IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v15y2018i4p570-d137487.html
   My bibliography  Save this article

Design, Intervention Fidelity, and Behavioral Outcomes of a School-Based Water, Sanitation, and Hygiene Cluster-Randomized Trial in Laos

Author

Listed:
  • Anna N. Chard

    (Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA)

  • Matthew C. Freeman

    (Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA)

Abstract

Evidence of the impact of water, sanitation, and hygiene (WASH) in schools (WinS) interventions on pupil absence and health is mixed. Few WinS evaluations rigorously report on output and outcome measures that allow for comparisons of effectiveness between interventions to be made, or for an understanding of why programs succeed. The Water, Sanitation, and Hygiene for Health and Education in Laotian Primary Schools (WASH HELPS) study was a randomized controlled trial designed to measure the impact of the United Nations Children’s Fund (UNICEF) Laos WinS project on child health and education. We also measured the sustainability of intervention outputs and outcomes, and analyzed the effectiveness of group hygiene activities on behavior change and habit formation. Here, we present the design and intermediate results from this study. We found the WinS project improved the WASH environment in intervention schools; 87.8% of schools received the intervention per design. School-level adherence to outputs was lower; on average, schools met 61.4% of adherence-related criteria. The WinS project produced positive changes in pupils’ school WASH behaviors, specifically increasing toilet use and daily group handwashing. Daily group hygiene activities are effective strategies to improve school WASH behaviors, but a complementary strategy needs to be concurrently promoted for effective and sustained individual handwashing practice at critical times.

Suggested Citation

  • Anna N. Chard & Matthew C. Freeman, 2018. "Design, Intervention Fidelity, and Behavioral Outcomes of a School-Based Water, Sanitation, and Hygiene Cluster-Randomized Trial in Laos," IJERPH, MDPI, vol. 15(4), pages 1-17, March.
  • Handle: RePEc:gam:jijerp:v:15:y:2018:i:4:p:570-:d:137487
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/15/4/570/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/15/4/570/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Joshua V. Garn & Bethany A. Caruso & Carolyn D. Drews-Botsch & Michael R. Kramer & Babette A. Brumback & Richard D. Rheingans & Matthew C. Freeman, 2014. "Factors Associated With Pupil Toilet Use in Kenyan Primary Schools," IJERPH, MDPI, vol. 11(9), pages 1-18, September.
    2. Mitsuaki Hirai & Jay P. Graham & Kay D. Mattson & Andrea Kelsey & Supriya Mukherji & Aidan A. Cronin, 2016. "Exploring Determinants of Handwashing with Soap in Indonesia: A Quantitative Analysis," IJERPH, MDPI, vol. 13(9), pages 1-15, September.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Yuko Noguchi & Daisuke Nonaka & Sengchanh Kounnavong & Jun Kobayashi, 2021. "Effects of Hand-Washing Facilities with Water and Soap on Diarrhea Incidence among Children under Five Years in Lao People’s Democratic Republic: A Cross-Sectional Study," IJERPH, MDPI, vol. 18(2), pages 1-14, January.
    2. Celia McMichael, 2019. "Water, Sanitation and Hygiene (WASH) in Schools in Low-Income Countries: A Review of Evidence of Impact," IJERPH, MDPI, vol. 16(3), pages 1-21, January.
    3. Denise Duijster & Bella Monse & Marvin Marquez & Ubo Pakes & Nicole Stauf & Habib Benzian, 2022. "Improving Toilet Usability and Cleanliness in Public Schools in the Philippines Using a Packaged Operation and Maintenance Intervention," IJERPH, MDPI, vol. 19(16), pages 1-11, August.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Jedidiah S. Snyder & Graeme Prentice-Mott & Charles Boera & Alex Mwaki & Kelly T. Alexander & Matthew C. Freeman, 2020. "The Sustainability and Scalability of Private Sector Sanitation Delivery in Urban Informal Settlement Schools: A Mixed Methods Follow Up of a Randomized Trial in Nairobi, Kenya," IJERPH, MDPI, vol. 17(15), pages 1-17, July.
    2. D. Daniel, 2021. "Contextual Determinants of General Household Hygiene Conditions in Rural Indonesia," IJERPH, MDPI, vol. 18(21), pages 1-15, October.
    3. Deepa R. Camenga & Sonya S. Brady & Cecilia T. Hardacker & Beverly R. Williams & Jeni Hebert-Beirne & Aimee S. James & Kathryn Burgio & Jesse Nodora & Jean F. Wyman & Amanda Berry & Lisa K. Low & The , 2019. "U.S. Adolescent and Adult Women’s Experiences Accessing and Using Toilets in Schools, Workplaces, and Public Spaces: A Multi-Site Focus Group Study to Inform Future Research in Bladder Health," IJERPH, MDPI, vol. 16(18), pages 1-16, September.
    4. Chang Sun & Qingzhi Wang & Sasmita Poudel Adhikari & Ruixue Ye & Sha Meng & Yuju Wu & Yuping Mao & Hein Raat & Huan Zhou, 2019. "Correlates of School Children’s Handwashing: A Study in Tibetan Primary Schools," IJERPH, MDPI, vol. 16(17), pages 1-12, September.
    5. Carmen Anthonj & Lisa Fleming & Samuel Godfrey & Argaw Ambelu & Jane Bevan & Ryan Cronk & Jamie Bartram, 2018. "Health Risk Perceptions Are Associated with Domestic Use of Basic Water and Sanitation Services—Evidence from Rural Ethiopia," IJERPH, MDPI, vol. 15(10), pages 1-19, September.
    6. Xuyu Chen & Li Ran & Qing Liu & Qikai Hu & Xueying Du & Xiaodong Tan, 2020. "Hand Hygiene, Mask-Wearing Behaviors and Its Associated Factors during the COVID-19 Epidemic: A Cross-Sectional Study among Primary School Students in Wuhan, China," IJERPH, MDPI, vol. 17(8), pages 1-11, April.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:15:y:2018:i:4:p:570-:d:137487. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.