Hygiene module Grades 6-9

Overview of session plan

Hygiene behaviour Hand hygiene Safe storage and Latrine use MHM
Personal hygiene handling of and clean
drinking water, toilet
safe water
Session duration Two session of 45 Two sessions of Two sessions 45 minutes
minutes each 45 minutes each of 45 minutes
45 minutes each
Introductory session
(activity, theory)
Recap and
reinforcement session
Quiz
Based on results,
recap and
reinforcement of key
messages
Regular peer
education (e.g., hand
washing messages
before MDM)
Campaigns around
key global days
Hygiene behaviour 1: Hand hygiene
GRADES 6-9

Aim Students will be able to state how germs spread and cause diseases
Resources required soap, water in a bucket, mug, towel , Glitter

Session plan

1 How do germs spread and make you  Divide the class into 2 groups: group A Annex 3
sick? and group B. ask a few students from Annex 4
Group A to apply glitter all over their
hands and touch various objects in the
room- black board, desk, chair, door,
duster, cupboard etc. ask students in
Group B to observe what is going on.
Then ask Group A to sit and ask some
students from Group B to touch those
objects with glitter on them. Ask Group
A to observe.
 Ask the volunteer students from the
two groups to show their hands –
students from Group A who touched
objects with glitter will continue to have
glitter on their hands, and students
from group B will also have glitter on
their hands from touching those items.
 Ask students what this activity means
and what the glitter stands for. Explain
to students that this is how germs
spread.
 Show the picture (Annex 3) about how
germs spread through water, food,
physical contact.
 When germs enter our bodies
through contaminated water, food,
and dirty hands, we fall sick.
 We can also pass these germs to
others and make our family
members and friends sick as well
 Ask children what symptoms they
experience when sick (vomiting,
loose motions, fever, stomach ache,
cold/cough)
 Then show a picture of the sick child
– with fever, and a bad stomach
ache (Annex 4).
  Highlight some of the key diseases
that spread through contaminated
food, water and dirty hands
o Diarrhoea
o Worm infections
o (viral) Cold and coughs
o Typhoid
o Cholera
Summarise : The session learning by asking
both the groups to take turns and share the
Dos and DONTs to avoid getting or giving
germs

 Quiz (true or false):

o There are many types of germs that can make us sick
o It is very hard for germs to spread through water, food and physical contact
o We can always see germs on our bodies and hands
o We can stop germs from spreading
 Key messages:
o Germs are all around us and can enter our bodies through contaminated food,
water, and dirty hands
o We can see, smell and even taste things that are dirty, unclean or spoilt, but Germs
are invisible
o Germs thrive in dirty places
o When germs enter our body, they can make us sick

Session -2

Aim Understanding the faecal-oral routes of disease transmission and how to protect
oneself
Resources required F-chart and picture cards, chart papers , sketch pens

1 Recap of key  Germs are all around us and can enter our Show annex 3: how germs
messages from bodies through contaminated food, water, and spread
session 1 dirty hands
 We can see, smell and even taste things that
are dirty, unclean or spoilt, but germs are
invisible
 Germs thrive in dirty places When germs enter
our body, they can make us sick
2 How germs Divide the children into groups of equal numbers Annex-4 ( F-Chart )
spread through (10-12 per group)
water, food,  Ask the participants to form teams
physical contact  Explain them that they will be playing the
game to understand the transmission of
disease from faecal matters and
 identification of various protective
measures for preventing faecal-oral
transmission.
 Demonstrate the F-chart and explain the
process of transmission.
 After the children have understood the
faecal-oral routes of disease transmission
ask them to draw the same picture on
chart papers and explain the process.
 The groups are given 20 min and once
completed they present in large groups
explaining the transmission process
 Verify the output of every team and
explain the correct method.

Facilitator’s Questions for larger group:

1. What happens when someone defecates in the

open?
2. Where do the faeces go?
3. What happens when it rains?
4. How do the faeces get from this person/that
spot into our mouths?

