Diarrhea Clinical Trial
Official title:
Sanitation Demand Creation in Peri-Urban Slums of Lusaka, Zambia
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)
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