Applied research and Monitoring and Evaluation (M&E) are integral elements of the Fit for School (FIT) Approach. Strengthening the evidence for Water, Sanitation, and Hygiene (WASH) in Schools (WinS) and demonstrating impact of interventions under real-life conditions contribute to a better understanding of the context and improving the effectiveness of the interventions. It also helps in advocacy, supports mobilisation of resources, and boosts credibility and communication with stakeholders, government partners and the wider international WASH in Schools (WinS) community.
A number of studies were conducted or are still ongoing to gain deeper insights in various aspects of WinS. The most comprehensive studies include the larger FIT Programme Assessment Study (FIT-PAS) which was conducted in Cambodia, Indonesia and Lao PDR. Inspired by an earlier study on health outcomes linked to FIT/Essential Health Care Programme interventions in the Philippines, this two-year longitudinal study looked at the impacts of the three FIT interventions (daily handwashing, toothbrushing with fluoride toothpaste, and biannual deworming) on body-mass index and intestinal worm infections of children, as well as the incidence and severity of tooth decay. Moreover, the impact of the programme on the school environment measured by availability and usability of WASH facilities was also evaluated. Study results showed positive effects on school environment, hygiene behavior, and disease prevention in schools with FIT interventions compared to control schools.
Qualitative and observational studies on handwashing and toothbrushing behavior, as well as WinS management and related aspects have likewise been successfully concluded. More details of research conducted in Cambodia, Indonesia, Lao PDR and the Philippines can be found in the resources section.(Click on country name for further details).
Below is a selection of topic-related research activities:
- Health outcomes focus – oral health
- 2002 – 2006: Research on effective interventions
- 2003: pilot of school-based fluoride toothbrushing programs in Cagayan de Oro, Misamis Oriental
- 2006: National Oral Health Survey
- 2007: Scale-up of school-based toothbrushing in all schools in Misamis Oriental
- 2008: Start of roll-out of Fit for School approach in 19 provinces in the Philippines
- Expansion of health outcomes focus: oral health + intestinal worms + hand hygiene
- 2009: Department of Education institutionalized Essential Health Care Package (EHCP) that uses the Fit for School approach
- 2010: Collaboration of DepEd and GTZ
- 2009 – 2012: Health Outcome Study in the Philippines
- 2012: Relationship of oral health and weight gain
- Expansion of Fit for School Approach in SEA: Research and Development Phase
- 2011: Launch of Regional Fit for School Programme with SEAMEO INNOTECH
- 2012 – 2014: Health outcome study in Cambodia, Indonesia, Lao PDR
- 2014: Assessment of fluoride content in toothpastes in the Philippines
- Beginnings of behavior-oriented approach
- 2012: Knowledge Attitudes Practices survey in Cambodia
- 2014: Social norms survey in Cambodia
- 2015: Hygiene habits survey in ARMM
- Beginnings of systems thinking approach
- 2014: Broadening of health outcome study to look at school level WASH and SBM indicators = FIT PAS
- 2015: Lao Sisattanak scale-up study to look at the role of entire MOE system in successful scale-up
- 2018: Cambodia Kampot Scale-Up Success Factors study that identified 6 factors in successfully bringing WinS to scale within the provincial and district structures
- Integration of WASH and School Feeding
- 2015: Piloting of localized school-based feeding concept in ARMM and its impact on nutritional status and attendance
- 2016: Assessment of cooking systems in the Philippines to investigate readiness of public schools for scale-up of school feeding
- 2017: Philippines comprehensive policy on DepEd WinS and SBFP outlining integration of daily group handwashing before feeding and toothbrushing after feeding
- 2015 – 2016: Collaboration with WFP to integrate school feeding and FIT approach in Lao PDR
- Research on Operations and Maintenance
- 2014: WASH survey in Cambodia, Indonesia, Lao PDR highlighted the importance of functionality and cleanliness of toilets
- 2016: conceptualization of FIT Plus, an expanded FIT approach that includes a WASH O&M component (in cooperation with Unilever via the GIZ develoPPP.de project modality)
- 2020: A cluster-controlled trial that assessed the impact of packaged operation and maintenance intervention on sanitation conditions of primary schools in the Philippines