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

Authors

Stephanie O. Sangalang, University of Bonn
Shelley Anne J. Medina, University of the Philippines Diliman
Zheina J. Ottong, University of the Philippines Diliman
Allen Lemuel G. Lemence, University of the Philippines Diliman
Donrey Totanes, University of the Philippines Diliman
John Cedrick Valencia, University of the Philippines Diliman
Patricia Andrea A. Singson, Ateneo de Manila University
Mikaela Olaguera, University of the Philippines Diliman
Nelissa O. Prado, University of Tokyo
Roezel Mari Z. Ocaña, Far Eastern University
Rovin James F. Canja, University of the Philippines Diliman
Alfem John T. Benolirao, Adamson University
Shyrill Mae F. Mariano, University of the Philippines Diliman
Jergil Gyle Gavieres
Clarisse P. Aquino, University of the Philippines Diliman
Edison C. Latag, Technological University of the Philippines
Maria Vianca Jasmin C. Anglo, University of the Philippines Diliman
Christian Borgemeister, University of Bonn
Thoomas Kistemann, University of Bonn

Document Type

Article

Publication Date

12-30-2020

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.

Recommended Citation

Sangalang, S. O., Medina, S. A. J., Ottong, Z. J., Lemence, A. L. G., Totanes, D., Valencia, J. C., Singson, P. A. A., Olaguera, M., Prado, N. O., Ocaña, R. M. Z., Canja, R. J. F., Benolirao, A. J. T., Mariano, S. M. F., Gavieres, J. G., Aquino, C. P., Latag, E. C., Anglo, M. V. J. C., Borgemeister, C., & Kistemann, T. (2020). 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. International Journal of Environmental Research and Public Health, 18(1), 226. https://doi.org/10.3390/ijerph18010226