A Randomized, Controlled Study of a Rural Sanitation Behavior Change Program in Madhya Pradesh, India

Poor sanitation and open defecation are thought to be a major cause of diarrhea and intestinal parasite infections among young children. In 1999, India launched the Total Sanitation Campaign with the goal of achieving universal toilet coverage in r...

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Main Authors:	Patil, Sumeet R., Arnold, Benjamin F., Salvatore, Alicia, Briceno, Bertha, Colford, Jr., John M., Gertler, Paul J.
Format:	Policy Research Working Paper
Language:	English en_US
Published:	World Bank, Washington, DC 2014
Subjects:	ACCESS TO WATER AGED AGING BEHAVIOR CHANGE BREASTFEEDING CENTRAL GOVERNMENT CHILD DEVELOPMENT CHILD HEALTH CHILD NUTRITION CHILDHOOD DIARRHOEA CHOLERA COLLECTION ACTIVITIES COMMUNITIES COMMUNITY ACTION COMMUNITY HEALTH COMMUNITY SANITATION DEMAND FOR SANITATION DESCRIPTION DIARRHEA DIARRHEAL DISEASE DIARRHEAL DISEASES DISINFECTION DISTRIBUTION NETWORKS DISTRICTS DRINKING WATER DRINKING WATER QUALITY DRINKING WATER SOURCE DWELLING EPIDEMIOLOGY EXERCISES FINANCIAL INCENTIVES FLY CONTROL GROUNDWATER HAND WASHING HANDWASHING HEALTH EFFECTS HEALTH INTERVENTIONS HEALTH OUTCOMES HOUSEHOLD LATRINES HOUSEHOLDS HUMAN EXCRETA HYGIENE HYGIENE EDUCATION HYGIENIC METHODS INFANT MORTALITY INFORMED CONSENT INTERVENTION INTESTINAL PARASITES INTESTINAL WORMS IRON LARGE-SCALE SANITATION PROGRAMS LATRINE LATRINE PROMOTION LOCAL AUTHORITIES MIGRATION MORTALITY NEIGHBORHOODS NUTRITION PEDIATRICS PIT LATRINES PRIVATE TOILET PROVISION OF LATRINES PUBLIC HEALTH RISK OF CONTAMINATION RURAL AREAS RURAL DEVELOPMENT RURAL SANITATION RURAL VILLAGES SANITATION SANITATION COVERAGE SANITATION FACILITIES SANITATION HYGIENE SANITATION PROGRAM SANITATION PROMOTION SANITATION REQUIREMENTS SANITATION SECTOR SANITATION SERVICES SCHISTOSOMIASIS SCHOOL SANITATION SERVICE DELIVERY SEWERAGE SEWERAGE SYSTEMS SHELTER SIBLINGS SOAP SOCIAL MARKETING SOCIAL MOBILIZATION TOILET TOILETS URBAN CENTERS URBAN COMMUNITY USE OF TOILETS VILLAGE LEVEL VILLAGES WASTE WASTE MANAGEMENT WATER DISTRIBUTION WATER QUALITY WATER SEAL WATER SOURCE WATER SOURCES WATER SUPPLIES WATER SUPPLY WELLS WORKERS
Online Access:	http://documents.worldbank.org/curated/en/2013/11/18512377/randomized-controlled-study-rural-sanitation-behavior-change-program-madhya-pradesh-india http://hdl.handle.net/10986/16913

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spelling	okr-10986-169132021-04-23T14:03:33Z A Randomized, Controlled Study of a Rural Sanitation Behavior Change Program in Madhya Pradesh, India Patil, Sumeet R. Arnold, Benjamin F. Salvatore, Alicia Briceno, Bertha Colford, Jr., John M. Gertler, Paul J. ACCESS TO WATER AGED AGING BEHAVIOR CHANGE BREASTFEEDING CENTRAL GOVERNMENT CHILD DEVELOPMENT CHILD HEALTH CHILD NUTRITION CHILDHOOD DIARRHOEA CHOLERA COLLECTION ACTIVITIES COMMUNITIES COMMUNITY ACTION COMMUNITY HEALTH COMMUNITY SANITATION DEMAND FOR SANITATION DESCRIPTION DIARRHEA DIARRHEAL DISEASE DIARRHEAL DISEASES DISINFECTION DISTRIBUTION NETWORKS DISTRICTS DRINKING WATER DRINKING WATER QUALITY DRINKING WATER SOURCE DWELLING EPIDEMIOLOGY EXERCISES FINANCIAL INCENTIVES FLY CONTROL GROUNDWATER HAND WASHING HANDWASHING HEALTH EFFECTS HEALTH INTERVENTIONS HEALTH OUTCOMES HOUSEHOLD LATRINES