(Possible answers:-The rain carries faeces into

fields and streams and ponds; People drink
contaminated water; People can walk through
fields and track the faeces into homes; Flies
can land on the faeces and then land on food;
Hands can touch the faeces and then touch
others, or touch food)
o Activity: Stop the transmission
Take a flip chart and write the 6 words: feet, flies,
fingers, fluids, food and fields. Ask
participants to give an example of faeces
transmission from one person to another for each
“F”. For example:
 FEET: someone walking in a pile of faeces
will carry it into a house
 FLIES: land on faeces, then land on
uncovered food
 FINGERS: touch faeces when cleaning
after defecation, then touch food or other
people
 FIELDS: can be places where people
defecate and then walk in the shit
 FLUIDS: runoff from fields and open
defecation spots can go into streams
where people get water; drinking water is
stored unsafely and gets contaminated
  FOOD: can be contaminated by unwashed
hands or by flies landing on it

Tell each group to think of and discuss different

ideas for blocking each “F” pathway and write
down one key blocking or prevention behaviour
idea for each pathway on the flipchart. When
groups have finished, ask them to present one
example of blocking transmission. Complete the
prevention activity by taking examples from all the
groups.

Habits to be developed to prevent

transmission/contamination:
o Proper construction and use of
toilet
o Proper hand washing with soap
after defecation
o Proper hand washing with soap
before eating
o Drinking safe water
o Handling drinking water properly
o Covering food properly
o Hand washing before handling/
cooking food
o Proper washing of raw fruits and
vegetables
o Cooking food properly
o Wearing slippers/shoes

Other preventive measures to be taken:

o Proper drinking water treatment
and storage
o School compound sanitation,
drainage, and proper waste
management
o Proper washing and storage of
cooking utensils
Conclude:
Ask students to stand in a circle and each student
shares one preventive measure to stop
transmission of germs

 Quiz (True or False):

o Open defecation does not contaminate food/ water
o There are three F’s through which food gets contaminated
o Washing hand with soap and water before eating and handling water avoids
transmission of germs
 o Runoff water from the field will not contaminate drinking water
 Key messages:
o Transmission of faeces from one person to other though five ‘’F”s
o How different habits like proper hand washing with soap and water before eating/
handling water or food prevents contamination
o Proper storage and handling of water, waste management system and proper
cleaning of cooking utensils can prevent contamination/ transmission of germs

Session-3, Hand Hygiene and personal hygiene

Aim Students will be able to understand the criticality of hand washing , its advantages ,list
critical times of hand washing , demonstrate correct handwashing steps, and list the
key personal hygiene behaviours they can engage in to avoid getting sick
Resources required  Two handwashing kit sets (for a class of 50 students): soap, water in a bucket,
mug, towel, Two transparent glasses/transparent containers, picture cards
with body part (e.g., nails) and hygiene behaviour (nail cutter)
 WaterAid song on hand hygiene (in different languages) played during hand
washing demonstration

Session plan

1 Recap of key o Transmission of faeces from one person to other though five Show Annex-4
messages from ‘’F”s (F chart)
session 2 o How different habits like proper hand washing with soap
and water before eating/ handling water or food prevents
contamination
o Proper storage and handling of water, waste management
system and proper cleaning of cooking utensils can prevent
contamination/ transmission of germs

2 How can we Ask students for actions they can do to prevent germs from Daily hygiene
prevent the spreading. activity sheet
spread of  Hand washing
diseases  Cut nails/keep nails short
 Bathe daily
 Wear clean clothes
 Brush your teeth daily
 Combing hair neatly
 Wearing slippers/shoes
 Use toilet
Tell students: Personal hygiene means keeping yourself clean, by
which you can prevent disease and be healthy. Besides, our social
status before others and our self-confidence increases by
maintaining personal hygiene.Facilitator to tell students that these
behaviours should be practiced daily (or in the case of nail cutting,
weekly)

Tell the students that if the hands look clean, it is not necessary that
hands are clean. There are many disease-spreading elements in the
 hand, which cannot be seen in the normal eyes. Hence, it is essential
to give proper importance to hand washing. Also, tell them that
washing hand in normal water is not enough, they should wash
hands using soaps.

