Sanitation Demand Creation in Peri-Urban Slums of Lusaka, Zambia

Diarrhea Clinical Trial

— SanDem  

Official title:

Sanitation Demand Creation in Peri-Urban Slums of Lusaka, Zambia

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03174015
• Other study ID #: QA_840
• Status: Completed
• Phase: N/A
• Start date: August 7, 2017
• Est. completion date: March 5, 2018

Study information

• Verified date: April 2019
• Source: London School of Hygiene and Tropical Medicine
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This intervention will experimentally test the hypothesis that sanitation can be improved in a peri-urban setting using state-of-the-art behaviour change communications.

Formative research indicated that landlords are the effective decision-makers about investments in sanitation on their plots (which can include a number of tenant households as well). Landlords will therefore be the primary targets of the intervention. The study will take the form of a randomized controlled trial of the intervention evaluated at the plot level. The intervention will invite enrolled landlords to a series of meetings in which various mechanisms will be used, each designed to increase their likelihood of improving the toilet(s) on their plot. These meetings will be the main vehicle for a status-building campaign associated with increasing wealth by improving plot sanitation, understanding tenants' implicit demand, understanding the processes by which toilets can be improved, and a competition rewarding landlords that make the greatest improvements to the improvement of their toilet(s). The desired improvements will be measured via multiple primary outcomes that measure aspects of changes to hardware and software components, including indicators of hygienic quality, psychological desirability, accessibility, and ecological sustainability. This is because the investigators argue that, to have a significant impact on population-level diarrheal disease indicators, any sanitation solution must be:

• effective at reducing exposure to pathogens (i.e., hygienic),

• desirable (i.e., seen as valuable or humane), and

• accessible (i.e., no one excluded), so that it can be used by all

• for a reasonably long time (i.e., sustainable)

Recruitment information / eligibility

• Status: Completed
• Enrollment: 1085
• Est. completion date: March 5, 2018
• Est. primary completion date: March 5, 2018
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Plots will be selected for inclusion in the study based on meeting the inclusion criteria. The intervention will be delivered to the landlord on each plot assigned to the intervention arm.

Intervention Inclusion Criteria:

• Plot located in Bauleni compound

• Adult landlord (age 18 or higher) resides on plot

Intervention Exclusion Criteria:

• None

Data will be collected from the landlord and one randomly selected tenant from all eligible adult tenants on each plot.

Data Collection Inclusion Criteria:

• Adult landlord or tenant (age 18 or higher) resides on selected plot most of the time

Data Collection Exclusion Criteria:

• None

Related Conditions & MeSH terms

• Diarrhea

Intervention

Behavioral:
• Bauleni Secret
The intervention will invite enrolled landlords to a series of meetings in which various mechanisms will be used, each designed to increase their likelihood of improving the toilet(s) on their plot. These meetings will be the main vehicle for a status-building campaign associated with increasing wealth by improving plot sanitation, understanding tenants' implicit demand, understanding the processes by which toilets can be improved, and a competition rewarding landlords that make the greatest improvements to the improvement of their toilet(s).

Locations

Country	Name	City	State
Zambia	Bauleni Compound	Lusaka

Sponsors (2)

Lead Sponsor	Collaborator
London School of Hygiene and Tropical Medicine	Centre for Infectious Disease Research in Zambia

Country where clinical trial is conducted

Zambia, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Having a hole-cover or water-sealed pan	Reduces spread of pathogens by creating barrier between containment and above-ground environment	5 months after intervention begins
Primary	Having a latrine door that locks from the inside	Provide safety and privacy for toilet users	5 months after intervention begins
Primary	Having a latrine door that locks from the outside	Exclude those not living on the plot from the toilet	5 months after intervention begins
Primary	Having a rotational cleaning system in place	To maintain hygienic condition of the toilet interface	5 months after intervention begins
Secondary	Willingness to pay	Change in landlord stated willingness to pay for toilet improvements	5 months after intervention begins
Secondary	Attitudes towards sanitation	Scales measuring landlord attitudes towards the importance of sanitation	5 months after intervention begins
Secondary	Financial preparation for toilet improvement	Landlords report saving money, either individually or by participating in a rotating savings scheme, for toilet improvement	5 months after intervention begins
Secondary	Partial construction progress towards toilet improvement	Landlords have either amassed raw materials on the plot (concrete blocks, wood, etc.) for toilet improvement or new construction/upgrading of toilet began (hole dug for new toilet, new slab poured for flushing toilet, etc.)	5 months after intervention begins
Secondary	Peri-urban Healthy Toilet Index	A theory-based comprehensive index of on-site peri-urban sanitation status including hygienicity, accessibility, desirability, and sustainability of sanitation systems	5 months after intervention begins
Secondary	Cleaning rota initiated	Landlord reports taking any action directed at establishing a rotational cleaning system (e.g., holding a plot meeting explicitly for this purpose, posting a written rota, or otherwise tangibly indicating rota responsibilities)	5 months after intervention begins

External Links

•   Study website