HOUSEHOLDS HUMAN EXCRETA HYGIENE HYGIENE EDUCATION HYGIENIC METHODS INFANT MORTALITY INFORMED CONSENT INTERVENTION INTESTINAL PARASITES INTESTINAL WORMS IRON LARGE-SCALE SANITATION PROGRAMS LATRINE LATRINE PROMOTION LOCAL AUTHORITIES MIGRATION MORTALITY NEIGHBORHOODS NUTRITION PEDIATRICS PIT LATRINES PRIVATE TOILET PROVISION OF LATRINES PUBLIC HEALTH RISK OF CONTAMINATION RURAL AREAS RURAL DEVELOPMENT RURAL SANITATION RURAL VILLAGES SANITATION SANITATION COVERAGE SANITATION FACILITIES SANITATION HYGIENE SANITATION PROGRAM SANITATION PROMOTION SANITATION REQUIREMENTS SANITATION SECTOR SANITATION SERVICES SCHISTOSOMIASIS SCHOOL SANITATION SERVICE DELIVERY SEWERAGE SEWERAGE SYSTEMS SHELTER SIBLINGS SOAP SOCIAL MARKETING SOCIAL MOBILIZATION TOILET TOILETS URBAN CENTERS URBAN COMMUNITY USE OF TOILETS VILLAGE LEVEL VILLAGES WASTE WASTE MANAGEMENT WATER DISTRIBUTION WATER QUALITY WATER SEAL WATER SOURCE WATER SOURCES WATER SUPPLIES WATER SUPPLY WELLS WORKERS Poor sanitation and open defecation are thought to be a major cause of diarrhea and intestinal parasite infections among young children. In 1999, India launched the Total Sanitation Campaign with the goal of achieving universal toilet coverage in rural India by 2012. This paper reports on a cluster-randomized, controlled trial that was conducted in 80 rural villages in Madhya Pradesh to measure the effect of the program on toilet access, sanitation behavior, and child health outcomes. The study analyzed a random sample of 3,039 households and 5,206 children under five years of age. Field staff collected baseline measures of sanitation conditions, behavior, and child health, and re-visited households 21 months later. The analysis finds that implementation of the program activities was slower than the original timeline (only 35 percent of villages were triggered more than six months before the follow-up survey). Nevertheless, the Total Sanitation Campaign successfully increased toilet coverage by 19 percent in intervention villages compared with control villages (41 percent v. 22 percent), while reported open defecation decreased by 10 percent among adults (74 percent v. 84 percent). The intervention also led to some improvements in water quality and protozoan infection, but consistent improvements were not observed across multiple child health outcomes (diarrhea, helminth infections, child growth). However, the exposure period was likely to have been too short to result in any benefit of the sanitation interventions on child health. Given the large improvements in toilet construction documented, an additional follow-up survey with a longer period of exposure would yield valuable information on the effects of improved sanitation conditions on health outcomes. 2014-02-05T13:53:39Z 2014-02-05T13:53:39Z 2013-11 http://documents.worldbank.org/curated/en/2013/11/18512377/randomized-controlled-study-rural-sanitation-behavior-change-program-madhya-pradesh-india http://hdl.handle.net/10986/16913 English en_US Policy Research Working Paper;No. 6702 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank, Washington, DC Publications & Research :: Policy Research Working Paper Publications & Research South Asia India
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	English en_US
