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Pilot Cluster Randomized Controlled Trials to Evaluate Adoption of Water, Sanitation, and Hygiene Interventions and Their Combination in Rural Western Kenya

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  • Rollins School of Public Health, Emory University, Atlanta, Georgia; Innovations for Poverty Action, Busia, Kenya; Department of Civil and Environmental Engineering, Stanford University, Stanford, California; Division of Epidemiology, University of California, Berkeley, California

In preparation for a larger trial, the Water, Sanitation, and Hygiene (WASH) Benefits pilot study enrolled 72 villages and 499 subjects in two closely related randomized trials of WASH interventions in rural western Kenya. Intervention households received hardware and promotion for one of the following: water treatment, sanitation and latrine improvements, handwashing with soap, or the combination of all three. Interventions were clustered by village. A follow-up survey was conducted 4 months after intervention delivery to assess uptake. Intervention households were significantly more likely than controls to have chlorinated stored water (36–60 percentage point increases), covers over latrine drop holes (55–75 percentage point increases), less stool visible on latrine floors (16–47 percentage point reductions), and a place for handwashing (71–85 percentage point increases) with soap available (49–66 percentage point increases). The high uptake in all arms shows that combined interventions can achieve high short-term adoption rates if well-designed.

Author Notes

* Address correspondence to Garret Christensen, CEGA, 207 Giannini Hall, Berkeley CA 94720-3310. E-mail: garret@berkeley.edu

Financial support: This work was funded by a grant to the University of California Berkeley from the Bill and Melinda Gates Foundation.

Authors' addresses: Garret Christensen, CEGA, UC Berkeley, Berkeley, CA, E-mail: garret@berkeley.edu. Holly N. Dentz Department of Nutrition, University of California, Davis, CA, E-mail: hdentz@ucdavis.edu. Clair Null, Mathematica Policy Research, Washington, DC, E-mail: cnull@mathematica-mpr.com. Amy J. Pickering, Department of Civil and Environmental Engineering, Stanford University, Stanford, CA, E-mail: amyjanel@stanford.edu. Tomoé Bourdier, Agricultural and Resource Economics, University of California, Davis, CA, E-mail: bourdier@primal.ucdavis.edu. Benjamin F. Arnold and John M. Colford Jr, Division of Epidemiology, University of California, Berkeley, CA, E-mails: benarnold@berkeley.edu and jcolford@ucberkeley.edu.

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