Sanitation Demand Creation in Peri-Urban Slums of Lusaka, Zambia (SanDem)

London School of Hygiene and Tropical Medicine

Status: Completed

Conditions: Diarrhea

Treatments: Behavioral: Bauleni Secret

Study type: Interventional

Funder types: Other

Identifiers

NCT03174015

QA_840

Details and patient eligibility

About

This intervention will experimentally test the hypothesis that sanitation can be improved in a peri-urban setting using state-of-the-art behaviour change communications.

Formative research indicated that landlords are the effective decision-makers about investments in sanitation on their plots (which can include a number of tenant households as well). Landlords will therefore be the primary targets of the intervention. The study will take the form of a randomized controlled trial of the intervention evaluated at the plot level. The intervention will invite enrolled landlords to a series of meetings in which various mechanisms will be used, each designed to increase their likelihood of improving the toilet(s) on their plot. These meetings will be the main vehicle for a status-building campaign associated with increasing wealth by improving plot sanitation, understanding tenants' implicit demand, understanding the processes by which toilets can be improved, and a competition rewarding landlords that make the greatest improvements to the improvement of their toilet(s). The desired improvements will be measured via multiple primary outcomes that measure aspects of changes to hardware and software components, including indicators of hygienic quality, psychological desirability, accessibility, and ecological sustainability. This is because the investigators argue that, to have a significant impact on population-level diarrheal disease indicators, any sanitation solution must be:

• effective at reducing exposure to pathogens (i.e., hygienic),
• desirable (i.e., seen as valuable or humane), and
• accessible (i.e., no one excluded), so that it can be used by all
• for a reasonably long time (i.e., sustainable)

Enrollment: 1,085 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Plots will be selected for inclusion in the study based on meeting the inclusion criteria. The intervention will be delivered to the landlord on each plot assigned to the intervention arm.

Intervention Inclusion Criteria:

• Plot located in Bauleni compound
• Adult landlord (age 18 or higher) resides on plot

Intervention Exclusion Criteria:

* None

Data will be collected from the landlord and one randomly selected tenant from all eligible adult tenants on each plot.

Data Collection Inclusion Criteria:

* Adult landlord or tenant (age 18 or higher) resides on selected plot most of the time

Data Collection Exclusion Criteria:

* None

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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1,085 participants in 2 patient groups

Intervention

Experimental group

Description:

Landlords on selected plots will receive the "Bauleni Secret" intervention. Landlords and selected tenants will be surveyed in baseline/end-line data collection.

Treatment:

Behavioral: Bauleni Secret

Control

No Intervention group

Description:

Landlords and selected tenants will be surveyed in baseline/end-line data collection only.