Water, Sanitation and Hygiene (WASH) in Japanese elementary schools: Current conditions and practices

BACKGROUND: Water, sanitation, and hygiene (WASH) is the foundation for preventing infectious diseases, as the current COVID‐19 pandemic has shown. WASH is essential for school health, yet there have been very few papers published on WASH in Japanese schools. The objective of this review is to describe the current conditions and practices in Japanese elementary schools using an international framework for WASH in schools and identify implications for handwashing promotion in other areas. METHODS: This research was based primarily on a literature review. Information on common WASH practices was also collected through an international workshop attended by school health experts. RESULTS: There is a rigorous legal foundation for ensuring the physical infrastructure and quality control of a safe water supply in Japanese schools. Water quality is monitored regularly by Yogo teachers and school pharmacists. Strategic locations and an abundance of water supply infrastructure facilitate handwashing behavior. Hygiene promotion activities by Yogo teachers and student's health committees play a major role in increasing awareness, while health education classes provide minimal but necessary knowledge on handwashing with soap. Flush toilets are the standard, but there is still a demand for improvement of toilet facilities. Children’s participation in daily cleaning of school toilets contributes to students understanding the importance of cleanliness. CONCLUSIONS: Drawing from the Japanese example, WASH in schools' interventions are suggested to include laws and policies, a designated teacher, and children’s participation to sustain both infrastructure and hygiene promotion.