HOW IS INADEQUACY OF HAND WASHING FACILITIES AFFECTING PUPILS

ADHERENCE TO SOPS IN KIBAALE PRIMARY SCHOOL

KALANGALA DISTRICT?

BY

NAKABUUBI GRACE
2019-B123-14388

AN ACTION RESEARCH PROPOSAL SUBMITTED TO THE FACULTY OF

EDUCATION IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE
AWARD OF A DEGREE IN PRIMARY EDUCATION OF UGANDA MARTYRS
UNIVERSITY NKOZI

JUNE, 2021
 Declaration

I Nakabuubi Grace do hereby declare that this action research proposal titled “How is
inadequacy of hand washing facilities affecting pupils adherence to SOPS in Kibaale Primary
School Kalangala District?” is my original work and has never been submitted to any
University for any award.

Signature…………………………………………………..Date……………………………….
Nakabuubi Grace
2019-B123-14388

ii
 Approval

I hereby certify that this action research proposal titled “How is inadequacy of hand washing
facilities affecting pupils adherence to SOPS in Kibaale Primary School Kalangala District?”
was carried out under my supervision as a university supervisor.

Signature………………………………………………..Date………………………………….

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 Table of contents

Declaration.................................................................................................................................ii
Approval...................................................................................................................................iii
Table of contents.......................................................................................................................iv
List of tables...............................................................................................................................v
CHAPTER ONE : INTRODUCTION.......................................................................................1
1.1 Area of focus........................................................................................................................1
1.2 Description of the site..........................................................................................................1
1.3 Statement of the problem/description the incidence............................................................2
1.4 Research questions...............................................................................................................2
1.5 Justification of the study......................................................................................................2
1.6 Significance of the study......................................................................................................3
CHAPTER TWO : LITERATURE REVIEW...........................................................................4
2.0 Introduction..........................................................................................................................4
2.1 Peoples knowledge on COVID 19 and SOPs......................................................................4
2.2 Reasons impacting washing hands in the COVID 19 crisis.................................................6
2.3 Strategies to foster people to frequently washing of hands..................................................7
CHAPTER THREE : METHODOLOGY...............................................................................10
3.0 Introduction........................................................................................................................10
3.1 Research Design.................................................................................................................10
3.2 Population..........................................................................................................................10
3.3 Sample size determination.................................................................................................10
3.4 Sampling strategy...............................................................................................................11
3.5 Data collection methods.....................................................................................................11
3.6 Data collection instruments................................................................................................11
3.7 Data quality control............................................................................................................12
3.8 Procedure of data collection...............................................................................................12
3.9 Data analysis......................................................................................................................12
3.10 Ethical consideration........................................................................................................13
3.9 Limitation and delimitation................................................................................................13
CHAPTER FOUR : FINDINGS, DISCUSSION AND IMPLICATIONS..............................14
4.0 Introduction........................................................................................................................14
4.1 People’s knowledge on COVID 19 and SOPs...................................................................14
4.2 Reasons impacting washing hands in the COVID 19 crisis...............................................16
4.3 Strategies to foster people to frequent washing of hands...................................................17
4.4 Implications of the findings...............................................................................................18
4.5 Conclusion..........................................................................................................................19
CHAPTER FIVE : DESCRITION OF THE INTERVENTION AND ACTION PLAN........20
5.0 Introduction........................................................................................................................20
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5.1 Description of the innovation.............................................................................................20
5.2 Pre- intervention phase.......................................................................................................21
5.3 While-intervention.............................................................................................................21
5.4 Post intervention.................................................................................................................22
5.5 Timeline for monitoring the intervention...........................................................................22
References................................................................................................................................23
Appendix 1: Interview guide for the participants.......................................................................i
Appendix 11: Observation guide for the participants................................................................ii
Appendix 111: Budget..............................................................................................................iii
Appendix 111: Journal abstracts...............................................................................................iv

List of tables
v
vi
 CHAPTER ONE

INTRODUCTION

1.1 Area of focus

The study initially aimed at examining the extent how the people at school adhere to the
Standard Operating Procedures (SOPs) set by the ministry of Health and issued by the
Ministry of Education and Sports at the opening of schools after the COVID 19 lockdown.
This study led for the establishment of inadequacy of hand washing facilities to affecting
pupils in adherence to SOPS in Kibaale primary school Kalangala district. An SOP is a set of
written instructions that document a routine or repetitive activity. It is a set of detailed written
instructions to achieve uniformity of the performance of a specific function.A standard
operating procedure or SOP is a set of instructions that address the who, what, where and
when of an activity(Akyar, 2020). Based on this study SOPs are instructions that document
routine or repetitive activities for the prevention of the spread of COVID 19 to the
community in this aspect the school. Handwashing facilities may be fixed or mobile and
include a sink with tap water, buckets with taps, tippy-taps, and jugs or basins designated
for handwashing. Soap includes bar soap, liquid soap, powder detergent, and soapy water but
does not include ash, soil, sand or other handwashing agents(UNICEF 2019). The
inadequacy of the washing facilities makes constant washing of hands impossible and
Kibaale primary school and this is likely to escalade the spread of COVID 19 thus utilizing
local materials in making enough washing facilities is important.

