Assessing the Health Impact of Safe Water, Sanitation, and Hygiene Education in the Developing World

A multidimensional approach is needed to meet the Millennium development Goals (MDG) to address Water and Sanitation Hygiene Knowledge, Attitudes and Practices. The MDG of reducing child mortality by 2015 will require an increased focus on countries and regions where children death rates are the highest, and a renewed commitment to reach the most vulnerable children (UN, 2013). India and Nigeria account for more than one third of all deaths in children less than five years of age (UN, 2013). Using a combination of a research based literature review, expert opinion and the policy reports a multifactor model was developed to determine the necessary variables that need to be addressed so that an integrated approach to WASH related problems could be designed.

Variables were identified that impact WASH outcomes. These variables have been classified into several categories including:

1. Socio-demographics
2. Environmental and Access
3. Knowledge, Attitudes, and Practices
4. Family Health Profile
5. School Characteristics

The proposed study is to conduct a randomized control clinical trial to meet the overall study objectives by evaluating Planet Water Foundation's Program through the developed multidimensional framework. The proposed clinical trial will include 12 schools (6 residential and 6 non-residential). Six schools (n=3 residential; n=3 non-residential) each will be included into Group 1 (No Planet Water intervention) and Group 2 (With Planet Water intervention) from two locations including districts of Pune and Thane in the State of Maharashtra. Locations were matched based on similar water sources at school, toilet facilities, water quality testing, water purification techniques, geographic setting, and geographic population size.

Planet Water Foundation's Program (PWP) provides a school-based program with an aim to improve health outcomes in children using three components: (a) access to safe water, (b) access to hand washing facilities, and (c) access to water-health and hygiene education. As part of the PWP, access to safe water is provided through the use of an AquaTower, which incorporates an Ultra Filtration (UF) system. PWP's Water-Health & Hygiene education program is a four week program including four modules: (1) importance of clean water, (2) how to wash your hands, (3) when to wash your hands, and (4) protecting against germs through a hands-on, activity-based program that incorporates games, drama, song, and dance.