Andrew Owusu Ph.D.

Research Workshop in Water Supply, Sanitation and health related to schools and local

communities in West AfricaSeptember 18th – 20th 2007

*A contribution to the WHO STEPwise approach to Surveillance

Global School-Based Student Health Survey: Monitoring Student

Hygiene/Sanitation Behaviors in Ghana

Presentation Overview

Background Introduction to GSHS

GSHS PurposeGSHS Modules (10)

HygieneSampling and Questionnaire

(hygiene questions)Implications for the futureSummary

GSHS Introduction2001: WHO with technical assistance

from CDC, initiates development of the GSHS (CDC, 2006)

GSHS relation to US Youth Risk Behavior Survey (YRBS).

2003: Ghana Nutritional Risk Behavior Survey (School-Based, Youth)

2006: Middle Tennessee State University initiates implementation work on GSHS

2007 GSHS data collectionSeptember 17th – 28th

GSHS Purpose

To provide accurate data on students to:

1. Help countries develop priorities, establish programmes, and advocate for resources

2. Establish trends in the prevalence of health behaviors and protective factors by country

3. Allow countries and international agencies to make comparisons across countries

The GSHS Sample

2-stage probability sample1st stage – selection of schools

selected with probability proportional to size

schools with grades that 13-15 year olds attend

selected at CDC2nd stage – selection of

classroomsselected randomlyselected in country

Ghana Sample75 Schools from all 10 regions in

Ghana3 Super Zones (SR)

North, Central and South25 Schools Per Zone

*Target number is 1500 in each zone. Presented number reflects over sampling due to expect 80% participation rate

Super Region Enrollment

Sample Size*

North 6,084 1,875

Central 4,426 1,875

South 4,638 1,875

Eligible Population

15,148 5,625

Ghana Super Zones for 2007 GSHS Implementation

Southern Zone

Central Zone

Northern Zone

GSHS Questionnaire

GSHS Questionnaire

The GSHS questionnaire consists of:Core questionnaire modules

Core-expanded questionsCountry-specific questions

Core Questionnaire Modules

10 core questionnaire modulesContain 52 questionsMeasure the most important health

behaviors and protective factorsContain from 3 to 7 questionsMust use at least 6 of the 10

modules with no changesCannot have more than 99

questions total – fewer are recommended

Core Questionnaire Modules

Respondent demographics – 3Alcohol and other drug use – 6 Dietary behaviors – 5Hygiene – 4Mental health – 6Physical activity - 5Protective factors – 5Sexual behaviors that contribute to HIV

infection, other STI, and unintended pregnancy – 5

Tobacco use – 6Unintentional injury and violence - 7

Core-expanded questions

To collect more detailed information on selected core questionnaire module topics.

More questionsBehaviorAttitude KnowledgeSources of information

Hygiene (7)

Country Specific Questions

Question on topics of unique interest and importance to a particular country.

GhanaHygieneMalariaWorm infestation

Ghana GSHS Hygiene Module

The 2007 Ghana GSHS looks at hygiene in 2 settingsA. General B. At School

GSHS Hygiene Components

Summary

Youth health risk behavior assessment

Assessment capacity buildingUse of prevalence dataFuture Issues

Future Issues

SustainabilityExpansion to older youth

Senior secondary schoolsInterventions/Programs

Data based, customizedHypothesis generation and testing

Promoting Hygiene/Sanitation through school sports

SO, did I give you……