Combined education course on nutrition, hand-washing and dental care in primary schools in Yaoundé, Cameroon

Abstract

Background Poor nutritional habits and related hygiene and sanitation practices impair food and nutrition security, and increase the risk of foodborne diseases and related school absenteeism. While the WASH program promoted by the UNICEF boosts water, sanitation, and hygiene, only a few studies thus far encouraged healthy eating habits and safe and nutritious meals at school. This study aimed at combining education of schoolchildren on nutrition and hygiene (nutrition knowledge, attitudes, practices; food choices; nutrient sources; dental care; handwashing), and at boosting the engagement of parents and teachers in the promotion of nutrition-related behaviors conducive to health and well-being. Methods Four primary schools in different Yaoundé Urban Councils and 71 schoolchildren aged 7-12 years enrolled in the study. In this paper we report on the i) administrative and ethical clearance, ii) sensitisation and demonstration activities, iii) donation of WASH equipment, disposable materials for hand and teeth hygiene, toolkit policy, and guidebook, iv) baseline assessment by structured questionnaire, v) combined course (1 hour/week, 6 weeks), and vi) measured impact. Scores were analysed using paired z- and t-tests with SPSS 23.0 for windows. Results In the four schools, handwashing showed the best improvement. Older children benefited more from the whole course, while the improvement in younger children focused more on practices. The school that scored lowest at baseline obtained marked general improvement. Interestingly, general improvement in food choices coupled with persistent difficulty in recognising nutrient sources. Although sociocultural and socioeconomic parameters were not included in the questionnaire, these emerged as possible modifiers. Despite limited hours of direct training and limited resources invested, this short-term intervention significantly changed habits of children and the school community. Availability of hand and teeth hygiene materials facilitated and motivated the proactivity of the school community to boost good nutrition and hygiene practices sustainably. Conclusions Preventive medicine is a balance of awareness and affordability. Having this in mind, more coordinated efforts (WASH, food safety, food security) will enforce proper nutrition and hygiene of children at school in the different Cameroonian sociocultural and socioeconomic settings.