topic	ACCESS TO WATER AGED AGING BEHAVIOR CHANGE BREASTFEEDING CENTRAL GOVERNMENT CHILD DEVELOPMENT CHILD HEALTH CHILD NUTRITION CHILDHOOD DIARRHOEA CHOLERA COLLECTION ACTIVITIES COMMUNITIES COMMUNITY ACTION COMMUNITY HEALTH COMMUNITY SANITATION DEMAND FOR SANITATION DESCRIPTION DIARRHEA DIARRHEAL DISEASE DIARRHEAL DISEASES DISINFECTION DISTRIBUTION NETWORKS DISTRICTS DRINKING WATER DRINKING WATER QUALITY DRINKING WATER SOURCE DWELLING EPIDEMIOLOGY EXERCISES FINANCIAL INCENTIVES FLY CONTROL GROUNDWATER HAND WASHING HANDWASHING HEALTH EFFECTS HEALTH INTERVENTIONS HEALTH OUTCOMES HOUSEHOLD LATRINES HOUSEHOLDS HUMAN EXCRETA HYGIENE HYGIENE EDUCATION HYGIENIC METHODS INFANT MORTALITY INFORMED CONSENT INTERVENTION INTESTINAL PARASITES INTESTINAL WORMS IRON LARGE-SCALE SANITATION PROGRAMS LATRINE LATRINE PROMOTION LOCAL AUTHORITIES MIGRATION MORTALITY NEIGHBORHOODS NUTRITION PEDIATRICS PIT LATRINES PRIVATE TOILET PROVISION OF LATRINES PUBLIC HEALTH RISK OF CONTAMINATION RURAL AREAS RURAL DEVELOPMENT RURAL SANITATION RURAL VILLAGES SANITATION SANITATION COVERAGE SANITATION FACILITIES SANITATION HYGIENE SANITATION PROGRAM SANITATION PROMOTION SANITATION REQUIREMENTS SANITATION SECTOR SANITATION SERVICES SCHISTOSOMIASIS SCHOOL SANITATION SERVICE DELIVERY SEWERAGE SEWERAGE SYSTEMS SHELTER SIBLINGS SOAP SOCIAL MARKETING SOCIAL MOBILIZATION TOILET TOILETS URBAN CENTERS URBAN COMMUNITY USE OF TOILETS VILLAGE LEVEL VILLAGES WASTE WASTE MANAGEMENT WATER DISTRIBUTION WATER QUALITY WATER SEAL WATER SOURCE WATER SOURCES WATER SUPPLIES WATER SUPPLY WELLS WORKERS
spellingShingle	ACCESS TO WATER AGED AGING BEHAVIOR CHANGE BREASTFEEDING CENTRAL GOVERNMENT CHILD DEVELOPMENT CHILD HEALTH CHILD NUTRITION CHILDHOOD DIARRHOEA CHOLERA COLLECTION ACTIVITIES COMMUNITIES COMMUNITY ACTION COMMUNITY HEALTH COMMUNITY SANITATION DEMAND FOR SANITATION DESCRIPTION DIARRHEA DIARRHEAL DISEASE DIARRHEAL DISEASES DISINFECTION DISTRIBUTION NETWORKS DISTRICTS DRINKING WATER DRINKING WATER QUALITY DRINKING WATER SOURCE DWELLING EPIDEMIOLOGY EXERCISES FINANCIAL INCENTIVES FLY CONTROL GROUNDWATER HAND WASHING HANDWASHING HEALTH EFFECTS HEALTH INTERVENTIONS HEALTH OUTCOMES HOUSEHOLD LATRINES HOUSEHOLDS HUMAN EXCRETA HYGIENE HYGIENE EDUCATION HYGIENIC METHODS INFANT MORTALITY INFORMED CONSENT INTERVENTION INTESTINAL PARASITES INTESTINAL WORMS IRON LARGE-SCALE SANITATION PROGRAMS LATRINE LATRINE PROMOTION LOCAL AUTHORITIES MIGRATION MORTALITY NEIGHBORHOODS NUTRITION PEDIATRICS PIT LATRINES PRIVATE TOILET PROVISION OF LATRINES PUBLIC HEALTH RISK OF CONTAMINATION RURAL AREAS RURAL DEVELOPMENT RURAL SANITATION RURAL VILLAGES SANITATION SANITATION COVERAGE SANITATION FACILITIES SANITATION HYGIENE SANITATION PROGRAM SANITATION PROMOTION SANITATION REQUIREMENTS SANITATION SECTOR SANITATION SERVICES SCHISTOSOMIASIS SCHOOL SANITATION SERVICE DELIVERY SEWERAGE SEWERAGE SYSTEMS SHELTER SIBLINGS SOAP SOCIAL MARKETING SOCIAL MOBILIZATION TOILET TOILETS URBAN CENTERS URBAN COMMUNITY USE OF TOILETS VILLAGE LEVEL VILLAGES WASTE WASTE MANAGEMENT WATER DISTRIBUTION WATER QUALITY WATER SEAL WATER SOURCE WATER SOURCES WATER SUPPLIES WATER SUPPLY WELLS WORKERS Patil, Sumeet R. Arnold, Benjamin F. Salvatore, Alicia Briceno, Bertha Colford, Jr., John M. Gertler, Paul J. A Randomized, Controlled Study of a Rural Sanitation Behavior Change Program in Madhya Pradesh, India