1.2 Description of the site

Kibaale Primary School is a school in Uganda. This school is located in Kibaale village,
Bbeta parish, Mugoye subcounty, Kalangala district. The school was established in 1953 by
the Catholic Church and in later in 1997 it became a government aided school operating from
primary one to seven with total of 220 pupils. Currently Kibaale primary school has a total of
448 pupils of which 228 are boys and 220 are girls. The school has 12 teachers of which 8
are female and 4 are male. This gives a 1:48 teacher /pupil ratio. Primary seven the class that
was examined has a total of 33 pupils of which 16 are girls and 17 are boys. The opening of
the class after the local down was guided by SOPs guidelines given by the ministry of
education and approval certificate was given to the school. At the approval, the Headteacher
had only one washing facility at one of the entrance of primary seven class. This hinders
other people who enters the school to access and wash hands yet they interact with the pupils.
This is likely to escalade the spread of COVID 19 thus improvisation of local materials in
making of enough washing facilities is necessary.
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1.3 Statement of the problem/description the incidence

The outbreak of COVID 19 came with several affected the operation of several institutions
schools inclusive. The government of Uganda imposed a lockdown as a pre-emptive measure
to control the spread of the COVID-19 pandemic. This action saw all schools and education
institutions close in March 2020 and since then, over 15 million children have been locked
out of. At the opening of schools, the ministry of education issued out guidelines called SOPs
which each school had to fulfill before it is allowed to operate and a certificate of operation
was issued to each school after inspection. Despite receipt of the certificate of operation,
primary seven pupils and teacher still find it hard to wash hands frequently as one of the
measures to prevent the spread of COVID 19. Pupils and teachers mainly wash hands once
while reporting in the morning school. This problem is likely to have been brought up by the
scarce hand washing facilities at school. The school owns only one washing tank which is
placed at the main entrance yet there are other entrances which are used by some other
members and people at school. When a person crosses the main entrance and washes hands
in the morning, the same person can use other outlets to get out and come back without
washing hands. This puts the person and other people at stake of the spreading the disease.
Since these inlets and outlets cannot be closed because they lead many people to their homes,
the school need to put up other washing facilities and strict rules on washing hands. This
calls for the need in utilizing the local materials in making enough washing facilities.

1.4 Research questions

1. What are the pupils and teachers knowledge on COVID 19 and SOPs?
2. Why is washing hands becoming impossible in this COVID 19 crisis at Kibaale
primary school?
3. What strategy can be utilized to foster people’s frequent washing of hands?

1.5 Justification of the study

When the COVID-19 pandemic was announced in Uganda in March 2020, closure of schools
followed. The education of 15 million children was disrupted. Children spend majority of
their time at home playing, helping their parents with chores, engaged in agriculture but also
spare some hours a day to study. The education of children has been impacted, in urban
areas, some children are relying on lessons available online, televisions and radios, while
those in faraway/rural areas, fall back on their notebooks and printed learning materials
provided by the Government with support from UNICEF. As this was not enough the
government scheduled for the opening of schools starting with candidate classes. This led to
the setting up guidelines called SOPs for better operation of schools. These included having
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enough washing facilities at school for washing hands, all people at schools to put on
respiratory masks, social distancing, use of disinfectants (Sanitizing), having a temperature
Gun to checking temperature and avoiding touching soft parts of the Body. All these would
have been possible if enough washing facilities exist at school because cleanliness starts with
washing hands. The inadequacy of enough washing facilities has made the breaching of the
SOPs and this calls for utilization of local materials to make enough washing materials.

1.6 Significance of the study

The study is likely to help the Headteacher to set mobilize the neighbor to contribute local
materials for making of the washing facilities. The poles and jerrycans will be from the
neighboring community which uses the school entrance and outlets. This will help the
Headteacher from minimizing on expenditures.

The pupils will have knowledge of making washing facilities which knowledge they will
transfer to their home. They will be able to make washing facilities for their homes and also
improve in the exercise of washing hands as a means of killing jams an improving on
cleanliness.

Teacher will be helped to foster and teach about the importance of washing hands. They will
have enough materials for the pupils to wash their hands. It will easy for teachers to instill the
hand washing behavior to the learners.

The school neighbors will also feel free to use the entrance and outlets of the school since
will be able to wash hands at any time.

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 CHAPTER TWO

LITERATURE REVIEW

2.0 Introduction

This chapter presents the literature related to COVID 19 and its related aspects including
standard operating procedure and their implementation amongst people. The literature in this
chapter is presented under themes derived from the research question which are; peoples
knowledge on COVID 19 and SOPs, reasons impacting washing hands in the COVID 19
crisis and Strategies to foster people’s frequent washing of hands.

2.1 Peoples knowledge on COVID 19 and SOPs

Sops are written with the aim to provide people with all the information necessary to perform
a job properly. Sops In Healthcare is defined as a written set of instructions that a healthcare
worker should follow to complete a job safely, with no adverse effect on personal health or
environment and in a manner that maximizes the probability of a beneficial health outcome
in an efficient manner. An SOP is a set of written instructions that document a routine or
repetitive activity. It is a set of detailed written instructions to achieve uniformity of the
performance of a specific function. A standard operating procedure or SOP is a set of
instructions that address the who, what, where and when of an activity. SOPs (Standard
Operating Procedures) have been found to be of immense use in proper working, training of
personnel and favorable outcomes in every Industry. Thus SOPs are an essential prerequisite
for any Quality initiative. Studies show that SOPs have significant potential to enable
provider organizations to improve quality without increasing costs. SOP is therefore an
important document in terms of quality measures and evaluation.

