This paper presents the main results from a knowledge, attitudes, and practices (KAP) survey on water, sanitation, and hygiene (WASH) in government schools in the State of Palestine (SoP). In 2012 a baseline WASH KAP survey was conducted in 411 schools. In 2015–2016 a statistically representative survey was performed; the sample included 381 of the 411 schools originally sampled in 2012. The survey targeted basic and secondary schools in urban and rural areas of all educational directorates in the West Bank and Gaza Strip. The survey was conducted by UNICEF in coordination with the Ministry of Education and Higher Education (MoEHE). The findings of the 2016 survey show positive changes in the availability of potable water in schools, which also enabled hygiene and sanitation activities to improve. For instance, more schools taught hygiene education to students on a daily basis in 2016 than in 2012. However, the survey revealed that ensuring the participation of parents and students in WASH activities and continuity of supply of soap, toilet paper, and sanitary pads remains a challenge. This paper concludes with recommendations to further improve the access to WASH in Palestinian schools.

Alexander, K.T., Mwaki, A., Adhiambo, D., Cheney-Coker, M., Muga, R. and Freeman, M.C. (2016) ‘The life-cycle costs of school water, sanitation and hygiene access in Kenyan primary schools’, International Journal of Environmental Research and Public Health 13(7): 637 <http://dx.doi.org/10.3390/ijerph13070637>.

Al-Khatib, Issam A., Abusara, L.W., Odeh, Y.M., Sbeih, S.A. and Massoud, M.A. (2015) ‘Hand washing among Palestinians in the West Bank and Gaza Strip: attitudes and practices’, Journal of Environmental Health 77(6): 50–7.

Chard, A.N., and Freeman, M.C. (2018) ‘Design, intervention fidelity, and behavioral outcomes of a school-based water, sanitation, and hygiene cluster-randomized trial in Laos’, International Journal of Environmental Research and Public Health 15(4): 570 <http://dx.doi.org/10.3390/ijerph15040570>.

Dreibelbis, R., Freeman, M.C., Greene, L.E., Saboori, S. and Rheingans, R. (2014) ‘The impact of school water, sanitation, and hygiene interventions on the health of younger siblings of pupils: a cluster-randomized trial in Kenya’, American Journal of Public Health 104(1): e91-7 <http://dx.doi.org/10.2105/AJPH.2013.301412>.

Freeman, M.C., Strunz, E., Utzinger, J. and Addiss, D.G. (2016) ‘Interventions to improve water, sanitation, and hygiene for preventing soil−transmitted helminth infection’, Cochrane Database of Systematic Reviews 5: CD012199 <http://dx.doi.org/10.1002/14651858.CD012199>.

Garn, J.V., Greene, L.E., Dreibelbis, R., Saboori, S., Rheingans, R.D. and Freeman, M.C. (2013) ‘A cluster-randomized trial assessing the impact of school water, sanitation, and hygiene improvements on pupil enrollment and gender parity in enrollment’, Journal of Water, Sanitation and Hygiene for Development 3(4): 592–601 <http://dx.doi.org/10.2166/washdev.2013.217>.

Garn, J.V., Brumback, B.A., Drews-Botsch, C.D., Lash, T.L., Kramer, M.R., Freeman, M.C. (2016) ‘Estimating the effect of school water, sanitation, and hygiene improvements on pupil health outcomes’, Epidemiology 27(5): 752–60 <http://dx.doi.org/10.1097/EDE.0000000000000522>.

Ghrayeb Farid, A.W., Rusli, A.M., Al Rifai, A. and Ismail, I.M. (2015) ‘Hand-washing behavior and hygiene-related facilities among school adolescents in Palestine’, Indian Journal of Public Health Research and Development 6(3) <http://dx.doi.org/10.5958/0976-5506.2015.00132.1>.

Grimes, J.E., Tadesse, G., Mekete, K., Wuletaw, Y., Gebretsadik, A., French, M.D., Harrison, W.E., Drake, L.J., Gardiner, I.A., Yard, E. and Templeton, M.R. (2016) ‘School water, sanitation, and hygiene, soil-transmitted helminths, and schistosomes: national mapping in Ethiopia’, PLoS Neglected Tropical Diseases 10(3): e0004515 <http://dx.doi.org/10.1371/journal.pntd.0004515>.

GVC, UN Women, Palestinian Water Authority and AICS – Agenzia Italiana per la Cooperazione allo Sviluppo (2017) Gender Equality and Water, Sanitation and Hygiene in Palestine, Bologna: GVC.

