Geospatial-temporal, demographic, and programmatic adoption characteristics of a large-scale water filter and improved cookstove intervention in Western Province, Rwanda

Fankhauser, Katie; Nagel, Corey; Barstow, Christina; Kirby, Miles A.; Thomas, Evan

doi:10.1080/23311843.2019.1625481

Cited by 3 publications

(2 citation statements)

References 26 publications

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“…Although this point goes much deeper into the political economy, it is an important gap to bring up in the context of empowering women volunteers to enact positive change in their communities [70]. Further, when community health workers are paid to deliver the intervention, there is evidence of successful delivery [71]. Together, these findings raise questions about the possibility of bringing new programs and approaches to the HEP without adequate support.…”

Section: Discussionmentioning

confidence: 99%

The impact of a demand-side sanitation and hygiene promotion intervention on sustained behavior change and health in Amhara, Ethiopia: a cluster-randomized trial

Freeman

Delea

Snyder

et al. 2021

Preprint

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Background: Behaviors related to water, sanitation, and hygiene (WASH) are key drivers of infectious disease transmission, and experiences of WASH are potential influencers of mental well-being. Important knowledge gaps exist related to the content and delivery of effective WASH programs and their associated health impacts, particularly within the contexts of government programs implemented at scale. Methods: We developed and tested a demand-side intervention called Andilaye, which aimed to change behaviors related to sanitation, personal hygiene, and household environmental sanitation. This theory-informed intervention was delivered through the existing Ethiopian Health Extension Programme (HEP). It was a multilevel intervention with a catalyzing event at community level and behavior change activities at group and household level. We randomly selected and assigned 50 kebeles (sub-districts) from three woredas (districts), half to receive the Andilaye intervention, and half the standard of care sanitation and hygiene programming (i.e., community-led total sanitation and hygiene [CLTSH]). We collected data on WASH access, behavioral outcomes, and mental well-being. Results: A total of 1,589 households were enrolled into the study at baseline; 1,472 households (94%) participated in an endline assessment two years after baseline, and approximately 14 months after the initiation of a multi-level intervention. The intervention did not improve construction of latrines (prevalence ratio [PR] 0.99; 95% CI: 0.82, 1.21) or handwashing stations with water (PR: 0.96; 95% CI: 0.72, 1.26), or the removal of animal feces from the compound (PR=1.10; 95% CI: 0.95, 1.28). Nor did it impact anxiety (PR 0.90; 95% CI: 0.72, 1.11), depression (PR: 0.83; 95% CI: 0.64, 1.07), emotional distress (PR: 0.86; 95% CI: 0.67, 1.09) or well-being (PR: 0.90; 95% CI: 0.74, 1.10) scores. Discussion: We report limited impact of the intervention, as delivered, on changes inbehavior and mental well-being. The effectiveness of the intervention was limited by poor intervention fidelity. While sanitation and hygiene improvements have been documented in Ethiopia, behavioral slippage, or regression to unimproved practices, in communities previously declared open defecation free is widespread. Evidence from this trial may help address knowledge gaps related to challenges associated with scalable alternatives to CLTSH and inform sanitation and hygiene programming and policy in Ethiopia and beyond.

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Section: Discussionmentioning

confidence: 99%

The impact of a demand-side sanitation and hygiene promotion intervention on sustained behavior change and health in Amhara, Ethiopia: a cluster-randomized trial

Freeman

Delea

Snyder

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Although this point goes much deeper into the political economy, it is an important gap to bring up in the context of empowering women volunteers to enact positive change in their communities [71]. Further, when community health workers are paid to deliver the intervention, there is evidence of successful delivery [72]. Together, these findings PLOS GLOBAL PUBLIC HEALTH raise questions about the possibility of bringing new programs and approaches to the HEP without adequate support.…”

Section: Plos Global Public Healthmentioning

confidence: 99%

The impact of a demand-side sanitation and hygiene promotion intervention on sustained behavior change and health in Amhara, Ethiopia: A cluster-randomized trial