The new pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-
CoV-2) emerged in late 2019, disrupting health systems and critical care, even within the
most developed heath systems and economies (Chen, et al, 2020). As of April 22nd, 2020,
2.5 million confirmed cases of COVID-19 have been reported globally (Kate, Siddiqui,
&Pietromarchi, 2020). Sustained community transmission is expected in low- and middle-
income countries (LMICs) where COVID-19 containment strategies continue to be a
challenge (Salzberger,Glück, Ehrenstein, 2020). Extreme mitigation strategies have been put
in place in many countries to control COVID-19, to reduce disease transmission and to avoid
overburdening healthcare systems including mass lockdowns, curfews, and social distancing
measures (Roy, et, al 2020). SARSCoV-2 and interventions to reduce transmission are
negatively impacting already impoverished communities in LMICs and will test heath
systems that have little capacity for the management of high dependency patients, or
4
sufficient PPE to protect health workers (Kasozi, et al 2020). Interventions will have long-
lasting detrimental impacts on LMIC economies, and, in the absence of reliable and efficient
tools for early detection of infected and exposed individuals, are likely to extend beyond
2020/21 including in Africa (World Bank Group.2020).

In Uganda more extreme actions have been taken with total national lockdowns that have
involved closure of all non-essential businesses, public transport, and the closure of schools
and universities. Only local food stores,supermarkets, medical, and veterinary supplies are
exempt and for these services a mandatory curfew has been imposed. No motor
vehicles/motorists are permitted to use public roads unless they are listed among essential
service providers authorized by the Office of the President (Chris, 2020). Countries not
abiding with the social distancing guidelines as recommended by the WHO are putting
neighboring countries at risk and compromising health security within the East African
Community (EAC). The EAC continues to show a disorganized response against COVID-19
and this high level of disorganization has created confusion in the general public as to what is
“true” and “false” COVID-19 information. Rumors and misinformation have spread widely
within the community and the media; for example, a religious leader in Uganda claimed that
there was no COVID-19 in Uganda and stated that it was just “simple flu” and an individual
at Kampala City Council Football Club falsely claimed that Uganda had lost a patient to
COVID-19; these culprits are currently in jail awaiting trial for spreading false information
(Kelvin&Halperin, 2020). Risks and assumptions are causing disharmony in communities,
fearful of risk of infection and of the economic consequences of government interventions.

In the study on the Perceptions of Risk and Race Among Ugandans carried out by Kasozi et
al. (2020)showed that majority of participants agreed that all races were at risk of COVID-
19, however some participants thought that other races were more at risk than others.
Amongst those who thought that COVID was a disease of “the whites,” a majority of these
were males (32.4%, 33/102, 95% CI: 23.82–41.88) compared to 26.3% females (n = 15/57,
95% CI: 16.1–38.9). Furthermore, no significant differences were found between males
(5.9%, 6/102) and females (5.3%, 3/57) toward agreement that the disease also affects
Blacks. Furthermore, a majority of respondents stated that all races show severe signs of
COVID-19 and of these, a majority were females (57.9, 33/57%,) compared to 49.5%
(50/101) who were males. The findings were not different from the perception of the people
in the market I studied, many still believe of the non existence of COVID 19 in Uganda, this
the reason why they don’t adhere to the Sops set by the ministry of health.

Unemployment for both formal and informal workers has affected business and
incomesJavira (2020). The closure of business is already affecting millions of Uganda’s

5
who depend on them for employment. Closure of business imply that a large segment of the
population is already out of the market. Survival led to adoption of negative coping
strategies, such as cutting down on consumption to the bear minimum, theft and insecurity.
The shock on the services sector, which contributes to 43.5% of GDP9 and employs close to
43% of the total labour force (67% of whom are in urban areas, and more than 80%in
Kampala alone10) will significantly affect growth and livelihoods of millions of Ugandans.
Overall, the pandemic has directly affect the livelihoods of more than 60% employed in both
industry and services, close to 90% of whom depend on these two sectors in urban areas.
These sectors are largely informal, employing 90.5% of young people. This still confirms
why many traders in the market are worried of the customers and this has led to miss use of
the SOPs set by the ministry of health.

In terms of social effects, the closure of schools, places of worship, entertainment venues
negatively impacting quality of life and has potential to impact human capital development
going forward: In the education sector, the impact will be felt by low and average-income
households in both public and private schools, given the inability to access innovative
educational instructions. More than 17.5 million people are in both public and private
schools, all seated at home(Raymond., 2020).

2.2 Reasons impacting washing hands in the COVID 19 crisis

Hand hygiene facilities are lacking even in places where they are most needed: nearly half of
all schools do not have handwashing facilities with water and soap, affecting 900 million
schoolage children. Forty-three per cent of health care settings do not have hand hygiene
facilities at points of care where patients are treated. With limited or no hand hygiene
facilities and improvement programmes, health care workers’ompliance with hand hygiene
best practices can be as low as 8 per cent(Prüss-Ustün, et al.2019). This puts teachers,
doctors, nurses, patients – all of us – at risk.

The COVID-19 pandemic is a stark reminder that one of the most effective ways to stop the
spread of a virus is also one of the simplest: hand hygiene(WHO, 2020). It not only protects
us from contracting the disease, but also stops transmission to other people. To beat the virus
today – and be better prepared for future pandemics – universal access to hand hygiene must
become a reality for everyone, in all settings, especially in health care facilities, schools and
crowded public spaces. This approach is reiterated in WHO’s recommendations on ensuring
universal access to hand hygiene and improving hand hygiene practices to prevent COVID-
19 transmission. In agreement with the ideas, to get there, we need to not only improve
access through water supply and physical infrastructure, we also need innovative solutions to
fit different contexts, and make soap, alcohol-based handrub and hygiene supplies both
6
available and affordable. And we need individual behaviours to change. Handwashing must
become an integral part of our daily lives.