 Diseases that can be avoided by washing hands with soap

 Diarrhoea
 Stomach pain
 Hepatitis
 Cold, cough and fever
 Worms in the stomach
 Other water related diseases

Above diseases can be shown in a poster and discussed. Annex- 5 ( a

poster on
water borne
diseases )

2 Demonstration o Arrange a space where students can practice Annex- 6 (

session on hand handwashing hand washing
washing steps o Ensure water and soap are available for students to steps poster )
practice hand washing steps
o Divide class into two groups and provide each group
with the hand washing kit.
o Teacher to ask for two students volunteers to show
why handwashing with soap and water is required:
 Both students are asked to wash their
hands. One student asked to wash hand
only with water, other student asked to
wash with soap and water. Waste water
from both students to be collected
separately in glass container and shown to
students. The two volunteers to show their
hands as well to other students.
 Students are then asked which student’s
hands are clean – the one who washed only
with water or the one who washed with
soap and water?
 Explain that it is important to wash hands
with soap and water every time:

 Then ask students to practice hand washing one after

another. Encourage elder students to monitor the hand
washing by younger students.

 Ask the students – which are the critical times for hand
washing and list them on the board
  Then show them a poster with following critical times of
hand washing:
 Before eating food
 After using toilet
 Before handling water
 After cleaning or touching any
garbage/ waste
 After playing
 After disposal of child faeces
 After cough and touching any
wound, cut or scratch in the body
 Before cooking
 Ask the elder students to monitor the hand washing by
younger students during the mid-day meal (MDM). Ensure
that handwashing has been done by each and every
students using soap during MDM.
 Summing-up the session: Ask the students to brief what
they have learnt from the session to their family members
and also practice at the home

 Teacher now informs students of other hygiene behaviours

to be practiced daily using a daily schedule or calendar
o Daily: brush teeth, bathe, wear clean clothes, wash
hands after using toilet, before eating
o Once a week: cut nails
Things you need to keep yourself clean: bathing soap, comb, tooth
brush and tooth paste, nail cutter, mirror

 End with WaterAid video and song on hand washing

 Quiz:
o Washing hands with water only removes germs from hands
o It is important to wash hand after using the toilet, before eating and before handling
drinking water
o Name three more personal hygiene behaviours
o Name two diseases to be avoided by washing hands with soap daily

 Key messages:
o Hand washing with soap and water removed germs from our hands – and keeps us
healthy
o It is important that we wash our hands with soap and water every time before
eating, before handling drinking water, and after using the toilet for urination or
defecation, after disposal of child faeces, after touching garbage helps prevent
diseases and keeps us healthy
o Personal hygiene, including cutting nails, bathing daily, wearing clean clothes,
brushing teeth, combing hair, and wearing slippers/shoes also helps to keep us
healthy
Session-4 Safe handling of drinking water

Aim Students will be able to state how to handle drinking water safely.

Resources required Posters on safe storage and handling of water

Session plan
1 Recap of key messages from session 3
2 How to store and handle drinking
water
 Hand washing with soap and water Play WAI video on
before eating, before handling hand washing
drinking water, and after using the
toilet for urination or defecation
helps prevent diseases and keeps us
healthy
 Personal hygiene, including cutting
nails, bathing daily, wearing clean
clothes, brushing teeth, combing
hair, and wearing slippers/shoes
also helps to keep us healthy
 Divide class into 2 groups. Annex-7 ( poster
 Ask for 1 volunteer per group (one on safe storage
male and one female). of drinking water
 Give small container (pot) to the )
volunteers and ask them to collect
water from source, bring to the
class, and serve other students.
 Ask rest of the students to observe
the entire process.
 · Ask the students (all): The way
water has been collected and served
by selected students was right?
What were the flaws? Where the
water got contaminated –
collection, transportation, storage
and handling of drinking water?
Then tell the right way of collection,
transportation, storage, handling and
serving drinking water – ask everyone to
practice in smaller groups – one by one.
 Show poster with positive and poor
practices in terms of water
collection, transportation, storage,
handling and serving.
 Ask the students, which are positive
practices and which are poor
practices. Discuss on each picture in
the poster
  Ask the students to observe steps of
water collection, storage and
serving in their own house along
with three more nearby houses and
share the details in a written
format: They can consider the
following pointers:
o Whether the pots are properly
cleaned or not before collecting
water?
o Whether the pots are properly
covered or not while transporting
water from source to home?
o At home, the drinking water pot is
kept covered and placed at an
elevated place/platform or not?
o Whether finger gets in touch with
water, while fetching water from
the pot for drinking or not?
o Glass is properly handled or not,
while serving water to others for
drinking?
 Next day discuss on the answers
collected by students. Ask the
students that the houses, those are
into poor practices, it is our duty to
make them understand the proper
storage and water handling practice.

