Local Perceptions of an Integrated School Health and Nutrition Programme involving WASH, school feeding and deworming in Southwest Ethiopia

Introduction. The ‘Enhanced School Health Initiative’ (ESHI) targeted 30 primary schools in southern Ethiopia and aimed to improve the health and educational outcomes of school children through an integrated package of school feeding, deworming and the provision of improved water sanitation and hygiene (WASH). This study investigated parental perceptions of this integrated school health and nutrition programme. Methods. The data was collected through group interviews with parents of children at schools targeted by the programme. Ten schools were purposively selected to represent geographical diversity. A team of two trained facilitators led the group interview in each school. All interviews were conducted in local dialects and then directly translated into English and transcribed. The transcripts were analysed using thematic analysis. Findings are structured around key themes identified from the discussions. Results and Discussion. Three main themes are identified from the interviews. The first relates to the perceptions of equity and opportunity generated for the children and the parents as a result of the programme. The second theme identifies the dissemination of learning throughout the community reported by parents. This includes the use of children as messengers, particularly for good hygiene practices and importance of deworming. The final theme explores concerns about ownership and sustainability of the programme within the communities. When probed on the topic of sustainability, parents raised conflicts surrounding ownership, and their ability to sustain the programme without further external input. Conclusions. The findings highlight the parent’s perceptions of this integrated school health and nutrition programme, and the multiple mechanisms through which it has an impact on the wider community. They also highlight what aspects of the programme are felt to be sustainable without further input, particularly behaviour change.