The 2030 Agenda states that the global goals and targets are aspirational. Governments are
therefore expected to localize them and set their own national targets for WASH in schools.
These should be guided by the global level of ambition and by existing international
commitments (including the human rights to education and to safe water and sanitation), and
take into account national circumstances(McMichael, 2019). To ensure ‘no one is left
behind’, governments are also expected to establish mechanisms to identify the most relevant
dimensions of inequality in access to WASH in schools and to monitor progress among
disadvantaged groups.

Schools with adequate water, sanitation and hygiene (WASH) facilities have: a reliable water
system that provides safe and sufficient water, especially for hand-washing and drinking;
sufficient number of toilets for students and teachers that are private, safe, clean, and
culturally and gender appropriate; water-use and hand-washing facilities, including some
close to toilets; and sustained hygiene promotion(Appiah-Brempong, 2018). Facilities should
cater to all, including small children, girls of menstruation age, and children with disabilities.
WASH conditions in schools in many low-income countries, however, are inadequate with
associated detrimental effects on health and school attendance. An evaluation by UNICEF
found that in schools in low-income countries, only 51% of schools had access to adequate
water sources and only 45% had adequate sanitation.

2.3 Strategies to foster people to frequently washing of hands

To beat the virus today – and be better prepared for future pandemics – universal access to
hand hygiene must become a reality for everyone, in all settings, especially in health care
facilities, schools and crowded public spacesWHO, (2020). This approach is reiterated in
WHO’s recommendations on ensuring universal access to hand hygiene and improving hand
hygiene practices to prevent COVID-19 transmission.To get there, we need to not only
improve access through water supply and physical infrastructure, we also need innovative
solutions to fit different contexts, and make soap, alcohol-based handrub and hygiene
supplies both available and affordable. And we need individual behaviours to change.
Handwashing must become an integral part of our daily lives.

Washing hands save lives of the people (WHO, 2020). Access to hand hygiene in health care
facilities, schools, public places and homes is essential to protect global health and reduce the
risk of future outbreaks. Scaling up hand hygiene in all settings could potentially prevent an
estimated 165,000 deaths from diarrhoeal diseases each year. Scientific evidence and

7
experience from WHO has also shown that improving hand hygiene strategies in health care
can reduce health care-associated infection and antimicrobial resistance.

Hand washing helps in saving money. Hand hygiene is also one of the most costeffective
ways to prevent the spread of infectious diseases. The cost of implementing hand hygiene
strategies in health care facilities is low: estimated between US$0.90 and US$2.50 per capita
per year, depending on the country. Improving hand hygiene policies can generate savings in
health expenditure up to 15 times the costWHO, (2020).

WHO, (2020) hand washing is an aspect of preparing for the future. Hand hygiene is key to
stopping the spread of COVID-19 now – but smart investments now will also prepare us
better for any future disease. Adopting strong hand hygiene strategies is the single most
effective intervention to prevent disease and death due to antimicrobial resistance (AMR).
Hand hygiene also protects against a range of other diseases, including common colds, flu,
diarrhoea and pneumonia.

In the short term, controlling the outbreak is most urgent, with an immediate need to improve
hand hygiene access and practices in public spaces and health care facilities(WHO, 2020).
Governments need to rapidly roll out hand hygiene stations in public settings, ensure health
workers have access to hand hygiene and infection prevention and control (IPC) supplies,
ensure hand hygiene facilities are available to those caring for COVID-19 patients at home
and for essential workers, and ensure continuity of water supply services. Health workers,
teachers and community leaders must be given the tools and guidance they need to practice
and teach hand hygiene in their places of work. At the same time, countries should review
financing and investment opportunities, put in place national hand hygiene policies and
plans, strengthen legal and regulatory frameworks, and assess gaps in hand hygiene policies,
capacities and monitoring.

According to WHO/UNICEF, (2020) there is a need to rebuild the necessary washing

hygiene. In the medium term, the response needs to ensure that hand hygiene systems are
built or changed to be better than before, so that if COVID-19 or another infectious disease
appears, countries are better placed to block transmission. Countries need costed roadmaps
and timelines for scaling up and sustaining hand hygiene beyond COVID-19. Globally, the
initiative will develop a system for monitoring hand hygiene, and a platform for knowledge
exchange and best practices among countries and thought leaders. It will establish
partnerships with businesses, as well as cross-sectoral partnerships in the fields of health,
education and other sectors.

8
Political leadership should champion hand hygiene as a key part of the COVID-19 response
and frame hand hygiene in the broader context of IPC. Establish hand hygiene as a key part
of public health and preparedness strategies andMake hand hygiene everyone’s business for a
healthy population and clean care provision(Friedrich, 2016).

Hand hygiene behaviour change should include rapid behaviour change approaches and
messages, strengthen hand hygiene promotion in the community and health care according to
existing strategies and disseminate technical guidance on evidence-based behavioural change
strategies. There should also be continued behaviour change interventions, increasingly
following a strategy to adapt interventions to the evolving context and remaining gaps(WSP
Uganda., 2012). School stake holders should also mobilize communities and relevant players
to actively engage with service providers and policy-makers, and create and maintain hand
hygiene as a social norm.

