Safe Water, Sanitation, and Hygiene Practices and Challenges in Selected Durban High Schools, KwaZulu-Natal Province, South Africa

Abstract

Effective water, sanitation and hygiene (WASH) services are vital for public health, education and sustainable development. Despite global commitments like the Sustainable Development Goals (SDGs), significant challenges persist in low- and middle-income countries. This study assessed WASH conditions and Menstrual Hygiene Management (MHM) practices across 40 high schools representing all five socio-economic quintiles (Quintile 1–5) in Durban, South Africa, with a focus on evaluating services; identifying microbial risks; and developing a risk reduction framework. A mixed-methods approach was employed, incorporating quantitative surveys to assess student knowledge and infrastructure quality, alongside microbiological analyses of drinking water for diarrhoeagenic E. coli. Qualitative insights were gathered through focus groups with school administrators and educators. Findings revealed substantial inequities across school quintiles: lower-quintile schools (1–3) experienced inadequate sanitation, intermittent water supply and poor maintenance, while higher-quintile schools (4–5) demonstrated better facility functionality and hygiene resources. The absence of gender-sensitive sanitation facilities adversely affected female students' dignity during menstruation. Water quality analyses indicated 99.98% compliance with SANS 241:2015 guidelines, although one isolated non-hazardous E. coli instance was detected. Qualitative analyses highlighted systemic issues, including maintenance gaps and insufficient policy support for MHM. The study developed a novel WASH Risk Reduction Framework to guide policymakers and administrators in identifying risks and implementing targeted interventions. By emphasising stakeholder engagement and sustainability, this framework aims to enhance WASH environments in schools. This research supports SDG 6 (Clean Water and Sanitation) and contributes to SDGs 3 (Good Health), 4 (Quality Education) and 5 (Gender Equality).