Assessment of Dietary Habits, Water, Sanitation, and Hygiene Practices Among School Aged Children and Adolescents in Zanzibar: Implications for Health and Academic Performance

Background: Consumption of healthy foods, intake of safe and clean water, use of improved toilets, and good hand-washing hygiene practices have a huge impact on academic performance, overall health and well-being among young children and adolescents. However, there is limited evidence of these habits and practices among schoolchildren and adolescents in Zanzibar. This study examined the current state of food, water, sanitation, and hygiene practices among school-going children in Zanzibar . Methods: This was a school-based cross-sectional study. Data were gathered from students aged between 5 and 19 years enrolled in primary and secondary schools during the academic year 2022. Data collection involved dietary surveys and food frequency questionnaires (Prime Diet Quality Score, PDQS). Simple descriptive analyses were conducted using Stata Version 17. Results: The consumption of unhealthy food groups was alarming with over 2 in 5 children consuming refined grains and baked goods (40.9%), and desserts and ice cream (26.0%), with a mean PDQS of 16.4±3.7 (Range 7-34). Higher PDQS scores were statistically significantly associated with male gender (uβC 1.5 (95%CI 1.2-1.8), living in Kaskazini A, Magharibi A, Kaskazini Unguja and Mjini Magharibi. Over half (50.4%) did not consume breakfast in the previous seven (7) days before the survey, and 56.6 percent eat snacks almost every day. Furthermore, most (94.2%) of the study respondents reported using improved drinking water sources, however, a third (33%) reported not treating water for drinking purposes with either boiling, clorination or letting it settle. Additionally, only about 20% of participants had unimproved toilet facilities whereas 5.6% did not have latrines at all. About 67% of the participants reported washing their hands with soap and water before eating. However, 29.8% reported using water only, and 0.2% reported not washing their hands at all. Conclusion: Majority of Children and adolescents in Zanzibar have poor dietary habits. Over half consume breakfast the most important meal of the day. A commendable number reported to drink clean water and wash their hands with soap and water. With a global commitment to improve WASH for school children, the findings indicare a need for the government, development partners and implementation researchers to develop and implement effective interventions for improving food habits, and water and hygienic practices as an entry point for improving both academic and health outcomes among school children and adolescents.