. Furthermore, identifying predictors of schools' pre-adolescent practices. PARTICIPANTS AND METHODS: A cross-sectional School-Based Study design was employed among a sample of School students from Amman city (n = 600). Data collection included a Self-administered questionnaire and a list of school characteristics that were observed and recorded. The statistical analysis included descriptives, Pearson r correlation, independent t-test, and hierarchical linear regression. RESULTS: Statistics revealed a significant positive relationship (p < 0.001) between knowledge and attitude, and between (p < 0.001) knowledge, attitudes, and practices with grades and age. A t-test revealed a statistically significant difference between public and private schools in scoring attitudes and practices of water, sanitation, and hygiene (P ≤ 0.001, P ≤ 0.000, respectively). Despite the absence of significant differences in knowledge between public and private schools, six items had the highest agreement rate. Furthermore, a multiple hierarchical linear regression analysis showed that sex, school type, age, knowledge, and attitudes were significant predictors of practices (p < 0.001). CONCLUSION: The results of our study showed the need for interventions to address gaps and challenges in health education and to develop policies to ensure adequate, hygienic WASH facilities, particularly in public schools, to reduce health risks, especially among pre-adolescent age groups.