Assessing the Health Impact of a Combined Water and Sanitation Intervention in Rural Odisha, India

Study Overview
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Brief Summary
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This is a matched-cohort study designed to assess the health impact of a rural demand-driven water and sanitation intervention that provides piped treated water and household level pour-flush latrines and bathing rooms, as implemented by Gram Vikas.

Detailed Description
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We will undertake a matched-cohort study among 84 villages in Ganjam district, Orissa, India to assess the health impact of a program that provides improved water supplies and sanitation to rural villages.

Official Title
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Assessing the Health Impact of a Combined Water and Sanitation Intervention in Rural Odisha, India

Conditions
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Diarrhea, Enteric Infection, Soil-transmitted Helminth Infection, Stunting

Intervention / Treatment
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* Behavioral: Improved water supply and sanitation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Households in participating villages will be eligible to participate in the study if they have at least one child under 5 years. Exclusion Criteria: None
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Intervention group<br>Rural villages in which Gram Vikas has fully implemented its water supply and sanitation (Mantra) intervention. Intervention villages must: 1) be within 3 hours travel to the study office in Brahmapur, 2) have started the intervention by January 2003, and 3) have completed the intervention by January 2013. | Behavioral: Improved water supply and sanitation<br>* Village-level reticulated water supply with distribution to household taps; pour-flush pit latrines.<br>|
| Control group<br>Rural villages that have been matched with intervention villages on demographics and other criteria. The sampling frame for control villages is limited to those: 1) within 3 hours travel to the study office in Brahmapur, and 2) within Gram Panchayats which do not include an intervention village and are not adjacent to an intervention village, to minimize spillover effects. In addition, both intervention and control villages must appear in the Government of India Census in 2001. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Reported diarrhoea in children <5 years |  | 7-day recall, assessed 4 times during 3-month follow-up rounds | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Reported lower respiratory infection in children <5 |  | 7-day recall, assessed 4 times during 3-month follow-up rounds | 
| Diarrhoea among all ages |  | 7-day recall, assessed 4 times during 3-month follow-up roundsits | 
| Lower respiratory infection among all ages |  | 7-day recall, assessed 4 times during 3-month follow-up roundsts | 
| Soil-transmitted helminth infection | Stool samples taken and assayed for ascaris, trichuris, hookworm | Point prevalence assessed in rounds 2 (approximately 90-120 days after study commencement) and 4 (approximately 240 to 360 days after study commencement) | 
| Height-for-age among children < 2 years | Children height measured and HAZ scores computed | Assessed approximately every 90 days for a total of four measurement over study period | 
| Weight-for-age among children <5 | Children weighed and WAZ scores computed | Assessed approximately every 90 days for a total of four measurement over study periodAssessed during all four follow up rounds | 
| Biomarkers of environmental enteropathy and enteric infection |  | Assessed once during round 3 (approximately 180 to 240 days following commencement of study |