# Evaluating Knowledge, Attitudes and Practices Related to Water, Sanitation and Hygiene (WASH): A Case Study of Durban High Schools in South Africa

## TL;DR

This study examines hygiene knowledge and practices among high school students in Durban, South Africa, revealing significant gaps and inequalities linked to socio-economic factors.

## Contribution

The study provides new insights into how knowledge and attitudes predict hygiene practices in schools across different socio-economic contexts.

## Key findings

- Learners from higher-quintile schools had significantly better hygiene knowledge, attitudes, and practices than those from lower quintiles.
- Both knowledge and positive attitudes were strong predictors of improved hygiene practices among students.
- Significant differences in hygiene practices were observed by gender and district.

## Abstract

Inadequate hygiene knowledge and poor sanitation practices remain key challenges to safe learning environments in South Africa, with 462 million learners attending schools without basic handwashing facilities and many schools failing to meet sanitation standards. Although national policies and infrastructure investments have improved water, sanitation, and hygiene (WASH) services in some schools, access and behaviours remain uneven across socio-economic contexts. This study evaluated knowledge, attitudes, and practices (KAP) related to WASH among 1200 learners from 40 high schools in Durban using a cross-sectional design and interviewer-administered questionnaires. Data were analysed using descriptive statistics, Pearson correlations, ANOVA, and multiple regression. The study addressed the research question: To what extent do learners’ knowledge and attitudes predict hygiene practices across socio-economic contexts? It was hypothesised that higher knowledge and more positive attitudes would significantly predict improved hygiene practices. Results showed that while 74.6% reported handwashing after toilet use, only 39.3% consistently used soap. Knowledge of disease transmission through unsafe water was 35.4%, although overall attitudes were positive. Learners from higher-quintile schools had significantly better KAP scores than those from lower quintiles (p < 0.001). Both knowledge (β = 0.232, p < 0.001) and attitudes (β = 0.266, p < 0.001) were significant predictors of learners’ hygiene practices. Significant group differences were also observed by gender (t = 18.032, p = 0.001) and district (t = −3.895, p = 0.001). These findings highlight persistent WASH gaps and inequities across schools, underscoring the need for integrated interventions that strengthen both hygiene education and school infrastructure to achieve Sustainable Development Goal 6.