Hunter, P.R., Risebro, H., Yen, M., Lefebvre, H., Lo, C., Hartemann, P., Longuet, C. and Jaquenoud, F. (2015) ‘Impact of the provision of safe drinking water on school absence rates in Cambodia: a quasi-experimental study’, Annals of Nutrition & Metabolism 66(Suppl 3): 31–7 <http://dx.doi.org/10.1159/000381244>.

MoEHE (2003) Guidebook of School Health and Environment Standards, Palestinian National Committee of School Health and Environment Standards, School Health National Committee.

Trinies, V., Garn, J., Chan, H.H. and Freeman, M.C. (2016) ‘The impact of a comprehensive school WASH program on absenteeism, diarrhea, and respiratory infection symptoms: a matched-control trial in Mali’, American Journal of Tropical Medicine and Hygiene 94: 1418–25.

UNICEF and Ministry of Education, State of Palestine (2016) Water, Sanitation and Hygiene in Schools: Knowledge, Attitudes and Practices Survey [pdf], Government of Australia (DFAT), Ministry of Education and Higher Education, the United Nations Children’s Fund (UNICEF) office in the State of Palestine, and Alpha International <https://www.unicef.org/oPt/Water_Sanitation_Survey.pdf> [accessed 13 February 2019].

WASH in Schools (no date) ‘Mapping: Palestine’ [online] <http://washinschoolsmapping.com/projects/Palestine.html> [accessed 12 February 2019].

WHO/UNICEF Joint Monitoring Programme (2018) Drinking Water, Sanitation and Hygiene in Schools: Global Baseline Report 2018 [pdf], WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene <https://washdata.org/sites/default/files/documents/reports/2018-11/JMP%20WASH%20in%20Schools%20WEB%20final.pdf> [accessed 12 February 2019].

Alexander, K.T., Mwaki, A., Adhiambo, D., Cheney-Coker, M., Muga, R. and Freeman, M.C. (2016) ‘The life-cycle costs of school water, sanitation and hygiene access in Kenyan primary schools’, International Journal of Environmental Research and Public Health 13(7): 637 <http://dx.doi.org/10.3390/ijerph13070637>.

Al-Khatib, Issam A., Abusara, L.W., Odeh, Y.M., Sbeih, S.A. and Massoud, M.A. (2015) ‘Hand washing among Palestinians in the West Bank and Gaza Strip: attitudes and practices’, Journal of Environmental Health 77(6): 50–7.

Chard, A.N., and Freeman, M.C. (2018) ‘Design, intervention fidelity, and behavioral outcomes of a school-based water, sanitation, and hygiene cluster-randomized trial in Laos’, International Journal of Environmental Research and Public Health 15(4): 570 <http://dx.doi.org/10.3390/ijerph15040570>.

Dreibelbis, R., Freeman, M.C., Greene, L.E., Saboori, S. and Rheingans, R. (2014) ‘The impact of school water, sanitation, and hygiene interventions on the health of younger siblings of pupils: a cluster-randomized trial in Kenya’, American Journal of Public Health 104(1): e91-7 <http://dx.doi.org/10.2105/AJPH.2013.301412>.

Freeman, M.C., Strunz, E., Utzinger, J. and Addiss, D.G. (2016) ‘Interventions to improve water, sanitation, and hygiene for preventing soil−transmitted helminth infection’, Cochrane Database of Systematic Reviews 5: CD012199 <http://dx.doi.org/10.1002/14651858.CD012199>.

Garn, J.V., Greene, L.E., Dreibelbis, R., Saboori, S., Rheingans, R.D. and Freeman, M.C. (2013) ‘A cluster-randomized trial assessing the impact of school water, sanitation, and hygiene improvements on pupil enrollment and gender parity in enrollment’, Journal of Water, Sanitation and Hygiene for Development 3(4): 592–601 <http://dx.doi.org/10.2166/washdev.2013.217>.

Garn, J.V., Brumback, B.A., Drews-Botsch, C.D., Lash, T.L., Kramer, M.R., Freeman, M.C. (2016) ‘Estimating the effect of school water, sanitation, and hygiene improvements on pupil health outcomes’, Epidemiology 27(5): 752–60 <http://dx.doi.org/10.1097/EDE.0000000000000522>.

