Nurturing Learners: The Role of WASH and Nutrition in Promoting Student Well-Being in Sri Lanka

• In Event: Watering Young Minds: Evidence from Water, Sanitation and Hygiene-Related Interventions in Schools in Asia

Proposal

The first paper focuses on an evaluation of the Sri Lanka PALAM/A (Promoting Autonomy for Literacy and Attentiveness through Market Alliances) Food for Education project, implemented by Save the Children with support from the USDA McGovern-Dole Program, which integrates WASH interventions as a foundational component to improve student health and educational outcomes. At baseline, many target schools initially lacked access to safe drinking water, functional toilets, and hygiene education, contributing to high rates of absenteeism and poor attentiveness in class. In response, the PALAM/A project rehabilitated WASH infrastructure, provided hygiene training for teachers and students, and aligned school-level practices with national health standards. These efforts were designed to reduce health-related absences and support improved literacy outcomes by creating a safer, more inclusive learning environment—particularly for girls.

The evaluation revealed significant challenges and mixed progress in WASH implementation. At baseline, only 63% of schools had latrines accessible to students with disabilities, which declined to 36% by endline, highlighting a regression in inclusive sanitation access. Water availability remained uneven across districts, with 20% of schools lacking any drinking water source at endline. Among schools with water access, only 66% had treated, safe water, and many reported insufficient volumes to meet daily needs.

Training and knowledge improvements were evident among teachers and School Meal Providers (SMPs). Teachers showed increased awareness of hygiene practices, including a 33-percentage point rise in knowledge of proper water boiling times and a 37-point increase in understanding its role in illness prevention. SMPs demonstrated improved knowledge of food safety and hygiene, yet gaps persisted. For instance, while 98% recognized the importance of refrigerating perishables, only 68% reported doing so. Knowledge of handwashing declined, with fewer SMPs able to name all six key times for handwashing or describe proper techniques.

Structural issues also impeded WASH effectiveness. Many school kitchens lacked adequate ventilation and space, and cleanliness deteriorated over time, with fewer schools free of standing water and hazardous materials. SMPs cooking at home faced limited oversight, with inconsistent inspections by public health officials.

The evaluation recommends targeted interventions to address these gaps, including increased inspections of home kitchens, additional training on food storage and hygiene, structural improvements to school kitchens, and enhanced water infrastructure in the next phase of the program. These measures are essential to sustain WASH improvements and ensure equitable access to safe, hygienic learning environments. Overall, while PALAM/A made strides in WASH-related knowledge and infrastructure, persistent disparities and implementation challenges underscore the need for continued investment and strategic planning to achieve lasting impact.

Authors

• Hannah Ring, American Institutes for Research

• Adria Molotsky, American Institutes for Research

• Pooja Nakamura, American Institutes for Research

• Chinmaya Holla, American Institutes for Research (AIR)

• Kaitlin Carson, American Institutes For Research