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The impact of school water, sanitation, and hygiene interventions on the health of younger siblings of pupils: A cluster-randomized trial in Kenya

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  • Dreibelbis, R.
  • Freeman, M.C.
  • Greene, L.E.
  • Saboori, S.
  • Rheingans, R.

Abstract

Objectives: We examined the impact of school water, sanitation, and hygiene (WASH) interventions on diarrhea-related outcomes among younger siblings of school-going children. Methods: We conducted a cluster-randomized trial among 185 schools in Kenya from 2007 to 2009. We assigned schools to 1 of 2 study groups according to water availability. Multilevel logistic regression models, adjusted for baseline measures, assessed differences between intervention and control arms in 1-week period prevalence of diarrhea and 2-week period prevalence of clinic visits among children younger than 5 years with at least 1 sibling attending a program school. Results: Among water-scarce schools, comprehensive WASH improvements were associated with decreased odds of diarrhea (odds ratio [OR] = 0.44; 95% confidence interval [CI] = 0.27, 0.73) and visiting a clinic (OR = 0.36; 95% CI = 0.19, 0.68), relative to control schools. In our separate study group of schools with greater water availability, school hygiene promotion and water treatment interventions and school sanitation improvements were not associated with differences in diarrhea prevalence between intervention and control schools. Conclusions: In water-scarce areas, school WASH interventions that include robust water Simprovements can reduce diarrheal diseases among young children.

Suggested Citation

  • Dreibelbis, R. & Freeman, M.C. & Greene, L.E. & Saboori, S. & Rheingans, R., 2014. "The impact of school water, sanitation, and hygiene interventions on the health of younger siblings of pupils: A cluster-randomized trial in Kenya," American Journal of Public Health, American Public Health Association, vol. 104(1), pages 91-97.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2013.301412_2
    DOI: 10.2105/AJPH.2013.301412
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    Cited by:

    1. Balwani Chingatichifwe Mbakaya & Paul H. Lee & Regina L. T. Lee, 2017. "Hand Hygiene Intervention Strategies to Reduce Diarrhoea and Respiratory Infections among Schoolchildren in Developing Countries: A Systematic Review," IJERPH, MDPI, vol. 14(4), pages 1-14, April.
    2. Hassan Vally & Celia McMichael & Claire Doherty & Xia Li & Gilbert Guevarra & Paola Tobias, 2019. "The Impact of a School-Based Water, Sanitation and Hygiene Intervention on Knowledge, Practices, and Diarrhoea Rates in the Philippines," IJERPH, MDPI, vol. 16(21), pages 1-14, October.
    3. 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.
    4. Jesse D. Contreras & Joseph N.S. Eisenberg, 2019. "Does Basic Sanitation Prevent Diarrhea? Contextualizing Recent Intervention Trials through a Historical Lens," IJERPH, MDPI, vol. 17(1), pages 1-35, December.
    5. Kate Bohnert & Anna N. Chard & Alex Mwaki & Amy E. Kirby & Richard Muga & Corey L. Nagel & Evan A. Thomas & Matthew C. Freeman, 2016. "Comparing Sanitation Delivery Modalities in Urban Informal Settlement Schools: A Randomized Trial in Nairobi, Kenya," IJERPH, MDPI, vol. 13(12), pages 1-14, November.
    6. Paola A. Torres-Slimming & Carlee Wright & Cesar P. Carcamo & Patricia J. Garcia & IHACC Research Team & Sherilee L. Harper, 2019. "Achieving the Sustainable Development Goals: A Mixed Methods Study of Health-Related Water, Sanitation, and Hygiene (WASH) for Indigenous Shawi in the Peruvian Amazon," IJERPH, MDPI, vol. 16(13), pages 1-17, July.
    7. Robert Dreibelbis & Anne Kroeger & Kamal Hossain & Mohini Venkatesh & Pavani K. Ram, 2016. "Behavior Change without Behavior Change Communication: Nudging Handwashing among Primary School Students in Bangladesh," IJERPH, MDPI, vol. 13(1), pages 1-7, January.
    8. Emmy De Buck & Hans Van Remoortel & Karin Hannes & Thashlin Govender & Selvan Naidoo & Bert Avau & Axel Vande Veegaete & Alfred Musekiwa & Vittoria Lutje & Margaret Cargo & Hans‐Joachim Mosler & Phili, 2017. "Approaches to promote handwashing and sanitation behaviour change in low‐ and middle‐income countries: a mixed method systematic review," Campbell Systematic Reviews, John Wiley & Sons, vol. 13(1), pages 1-447.

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