Recent research indicates that investments in infrastructure for safe water and sanitation provision do not significantly reduce the incidence of water-borne diseases in the developing world unless they are accompanied by education in water handling and hygiene practices. School-based hygiene education initiatives are popular, but there is little evidence that they are effective in teaching students about safe water-handling practices. This study compared the outcomes of two approaches to teaching schoolchildren about the links between hygiene, water handling, and water-borne diarrhea. One approach combined messages about safe water handling and hygiene practices with water testing; the other used messages alone. A quasi-experimental design was used with 120 middle-school students. Forty students received messages alone, 40 received messages and tested water quality, and 40 served as a control group. An evaluation 1 week after the interventions measured students’ hygiene knowledge. Results showed significant improvement in knowledge among students who received messages and tested water, compared to their counterparts who received intervention through hygiene messages only. Evaluation after 12 months showed that the hygiene knowledge gained in both groups was retained. Including participatory water testing in hygiene education interventions can improve students’ knowledge about safe water handling and hygiene practices.

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