 Quiz: ( True/False )
o Drinking water containers do not need to be covered
o Dipping fingers/hands in drinking water container is okay – it will not contaminate the
water
o Always keep drinking water container on an elevated platform
o To take water from container, use a ladle or fix a tap
 Key messages:
o Drinking water container should be kept covered at all times; container should be kept
on an elevated platform. If there is no tap, a clean ladle should be made available.
o The drinking water container, ladle and drinking glasses should be washed regularly and
kept clean
o Not covering the container may lead to contamination
o Don’t put fingers/hands into drinking water container while taking water out. Germs
may be living in your nails and hands and can then enter the water and by drinking
contaminated water, you can fall sick
Session-5 Safe water

Aim Students will be able to explain ways to keep water safe and clean for use.

Resources required One bottle of clean drinking water, four samples of water in transparent bottles ( One
muddy, One with dust and other particles, One clear and One coloured )

Session plan

1 Recap of messages
from Session 4
 Drinking water container Show the poster on safe storage of
should be kept covered at all drinking water
times; container should be kept
on an elevated platform. If
there is no tap, a clean ladle
should be made available.
 The drinking water container,
ladle and drinking glasses
should be washed regularly and
kept clean
 Not covering the container may
lead to contamination
 Don’t put fingers/hands into
drinking water container while
taking water out. Germs may
be living in your nails and hands
and can then enter the water
and by drinking contaminated
water, you can fall sick

2 How to assess water  Show a bottle of water

we drink is safe  Ask why do we need water?
From where we get water?
 Summarise the responses on
the board
 Brief the students that they
are going to learn how to keep
water clean and safe for use
 Show the four samples of
water, marked as A, B, C & D
one by one.
 Ask students to come and
observe bottles one by one
and note which bottle has
clean water that is good for
drinking
 Ask which bottle has clean
water? How did you recognise
 it? Where can you find water
that is safe for drinking? Why it
is important to drink clean
water
 Summarise students responses
Explain that clean water does not have
any colour, odour and dust particles
(physical parameters). However, even Annex- 8 (different water
clear water can have germs / treatment methods and water
minerals/chemicals and make us sick. quality testing at lab )
Water consumed directly from lakes,
ponds, open wells, streams, etc. is Annex-9 ( poster on different
generally unsafe and not good for sources of drinking water )
drinking . Underground water from
hand pumps, covered wells and stand
posts are better to drink, however it is
advised to test the drinking water for
both bacteriological (to know the
presence or absence of bacteria’s )
through H2S vials and chemical ( to
know the level of chemicals present is
drinking water which are harmful to
health for example fluoride, arsenic,
nitrate, iron ) through field testing kits
/ water quality testing labs
 Show the students a poster
showing all the water related
diseases along with brief about
those diseases. Discuss and
make them understand the link
between microbes in water and
diseases
 Ask how can you make sure
that the water you drink or use
is clean?
Summarise responses on the board, we
can clean the water by boiling and
filtering at household level. We can use
chlorine tablets to kill the bacteria or
germs in water and in case of chemical
contamination different treatment
methods need to be adopted like RO
plant, iron, fluoride and arsenic
removal plant , etc.

