Handwashing Practice among Elementary Schoolchildren in Urban Setting, Mongolia: A School-Based Cross-Sectional Survey

OBJECTIVES: Handwashing with soap is the simplest, most affordable, and cost-effective preventative intervention for reducing the burden of communicable diseases, including the COVID-19. This study was aimed at investigating elementary schoolchildren's handwashing practice at two critical moments, namely, before eating and after using the toilet and its associated factors. METHODS: The cross-sectional study was conducted at ten public secondary schools in Ulaanbaatar, Mongolia, between February and March 2019. Data were collected from all fifth-grade children's parents at the selected schools by using a self-reported questionnaire. Descriptive and multiple regression analyses were conducted using STATA/MP version 13.0. RESULTS: A total of 1507 parents/guardians of 5(th)-grade school children participated. Reported schoolchildren's handwashing practice for both critical moments was 50.1%. It was significantly associated with female gender (adjusted odds ratio [AOR] = 0.56 (95%CI = 0.45, 0.70)), number of siblings (AOR = 0.72 (95%CI = 0.61, 0.80)), and availability of handwashing amenity at school (AOR = 1.1595%CI = 0.86, 1.42)). Only 34% of children wash their hands with soap at school, and the most common reasons for skipping handwashing were an absence of soap (23.9%), lack of sink (14.5%), and the use of hand sanitizer (19.7%). CONCLUSIONS: The school children's handwashing practice at two critical moments is considerably low. The main disabling factors of regular handwashing at school included insufficient handwashing facility and soap. Therefore, promoting HW facilities and innovative and participatory education for elementary schoolchildren should be prioritized.