Research on the Impact of Targeted Subsidies Within Open Defecation Free (ODF) Communities

Not Applicable

Completed

• Conditions: Sanitation
• Interventions: Behavioral: Targeted Subsidy

• Registration Number: NCT03822611
• Lead Sponsor: The Aquaya Institute

Brief Summary

This study evaluates targeted subsidies as a strategy to improve sanitation infrastructure and behaviours in communities that have reached Open Defecation Free (ODF) status after a Community-Led Total Sanitation (CLTS) program. The investigator's hypothesis is that sanitation subsidies targeted at the most vulnerable households within ODF communities will increase and help sustain latrine coverage, quality, and use amongst the targeted households, and through a spill-over effect, amongst the rest of the community. Half of participating communities will receive the targeted subsidy, while the other half will not receive any treatment.

Detailed Description

Community-Led Total Sanitation (CLTS) is a widely used approach to eradicate open defecation in rural communities in developing countries. Using emotional triggers, CLTS promotes community self-help to build household latrines. In Ghana, where CLTS is part of the government's official sanitation strategy, a community is declared "Open Defecation Free" (ODF) when 80 percent of households own a latrine.

There is however evidence that open defecation persists in so-called "ODF" communities, especially as the most vulnerable households (the poorest of the poor) cannot afford to construct or maintain durable latrines. As a result, subsidies for these vulnerable households have been proposed as a strategy to promote the construction of durable latrines and help sustain safe sanitation behaviours in communities having received CLTS.

Study Timeline

• Study First Submitted: 2019-01-25
• Study First Submitted QC: 2019-01-28
• Study First Posted: 2019-01-30
• Study Start: 2019-02-18
• Primary Completion: 2021-03-31
• Study Completion: 2021-03-31
• Status Verified: 2021-10
• Last Update Submitted: 2021-10-01
• Last Update Posted: 2021-10-04

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 5615

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Targeted Subsidy	Targeted Subsidy	In these communities, households identified as vulnerable receive a voucher for a free latrine sub-structure (slab + pit lining), redeemable with local sanitation suppliers.

Primary Outcome Measures

Name	Time	Method
Percentage of households owning an individual, functional latrine with full superstructure	Approximately 18 months	Household ownership (yes/no) of a latrine that is i) not shared with other households ("individual"), ii) whose pit is not collapsed and not full ("functional"), and iii) with four walls (or circular walls) and a roof of any materials ("full superstructure").

Secondary Outcome Measures

Name	Time	Method
Percentage of households owning an individual, functional latrine with full superstructure and durable superstructure	Approximately 18 months	Household ownership (yes/no) of a latrine that is i) not shared with other households ("individual"), ii) whose pit is not collapsed and not full ("functional"), iii) with four walls (or circular walls) and a roof of any materials ("full superstructure"), iv) with a concrete/plastic slab and pit lining with plastic/rocks/bricks/concrete ("durable substructure").
Percentage of households reporting practicing open defecation	Approximately 18 months	Self report by the respondent of not always using a toilet to defecate when at home.
Percentage of households reporting satisfaction with latrine	Approximately 18 months	Self report by the respondent of being satisfied with the latrine (s)he uses for defecation.

Trial Locations

Locations (1)

Districts of Tatale and Kpandai, Northern Region; 🇬🇭 Tamale, Ghana