Table 5 Qualitative themes related to WASH practices
Category/Theme/Subtheme | Government School Students | Non-Government School Students |
|---|---|---|
1. Individual Level Factors | ||
1.1 Knowledge and Attitudes | ||
Gaps in knowledge | “I did not know the amount of water a person needs daily” | “Teachers emphasize clean water for health reasons” |
Attitudes about hygiene | “Handwashing feels like such a waste of time” | “Many cultural false beliefs about girl’s periods” |
1.2 Drivers of Behavior | ||
Habit | “I never remember to wash hands without reminders” | “I wash my hands automatically without even thinking” |
Social norms | “No one else I know washes hands here” | “Friends make fun if you don’t use soap” |
2. Structural/Environmental Factors | ||
2.1 Environmental Factors | ||
Water and sanitation infrastructure | “The toilet is always filthy and has no water anyway” | “Toilets don’t work well here, often dirty” |
Safety of water sources | “Animals and kids play near the hand pump where we collect water” | “We always bring bottled water with us every day” |
2.2 Access to Products and Resources | ||
Handwashing materials | “We have no soap or towels to clean hands properly” | “My family can’t afford soap or enough water” |
Information and guidance | “No one ever taught us how to conserve water” | “I learned about safe hygiene from school talks” |
2.3 Government Role | ||
Responsiveness | “Our issues with dirty toilets are always ignored” | “Govt fixes problems with water supply pretty fast here” |
Policy awareness | “More rules needed for safe drinking water in schools” | “Govt policies on WASH helped our school a lot” |
2.4 Barriers to Progress | ||
Poverty | “My family struggles to get necessities” | “My family can’t afford soap or enough water” |
Structural barriers | “Old habits hard to change” | “It’s tradition - periods mean isolation” |
3. Sociocultural Factors | ||
3.1 Menstrual Hygiene Practices | ||
Cultural taboos and stigma | “My parents don’t allow me in the kitchen or puja room during periods” | “It’s tradition - periods mean isolation” |
Lack of facilities | “No privacy to change pads or dispose of in school toilets” | “No place to wash or change during periods at school” |
3.2 Support Availability | ||
Emotional | “Teachers here listen and offer good advice” | “Counsellors available to talk about period issues” |
Resources | “School provides free pads and clean toilets” | “Lots of posters and talks on hygiene here” |