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. 2025 May 26;22(6):835.
doi: 10.3390/ijerph22060835.

Hand Hygiene Roles, Challenges, and Intervention Feedback from School Staff: A Qualitative Analysis, Belize, 2022-2023

Anh N Ly  1 , Christina Craig  2 , Dian Maheia  3 , Yolanda Gongora  3 , Vickie Romero  1 , Rosalva Blanco  1 , Allison Lino  1 , Kelsey McDavid  2 , Allison Stewart  4 , Victoria Trinies  2 , Alexandra Medley  2 , Francis Morey  5 , Russell Manzanero  5 , Matthew Lozier  2   6 , Kristy O Murray  1   7
Affiliations

Hand Hygiene Roles, Challenges, and Intervention Feedback from School Staff: A Qualitative Analysis, Belize, 2022-2023

Anh N Ly et al. Int J Environ Res Public Health. .

Abstract

Hand hygiene (HH) in school settings can reduce the spread of infectious diseases and student absenteeism due to illness. During the COVID-19 pandemic, the World Health Organization recommended HH as a public health measure to prevent disease transmission. Understanding school staff's experiences with school-based programs is important for future program development and improvement. As part of a mixed-methods study, we conducted in-depth interviews in March 2022 with school administrators and teachers at 12 primary schools in Belize, selected based on high gaps in HH resources, to understand HH responsibilities, supplies, and challenges. An intervention was implemented to increase HH knowledge and practices among students, which included environmental nudges, supplemental provision of soap, and HH lesson implementation. Follow-up interviews were conducted in June 2023 among school administrators to garner feedback on the intervention. School staff described roles in teaching and managing HH supplies at both timepoints. The environmental nudges and HH lessons were perceived as helpful, but there were gaps remaining in HH practices, which may be partially influenced by practices and beliefs outside of school. Procurement of HH supplies remained a challenge at some schools due to financial constraints. The feedback from school staff will be valuable for the implementation of future hand hygiene programs in schools.

Keywords: Belize; COVID-19; Central America; WASH in schools; behavior change; hand hygiene.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Themes that emerged from the staff interviews at baseline and follow-up.
See this image and copyright information in PMC

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