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 CHAPTER THREE

METHODOLOGY

3.0 Introduction

This chapter presents the methods I employed to establish the extent to which people at
Kibaale primary school community have adhered to the SOPs. Specifically the methods used
to establish the reasons why pupils and teacher do not wash hands frequently and the
strategies to employ for washing hands frequently. This chapter shows the research design,
population of the study, sample size and sampling strategies, data collection methods, data
collection tools, data quality control, procedure of data collection, data analysis, ethical
consideration and limitations.

3.1 Research Design

In this study I employed an action research design. Action research design is an

educational research involving collecting information regarding current educational programs
and outcomes, analyzing the information, developing a plan to improve it, collecting changes
after a new plan is implemented, and developing conclusions regarding the improvements. In
this study I analyzed the SOPs and also examined how they are adhered to by school
community which led me to establish failure to wash hands frequently as a major obstacle in
the implementation of SOPs. Together with participants we discovered that we can utilize the
local materials and make enough washing facilities to foster frequent washing of hand of all
people in the school community.

3.2 Population

A population refers to any collection of specified group of human beings or of non-human

entities such as objects, educational institutions, time units, and geographical areas (Murphy,
2016). In this study the population consisted of pupils and teachers in primary seven class.
The class has a total of 40 pupils and 4 teachers and the total population was 52 respondents.
This population was chosen because the study was to detect how inappropriate masking
impacting teachers and pupils adherence to the sops towards the prevention of spreadof
COVID 19.

3.3 Sample size determination

A selected group of some elements from the totality of the population is known as the
sample. It is from the study of this sample that something is known and said about the whole
population (Murphy, 2016). The sample size consisted of 30 respondents who included

10
20primary seven pupils, 4primary seven teachers and 6 people from the neighboring
community.

3.4 Sampling strategy

To select the sample for the study I employed both the random sampling and purposive
sampling techniques. Random sampling technique was to select pupils from the primary
seven class. A lottery system was used to select the pupils. This was done in order to
consider equal chances of participation of all learners. Teachers were selected by use of
purposive sampling because there were no other alternatives to teachers. Also purposive
sampling strategy was use to select the 6 people who were the neighbors of the school and
using the school inlets and outlets.

3.5 Data collection methods

In this study, I employed interviews.Interviews were used to pupils as ways of establishing

the real information from pupils on the causes of inadequate hand washing facilities and it
impacts their adherence to COVID 19 prevention. Teachers were also interviewed in finding
out their views on how they manage pupils with inadequate materials and especially to
breaking of the school rules.

3.6 Data collection instruments

In order to collect accurate data, I used two instruments including the interview guide, and
the observation guide. Generally the instruments were used to explore the causes of
inadequate hand washing facilities and it impacts their adherence to COVID 19 prevention.

Interview guide for pupils. An open ended interview guide about pupils knowledge on the
standard operating procedures, pupils reasons for inadequate hand washing facilities and the
pupils views/strategies that can be employed for adequate hand washing facilities and
adherence to COVID 19 SOPs.

Interview guide for teachers. An open ended questionnaire interview guide was developed to
seek information from teacher about their experiences of COVID 19, knowledge on the
SOPs, reasons why pupils and other stake holders lack enough hand washing facilities and
the strategies that can be followed to foster enough hand washing facilities.

Observation guide: An observation guide for learners and teachers was developed to find out
how follow the standard operating procedures for the mitigation of COVID 19 from schools.
This was so to record instances the participants failed the follow the set standard operating
procedures.

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3.7 Data quality control

Data quality control is the process of controlling the usage of data for an application or a
process. This process is performed both before and after a data quality assurance (QA)
process, which consists of discovery of data inconsistency and correction
(Abeysirigunawardena & Morley, 2015). In this study I took control of the validity and
reliability.

Validity: Validity tells how accurately a method measures something. If a method measures
what it claims to measure, and the results closely correspond to real-world values, then it can
be considered valid (Oluwatayo, 2012). In this study I used criterion validity to evaluate how
closely the results of the instruments correspond to the results the same instrument. The
criterion is an external measurement of the same thing. I constructed the instruments and sent
them to the supervisor who helped me in modification and removing ambiguity thus making
them valid.

Reliability: Reliability refers to the consistency, stability and repeatability of results, that is,
the result of a researcher is considered reliable if consistent results have been obtained in
identical situations but different circumstances (Taherdoost, 2016). To ensure the reliability
of the instruments I used the test-retest reliability. It is a measure of consistency between
measurements of the same construct administered to the same sample at two different points
in time (Drost, 2011). In this case I used the same instruments on four people in the school
community who were not part of the participants and the results I received were similar of
what aimed for.

3.8 Procedure of data collection

Having received the research guideline and guidance from Uganda Martyrs University,
Nkozi I bought an action research journal where my journey for action research started from.
I formulated an observation guide to observe the people in the school community in the
implementation of the Sops and then later developed an interview guide which I used to
collect responses on the people’s understanding of SOPs and how they have adhered of
breached them and the reasons behind both. This led to establish that most people at Kibaale
school community don’t wash hands as expected and to also set up strategies to improve on
the washing of hands.

3.9 Data analysis

Information or data collected in interviews, observation and from school and from school
documents was transcribed into the research journal, I used descriptive data analysis.I formed
frequency tables to analyze the data collected during interviews, and observations.

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3.10 Ethical consideration

While carrying out this research study, participants’ names were not used. Participants’
names were never mentioned. Concealing the names of participants who do not wash hands
was one way of ensuring research ethics. Letters is A,B,C were used to refer participants
respectively. In some cases instead of mentioning the participants name letters like
participant two for example were used. The neighbors consent was sought before they
involved in the study. The ideas they gave were considered and this made them proud in
participating in the study.

