Clinical trial NCT02617225: Effect of a Pilot Group Hand-washing Program on Handwashing Behaviors Among Elementary School Children in Assam
Official title: Evaluation of DHaAL Intervention of Group Handwashing With Soap Before Mid-day Meals in Rural Elementary School of Assam
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Handwashing Behaviors
Lead sponsor: Network for Engineering and Economics Research and Management
Sponsor class: OTHER
Collaborators: name: UNICEF
First posted: 2015-11-30
Enrollment: 823
Sex: ALL
Minimum age (years): 8
Maximum age (years): 75
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: CROSS_SECTIONAL
Sampling method: PROBABILITY_SAMPLE
Study population: Elementary schools (Class 1-5) from five education blocks in Kamrup district. The respondents/participants include school teachers (Interview/observations), Class 1-5 students (distant observation), Class 3-5 students (personal Interviews/observations) and their parents/other household members (personal Interview/observations).

Brief summary: The United Nation's International Children's Emergency Fund (UNICEF) is supporting Saba Shikha Abihyan (SSA) (Education-for-All Mission) of the Government of Assam (GoA) under their Water-Sanitation-Hygiene in School (WinS) program to improve WASH facilities, practices and institutionalize WASH in school settings. Under the WinS program, UNICEF piloted a group hand washing program in 100 elementary schools. Multiple past studies have shown that handwashing is an effective intervention to reduce diarrheal diseases and respiratory tract infections, but the evidence on the interventions or programs that can achieve this behavior change is mixed and limited in case of school setting. The main objective of Daily Handwashing for an Ailment-free Life (DHaAL) program was to institutionalize handwashing with soap before consuming mid-day meals and after using toilets among elementary school students. DHaAL is implemented on the Mid-day Meal platform where free meals are given to all students attending government schools.

In addition to the standard DHaAL intervention, several pilot phase schools also received an additional program for a holistic and participatory development of school systems for health, nutrition, learning outcomes and wellbeing of children called Child Friendly School System (CFSS). Although CFSS is not a WASH intervention it can develop systems and processes and offer longer support from and implementing agencies which help DHaAL Intervention also.

This evaluation study seeks to answer whether DHaAL improved handwashing practice before the mid-day meals in rural lower primary schools as a primary research question. The intermediate outputs and secondary outcomes evaluated in this study include functionality of handwashing infrastructure at school, handwashing practice after toilet use, and availability of and use of handwashing facilities at homes (indirect effect). The evaluation study has other supplemental operations research objectives to help improve the program in future.


Eligibility criteria: Inclusion Criteria:

* Should be present in the school on the day of interview/survey

Exclusion Criteria:

* None

Primary outcomes:
measure: Proportion of Class 1-5 children washing hands with soap before consuming mid-day meals in schools
timeFrame: On the day of interview (~12-24 months after the external support under DHaAL ceased)
Secondary outcomes:
measure: Proportion of Class 1-5 children washing hands with soap after the use of toilets for defecation or urination in schools
timeFrame: On the day of interview (~12-24 months after the external support under DHaAL ceased)
measure: Proportion of schools having a functional handwashing station with water and soap
timeFrame: On the day of interview (~12-24 months after the external support under DHaAL ceased)
measure: Proportion of households having a functional handwashing station with water and soap
timeFrame: On the day of interview (~12-24 months after the external support under DHaAL ceased)
Other outcomes:
Locations:
city: Mumbai
country: India
facility: NEERMAN
state: Maharashtra
Study officials:
affiliation: Network for Engineering and Economics Research and Management
name: Sumeet Patil
role: PRINCIPAL_INVESTIGATOR
References: