WASH in rural Cambodian primary schools: roles, responsibilities, attitudes and priorities of key stakeholders

A sustained and sufficient school water, sanitation, and hygiene (sWASH) environment consisting of strong WASH facilities, services, and practice is very important for student health and to reduce absenteeism. A strong sWASH environment may be associated with various contextual, institutional, and psychosocial factors internal to school governance, management, and decision-making. To address a knowledge gap and to inform future design and implementation of sWASH programs in Cambodia, an innovative and comprehensive cross-sectional study of 24 rural primary schools was completed to understand the roles of key players in sWASH in Cambodia, while also examining the decision-making processes and priorities at leadership levels. Our findings suggest the sWASH context in Cambodia is diverse and complex. Satisfaction with current sWASH services is low, even in cases of recent government or non-government organization intervention. School directors have ideas to improve WASH facilities and services and have identified these as priorities. Funding is scarce, and roles and responsibilities are shared among key stakeholders.