Effectiveness of community and school-based sanitation interventions in improving latrine coverage: a systematic review and meta-analysis of randomized controlled interventions

Environmental Health and Preventive Medicine

Parshal Bhandari¹  Mostafa Elsayed Hewalla²  Caroline Ibrahim Lotify³  Amr Elhamamsy⁴  Tran Thi Tuyet Nga⁵  Nguyen Tien Huy⁶  Peterson Gitonga Mathenge⁷  Nguyen Hai Nam⁸  Nguyen Tran Minh Duc⁸  Gehad Mohamed Tawfik⁸  Satoshi Igaki⁹  Masahiro Hashizume⁹ 

[1] Department of Anesthesiology and Intensive Care, Post Graduate Medical Institute, Lahore General Hospital;Faculty of Medicine, Alexandria University;Faculty of Pharmacy, Assiut University;Faculty of Pharmacy, Tanta University;Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City;Institute of Research and Development, Duy Tan University;Leading Program, Graduate School of Biomedical Sciences, Nagasaki University;Online Research Club;School of Tropical Medicine and Global Health, Nagasaki University;

关键词: Sanitation;    Latrine;    Meta-analysis;    Systematic review;   

DOI  :  10.1186/s12199-021-00934-4

来源: DOAJ

【 摘 要 】

Abstract Introduction Approximately 1000 children die each year due to preventable water and sanitation-related diarrheal diseases. Six in 10 people lacked access to safely managed sanitation facilities in 2015. Numerous community- and school-based approaches have been implemented to eradicate open defecation practices, promote latrine ownership, improve situation sanitation, and reduce waterborne disease. Objective Given that current evidence for sanitation interventions seem promising, the aim of this study was to systematically summarize existing research on the effectiveness of community- and school-based randomized controlled sanitation intervention in improving (1) free open defecation (safe feces disposal), (2) latrine usage, (3) latrine coverage or access, and (4) improved latrine coverage or access. Methods Eight electronic databases were searched: PubMed, Scopus, WHO Global Health Library (GHL), Virtual Health Library (VHL), POPLINE, Web of Science, Cochrane, and Google Scholar up to 26 April 2019. Original randomized clinical trials addressing community-based or school-based intervention that reported feces disposal and latrine coverage were deemed eligible. More than two researchers independently contributed to screening of papers, data extraction, and bias assessment. We conducted a meta-analysis by random-effects model. The risk of bias was assessed by the Cochrane risk of bias tool. Results Eighteen papers that matched all criteria and 16 studies were included in the final meta-analysis. Compared to the control, the sanitation intervention significantly increased safe feces disposal (OR 2.19, 95% CI 1.51–3.19, p < 0.05, I 2 = 97.28), latrine usage (OR 3.72, 95% CI 1.71–8.11, p < 0.05, I 2 = 91.52), latrine coverage or access (OR 3.95, 95% CI 2.08–7.50, p < 0.05, I 2 = 99.07), and improved latrine coverage or access (OR 3.68, 95% CI 1.52–8.91, p < 0.05, I 2 = 99.11). A combination of education and latrine construction was more effective compared to educational intervention alone. Conclusion Our study showed strong evidence for both community- and school-based sanitation interventions as effective for the safe disposal of human excreta. The finding suggests major implications for health policy and design of future intervention in developing countries.

【 授权许可】

Unknown