Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Kenya: a cluster-randomised controlled trial

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Poor nutrition and exposure to faecal contamination are associated with diarrhoea and growth faltering, both of which have long-term consequences for child health. This trial aimed to assess whether water, sanitation, handwashing, and nutrition interventions reduced diarrhoea or growth faltering.

Overall the trial found that behaviour change messaging combined with simple interventions such as water treatment, household sanitation upgrades from unimproved to improved latrines, and handwashing stations did not reduce childhood diarrhoea or improve growth, even when adherence was at least as high as has been achieved by other programmes. Nutrition counselling and supplementation along with combined water, sanitation, handwashing, and nutrition interventions led to small growth benefits, but there was no advantage to integrating water, sanitation, and handwashing with nutrition. The interventions might have been more effective with higher adherence or in an environment with lower baseline sanitation coverage, especially in this context of high diarrhoea prevalence.

Date: 26 February 2018