Expanding Access to Safe Water in Nigeria

NCT07246824 | Recruiting

• 1 other identifier: HUM00277959
• Study Type: interventional
• Target: 700
• Locations: 1 country
• Sites: 1

Brief Summary

Access to safe water remains a pressing public health challenge in Nigeria, where 67% of the population lacks safely managed drinking water and waterborne diseases cause an estimated 70,000 child deaths annually. Building on evidence that point-of-use chlorination is highly cost-effective in reducing diarrheal disease, this study evaluates a scalable, community-based chlorine distribution model through a cluster-randomized controlled trial (RCT) in Kano State. Thirty communities across four Local Government Areas will be randomly assigned to one of three groups: (i) 20 treatment communities receiving community demonstrations and local chlorine redemption points, (ii) 10 control communities where no intervention will be conducted. After 3 months, 5 control communities will receive an individual-level sensitization and a voucher program and 5 will remain pure control communities. The RCT aims to estimate the causal impact of the community-based intervention on household chlorination rates, water quality (E. coli contamination), and knowledge of safe water practices over six months. By rigorously testing a community-led water treatment model, this study contributes new evidence on sustainable and cost-effective approaches to expand safe water access in low-resource settings. The results will inform national and regional strategies for scaling point-of-use chlorination across sub-Saharan Africa.

Conditions

Chlorination

Keywords

Diarrhea; Health Systems

Outcome Measures

Primary Outcomes (1)

• Treat drinking water with chlorine (tested in water sample)

  Proportion of water samples with detectable chlorine in stored drinking water

  Measured up to 6 months of follow-up

Secondary Outcomes (7)

• Treat drinking water with chlorine (self-reported)

  Measured up to 6 months of follow-up

• Presence of E.coli

  Measured up to 6 months of follow-up

• Level of E.coli

  Measured up to 6 months of follow-up

• Unsafe risk of Coliform

  Measured up to 6 months of follow-up

• Heard about chlorine

  Measured up to 6 months of follow-up

Study Arms (2)

Treatment

EXPERIMENTAL

Community Demonstrations and Redemption Points

Behavioral: Community Demonstrations; Behavioral: Redemption points

Control

NO INTERVENTION

Neither community distributions will be conducted nor redemption points will be set-up during the study period

Interventions

Community Demonstrations BEHAVIORAL

Facilitators will collaborate with local leaders, WASH officials and health facility staff in conducting community demonstrations introducing the chlorine product (WaterGuard+) to communities in the treatment group. Local leaders in the community will organize the meeting, while facilitators in the country will demonstrate how to use the product, what the correct dosage is, and explain the importance of water treatment. They will also show how village water is contaminated with Ecoli. These meetings will be targeted at eligible women (pregnant women and women with children under the age of 5), however all members of the community will be invited to attend. At the meeting, each attendee will be given one bottle of WaterGuard+, which is enough to treat drinking water for a household of 5 members for about a month, and 1,000 naira. Water Guard + is a 180g bottle of sodium dichloroisocyanurate (NaDCC) in granulated / powder form, produced and distributed by the Society for Family Health.

Treatment

Redemption points BEHAVIORAL

Study staff will set up at least one chlorine redemption point for each community. The location of the redemption point will be determined in consultation with the local community during Community Demonstrations. The redemption points could be health facilities, local shops/dispensaries/kiosks, local pharmacies, house of the village leader, CHW, or health staff or other suitable sites. Households will be able to visit the location and redeem a month's supply of a chlorine product. Distributors will use a redemption log to keep track of when participants redeem the chlorine product.

Treatment

Eligibility Criteria

• Gender Eligibility Details: Female
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Pregnant mothers and women with children under 5 children

You may not qualify if:

• Men, women with no children under 5 years old

Sponsors & Collaborators

• University of Michigan: lead
• Princeton University: collaborator

Study Sites (1)

Kura, Dawakin Kudu, Kiru, and Rano LGAs

Kano, Nigeria

RECRUITING

MeSH Terms

Conditions

Diarrhea

Condition Hierarchy (Ancestors)

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

Study Officials

• Elisa Maria Maffioli, PhD

  University of Michigan

  PRINCIPAL INVESTIGATOR

• Pascaline Dupas

  Princeton University

  PRINCIPAL INVESTIGATOR

• Ana Radu

  Princeton University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Elisa Maria Maffioli, PhD

CONTACT

4438754930; elisamaf@umich.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: November 17, 2025
• First Posted: November 24, 2025
• Study Start: September 30, 2025
• Primary Completion (Estimated): September 30, 2026
• Study Completion (Estimated): September 30, 2026
• Last Updated: November 24, 2025

Record last verified: 2025-10

Data Sharing

• IPD Sharing: Will not share

Locations

NG (1)