geographic_facet	South Asia India
relation	Policy Research Working Paper;No. 6702
description	Poor sanitation and open defecation are thought to be a major cause of diarrhea and intestinal parasite infections among young children. In 1999, India launched the Total Sanitation Campaign with the goal of achieving universal toilet coverage in rural India by 2012. This paper reports on a cluster-randomized, controlled trial that was conducted in 80 rural villages in Madhya Pradesh to measure the effect of the program on toilet access, sanitation behavior, and child health outcomes. The study analyzed a random sample of 3,039 households and 5,206 children under five years of age. Field staff collected baseline measures of sanitation conditions, behavior, and child health, and re-visited households 21 months later. The analysis finds that implementation of the program activities was slower than the original timeline (only 35 percent of villages were triggered more than six months before the follow-up survey). Nevertheless, the Total Sanitation Campaign successfully increased toilet coverage by 19 percent in intervention villages compared with control villages (41 percent v. 22 percent), while reported open defecation decreased by 10 percent among adults (74 percent v. 84 percent). The intervention also led to some improvements in water quality and protozoan infection, but consistent improvements were not observed across multiple child health outcomes (diarrhea, helminth infections, child growth). However, the exposure period was likely to have been too short to result in any benefit of the sanitation interventions on child health. Given the large improvements in toilet construction documented, an additional follow-up survey with a longer period of exposure would yield valuable information on the effects of improved sanitation conditions on health outcomes.
format	Publications & Research :: Policy Research Working Paper
author	Patil, Sumeet R. Arnold, Benjamin F. Salvatore, Alicia Briceno, Bertha Colford, Jr., John M. Gertler, Paul J.
author_facet	Patil, Sumeet R. Arnold, Benjamin F. Salvatore, Alicia Briceno, Bertha Colford, Jr., John M. Gertler, Paul J.
author_sort	Patil, Sumeet R.
title	A Randomized, Controlled Study of a Rural Sanitation Behavior Change Program in Madhya Pradesh, India
title_short	A Randomized, Controlled Study of a Rural Sanitation Behavior Change Program in Madhya Pradesh, India
title_full	A Randomized, Controlled Study of a Rural Sanitation Behavior Change Program in Madhya Pradesh, India
title_fullStr	A Randomized, Controlled Study of a Rural Sanitation Behavior Change Program in Madhya Pradesh, India
title_full_unstemmed	A Randomized, Controlled Study of a Rural Sanitation Behavior Change Program in Madhya Pradesh, India
title_sort	randomized, controlled study of a rural sanitation behavior change program in madhya pradesh, india
publisher	World Bank, Washington, DC
publishDate	2014
url	http://documents.worldbank.org/curated/en/2013/11/18512377/randomized-controlled-study-rural-sanitation-behavior-change-program-madhya-pradesh-india http://hdl.handle.net/10986/16913
_version_	1764434871572234240

A Randomized, Controlled Study of a Rural Sanitation Behavior Change Program in Madhya Pradesh, India

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