Impact Evaluation of Large-Scale Sanitation and Hygiene Interventions

Not Applicable

• Conditions: Infant Diarrhea
• Interventions: Behavioral: Scaling Up Handwashing Behavior Change; Behavioral: Total Sanitation and Sanitation Marketing

• Registration Number: NCT01465204
• Lead Sponsor: Water and Sanitation Program, World Bank

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.

Detailed Description

Not available

Study Timeline

• Study Start: 2007-11
• Primary Completion: 2010-12
• Status Verified: 2011-11
• Study First Submitted: 2011-11-01
• Study First Submitted QC: 2011-11-03
• Last Update Submitted: 2011-11-03
• Study First Posted: 2011-11-04
• Last Update Posted: 2011-11-04
• Study Completion: 2012-07

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 21878

Inclusion Criteria

• 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

Exclusion Criteria

• none

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Handwashing Intervention	Scaling Up Handwashing Behavior Change	scaling up handwashing with soap
Combined	Total Sanitation and Sanitation Marketing	combined scaling up handwashing with soap and total sanitation and sanitation marketing interventions
Combined	Scaling Up Handwashing Behavior Change	combined scaling up handwashing with soap and total sanitation and sanitation marketing interventions
Sanitation Intervention	Total Sanitation and Sanitation Marketing	total sanitation and sanitation marketing

Primary Outcome Measures

Name	Time	Method
Diarrhea in Children Under 5	one year after the intervention	incidence and prevalence of diarrhea and highly credible gastrointestinal illness (HCGI) in children under 5 years old (outcome measured in selected countries)

Secondary Outcome Measures

Name	Time	Method
ALRI in Children Under 5	one year after the intervention	incidence and prevalence of acute lower respiratory infections (ALRI) in children under 5 years old (outcome measured in selected countries)
Malnutrition in Children Under 5	one year after the intervention	prevalence of stunting, wasting and underweight in children under 5 years old by recording key anthropometric measurements (outcome measured in selected countries)
Anemia in Children Under 5	one year after the intervention	prevalence of anemia in children 6 months to 5 years old by measuring hemoglobin levels in the blood (outcome measured in selected countries)