Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Evaluating the Impact of Community Led Total Sanitation in Mali. A Randomized Controlled Trial
Brief Summary: Behavioral change is a key ingredient for successful adoption of better sanitation practices in rural Africa. Sanitation programs have, for some time now, incorporated the need to raise awareness and emphasize the benefits of toilet usage. These endeavors, often combined with subsidies linked to toilet construction by households, seek to create a demand for sanitation goods. Yet, progress in securing the desired outcomes from sanitation programs has been slow. Moreover, benefits of sanitation largely take the form of externalities, which individuals do not take into account when making their own decisions about investments. This makes sanitation promotion at the household level particularly challenging.

A new approach to sanitation entails a shift away from the provision of subsidies for toilets to individual households and a promotion of behavioral change at individual-level towards emphasizing collective decision-making in order to produce 'open defecation-free' villages. The objective of the intervention is to reduce the incidence of diseases related to poor sanitation and manage public risks posed by the failure to safely confine the excreta of some community members. The way to achieve this objective is by empowering communities motivated to take collective action. Local governments and other agencies perform a facilitating role. There is a growing recognition that this approach, referred to as Community-Led Total Sanitation (CLTS), may help with the reduction of open defecation practices. However, no rigorous impact evaluation of CLTS has been conducted so far. This randomized controlled trial will study the effect of CLTS in rural Mali. As a result, sound evidence will become available to see to what extent CLTS improves health outcomes and what is driving collective action in order to increase sanitation coverage.

The direct recipients of the intervention are members of rural communities in Mali who aspire to live in a cleaner environment. The donor community, international organizations, and governments in developing countries will benefit from having simple and clear evidence on the effectiveness of an innovative program for improving sanitation in rural areas. They will learn whether the program has worked or failed to achieve its objective of eradicating open defecation, and about key factors explaining success and failure.


Options:
A: Arm Label: CLTS communities; Type: EXPERIMENTAL; Interventions: Other: CLTS | Arm Label: Rural communities; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: OTHER; Name: CLTS; Assigned to Arm(s): CLTS communities
B: Arm Label: Standard of Care; Type: PLACEBO_COMPARATOR; Interventions: Behavioral: Standard care | Arm Label: WASH; Type: ACTIVE_COMPARATOR; Interventions: Other: WASH | Arm Label: Nutrition; Type: ACTIVE_COMPARATOR; Interventions: Dietary Supplement: Infant and young child feeding | Arm Label: WASH and Nutrition; Type: ACTIVE_COMPARATOR; Interventions: Other: WASH and Nutrition | Intervention Type: BEHAVIORAL; Name: Standard care; Assigned to Arm(s): Standard of Care | Intervention Type: OTHER; Name: WASH; Assigned to Arm(s): WASH | Intervention Type: DIETARY_SUPPLEMENT; Name: Infant and young child feeding; Assigned to Arm(s): Nutrition | Intervention Type: OTHER; Name: WASH and Nutrition; Assigned to Arm(s): WASH and Nutrition
C: Arm Label: Sanitation intervention; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: Provision of household latrines | Arm Label: Control; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: BEHAVIORAL; Name: Provision of household latrines; Assigned to Arm(s): Sanitation intervention
D: Arm Label: Control; Type: NO_INTERVENTION; Interventions: N/A | Arm Label: Handwashing Intervention; Type: EXPERIMENTAL; Interventions: Behavioral: Scaling Up Handwashing Behavior Change | Arm Label: Sanitation Intervention; Type: EXPERIMENTAL; Interventions: Behavioral: Total Sanitation and Sanitation Marketing | Arm Label: Combined; Type: EXPERIMENTAL; Interventions: Behavioral: Total Sanitation and Sanitation Marketing, Behavioral: Scaling Up Handwashing Behavior Change | Intervention Type: BEHAVIORAL; Name: Total Sanitation and Sanitation Marketing; Assigned to Arm(s): Combined, Sanitation Intervention | Intervention Type: BEHAVIORAL; Name: Scaling Up Handwashing Behavior Change; Assigned to Arm(s): Combined, Handwashing Intervention

Answer: A