Protocol for a Trial Assessing the Impacts of School-Based WaSH Interventions on Children’s Health Literacy, Handwashing, and Nutrition Status in Low- and Middle-Income Countries

Stephanie O. Sangalang, Shelley Anne J. Medina, Zheina J. Ottong, Allen Lemuel G. Lemence, Donrey Totanes, John Cedrick Valencia, Patricia Andrea A. Singson, Mikaela Olaguera, Nelissa O. Prado, Roezel Mari Z. Ocaña, Rovin James F. Canja, Alfem John T. Benolirao, Shyrill Mae F. Mariano, Jergil Gyle Gavieres, Clarisse P. Aquino, Edison C. Latag, Maria Vianca Jasmin C. Anglo, Christian Borgemeister and Thomas Kistemann
Additional contact information
Stephanie O. Sangalang: Center for Development Research, University of Bonn, 53113 Bonn, Germany
Shelley Anne J. Medina: College of Social Work and Community Development, University of the Philippines Diliman, Quezon City 1101, Philippines
Zheina J. Ottong: Marine Science Institute, University of the Philippines Diliman, Quezon City 1101, Philippines
Allen Lemuel G. Lemence: National Graduate School of Engineering, College of Engineering, University of the Philippines Diliman, Quezon City 1101, Philippines
Donrey Totanes: College of Mass Communication, University of the Philippines Diliman, Quezon City 1101, Philippines
John Cedrick Valencia: National College of Public Administration and Governance, University of the Philippines Diliman, Quezon City 1101, Philippines
Patricia Andrea A. Singson: School of Social Sciences, Ateneo de Manila University, Quezon City 1800, Philippines
Mikaela Olaguera: College of Mass Communication, University of the Philippines Diliman, Quezon City 1101, Philippines
Nelissa O. Prado: Kashiwa Campus, University of Tokyo, Chiba 277-0882, Japan
Roezel Mari Z. Ocaña: School of Medicine, Far Eastern University, Nicanor Reyes Medical Foundation, Quezon City 1118, Philippines
Rovin James F. Canja: National College of Public Administration and Governance, University of the Philippines Diliman, Quezon City 1101, Philippines
Alfem John T. Benolirao: College of Business Administration, Adamson University, Manila 1000, Philippines
Shyrill Mae F. Mariano: Marine Science Institute, University of the Philippines Diliman, Quezon City 1101, Philippines
Jergil Gyle Gavieres: Department of Sociology, College of Social Sciences and Philosophy, University of the Philippines Dili-man, Quezon City 1101, Philippines
Clarisse P. Aquino: Department of Sociology, College of Social Sciences and Philosophy, University of the Philippines Dili-man, Quezon City 1101, Philippines
Edison C. Latag: College of Engineering, Technological University of the Philippines, Manila 1008, Philippines
Maria Vianca Jasmin C. Anglo: Department of Psychology, College of Social Sciences and Philosophy, University of the Philippines Diliman, Quezon City 1101, Philippines
Christian Borgemeister: Center for Development Research, University of Bonn, 53113 Bonn, Germany
Thomas Kistemann: Center for Development Research, University of Bonn, 53113 Bonn, Germany

IJERPH, 2020, vol. 18, issue 1, 1-19

Abstract: Diarrhea, soil-transmitted helminth infection and malnutrition are leading causes of child mortality in low- and middle-income countries (LMICs). To reduce the prevalence of these diseases, effective interventions for adequate water, sanitation, and hygiene (WaSH) should be implemented. This paper describes the design of a cluster-randomized controlled trial that will compare the efficacy of four school-based WaSH interventions for improving children’s health literacy, handwashing, and nutrition. Interventions consisted of (1) WaSH policy reinforcement; (2) low-, medium-, or high-volume health education; (3) hygiene supplies; and (4) WaSH facilities (e.g., toilets, urinals, handwashing basins) improvements. We randomly allocated school clusters from the intervention arm to one of four groups to compare with schools from the control arm. Primary outcomes were: children’s health literacy, physical growth, nutrition status, and handwashing prevalence. Secondary outcomes were: children’s self-reported health status and history of extreme hunger, satisfaction with WaSH facilities, and school restrooms’ WaSH adequacy. We will measure differences in pre- and post-intervention outcomes and compare these differences between control and intervention arms. This research protocol can be a blueprint for future school-based WaSH intervention studies to be conducted in LMICs. Study protocols were approved by the ethics committees of the University of Bonn, Germany, and the University of the Philippines Manila. This trial was retroactively registered, ID number: DRKS00021623.

Keywords: children’s health; health literacy; malnutrition; water; sanitation; and hygiene (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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