Effect of a Pilot Group Hand-washing Program on Handwashing Behaviors Among Elementary School Children in Assam

Network for Engineering and Economics Research and Management

Status: Completed

Conditions: Handwashing Behaviors

Treatments: Behavioral: DHaAL Intervention; Behavioral: DHaAL + CFSS Intervention

Study type: Observational

Funder types: Other

Identifiers

NCT02617225

2016/06/UNICEF01

Details and patient eligibility

About

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.

Enrollment: 823 patients

Sex: All

Ages: 8 to 75 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

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

Exclusion criteria

• None

Trial design

823 participants in 3 patient groups

DHaAL Intervention

Description:

The group receives standard Ailment-free Life (DHaAL) DHaAL intervention

Treatment:

Behavioral: DHaAL Intervention

DHaAL +CFSS Intervention

Description:

This group received the standard DHaAL intervention and additional support under another UNICEF program named Child Friendly School System (CFSS).

Treatment:

Behavioral: DHaAL Intervention

Behavioral: DHaAL + CFSS Intervention

Control

Description:

This group receive the standard / business-as-usual support from the Education Department, but does not receive DHaAL or CFSS Interventions.