Hygiene system modeling for toileting in schools.

Area of Science:

• Public Health
• Systems Science
• Environmental Health

Background:

• Hygienic toileting is crucial for health but faces challenges in schools.
• Limited access to anal cleansing materials, proper facilities, and handwashing hinders practice.
• Systems thinking offers a framework to understand and address complex hygiene determinants.

Purpose of the Study:

• To model interconnected factors influencing hygienic toileting preconditions in schools.
• To identify key leverage points for improving school hygiene using systems modeling.
• To compare findings across two distinct groups of hygiene experts.

Main Methods:

• Expert-based participatory systems modeling was employed.
• Participants identified and prioritized hygiene system factors.
• Influence maps and causal loop diagrams were used for structural analysis.

Main Results:

• Nine influential factors were prioritized by participants.
• WASH leadership, governance, and partnerships emerged as a core driver.
• Resource mobilization and human resource capacity were also highly influential.

Conclusions:

• Leverage points for strengthening school hygienic toileting systems were identified.
• Systems thinking is essential before system strengthening for efficiency and sustainability.
• Interventions should focus on leadership, resources, and capacity building for lasting impact.