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.

World Bank, Washington, DC

关键词: ACCESS TO WATER;    AGED;    AGING;    BEHAVIOR CHANGE;    BREASTFEEDING;   

DOI  :  10.1596/1813-9450-6702
RP-ID  :  WPS6702

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

Poor sanitation and open defecation arethought to be a major cause of diarrhea and intestinalparasite infections among young children. In 1999, Indialaunched the Total Sanitation Campaign with the goal ofachieving universal toilet coverage in rural India by 2012.This paper reports on a cluster-randomized, controlled trialthat was conducted in 80 rural villages in Madhya Pradesh tomeasure the effect of the program on toilet access,sanitation behavior, and child health outcomes. The studyanalyzed a random sample of 3,039 households and 5,206children under five years of age. Field staff collectedbaseline measures of sanitation conditions, behavior, andchild health, and re-visited households 21 months later. Theanalysis finds that implementation of the program activitieswas slower than the original timeline (only 35 percent ofvillages were triggered more than six months before thefollow-up survey). Nevertheless, the Total SanitationCampaign successfully increased toilet coverage by 19percent in intervention villages compared with controlvillages (41 percent v. 22 percent), while reported opendefecation decreased by 10 percent among adults (74 percentv. 84 percent). The intervention also led to someimprovements in water quality and protozoan infection, butconsistent improvements were not observed across multiplechild health outcomes (diarrhea, helminth infections, childgrowth). However, the exposure period was likely to havebeen too short to result in any benefit of the sanitationinterventions on child health. Given the large improvementsin toilet construction documented, an additional follow-upsurvey with a longer period of exposure would yield valuableinformation on the effects of improved sanitation conditionson health outcomes.