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A Review of the Community Health Club Literature Describing Water, Sanitation, and Hygiene Outcomes

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  • Jason Rosenfeld

    (Center for Medical Humanities & Ethics, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229-3900, USA)

  • Ruth Berggren

    (Center for Medical Humanities & Ethics, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229-3900, USA)

  • Leah Frerichs

    (Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1102C McGavran-Greenberg, Chapel Hill, NC 27599-7411, USA)

Abstract

The Community Health Club (CHC) model is a community-based health promotion program that utilizes water, sanitation, and hygiene (WASH) education as the first stage of a longitudinal development process. Although the CHC model has been implemented in fourteen countries over 20 years, this is the first review of the literature describing the model’s outcomes and impact. We conducted a review of the literature that provided quantitative or qualitative evidence of CHC interventions focused on WASH in low- and middle-income countries. We identified 25 articles that met our inclusion criteria. We found six major outcomes: WASH behaviors and knowledge, social capital, collective action, health, and cost or cost-effectiveness. The most consistent evidence was associated with WASH behaviors and knowledge, with significant effects on defecation practices, hand washing behaviors, and WASH knowledge. We also found qualitative evidence of impact on social capital and collective action. CHCs catalyze favorable changes in WASH behaviors and knowledge, yielding outcomes commensurate with other WASH promotion strategies. This review provides insights into the model’s theory of change, helping identify areas for further investigation. The CHC model’s holistic focus and emphasis on individual and collective change offer promising potential to address multiple health and development determinants.

Suggested Citation

  • Jason Rosenfeld & Ruth Berggren & Leah Frerichs, 2021. "A Review of the Community Health Club Literature Describing Water, Sanitation, and Hygiene Outcomes," IJERPH, MDPI, vol. 18(4), pages 1-33, February.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:4:p:1880-:d:499709
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    References listed on IDEAS

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    1. Evans, W.D. & Pattanayak, S.K. & Young, S. & Buszin, J. & Rai, S. & Bihm, Jasmine Wallace, 2014. "Social marketing of water and sanitation products: A systematic review of peer-reviewed literature," Social Science & Medicine, Elsevier, vol. 110(C), pages 18-25.
    2. 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.
    3. Kawachi, I. & Kennedy, B.P. & Lochner, K. & Prothrow-Stith, D., 1997. "Social capital, income inequality, and mortality," American Journal of Public Health, American Public Health Association, vol. 87(9), pages 1491-1498.
    4. Cameron, Lisa A. & Olivia, Susan & Shah, Manisha, 2015. "Initial Conditions Matter: Social Capital and Participatory Development," IZA Discussion Papers 9563, Institute of Labor Economics (IZA).
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