3.9 Limitation and delimitation

Several limitations were anticipated in the study but the most experienced limitation was
participants expectations but after a though explanation they also saw it possible to work
together to make local washing materials from the local materials.

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 CHAPTER FOUR

FINDINGS, DISCUSSION AND IMPLICATIONS

4.0 Introduction

This chapter presents the findings from the study. The study aimed at examining how the
people at Kibaale primary school community observe and adhere to the SOPs. The findings
in this chapter are presented in themes derived from the research questions which are;
peoples knowledge on COVID 19 and SOPs, reasons impacting washing handsin the COVID
19 crisis and Strategies to foster people’s frequent washing of hands.

4.1 People’s knowledge on COVID 19 and SOPs

Table 4.1 Participants knowledge on COVID 19 (n=29)

Question Responses Frequenc Percentag

y e
What do COVID 19 is a disease that came from China. It 17 59
you know China made
It is a disease which has killed all people across the 24 83
about
world
COVID 19?
It is in form of flue but this one is very dangerous 17 59
It is a disease which affects the respiratory system 18 62
and quickly damages the lungs
People, lost jobs and travelled back to villages 15 51
It is a pandemic which has put the entire work on 26 90
tension
A disease which affected all human activities 25 86
worldwide
Source: Field study 2021

Raw data from table 4.1 indicate respondents’ knowledge on COVID 19 and 90% knows it as
a pandemic which has put the entire world on tension. This was followed by 86% who
confirms COVID 19 as a disease which affected all human activities worldwide, 83%
acknowledge it as a disease which has killed all people across the world, 62% described it as
a disease which affects the respiratory system and quickly damages the lungs, 59% confirms
that COVID 19 is a disease that came from China. It China made whereas 51% noted that
due to COVID 19 People, lost jobs and travelled back to villages. This confirms what
Ssebuufu, (2020) discovered in his study that people are aware of the existence of COVID 19
and always alert for any notification that come from the ministry of health.

14
Table 4.2 Participants knowledge on implementation of SOPs (n=29)

Question Responses Frequenc Percentag

y e
How have you Washing hands but lack enough facilities 16 55
Wearing masks 24 83
adhered to the
Cleaning the working places always 17 59
SOPs set by the By use of sanitizers 17 59
ministry of health? By social distancing 18 62
Sneezing in the handkerchief 26 90
Avoiding catching soft parts of the Body 25 86
God’s protection should also be considered 25 86
Source: Field data 2021

Raw data from table 4.2 shows participants responses on school community’s adherence to
SOPs. 90% participants reported to sneeze in the handkerchief, 86% said to live by avoiding
catching soft parts of the Body and by god’s protection. Also confirmed to wearing masks,
62% by social distancing, 59% by use of sanitizers and cleaning the working places always
whereas 55% washing hands but lack enough facilities. This confirms that washing hands is
the least observed SOP among those ones provide by the ministry by the school community.
This confirms what Ssebuufu, (2020) discovered that people are aware of the SOPs but rarely
adhere to washing hands.

Table 4.3 Participants observation of the SOPs (No=29)

SOPs Day Day Day Day Day Freq Av %

1 2 3 4 5 . e.
Hand washing always 12 13 08 10 06 49 10 34
Wearing masks properly 22 24 16 24 14 100 20 69
Checking temperature 26 27 27 27 26 133 27 93
Social distancing 20 20 20 20 20 100 20 69
Use of disinfectants 12 13 08 10 10 53 11 40
Coughing using a handkerchief 14 13 14 13 13 67 13 45
Avoiding catching soft parts of the 17 18 17 21 16 89 18 62
Body
Source: Field data 2021

Results from table 4.3 shows that the school’s community observation of the SOPs. It is
indicated that 93% have always had their temperatures checked, 69% always wear masks
properly, and keep social distances, 45% were observed to use a handkerchief while
coughing, 40% try to use disinfectants whereas 34% wash hands always. The observations

15
confirms that few participants wash hands always an indication that there is a challenge of
washing hands yet it is the cornerstone for cleaning a person thoroughly. WHO, (2020) notes
that washing hands is commonly affected by insufficient washing facilities in the community.
This implies that inadequacy of the washing facilities would be the most affect the school
community’s observation of SOPs.

4.2 Reasons impacting washing hands in the COVID 19 crisis

Having established that washing hands was the least observed among the SOPs, I took time
to investigate reasons that lead to participants inability to wash hands always and the results
received are indicated in table 4.4, 4.5 and 4.6 respectively.

Table 4.4 Pupils’ reasoning on washing hands (n=20)

Question Response Frequenc Percenta

y ge
What hinders you from Always walking a distance to the watering 18 90
washing hands stand for washing hands
At times water is over 16 80
frequently?
There is only one watering stand for all of 20 100
us
Lining up always to wash hands 12 60
At times there is no soap 10 50
Source: Field data 2021

Results from table 4.4 show pupils responses to aspects that hinder them from washing hands
frequently. 100% reported that there is only one watering stand for all of them, 90% pupils
reported walking a distance to the watering stand for washing hands, 80% said that at times
water is over, 60% reported lining up always to wash hands whereas 50% said at times there
is no soap. These all confirms lack of enough facilities to have an effect on the pupils
washing of hands frequently.