Ghrayeb Farid, A.W., Rusli, A.M., Al Rifai, A. and Ismail, I.M. (2015) ‘Hand-washing behavior and hygiene-related facilities among school adolescents in Palestine’, Indian Journal of Public Health Research and Development 6(3) <http://dx.doi.org/10.5958/0976-5506.2015.00132.1>.

Grimes, J.E., Tadesse, G., Mekete, K., Wuletaw, Y., Gebretsadik, A., French, M.D., Harrison, W.E., Drake, L.J., Gardiner, I.A., Yard, E. and Templeton, M.R. (2016) ‘School water, sanitation, and hygiene, soil-transmitted helminths, and schistosomes: national mapping in Ethiopia’, PLoS Neglected Tropical Diseases 10(3): e0004515 <http://dx.doi.org/10.1371/journal.pntd.0004515>.

GVC, UN Women, Palestinian Water Authority and AICS – Agenzia Italiana per la Cooperazione allo Sviluppo (2017) Gender Equality and Water, Sanitation and Hygiene in Palestine, Bologna: GVC.

Hunter, P.R., Risebro, H., Yen, M., Lefebvre, H., Lo, C., Hartemann, P., Longuet, C. and Jaquenoud, F. (2015) ‘Impact of the provision of safe drinking water on school absence rates in Cambodia: a quasi-experimental study’, Annals of Nutrition & Metabolism 66(Suppl 3): 31–7 <http://dx.doi.org/10.1159/000381244>.

MoEHE (2003) Guidebook of School Health and Environment Standards, Palestinian National Committee of School Health and Environment Standards, School Health National Committee.

Trinies, V., Garn, J., Chan, H.H. and Freeman, M.C. (2016) ‘The impact of a comprehensive school WASH program on absenteeism, diarrhea, and respiratory infection symptoms: a matched-control trial in Mali’, American Journal of Tropical Medicine and Hygiene 94: 1418–25.

UNICEF and Ministry of Education, State of Palestine (2016) Water, Sanitation and Hygiene in Schools: Knowledge, Attitudes and Practices Survey [pdf], Government of Australia (DFAT), Ministry of Education and Higher Education, the United Nations Children’s Fund (UNICEF) office in the State of Palestine, and Alpha International <https://www.unicef.org/oPt/Water_Sanitation_Survey.pdf> [accessed 13 February 2019].

WASH in Schools (no date) ‘Mapping: Palestine’ [online] <http://washinschoolsmapping.com/projects/Palestine.html> [accessed 12 February 2019].

WHO/UNICEF Joint Monitoring Programme (2018) Drinking Water, Sanitation and Hygiene in Schools: Global Baseline Report 2018 [pdf], WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene <https://washdata.org/sites/default/files/documents/reports/2018-11/JMP%20WASH%20in%20Schools%20WEB%20final.pdf> [accessed 12 February 2019].

Alexander, K.T., Mwaki, A., Adhiambo, D., Cheney-Coker, M., Muga, R. and Freeman, M.C. (2016) ‘The life-cycle costs of school water, sanitation and hygiene access in Kenyan primary schools’, International Journal of Environmental Research and Public Health 13(7): 637 <http://dx.doi.org/10.3390/ijerph13070637>.

Al-Khatib, Issam A., Abusara, L.W., Odeh, Y.M., Sbeih, S.A. and Massoud, M.A. (2015) ‘Hand washing among Palestinians in the West Bank and Gaza Strip: attitudes and practices’, Journal of Environmental Health 77(6): 50–7.

Chard, A.N., and Freeman, M.C. (2018) ‘Design, intervention fidelity, and behavioral outcomes of a school-based water, sanitation, and hygiene cluster-randomized trial in Laos’, International Journal of Environmental Research and Public Health 15(4): 570 <http://dx.doi.org/10.3390/ijerph15040570>.

Dreibelbis, R., Freeman, M.C., Greene, L.E., Saboori, S. and Rheingans, R. (2014) ‘The impact of school water, sanitation, and hygiene interventions on the health of younger siblings of pupils: a cluster-randomized trial in Kenya’, American Journal of Public Health 104(1): e91-7 <http://dx.doi.org/10.2105/AJPH.2013.301412>.

Freeman, M.C., Strunz, E., Utzinger, J. and Addiss, D.G. (2016) ‘Interventions to improve water, sanitation, and hygiene for preventing soil−transmitted helminth infection’, Cochrane Database of Systematic Reviews 5: CD012199 <http://dx.doi.org/10.1002/14651858.CD012199>.

