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

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

American Journal of Public Health, 2014, vol. 104, issue 1, e91-e97

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.

Keywords: article; child; controlled clinical trial; controlled study; diarrhea; female; hand washing; health promotion; human; hygiene; infant; Kenya; male; microbiology; newborn; preschool child; prevalence; randomized controlled trial; risk factor; sanitation; sibling; student; water management; water supply; diarrhea; Kenya, Child; Child, Preschool; Diarrhea; Female; Hand Disinfection; Health Promotion; Humans; Hygiene; Infant; Infant, Newborn; Kenya; Male; Prevalence; Risk Factors; Sanitation; Siblings; Students; Water Microbiology; Water Purification; Water Supply, Child; Child, Preschool; Diarrhea; Female; Hand Disinfection; Health Promotion; Humans; Hygiene; Infant; Infant, Newborn; Kenya; Male; Prevalence; Risk Factors; Sanitation; Siblings; Students; Water Microbiology; Water Purification; Water Supply (search for similar items in EconPapers)
Date: 2014
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Citations: View citations in EconPapers (8)

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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2013.301412_2

DOI: 10.2105/AJPH.2013.301412

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