Table 4.5 Teachers’ reasoning for washing hand (n=3)

Question Response Frequenc Percentag

y e
What hinders you There is only one washing facility 3 100
Lining up with pupils (fighting for washing 2 50
from washing hands
hands
frequently?
At times there is no detergent 2 67
Even most people whom we interact with 1 33
rarely wash hands.
Source: Field data 2021

16
Raw data from table 4.5 sought for what hinders teacher to wash hands frequently. 100%
teachers said that there is only one washing facility which confirms what all pupils said when
were asked. 67% teachers said that at times there is no detergent also corms what 50% pupils
mentioned in table 4.4. Also on the same cause 50% teachers said that lining up with pupils
(fighting for washing hands) prevent them from washing hands frequently. This is also
similar to what 60% pupils said in the table 4.4. There is 33% teachers who noted that even
most people whom we interact with rarely wash hands which confirmed that washing hands
at this school was still a big problem.

Table 4.6 School neighbors reasons for washing hands (n=6)

Question Response Frequenc Percentag

y e
What hinders you Lack of the washing facilities 6 100
For us we are farmers who are always dirty 4 67
from washing
Even the school has one washing facility which 5 83
hands frequently
we cannot all use
There is a lot of entrance even if we wash it 3 50
cannot help
Source: Field data 2021

Results from table 4.6 shows the school neighbors reasons for not washing hands and 100%
said they lack washing facilities, 83% said that even the school has one washing facility
which they cannot use all as neighbors confirming the inadequacy of the washing facilities.
67% said that they are farmers who are always dirty and do not need to wash hands
frequently which confirms the neighbors’ attitudes on washing hands. This makes washing
facilities and ignorance and the major issues affecting the washing hands as one of the SOPs.

4.3 Strategies to foster people to frequent washing of hands

Having discovered that washing hands was the main issue affecting the implementation of
SOPs, it was time for the participants to suggest measures of following the SOPs and also
washing hands and the results received are presented in table 4.7.

17
Table 4.7 Pupils responses on strategies to improve on washing hands (N0=29)

Question Responses Frequenc Percentag

y e
What strategies Teaching people to use masks properly 22 76
Use of local made sanitizer 23 79
can be adopted
Sensitizing neighbors about the dangers of COVID 23 79
to help people
19
adhere to SOPs? Sensitizing our parents about the deadly disease 24 83
Teaching people to wash hands properly 26 90
What strategies Making washing facilities from local materials 29 100
Putting washing materials at all corners 27 93
can be adopted
Frequent washing of hands 29 100
to help you wash
hands frequently
Source: Field data 2021

Raw data from table 4.7 shows the participants suggestion on adaptation of the SOPs and
washing of hands. It is shown that 100 % participants to suggest making washing facilities
out of local materials and to also washing hands frequently. They are followed by 90% who
suggested teaching people to wash hands properly, 83% suggested sensitizing parents about
the deadly disease COVID 19, 79% suggested sensitizing neighbors about the dangers of
COVID 19 and also making and use of locally made sanitizer whereas 76% suggested
teaching people to use mask regularly and properly. Also these suggestion related on washing
and keeping clean which align with Sun,Chen, &Viboud (2020) noted that in order to prevent
the spread maximum cleanliness must be mentioned and also that washing hands should be a
frequent routine. This implies that washing hands has to be given a priority by making
washing facilities from the local materials as suggested by 100% of the participants.

4.4 Implications of the findings

From the study it can be confirms that people are aware of the existence of COVID 19 and
where it came from. Which implies that they are set to perform any preventive activities if
well sensitize to do it.

The study findings also confirms people are aware of the standard operating procedures
given by the ministry of health which implies that their, observation or breaching them is out
of their understanding and when well sensitized can change their attitudes and work together
for their implementation.

The findings also showed that people commonly do not wash hands, it has been their habit
but when were told to wash hands they lacked enough facilities. This implies that people in

18
the school community would love to frequently wash hand but due to lack of enough
facilities they cannot do so. This has kept them in the old style of not washing hands always.

The findings also showed that participants align and want to improve on the observation of
the SOPS. Their suggestions imply that they are ready to sensitize the community about the
SOPs, ready to contribute and participate in the making of the washing facilities.

4.5 Conclusion

It can be concluded the people at the school community are aware of the existence of COVID
19, it can also be concluded the people are aware of the SOPs for the prevention of spread
COVID 19. It is also observed that the people at school breach the SOP that requires them to
wash hand frequently which is likely to bread more problems at school. People reported to
break the washing of hands because there are inadequate washing facilities and they have
suggested making washing facilities out of local materials so as to facilitate frequent washing
of hands.

19
 CHAPTER FIVE

DESCRITION OF THE INTERVENTION AND ACTION PLAN

5.0 Introduction

This chapter presents the description of the innovation that will be used while helping the
school to acquire enough washing facilities and encouraging school community to always
wash hands frequently. The chapter presents the pre-intervention phase, while intervention
phase and post intervention phase and later draws a frame work to be followed during the
intervention.

5.1 Description of the innovation

From the findings it is indicated that lack of enough washing facilities affects people at
Kibaale primary to frequently wash of hands as an SOP for preventing the spread of COVID
19. In order to deal with the challenge of inadequate washing facilities, all respondents
suggested developing washing facilities out of local materials. Hulland et al., (2013) contents
that hand washing facility can easily be made by using the available local resources. There is
no need to look for expensive materials to make washing facility, just utilize the materials in
your home, community to construct one (Hulland et al., 2013). In support Nayebare, et al.,
(2020) noted that locally made washing facilities promote awareness on how washing facility
can be created and used properly.

This means that when we engage school community, the knowledge received can be
extended to the parents and other people and improve on the washing of hands.

