{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:27:52Z","timestamp":1780471672704,"version":"3.54.1"},"reference-count":24,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T00:00:00Z","timestamp":1712880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U01 GH002235"],"award-info":[{"award-number":["U01 GH002235"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Access to water, sanitation, and hygiene (WASH) resources in schools is critical for disease prevention and control, especially during public health emergencies. In Belize, systematic, national data on WASH in schools are needed to inform public health decisions and interventions. From December 2021 to January 2022, a national survey was sent electronically to government and government-aided primary and secondary schools in Belize (N = 308) to gather information on WASH services. From the survey, 12 pilot schools were selected based on the highest self-reported need for WASH resources to participate in additional evaluation and intervention, which included environmental nudges, supplemental supply provision, and hand hygiene education. To understand how the progression of the COVID-19 pandemic may have influenced hand hygiene, facility assessments to evaluate access to hand hygiene resources were conducted in person when most schools reopened for face-to-face learning during the pandemic (March 2022) and 15 months later (June 2023). Among the schools participating in the national survey (N = 221), 55% reported times when water was not available at the schools. Almost 9 in 10 schools (89%) had a functional handwashing station, and 47% reported always having soap for handwashing. Between baseline and follow-up at the 12 pilot schools, we observed decreases in the proportion of functional handwashing access points (\u221211%), functional handwashing access points accessible for individuals with disabilities (\u221217%) and small children (\u221229%), and functional alcohol-based hand rub dispensers (\u221213%). Despite the ongoing COVID-19 pandemic, we observed gaps in WASH resources in schools in Belize during the onsite assessments at the pilot schools. Schools should be encouraged and provided with WASH resources to maintain vigilance for disease control measures.<\/jats:p>","DOI":"10.3390\/ijerph21040470","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T09:28:06Z","timestamp":1712914086000},"page":"470","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Water, Sanitation, and Hygiene Infrastructure and Resources in Schools in Belize during the COVID-19 Pandemic, 2021\u20132023"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8974-9637","authenticated-orcid":false,"given":"Anh N.","family":"Ly","sequence":"first","affiliation":[{"name":"Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children\u2019s Hospital, 1102 Bates Ave, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelsey","family":"McDavid","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1517-6995","authenticated-orcid":false,"given":"Christina","family":"Craig","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dian","family":"Maheia","sequence":"additional","affiliation":[{"name":"Belize Ministry of Education, Culture, Science, and Technology, West Block Independence Plaza, Belmopan, Belize"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yolanda","family":"Gongora","sequence":"additional","affiliation":[{"name":"Belize Ministry of Education, Culture, Science, and Technology, West Block Independence Plaza, Belmopan, Belize"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Medley","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Morey","sequence":"additional","affiliation":[{"name":"Belize Ministry of Health and Wellness, East Block Building, National Assembly, Bliss Parade, Belmopan, Belize"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell","family":"Manzanero","sequence":"additional","affiliation":[{"name":"Belize Ministry of Health and Wellness, East Block Building, National Assembly, Bliss Parade, Belmopan, Belize"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7981-5103","authenticated-orcid":false,"given":"Gerhaldine","family":"Morazan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children\u2019s Hospital, 1102 Bates Ave, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9903-8110","authenticated-orcid":false,"given":"Allison","family":"Lino","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children\u2019s Hospital, 1102 Bates Ave, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vickie","family":"Romero","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children\u2019s Hospital, 1102 Bates Ave, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalva","family":"Blanco","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children\u2019s Hospital, 1102 Bates Ave, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanako","family":"Ishida","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1000-151X","authenticated-orcid":false,"given":"Matthew","family":"Lozier","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA"},{"name":"United States Public Health Service, 1101 Wootton Parkway, Suite 300, Rockville, MD 20852, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristy O.","family":"Murray","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children\u2019s Hospital, 1102 Bates Ave, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,12]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2023, September 06). 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