Garn, J.V., Greene, L.E., Dreibelbis, R., Saboori, S., Rheingans, R.D. and Freeman, M.C. (2013) ‘A cluster-randomized trial assessing the impact of school water, sanitation, and hygiene improvements on pupil enrollment and gender parity in enrollment’, Journal of Water, Sanitation and Hygiene for Development 3(4): 592–601 <http://dx.doi.org/10.2166/washdev.2013.217>.

Garn, J.V., Brumback, B.A., Drews-Botsch, C.D., Lash, T.L., Kramer, M.R., Freeman, M.C. (2016) ‘Estimating the effect of school water, sanitation, and hygiene improvements on pupil health outcomes’, Epidemiology 27(5): 752–60 <http://dx.doi.org/10.1097/EDE.0000000000000522>.

Ghrayeb Farid, A.W., Rusli, A.M., Al Rifai, A. and Ismail, I.M. (2015) ‘Hand-washing behavior and hygiene-related facilities among school adolescents in Palestine’, Indian Journal of Public Health Research and Development 6(3) <http://dx.doi.org/10.5958/0976-5506.2015.00132.1>.

Grimes, J.E., Tadesse, G., Mekete, K., Wuletaw, Y., Gebretsadik, A., French, M.D., Harrison, W.E., Drake, L.J., Gardiner, I.A., Yard, E. and Templeton, M.R. (2016) ‘School water, sanitation, and hygiene, soil-transmitted helminths, and schistosomes: national mapping in Ethiopia’, PLoS Neglected Tropical Diseases 10(3): e0004515 <http://dx.doi.org/10.1371/journal.pntd.0004515>.

GVC, UN Women, Palestinian Water Authority and AICS – Agenzia Italiana per la Cooperazione allo Sviluppo (2017) Gender Equality and Water, Sanitation and Hygiene in Palestine, Bologna: GVC.

Hunter, P.R., Risebro, H., Yen, M., Lefebvre, H., Lo, C., Hartemann, P., Longuet, C. and Jaquenoud, F. (2015) ‘Impact of the provision of safe drinking water on school absence rates in Cambodia: a quasi-experimental study’, Annals of Nutrition & Metabolism 66(Suppl 3): 31–7 <http://dx.doi.org/10.1159/000381244>.

MoEHE (2003) Guidebook of School Health and Environment Standards, Palestinian National Committee of School Health and Environment Standards, School Health National Committee.

Trinies, V., Garn, J., Chan, H.H. and Freeman, M.C. (2016) ‘The impact of a comprehensive school WASH program on absenteeism, diarrhea, and respiratory infection symptoms: a matched-control trial in Mali’, American Journal of Tropical Medicine and Hygiene 94: 1418–25.

UNICEF and Ministry of Education, State of Palestine (2016) Water, Sanitation and Hygiene in Schools: Knowledge, Attitudes and Practices Survey [pdf], Government of Australia (DFAT), Ministry of Education and Higher Education, the United Nations Children’s Fund (UNICEF) office in the State of Palestine, and Alpha International <https://www.unicef.org/oPt/Water_Sanitation_Survey.pdf> [accessed 13 February 2019].

WASH in Schools (no date) ‘Mapping: Palestine’ [online] <http://washinschoolsmapping.com/projects/Palestine.html> [accessed 12 February 2019].

WHO/UNICEF Joint Monitoring Programme (2018) Drinking Water, Sanitation and Hygiene in Schools: Global Baseline Report 2018 [pdf], WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene <https://washdata.org/sites/default/files/documents/reports/2018-11/JMP%20WASH%20in%20Schools%20WEB%20final.pdf> [accessed 12 February 2019].

Alexander, K.T., Mwaki, A., Adhiambo, D., Cheney-Coker, M., Muga, R. and Freeman, M.C. (2016) ‘The life-cycle costs of school water, sanitation and hygiene access in Kenyan primary schools’, International Journal of Environmental Research and Public Health 13(7): 637 <http://dx.doi.org/10.3390/ijerph13070637>.

Al-Khatib, Issam A., Abusara, L.W., Odeh, Y.M., Sbeih, S.A. and Massoud, M.A. (2015) ‘Hand washing among Palestinians in the West Bank and Gaza Strip: attitudes and practices’, Journal of Environmental Health 77(6): 50–7.

Chard, A.N., and Freeman, M.C. (2018) ‘Design, intervention fidelity, and behavioral outcomes of a school-based water, sanitation, and hygiene cluster-randomized trial in Laos’, International Journal of Environmental Research and Public Health 15(4): 570 <http://dx.doi.org/10.3390/ijerph15040570>.