Quiz :

o Pond, well and river water is safe to drink (True/False)

o What are the physical parameters of drinking water?
o Hand pump water is not safe to drink (True/False)
o How to treat bacteriological contamination at household level.
Key messages:

o Drinking water free from colour, odour and smell is not safe, it will have germs/
bacteria and chemicals like fluoride, iron, nitrate, arsenic, which are not visible to
naked eyes
o Surface water sources are not safe for drinking and deep ground water sources are
considered as they are protected from faecal contamination.
o Testing of water quality is very critical to know the type of contamination.
o Water can be treated at household level for bacteriological contamination by
boiling or use of chlorine tablets and household filters

Session-6 Use of toilet

Aim Students will be able to understand why and how to use the toilet
Resources required Posters on correct use of toilet

Session plan

1 Recap of session
5 smell is not safe, it can have germs/ bacteria
 Drinking water free from colour, odour and Show poster on sources
and water treatment
and chemicals like fluoride, iron, nitrate, methods –Annex-8&9
arsenic, which are not visible with naked eyes
 Surface water sources are not safe for drinking
and deep ground water sources are safe
 Testing of water quality is very critical to know
the type of contamination
 Water can be treated at household level for
bacteriological contamination by boiling or use
of chlorine tablets and household filters

2 How to use toilet
 Show a poster with the following pictures: Annex-10 ( poster on
o Faeces to food and water through flies how to use toilet )
o Faeces to food and water through our
hand
o By showing these two picture, make
the students understand that by faeces
getting into our body, we may fall
severely sick. Hence, we should not
defecate in open

 Show a poster showing various steps of using

toilet in the following order:
o Pouring some water before use
o Seating (use) Squat and defecate
o Anal cleansing
o Pouring water in the pan (after use)
 o Hand washing with soap
 Show the picture, describe each step of use of
toilet

Advantages of  By open defecation – faeces goes into our body

toilet use through food, water and our hand.
 By using toilet properly, we can restrict faeces from
entering into our mouth
 Using toilet has other benefits like – comfort during
rain, safety from snakes and other wild animals and
convenience of not going in dark
 Helps to keep our surrounding clean and spread of
diseases
 Helps adolescent girls manage their menstruation
hygienically

 Quiz:
o Name two advantages/ benefits of having toilet?
o How to use toilet?
o What are the three critical times to wash hands?
o What happens if we defecate in the open?
 Key messages :
o By open defecation – faeces goes into our body through food, water and our hand.
o By using toilet properly, we can restrict faeces from entering into our mouth
and also keep our surroundings clean.

Session- 7 How to keep toilet clean

Aim Students will be able to know how to keep the toilet clean and the role of child cabinet
in ensuring cleanliness
Resources required Posters of well-maintained school toilet

Session plan

1 Recap of session 6  By open defecation – faeces enter into

our body through food, water and hand
 By using toilet properly, we can
restrict faeces from entering our
mouth and we can keep our
surrounding clean
 Advantages of having toilet

2 How to maintain toilet  Tell students – to ensure regular use of

toilet, they have to ensure proper
operation and maintenance of the toilet
 Show another poster to students in
which has: n:
 o What should go inside the pit
of toilet? (a) Faeces of child
and adult, (b)
Water after using the toilet
o What should not go inside the
pit of toilet? (a) Dirty water, (b)
Garbage, bottle, paper, cloth,
brick, stone, medicines and
chemicals.
o Show another poster to
students with pictures of
items, which are essential to
keep the toilet clean: Brush,
broom, bucket, mug, water tap
inside toilet and other cleaning
materials
o Process of cleaning the toilet
by using appropriate materials

 Discuss with students – ‘Child Cabinet’

has the prime role in ensuring usage of
toilet properly by all the students and
maintenance of toilet (always clean).
 Child Cabinet’ should perform the
following duties:
o The cleanliness of toilet should
be monitored daily.
o Ensure availability of water in
the toilet on regular basis
o Ensure sufficient cleaning
materials are stocked in the
school
o Ensure all the children have
been sensitised on how to use
toilet
o Make provision for soap and
water for hand washing
o Ensure children wash their
hands after using the toilet
with soap and before having
food

