IDEAS home Printed from https://ideas.repec.org/a/aph/ajpbhl/10.2105-ajph.2017.303686_7.html
   My bibliography  Save this article

Scaling up a water, sanitation, and hygiene program in rural Bangladesh: The role of program implementation

Author

Listed:
  • Benjamin-Chung, J.
  • Sultana, S.
  • Halder, A.K.
  • Ahsan, M.A.
  • Arnold, B.F.
  • Hubbard, A.E.
  • Unicomb, L.
  • Luby, S.P.
  • Colford, J.M.

Abstract

Objectives. To evaluate whether the quality of implementation of a water, sanitation, and hygiene program called SHEWA-B and delivered by UNICEF to 20 million people in rural Bangladesh was associated with health behaviors and sanitation infrastructure access. Methods. We surveyed 33 027 households targeted by SHEWA-B and 1110 SHEWA-B hygiene promoters in 2011 and 2012. We developed an implementation quality index and compared the probability of health behaviors and sanitation infrastructure access in counterfactual scenarios over the range of implementation quality. Results. Forty-seven percent of households (n = 14 622) had met a SHEWA-B hygiene promoter, and 47% of hygiene promoters (n = 527) could recall all key program messages. The frequency of hygiene promoter visits was not associated with improved outcomes. Higher implementation quality was not associated with better health behaviors or infrastructure access. Outcomes differed by only 1% to 3% in scenarios in which all clusters received low versus high implementation quality. Conclusions. SHEWA-B did not meet UNICEF's ideal implementation quality in any area. Improved implementation quality would have resulted in marginal changes in health behaviors or infrastructure access. This suggests that SHEWA-B's design was suboptimal for improving these outcomes.

Suggested Citation

  • Benjamin-Chung, J. & Sultana, S. & Halder, A.K. & Ahsan, M.A. & Arnold, B.F. & Hubbard, A.E. & Unicomb, L. & Luby, S.P. & Colford, J.M., 2017. "Scaling up a water, sanitation, and hygiene program in rural Bangladesh: The role of program implementation," American Journal of Public Health, American Public Health Association, vol. 107(5), pages 694-701.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2017.303686_7
    DOI: 10.2105/AJPH.2017.303686
    as

    Download full text from publisher

    File URL: http://hdl.handle.net/10.2105/AJPH.2017.303686
    Download Restriction: no
    File URL: https://libkey.io/10.2105/AJPH.2017.303686?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    Citations

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


    Cited by:

    1. Karen Setty & Ryan Cronk & Shannan George & Darcy Anderson & Għanja O’Flaherty & Jamie Bartram, 2019. "Adapting Translational Research Methods to Water, Sanitation, and Hygiene," IJERPH, MDPI, vol. 16(20), pages 1-31, October.
    2. Emily Kumpel & Caroline Delaire & Rachel Peletz & Joyce Kisiangani & Angella Rinehold & Jennifer De France & David Sutherland & Ranjiv Khush, 2018. "Measuring the Impacts of Water Safety Plans in the Asia-Pacific Region," IJERPH, MDPI, vol. 15(6), pages 1-18, June.

    More about this item

    Statistics

    Access and download statistics

    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:aph:ajpbhl:10.2105/ajph.2017.303686_7. 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.

    We have no bibliographic references for this item. You can help adding them by using 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: Christopher F Baum (email available below). General contact details of provider: https://www.apha.org .

    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.