Impact Evaluation of Large-Scale Sanitation and Hygiene Interventions

NCT01465204 | Unknown

• 1 other identifier: 1095420
• Study Type: interventional
• Target: 21,878
• Locations: 0 countries
• Sites: N/A

Brief Summary

This study consists of an impact evaluation (IE) of the Scaling up Handwashing with Soap (HWWS) and Total Sanitation and Sanitation Marketing (TSSM) projects of the Water and Sanitation Program (WSP) of the World Bank. The objective of this study is to estimate the causal impact of the HWWS and TSSM interventions on the health and welfare of the rural poor in six developing countries: Peru, Tanzania, Senegal, Vietnam, Indonesia, and India. The IE will assess the impact of exposure to the HWWS and TSSM promotion on individual-level hygiene and sanitation practices, and on the health and welfare of children 0-5 years old. By introducing exogenous variation in handwashing and sanitation practices (through exposure to the HWWS and TSSM promotion), the IE will also answer a number of important questions related to the effect of the intended behavioral change (handwashing and improved sanitation) on health and welfare, thus providing information on the extent to which these behaviors alter intended development outcomes. This study uses a cluster-randomized experimental design, whereby the geographic units called clusters (e.g. village, commune, ward, depending on administrative structure of country) are randomly assigned to receive certain components of the Handwashing and Sanitation interventions in the case of treatment arms, and no Handwashing or Sanitation intervention in the case of control arms. . The final sample for the evaluation will consist of approximately 14,000 households, randomly selected, with at least one child between 0 and 24 months of age at baseline. Data will be collected from these 14,000 households (approximately 54,781 subjects) through household surveys, anthropometric measurements, blood and stool samples, direct observations of behaviors, and community surveys. The data collected will be analyzed using a differences in differences approach, where possible, and the results will be disseminated to country officials and others stakeholders.

Conditions

Infant Diarrhea

Keywords

Behavior Change; Hygiene & Sanitation Marketing

Outcome Measures

Primary Outcomes (1)

• Diarrhea in Children Under 5

  incidence and prevalence of diarrhea and highly credible gastrointestinal illness (HCGI) in children under 5 years old (outcome measured in selected countries)

  one year after the intervention

Secondary Outcomes (3)

• ALRI in Children Under 5

  one year after the intervention

• Malnutrition in Children Under 5

  one year after the intervention

• Anemia in Children Under 5

  one year after the intervention

Study Arms (4)

Control

NO INTERVENTION

Handwashing Intervention

EXPERIMENTAL

scaling up handwashing with soap

Behavioral: Scaling Up Handwashing Behavior Change

Sanitation Intervention

EXPERIMENTAL

total sanitation and sanitation marketing

Behavioral: Total Sanitation and Sanitation Marketing

Combined

EXPERIMENTAL

combined scaling up handwashing with soap and total sanitation and sanitation marketing interventions

Behavioral: Total Sanitation and Sanitation Marketing; Behavioral: Scaling Up Handwashing Behavior Change

Interventions

Total Sanitation and Sanitation Marketing BEHAVIORAL

Total Sanitation and Sanitation Marketing (TSSM) program is designed to promote demand for and supply of improved sanitation. On the demand side, it includes "Community-Led Total Sanitation" (CLTS). On the supply side, TSSM incorporates sanitation marketing interventions. Both CLTS and sanitation marketing draw heavily on the behavior-change communication and social marketing approaches that have been well developed in other sectors. The basic TSSM approach also builds sustainability and scalability through the strengthening of the national level sanitation sector enabling environment.

Combined; Sanitation Intervention

Scaling Up Handwashing Behavior Change BEHAVIORAL

The Handwashing with soap (HWWS) behavior change program expands and improves existing hygiene behavior change efforts with new and innovative promotional approaches in order to generate widespread and sustained improvement in handwashing with soap practices. These approaches include social marketing to deliver handwashing messages; broad and inclusive partnerships with government, private commercial marketing channels, and concerned consumer groups and NGOs.

Combined; Handwashing Intervention

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• at least one child 0-24 months (at baseline) lives in the household
• adult family member (mother of primary caregiver of the selected children for the study) consents to participate in the study and provides consent for the child's participation

You may not qualify if:

• none

Sponsors & Collaborators

• Water and Sanitation Program, World Bank: lead

Related Publications (2)

• Briceno B, Coville A, Gertler P, Martinez S. Are there synergies from combining hygiene and sanitation promotion campaigns: Evidence from a large-scale cluster-randomized trial in rural Tanzania. PLoS One. 2017 Nov 1;12(11):e0186228. doi: 10.1371/journal.pone.0186228. eCollection 2017.

  PMID: 29091726 DERIVED

• Patil SR, Arnold BF, Salvatore AL, Briceno B, Ganguly S, Colford JM Jr, Gertler PJ. The effect of India's total sanitation campaign on defecation behaviors and child health in rural Madhya Pradesh: a cluster randomized controlled trial. PLoS Med. 2014 Aug 26;11(8):e1001709. doi: 10.1371/journal.pmed.1001709. eCollection 2014 Aug.

  PMID: 25157929 DERIVED

MeSH Terms

Conditions

Diarrhea, Infantile

Condition Hierarchy (Ancestors)

Diarrhea; Signs and Symptoms, Digestive; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Paul J Gertler, PhD

  UC Berkeley - Haas School of Business

  PRINCIPAL INVESTIGATOR

• Bertha Briceno, MPA/ID

  World Bank - Water and Sanitation Program

  STUDY DIRECTOR

• Alexandra Orsola-Vidal, MSc

  World Bank - Water and Sanitation Program

  PRINCIPAL INVESTIGATOR

• Claire Chase, MSc

  World Bank - Water and Sanitation Program

  PRINCIPAL INVESTIGATOR

• Sebastian F Galiani, PhD

  Washington University School of Medicine

  PRINCIPAL INVESTIGATOR

• Sebastian W Martinez, PhD

  Inter-American Development Bank

  PRINCIPAL INVESTIGATOR

• Paul M Wassenich, MPA

  UC Berkeley

  PRINCIPAL INVESTIGATOR

• Alicia L Salvatore, MPH, PhD

  Stanford University

  PRINCIPAL INVESTIGATOR

• Sumeet Patil, MA

  Network for Engineering and Economics Research and Management

  PRINCIPAL INVESTIGATOR

• Manisha B Shah, PhD

  UC Irvine

  PRINCIPAL INVESTIGATOR

• Lisa A Cameron, PhD

  University of Melbourne

  PRINCIPAL INVESTIGATOR

• Jack M Colford, MD, MPH, PhD

  UC Berkeley - School of Public Health

  PRINCIPAL INVESTIGATOR

• Ben Arnold, PhD

  UC Berkeley

  PRINCIPAL INVESTIGATOR

• Lia CH Fernald, MBA, PhD

  UC Berkeley - School of Public Health

  PRINCIPAL INVESTIGATOR

• Patricia K Kariger, PhD

  UC Berkeley

  PRINCIPAL INVESTIGATOR

• Christine Stauber, PhD

  Georgia State University - Institute of Public Health

  PRINCIPAL INVESTIGATOR

• Pavani K Ram, MD

  University of Buffalo - SUNY

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 1, 2011
• First Posted: November 4, 2011
• Study Start: November 1, 2007
• Primary Completion: December 1, 2010
• Study Completion: July 1, 2012
• Last Updated: November 4, 2011

Record last verified: 2011-11