FGDs in Palestine

Promoting hand hygiene is crucial to decrease the transmission of infectious diseases. However, many schools in Palestine lack functional water resources and depend mainly on water trucking as a source of water. The current interventions aimed at enhancing access to safe water, sanitation and hygiene do not address the complexity of the WASH-related problems. There is a need for more contextualised interventions that meet the needs and acceptance of different target groups.

To address this gap, Cesvi and the Renewable Energy & Environment Research Unit for Water Treatment (REERU) of the Palestine Polytechnic University (PPU) have been working to develop alternative technical WASH interventions. As part of the pilot phase of the hands4health project in Palestine, focus group discussions (FGDs) were carried out to collect further information for the design of contextualised interventions.

Insights obtained from the FGDs

Organised and implemented by the Swiss Tropical and Public Health Institute (Swiss TPH), the FGDs took place online via Zoom, and included teachers and students from 10 schools in Palestine. The discussions identified the local perception of hygiene, as well as challenges and proposed solutions related to safe water access, personal hygiene and menstrual hygiene management:

  • The local perception of hygiene was primarily related to personal and public cleanliness. Respondents believed that maintaining personal hygiene was closely related to keeping physical and mental health.
  • Challenges related to maintaining personal hygiene were mainly linked to unhealthy school environments and inappropriate hygiene behaviours of students. These behaviours result from inadequate awareness and support at community and family level. Respondents believe that efforts should be focused on developing long-term customised behaviour change approaches that target both, students and families.
  • Lack of toilets, cleaning staff, and cleaning materials were also reported to inhibit personal hygiene in schools.
  • The challenges related to safe water access were largely focused on the lack of maintenance services. Schools are often located inside decayed buildings or properties that were not built for educational or school purposes. Exceptionally difficult conditions were identified in schools situated in areas where Palestinian building activities were banned by the Israeli occupation.
  • Insufficient WASH infrastructure was reported (e.g., drinking taps, handwashing basins and Shattafs). The need to address this lack was emphasised, as insufficient numbers of appropriate facilities prevent users from achieving adequate hygiene. Inappropriate use of WASH facilities by students was also mentioned.
  • Increasing water storage capacity at schools was suggested by all educational institutions who suffered from water shortage.
  • Responses on water quality were mixed. Some groups expressed satisfaction, while others questioned the quality of water and suggested that on-site testing and/or chlorination should be carried out.
  • The social sensitivity around menstrual hygiene management did not allow for extensive discussion. Nevertheless, gender-mixed schools and lack of community awareness were thought to be the main challenges that needed addressing.
  • The idea of community-school boards emerged from the discussions as a promising approach to help address the different challenges faced by the schools in accessing safe water and maintaining high levels of personal hygiene.