Strategic Governance of School WASH and Physical Education in Ghanaian Basic Schools: A Narrative Literature Review

Abstract

Water, sanitation, and hygiene (WASH) and physical education are both central to healthy schools, yet they are often planned, implemented, and monitored as separate domains in basic education systems. This narrative literature review examined how school governance can connect WASH and physical education within one school health system and identified strategic areas for improving coordination between WASH and physical activity promotion in Ghanaian basic schools. Relevant peer-reviewed studies published mainly between 2021 and 2026 were identified through searching five electronic databases (Scopus, Web of Science, PubMed, ERIC, and Google Scholar), screened for relevance, and synthesised thematically. Twenty studies met the inclusion criteria and were included in the synthesis, of which four were conducted in or specifically about Ghana. The review found that effective coordination depends on governance practices such as policy alignment, role clarity, intersectoral collaboration, resource planning, facility oversight, and routine monitoring. The literature also shows that WASH and physical education interventions often produce mixed results when implementation is fragmented, measurement is inconsistent, or leadership capacity is weak. In the Ghanaian context, governance challenges appear in uneven WASH implementation, limited parental and community participation, weak collaboration, and insufficient support for physical education delivery. The review contributes to school health scholarship by integrating WASH and physical education within one governance framework and argues that strategic governance is essential for creating healthier, safer, and more active school environments.