Handwashing practices and associated factors among public primary schoolchildren in the Benadir Region, Somalia

Abstract

In Somalia, numerous schools lack adequate water, sanitation, and hygiene (WASH) facilities, which is associated with a high burden of diarrheal and respiratory infections among school-aged children. Despite this, there is a paucity of data on handwashing practices and their associated factors, particularly in the Benadir Region. This study evaluated handwashing practices and identified factors associated with proper handwashing among primary schoolchildren in the Benadir Region of Somalia. A cross-sectional study was conducted in schools From January 1 to January 31, 2026, employing a multistage cluster sampling technique. The study involved 834 students in grades 5–8, chosen from five public primary schools. Trained interviewers collected data using structured, pretested questionnaires. The data were inputted and analyzed using SPSS version 27. To determine the factors associated with effective handwashing practices, multivariable logistic regression analysis was performed, with statistical significance defined as p < 0.05. Overall, 76.0% (95% CI: 73.1–78.8) of the students reported practicing proper handwashing. In the multivariable analysis, several factors were independently associated with proper handwashing. These included recognizing odor elimination as a benefit of handwashing (AOR = 3.16, 95% CI: 2.03–4.94), having parents (AOR = 3.59, 95% CI: 1.55–8.29) or teachers (AOR = 3.06, 95% CI: 1.27–7.37) as the main influence for handwashing, having a handwashing station (AOR = 1.53, 95% CI: 1.02–2.29), having handwashing facilities at school (AOR = 2.12, 95% CI: 1.27–3.54), and the school celebrating Global Handwashing Day (AOR = 2.42, 95% CI: 1.12–5.23). Approximately 75% of primary school students reported washing their hands properly. Proper handwashing was significantly associated with perceived personal benefits, positive social influences, and school WASH infrastructure. Strengthening school hygiene programs, leveraging positive social influences, and upgrading WASH infrastructure may support higher handwashing compliance among primary school students.