WASH IN DAYCARE CENTERS OF SAIDA: DEVELOPMENT OF APPROPRIATE ASSSESSMENT AND MANAGEMENT TOOLS

Abstract

WASH facilities and services were documented in 17 out of 23 licensed child daycare centers (DCCs) in Saida Caza. A survey assessment tool was developed to evaluate WASH profiles through field visits that were administered without prior appointment or notification.

Collected data on WASH facilities and services were compared with the (a) 2012 UNICEF School’s WASH Guidelines, (b) 2017 National Physical School Environmental Guidelines and (c) 2019 Guidelines for Early Care and Education Programs of the American Academy of Pediatrics, American Public Health Association, and National Resource Center for Health and Safety in Child Care and Early Education, to determine compliance. Moreover, water samples from all DCCs were collected and analyzed, early December 2020, to determine the physical (electrical conductivity, color, total dissolved solids and turbidity), chemical (PH, alkalinity, total hardness, phosphates, sulfates, nitrates, ammonia, chlorides, sodium and free residual chlorine) and microbiological (total and fecal coliforms) quality. The overall quality profile characteristics were compared to the LIBNOR National Drinking Water Standards to determine compliance and safety. Additionally, swabs were collected from hands of two caregivers and different surfaces (toy, diapering area and food serving table) of each surveyed DCCs to reflect on the overall hygienic conditions.

Water quality analysis showed that 29% and 6% of the samples collected from piped water supplies used by DCCs, for removal of waste and hygienic purposes, were microbiologically contaminated with total and fecal coliforms, respectively. Additionally, the physiochemical properties of the piped water supplies showed inconsistent free residual chlorine levels, high total hardness levels, and color exceeding LIBNOR Standards in 17.64% of the samples. Noncarbonate hardness was also detected at minimal levels (31 -155 mg/L) reflecting on the possible exposure to sources of pollution such as sewage and sea water infiltration. As for samples collected from complementary water dispensers, results showed microbiological contaminants in 24% of samples with total coliforms and 6% with fecal coliforms. Still, all the surveyed DCCs showed ungrounded trust in this source that is considered a “safe and healthy” option for dinking and food preparation. Additionally, results of the microbiological swabs showed that 16.5% (14/85) of samples were fecally contaminated. Surveyed DCCs with fecally contaminated surfaces reflect on relatively poor performance of hygienic and sanitation practices. Overall, the average compliance rates did not exceed 70% for the total of five WASH clusters (diaper changing practices- water basins requirements- toilet facilities- onsite food preparation requirements- water storage, disinfection and monitoring) that were evaluated based on the Early Care and Education Programs Recommendations and UNICEF Guidelines. This is serious at a time where maximal precautions must be taken in response to COVID-19 pandemic. However, no significant association was found between scoring of compliant common WASH practices and the microbiological outputs documented by the study due to various limiting factors. In conclusion, and based on the findings, deficient WASH facilities and services prevail in the surveyed DCCs. As such, we recommend the development of National WASH Guidelines based on the identified indicators for proper monitoring and evaluation. This is critical to plan and implement sustainable evidence-based interventions to promote children health and safety.