Dreibelbis, R., Freeman, M.C., Greene, L.E., Saboori, S. and Rheingans, R. (2014) ‘The impact of school water, sanitation, and hygiene interventions on the health of younger siblings of pupils: a cluster-randomized trial in Kenya’, American Journal of Public Health 104(1): e91-7 <http://dx.doi.org/10.2105/AJPH.2013.301412>.

Freeman, M.C., Strunz, E., Utzinger, J. and Addiss, D.G. (2016) ‘Interventions to improve water, sanitation, and hygiene for preventing soil−transmitted helminth infection’, Cochrane Database of Systematic Reviews 5: CD012199 <http://dx.doi.org/10.1002/14651858.CD012199>.

Garn, J.V., Greene, L.E., Dreibelbis, R., Saboori, S., Rheingans, R.D. and Freeman, M.C. (2013) ‘A cluster-randomized trial assessing the impact of school water, sanitation, and hygiene improvements on pupil enrollment and gender parity in enrollment’, Journal of Water, Sanitation and Hygiene for Development 3(4): 592–601 <http://dx.doi.org/10.2166/washdev.2013.217>.

Garn, J.V., Brumback, B.A., Drews-Botsch, C.D., Lash, T.L., Kramer, M.R., Freeman, M.C. (2016) ‘Estimating the effect of school water, sanitation, and hygiene improvements on pupil health outcomes’, Epidemiology 27(5): 752–60 <http://dx.doi.org/10.1097/EDE.0000000000000522>.

Ghrayeb Farid, A.W., Rusli, A.M., Al Rifai, A. and Ismail, I.M. (2015) ‘Hand-washing behavior and hygiene-related facilities among school adolescents in Palestine’, Indian Journal of Public Health Research and Development 6(3) <http://dx.doi.org/10.5958/0976-5506.2015.00132.1>.

Grimes, J.E., Tadesse, G., Mekete, K., Wuletaw, Y., Gebretsadik, A., French, M.D., Harrison, W.E., Drake, L.J., Gardiner, I.A., Yard, E. and Templeton, M.R. (2016) ‘School water, sanitation, and hygiene, soil-transmitted helminths, and schistosomes: national mapping in Ethiopia’, PLoS Neglected Tropical Diseases 10(3): e0004515 <http://dx.doi.org/10.1371/journal.pntd.0004515>.

GVC, UN Women, Palestinian Water Authority and AICS – Agenzia Italiana per la Cooperazione allo Sviluppo (2017) Gender Equality and Water, Sanitation and Hygiene in Palestine, Bologna: GVC.

Hunter, P.R., Risebro, H., Yen, M., Lefebvre, H., Lo, C., Hartemann, P., Longuet, C. and Jaquenoud, F. (2015) ‘Impact of the provision of safe drinking water on school absence rates in Cambodia: a quasi-experimental study’, Annals of Nutrition & Metabolism 66(Suppl 3): 31–7 <http://dx.doi.org/10.1159/000381244>.

MoEHE (2003) Guidebook of School Health and Environment Standards, Palestinian National Committee of School Health and Environment Standards, School Health National Committee.

Trinies, V., Garn, J., Chan, H.H. and Freeman, M.C. (2016) ‘The impact of a comprehensive school WASH program on absenteeism, diarrhea, and respiratory infection symptoms: a matched-control trial in Mali’, American Journal of Tropical Medicine and Hygiene 94: 1418–25.

UNICEF and Ministry of Education, State of Palestine (2016) Water, Sanitation and Hygiene in Schools: Knowledge, Attitudes and Practices Survey [pdf], Government of Australia (DFAT), Ministry of Education and Higher Education, the United Nations Children’s Fund (UNICEF) office in the State of Palestine, and Alpha International <https://www.unicef.org/oPt/Water_Sanitation_Survey.pdf> [accessed 13 February 2019].

WASH in Schools (no date) ‘Mapping: Palestine’ [online] <http://washinschoolsmapping.com/projects/Palestine.html> [accessed 12 February 2019].

WHO/UNICEF Joint Monitoring Programme (2018) Drinking Water, Sanitation and Hygiene in Schools: Global Baseline Report 2018 [pdf], WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene <https://washdata.org/sites/default/files/documents/reports/2018-11/JMP%20WASH%20in%20Schools%20WEB%20final.pdf> [accessed 12 February 2019].