Summing-up the session, ask the students to

brief what they have learnt from the session to
their family members.
  Quiz:
o Children cannot throw bottles, cloth, etc. in the toilet pan (True/False)
o It is ok to clean the toilet once in fifteen days (True/False)
o List three key items/ materials required to clean the toilet
o With or without water toilets can be maintained clean (True/False)
o

 Key messages :
o What should go inside the toilet pit and what should not
o Key items to be used in cleaning the toilets.
o Role of school cabinet in ensuring cleanliness and proper usage of toilet

Session- 8 Menstrual Hygiene

Aim Students will understand the menstruation process and how to manage menstruation
Resources required WSSC material – menstrual wheel

Session plan

1 What is  During adolescence an important change that occurs in a girls’ Annex-11 (

menstruation body is menstruation menstrual
 Showing the female reproductive system explain that all girls wheel )
and women have a uterus. In the uterus, two ovaries are
attached by two tubes. Between the ages of 9-16, the eggs in the
ovaries start to mature
 Every month, one mature egg leaves the ovary and reaches the
uterus through the tubes. As the egg moves along the tube, a
blood lining starts to form in the uterus and thickens. If the egg
is fertilized, then the lining provides nutrition to the growing
baby. If the egg is unfertilized, the lining formed is of no use to
the body. Therefore the blood lining breaks down and is
released from the body along with the egg
 This is called menstruation and usually lasts for 4-6 days
 Menstruation is a normal, healthy process, that happens to all
girls and women
2 Menstrual cycle  Starts when girls are about 12 years old, but can be anytime
between the age of 8 and 16 years.
 Cycle lasts about 28 days
 In young girls just reaching puberty, it may be irregular but
as they grow older it usually settles down
Day: 1-5
• The uterus wall breaks down and comes out of the vagina.
• It contains lots of blood.
• It can be accompanied by pain in the abdominal.
• This is called period or menstruation
Day: 5-14
• The blood loss from the vagina stops
 • The uterus wall builds up again
• The ovary gets an egg cell ready to be released
Day: 14
• The uterus lining is at its thickest again
• The egg cell is released by the ovary
• It travels down the egg tube towards the uterus.
• We call thisovulation
Day: 14-28
• The uterus lining remains thick so it is ready if a fertilised egg
arrives
• If an unfertilised egg arrives, it passes through the uterus
and out of the body through the vagina
• The uterus lining starts to break down and the cycle repeats

Pre-menstrual symptoms :

Behavioural Psychological Physical

1. Fatigue, 1. Irritability 1. Headaches,

2. Insomnia ( 2. Anger, 2. Breast
sleeplessness 3. Depression, tenderness
), 4. Moods 3. Abdominal
3. Dizziness swings pain,
4. Back pain,
5. Weight
gain

Hygiene promotion messages

1. Hand washing with soap after changing the napkin/cloth

2. Change the napkin/cloth every four hours
3. Cutting nails and keeping them clean
4. In case of cloth – wash the cloth with soap and water and
dry it under the sun
5. Proper disposal of soiled napkin either in the designated
dust bin/ incinerator
6. Taking bath daily during menstruation

 Quiz : ( True/False)
o Menstruation is the monthly shedding of the uterine lining and is a normal process
o Do not take bath daily during menstruation, as it is not required.
o Pre-menstrual symptoms are sleeplessness, depression, mood swing, weight gain
o Menstrual cycle is a 30 days cycle , occurs every month in a girl/women’s life

 Key messages :
o Menstruation is a normal healthy event that starts when a girl is an adolescent
o Menstruation is the shedding of the protective uterine blood lining that is prepared
to receive a fertilized egg
o If an egg is not fertilized, the uterus lining is shed in the form of menstruation. This
is a normal process
o Menstrual cycle is for 28 days and what happens from day 1 to day 28
o Premenstrual symptoms to manage the menstruation properly by adolescent girls
o Hygiene practices to be followed during menstruation