Freeman

Delea

Snyder

et al. 2022

PLOS Glob Public Health

View full text Add to dashboard Cite

Behaviors related to water, sanitation, and hygiene (WASH) are key drivers of infectious disease transmission, and experiences of WASH are potential influencers of mental well-being. Important knowledge gaps exist related to the content and delivery of effective WASH programs and their associated health impacts, particularly within the contexts of government programs implemented at scale. We developed and tested a demand-side intervention called Andilaye, which aimed to change behaviors related to sanitation, personal hygiene, and household environmental sanitation. This theory-informed intervention was delivered through the existing Ethiopian Health Extension Programme (HEP). It was a multilevel intervention with a catalyzing event at the community level and behavior change activities at group and household levels. We randomly selected and assigned 50 kebeles (sub-districts) from three woredas (districts), half to receive the Andilaye intervention, and half the standard of care sanitation and hygiene programming (i.e., community-led total sanitation and hygiene [CLTSH]). We collected data on WASH access, behavioral outcomes, and mental well-being. A total of 1,589 households were enrolled into the study at baseline; 1,472 households (94%) participated in an endline assessment two years after baseline, and approximately 14 months after the initiation of a multi-level intervention. The intervention did not improve construction of latrines (prevalence ratio [PR]: 0.99; 95% CI: 0.82, 1.21) or handwashing stations with water (PR: 0.96; 95% CI: 0.72, 1.26), or the removal of animal feces from the compound (PR: 1.10; 95% CI: 0.95, 1.28). Nor did it impact anxiety (PR: 0.90; 95% CI: 0.72, 1.11), depression (PR: 0.83; 95% CI: 0.64, 1.07), emotional distress (PR: 0.86; 95% CI: 0.67, 1.09) or well-being (PR: 0.90; 95% CI: 0.74, 1.10) scores. We report limited impact of the intervention, as delivered, on changes in behavior and mental well-being. The effectiveness of the intervention was limited by poor intervention fidelity. While sanitation and hygiene improvements have been documented in Ethiopia, behavioral slippage, or regression to unimproved practices, in communities previously declared open defecation free is widespread. Evidence from this trial may help address knowledge gaps related to challenges associated with scalable alternatives to CLTSH and inform sanitation and hygiene programming and policy in Ethiopia and beyond. Trial registration: This trial was registered with clinicaltrials.gov (NCT03075436) on March 9, 2017.

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Systematic Review and Classification of the Engineering for Global Development Literature Based on Design Tools and Methods for Social Impact Consideration

Armstrong

Suk

Mabey

et al. 2022

Journal of Mechanical Design

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While many tools and methodologies for assessing social impact exist and are used in the social science and global development fields, there is a lack of standard methods for considering the broader social impact of products in the engineering community. Some reasons these methods are not as widely used in the engineering community include designers not being aware of the methods, or methods not being widely applicable. The purpose of this research is to help designers and researchers find relevant design tools and methods for implementing social impact considerations. This is done through the classification of 374 papers in the Engineering for Global Development (EGD) literature along several dimensions including method purpose, industry sector, social impacts considered, sustainable development goals, paper setting, and data inputs required. This paper describes how designers and researchers can use this set of classified papers to locate relevant design tools and methods to improve social impact considerations in their work.

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Geospatial-temporal, demographic, and programmatic adoption characteristics of a large-scale water filter and improved cookstove intervention in Western Province, Rwanda

Cited by 3 publications

References 26 publications

The impact of a demand-side sanitation and hygiene promotion intervention on sustained behavior change and health in Amhara, Ethiopia: a cluster-randomized trial

The impact of a demand-side sanitation and hygiene promotion intervention on sustained behavior change and health in Amhara, Ethiopia: a cluster-randomized trial

The impact of a demand-side sanitation and hygiene promotion intervention on sustained behavior change and health in Amhara, Ethiopia: A cluster-randomized trial

Systematic Review and Classification of the Engineering for Global Development Literature Based on Design Tools and Methods for Social Impact Consideration

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