WASH for Everyone: Testing Alternative Approaches to Sanitation and Hygiene Behaviour Change in Chiradzulu, Malawi

NCT05808218 | Completed

• 1 other identifier: 28249
• Study Type: interventional
• Target: 2,800
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to assess the impact of multiple community-based behaviour change approaches on sanitation and hygiene behaviours in rural Malawi. Three different sub-districts (Traditional Authorities) in Chiradzulu District will be selected, each receiving a different combination of community-based interventions or will serve as controls. Eligible communities, households, and individuals will be randomly selected in each Traditional Authority and sanitation and hygiene behaviours assessed through self-report and direct observation after 1 year of intervention.

Conditions

Behavior

Keywords

sanitation; handwashing; hygiene

Outcome Measures

Primary Outcomes (1)

• sanitation coverage

  Sanitation coverage is defined as confirmed presence of a functional sanitation facility in the home or compound that meets standard definitions of at least unimproved sanitation facilities according to the Joint Monitoring Programme. This will be determined by reported access to a private, household sanitation facility that respondents self-identify as completed. Self-reported access will be verified through visual inspection of the sanitation facilities.

  study endline (one year)

Secondary Outcomes (6)

• sanitation use

  study endline (one year)

• safe disposal of child feces

  study endline (one year)

• handwashing facility

  study endline (one year)

• Basic sanitation coverage

  study endline (one year)

• Sanitation-related Quality-of-Life Index

  study endline (one year)

Study Arms (3)

CLTS

EXPERIMENTAL

This arm will receive a standard community-led total sanitation) intervention).

Other: Community-Led Total Sanitation

CLTS Plus

EXPERIMENTAL

Includes all activities in the CLTS arm with the addition of village-level Care Groups for sanitation and hygiene promotion.

Other: Community-Led Total Sanitation; Other: Care Groups

Control

NO INTERVENTION

Interventions

Community-Led Total Sanitation OTHER

The community-led total sanitation intervention is implemented across an entire Traditional Authority and includes the following village-level activities: 1. Triggering: * Village transect walks and open defecation site mapping * Demonstrations of food contamination and medical expense calculations 2. Development of a Community-Action Plan and identification of "natural leaders" 3. Post-triggering: routine follow-up by selected natural leaders to track and monitor progress against the Community Action Plan In addition to the activities above, the WASH for Everyone team will: * Train a cadre of local masons on sanitation construction * Support the District Health office in the implementation of existing sanitation and hygiene promotion at village markets and other public spaces

Also known as: CLTS

CLTS; CLTS Plus

Care Groups OTHER

* Orientation and training of village-level Care Group members on CLTS, latrine construction, and hygiene promotion * Routine house-to-house follow-up of Care Group members to provide peer-to-peer counselling and support on sanitation and hygiene behaviours.

CLTS Plus

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Presence of an adult head of household age 18 or over who gives consent for the household to participate in the study; household is permanent resident of selected village

You may not qualify if:

• No permanent resident aged 18 or over; temporary resident of community/households
• In selected households, 1 individual will be selected at random to complete study survey. Individual eligibility requirements are:
• Permanent resident of selected household; able to provide informed consent
• Not a permanent resident of selected household, not able to provide informed consent

Sponsors & Collaborators

• London School of Hygiene and Tropical Medicine: lead
• Malawi University of Business and Applied Sciences (MUBAS) WASHTED Centre: collaborator
• University of Strathclyde: collaborator

Study Sites (1)

Malawi University of Business and Applied Sciences, WASHTED Centre

Blantyre, Malawi

Location

Related Publications (1)

• Chidziwisano K, Panulo M, MacLeod C, Vigneri M, White B, Wells J, Ross I, Morse T, Dreibelbis R. Water, Sanitation, and Hygiene for Everyone Intervention Study: Protocol for a Controlled Before-and-After Trial. JMIR Res Protoc. 2025 May 15;14:e68280. doi: 10.2196/68280.

  PMID: 40373302 DERIVED

MeSH Terms

Conditions

Behavior

Study Officials

• Robert Dreibelbis, PhD

  London School of Hygiene and Tropical Medicine

  PRINCIPAL INVESTIGATOR

Study Design

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

Study Record Dates

• First Submitted: March 29, 2023
• First Posted: April 11, 2023
• Study Start: April 13, 2023
• Primary Completion: May 1, 2024
• Study Completion: May 1, 2024
• Last Updated: March 7, 2025

Record last verified: 2024-10

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, ICF, ANALYTIC CODE
• Time Frame: Data will be made available within 1 year of final data collection

Locations

MA (1)