Assessment of Caregivers Hygiene Practices and Preschoolers Health in Public ECCE/Creche Centers in Calabar Educational Zone, Cross Rivers State

Abstract

Hygiene practices in Early Childhood Care and Education (ECCE)/crèche centres are essential for supporting healthy child development and preventing hygiene-related illnesses; however, inadequate infrastructure and suboptimal practices remain significant public health concerns in Nigeria. This study assessed caregivers’ hygiene knowledge and practices, determined the prevalence of hygiene-related health outcomes among preschoolers, identified barriers to effective hygiene practices, and examined improvement strategies in public ECCE/crèche centres in the Calabar Education Zone of Cross River State, Nigeria. A descriptive cross-sectional survey was conducted among a population comprising 1,756 caregivers and 16,038 preschoolers across 439 public ECCE/crèche centres. Using multistage sampling, 391 participants—111 caregivers and 280 preschoolers—from 49 centres were selected. Data were collected using three researcher-developed instruments: the Caregivers’ Hygiene Knowledge and Practices Questionnaire, Preschoolers’ Health Assessment Checklist, and Environmental Hygiene Observation Checklist. Responses from 105 caregivers and health assessments of 268 preschoolers were analysed using frequencies, percentages, and chi-square tests at a significance level of .05. The findings showed that caregivers had an average level of hygiene knowledge and generally demonstrated satisfactory hygiene practices. Nevertheless, hygiene-related illnesses were fairly prevalent among preschoolers, with respiratory tract infections and diarrhoeal diseases occurring more frequently than other conditions. Environmental assessments revealed inadequate sanitation facilities, handwashing infrastructure, potable water supplies, and waste-management systems across several centres. Significant associations were found between caregivers’ hygiene knowledge and practices (χ² = 27.52, p < .05), educational qualifications and hygiene practices (χ² = 16.55, p < .05), and environmental hygiene conditions and hygiene-related illnesses among preschoolers (χ² = 15.73, p < .05). These findings demonstrate that caregivers’ knowledge alone is insufficient without supportive environmental conditions and adequate hygiene infrastructure. Strengthening caregiver training, improving sanitation and hygiene facilities, reinforcing monitoring systems, and increasing government investment in school health programmes are therefore essential for reducing hygiene-related illnesses and improving preschoolers’ health and well-being in public ECCE/crèche centres.