Making handwashing facilities accessible to everyone is crucial to maintain handwashing

behaviour. Considerations for accessibility include age, disability, seasonality (with rains and
muddiness), location and more. These interventions should ideally be undertaken along with
the development of the handwashing facility to make it more accessible to people in the
community (Mulogo, et al, 2018). This justifies the fact that hand washing facilities need to
be accessible to all people within I the school community.

Alongside the provision or promotion of handwashing facilities, it is important to promote

handwashing with soap at key times amongst community members to maximise the extent to
which handwashing with soap is practised. Hygiene promotion efforts must seek to engage
and include everyone in a community, including men, women, boys and girls; people with
disabilities and chronic illnesses; people of all ages, genders, economic backgrounds, sexual
orientations, races, ethnicities and religions (Hulland et al., 2013). Community engagement is
essential to the success of hygiene promotion activities (UNICEF, 2020). In line with

20
UNICEF 2020, involving the community in making washing facilities can facilitate
community awareness of the importance of washing hands. In so doing, the school
community will involve the nearby people especially those with access to school outlet an
inlet.

The presence of a handwashing facility with soap and water on premises has been identified
as a priority indicator for global monitoring of hygiene.

5.2 Pre- intervention phase

The pre-intervention phase will include several activities including discussion with neighbors
on how to deal with the washing facilities. In this discussion we shall list all the required
material and also suggestions on how to access them to help in the creation of the washing
facilities. The list of materials will be a baseline for the start of the project.

We shall also Make a plan to incorporate health washing facilities communication activities
in the schools’ disease prevention and student healthcare programs; and also - Assign clear
responsibilities to relevant staff; prepare necessary equipment and items for hand washing
facilities demonstration includingleaflets introducing steps hand washing facilities with soap,
and appropriate messages.

5.3 While-intervention
In this phase we shall make different washing facilities using the materials gathered from the
pupils and neighbor. Teachers, pupils and the neighbor shall all join hands in making the
hand washing facilitate in the collection and washing of hands. Practically pupils will be
guided to make these facilities under the guidance of the neighbors and teachers.

Teachers will be assigned to write appropriate messages that encourage people who came to
school and use the school to always wash hands. The school administration will be in charge
of providing the writing tools like wooden bars and writing Markers, colors for the teachers
to practically write the messages. Together with pupils the messages will be placed in
different corners of the school where everyone can read and act accordingly (wash hands).

The school administrators will be asked to always provide soap and other detergents to help
in washing hands and make them clean. On daily basis pupils in charge will collect the soap
from the office and place it at the right place near on the washing facility for the people’s use.

Training will be carried out on the proper washing of hands. This will be on the first day of
washing hands by the use of the locally made hand washing facilities. Training will involve
placing the jerrycan and to taping water and the use of soap as well as washing properly for a
clean hand. This will be in guidance with the teachers. School neighbors will also be
examining and shall practice the behavior of washing hands
21
5.4 Post intervention

This will involve monitoring, supervision, and reporting the exercise. Pupils in charge of her
water facilities will be the first supervisors of their places, followed by teachers and the then
the school administration. The neighbors will also fully be responsible for maintaining the
operation of the washing facilities.

I will monitor and observe the learners, teachers and school neighbors who wash hands on
daily and how frequent they use the washing facilities available. I will also interview
teachers, pupils and neighbors on how they have benefited from placing the washing facilities
at every entrance of the school.

All the activities and the received results from observation and interviews will be transcribed
in research journal and later synthesize data to include feeling and thoughts for pupils,
teachers and neighbors. Then a report will be written and submitted to Uganda Martyrs
University faculty of education.

5.5 Timeline for monitoring the intervention

Table 5.1 Timeline for monitoring the intervention

Innovation Activity Time frame Responsible Indicators Remarks

person
Creating Meeting 1st week term Researcher Minutes from
hand neighbors one, 2021 meeting
washing Meeting 1st week term Researcher Minutes from
facilities teachers and one 2021 meeting
from local pupils
material Collecting of 1st and 2nd Teachers, Collected
the local week term pupils and local
materials one 2021 neighbors materials
Constructing Thursday and The Constructed
hand Friday of 2nd researcher, hand
washing week term and teachers washing
facilities one facilities
Writing 2nd and 3rd Teachers and Written and
posters week term researcher displayed
posts
Training to 3rd week The Records of
use of the immediately researcher, training
hand after and teachers
washing constructing
facilities the facilities
Use of the On daily and The teachers Records of
facilities timely basis using the
facilities
22
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26
 Appendix 1: Interview guide for the participants

1. What do you know about COVID 19?

2. How have you adhered to the SOPs set by the ministry of health?
3. What hinders you from washing hands frequently?
4. What strategies can be adopted to help people adhere to SOPs?
5. What strategies can be adopted to help you wash hands frequently

i
 Appendix 11: Observation guide for the participants

Area of observation Observation made Comments

Hand washing always is practiced
by all people at school
Wearing masks properly is clearly
observed
Checking temperature is done to
everyone at school
Social distancing is observed by all
at school
The people at school disinfectants to
clean the place of work
People at school use a handkerchief
while Coughing and sneezing
Are participants sensitive and
avoiding touching sensitive parts of
the face

ii
 Appendix 111: Budget

Item Quantity Cost

Black books 1 5,000/=
Pens and pencils 4 4,000/=
Ream of paper 1 20,000/=
Printing 1 50,000/=
Photocopying 1 20,000/=
Internet services 1 50,000/=
Bindings 2 20,000=
Total 169,000/=

Appendix 111: Journal abstracts

iii
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v