Effectiveness of a rural sanitation programme on diarrhoea, soil-transmitted helminth infection, and child malnutrition in Odisha, India: a cluster-randomised trial

Clasen, Thomas; Boisson, Sophie; Routray, Parimita; Torondel, Belén; Bell, Melissa J.; Cumming, Oliver; Ensink, Jeroen H. J.; Freeman, Matthew C.; Jenkins, Marion W.; Odagiri, Mitsunori; Ray, Subhajyoti; Sinha, Antara; Suar, Mrutyunjay; Schmidt, Wolf‐Peter

doi:10.1016/s2214-109x(14)70307-9

Cited by 458 publications

(507 citation statements)

References 31 publications

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“…An even stronger spillover effect is expected with respect to the coverage of proper sanitation in the community (Alderman et al, 2003). Although an improved toilet increases the hygiene level of the owner, it cannot fully eliminate faecal contamination from the neighbourhood if other households lack such a facility (Andres et al, 2014;Clasen et al, 2014). Indirect effects at the community level might also be important.…”

Section: Conceptual Frameworkmentioning

confidence: 99%

Clean water, sanitation and diarrhoea in Indonesia: Effects of household and community factors

Komarulzaman

Smits

Jong

2016

Global Public Health

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Diarrhoea is an important health issue in low-and middle-income countries, including Indonesia. We applied a multilevel regression analysis on the Indonesian Demographic and Health Survey to examine the effects of drinking water and sanitation facilities at the household and community level on diarrhoea prevalence among children under five (n = 33,339). The role of the circumstances was explored by studying interactions between the water and sanitation variables and other risk factors. Diarrhoea prevalence was reported by 4820 (14.4%) children, who on average were younger, poorer and were living in a poorer environment. At the household level, piped water was significantly associated with diarrhoea prevalence (OR = 0.797, 95% CI: 0.692-0.918), improved sanitation had no direct effect (OR = 0.992, 95% CI: 0.899-1.096) and water treatment was not related to diarrhoea incidence (OR = 1.106, 95% CI: 0.994-1.232). At the community level, improved water coverage had no direct effect (OR = 1.002, 95% CI: 0.950-1.057) but improved sanitation coverage was associated with lower diarrhoea prevalence (OR = 0.917, 95% CI: 0.843-0.998). Our interaction analysis showed that the protective effects of better sanitation at the community level were increased by better drinking water at the community level. This illustrates the importance of improving both drinking water and sanitation simultaneously. ARTICLE HISTORY

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Section: Conceptual Frameworkmentioning

confidence: 99%

Clean water, sanitation and diarrhoea in Indonesia: Effects of household and community factors

Komarulzaman

Smits

Jong

2016

Global Public Health

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“…But they have scope for further improvement (Hutchinson, 2006). In contrast, the sanitation program conducted in Odisha, India to prevent diarrhea, soil-transmitted helminth infection, and child malnutrition, for instance showed that though the quantitative coverage in constructing toilets were fulfilled, but the real success in terms of uptake could not be assumed (Clasen et al, 2014) . Other studies have also shown that mass media campaigns have been successful in bringing about positive changes or prevent negative changes in health-related behaviours across large populations (Wakefield, 2010).…”

Section: Literature Reviewmentioning

confidence: 98%

“…Public health campaigns targeted to the rural population to improve their preventive and curative health practices are common places in developing countries (Clasen et al, 2014;Naugle & Hornik, 2014). These interventions have their respective costs and consequences.…”

Section: Literature Reviewmentioning

confidence: 99%

Cost and Consequences of Integrated Public Health Campaign in Baglung District, Nepal

2018

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“…Similarly, the health benefits of sanitation, that is the separation and containment of human excreta, are entirely dependent on achieving a high, if not complete, level of coverage and use. Faeces contain a variety of disease-causing pathogens that are easily transmitted by feet, fingers, flies or fluids; even small amounts of faecal material in the environment can infect any number of people who themselves, use, or don't use a toilet, weakening or removing the effect of sanitation for the few who use it [17].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Conditional Cash Transfer on Toilet Use in eThekwini, South Africa

Tilley

Günther

2016

Sustainability

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Abstract:In the developing world, having access to a toilet does not necessarily imply use: infrequent or non-use limits the desired health outcomes of improved sanitation. We examine the sanitation situation in a rural part of South Africa where recipients of novel, waterless "urine-diverting dry toilets" are not regularly using them. In order to determine if small, conditional cash transfers (CCT) could motivate families to use their toilets more, we paid for urine via different incentive-based interventions: two were based on volumetric pricing and the third was a flat-rate payment (irrespective of volume). A flat-rate payment (approx. €1) resulted in the highest rates of regular (weekly) participation at 59%. The low volumetric payment (approx. €0.05/L) led to regular participation rates of only 12% and no increase in toilet use. The high volumetric payment (approx. €0.1/L) resulted in lower rates of regular participation (35%), but increased the average urine production per household per day by 74%. As a first example of conditional cash transfers being used in the sanitation sector, we show that they are an accepted and effective tool for increasing toilet use, while putting small cash payments in the hands of poor, largely unemployed populations in rural South Africa.

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Effectiveness of a rural sanitation programme on diarrhoea, soil-transmitted helminth infection, and child malnutrition in Odisha, India: a cluster-randomised trial

Abstract: Bill & Melinda Gates Foundation, International Initiative for Impact Evaluation (3ie), and Department for International Development-backed SHARE Research Consortium at the London School of Hygiene & Tropical Medicine.

Cited by 458 publications

References 31 publications

Clean water, sanitation and diarrhoea in Indonesia: Effects of household and community factors

Clean water, sanitation and diarrhoea in Indonesia: Effects of household and community factors

Cost and Consequences of Integrated Public Health Campaign in Baglung District, Nepal

The Impact of Conditional Cash Transfer on Toilet Use in eThekwini, South Africa

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