Research on the Impact of Targeted Subsidies Within Open Defecation Free (ODF) Communities

Sanitation Clinical Trial

Official title:

Research on the Impact of Targeted Subsidies Within Open Defecation Free (ODF) Communities

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03822611
• Other study ID #: WASHPaLS Subsidy Study
• Status: Completed
• Phase: N/A
• Start date: February 18, 2019
• Est. completion date: March 31, 2021

Study information

• Verified date: October 2021
• Source: The Aquaya Institute
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study evaluates targeted subsidies as a strategy to improve sanitation infrastructure and behaviours in communities that have reached Open Defecation Free (ODF) status after a Community-Led Total Sanitation (CLTS) program. The investigator's hypothesis is that sanitation subsidies targeted at the most vulnerable households within ODF communities will increase and help sustain latrine coverage, quality, and use amongst the targeted households, and through a spill-over effect, amongst the rest of the community. Half of participating communities will receive the targeted subsidy, while the other half will not receive any treatment.

Description:

Community-Led Total Sanitation (CLTS) is a widely used approach to eradicate open defecation in rural communities in developing countries. Using emotional triggers, CLTS promotes community self-help to build household latrines. In Ghana, where CLTS is part of the government's official sanitation strategy, a community is declared "Open Defecation Free" (ODF) when 80 percent of households own a latrine.

There is however evidence that open defecation persists in so-called "ODF" communities, especially as the most vulnerable households (the poorest of the poor) cannot afford to construct or maintain durable latrines. As a result, subsidies for these vulnerable households have been proposed as a strategy to promote the construction of durable latrines and help sustain safe sanitation behaviours in communities having received CLTS.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 5615
• Est. completion date: March 31, 2021
• Est. primary completion date: March 31, 2021
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

This study is a cluster randomized controlled trial that will enroll entire communities. Within a community, only specific households will be selected to receive sanitation subsidy vouchers. Outcomes will be measured both for voucher recipients and for the rest of the community.

Inclusion Criteria (for Communities):

• Community was targeted by UNICEF's Community-Led Total Sanitation (CLTS) program in Tatale, Yendi, and Kpandai districts in Ghana.

• Community has Open Defecation Free (ODF) status according to local authorities.

• Community has more than 15 and less than 100 households.

Exclusion Criteria (for Communities):

• Community is located less than 2 kilometers away from a community in the opposite treatment arm.

Inclusion Criteria (for voucher recipients within study communities):

• Household is extremely poor, as identified through community consultation and/or the government's Livelihood Empowerment Against Poverty (LEAP) program.

• Household has at least one vulnerable person, i.e. who meets one of the following criteria: i) older than 65 years old, ii) person with a disability, iii) orphan or vulnerable child, iv) female head of household, v) widow(er), vi) terminally-ill persons, vii) unemployed, viii) outcast groups.

Exclusion Criteria (for voucher recipients within study communities):

• Household owns a functional, individual (non-shared) latrine with durable sub-structure.

Related Conditions & MeSH terms

• Sanitation

Intervention

Behavioral:
• Targeted Subsidy
Voucher

Locations

Country	Name	City	State
Ghana	Districts of Tatale and Kpandai, Northern Region	Tamale

Sponsors (3)

Lead Sponsor	Collaborator
The Aquaya Institute	Tetratech, United States Agency for International Development (USAID)

Country where clinical trial is conducted

Ghana, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Percentage of households owning an individual, functional latrine with full superstructure	Household ownership (yes/no) of a latrine that is i) not shared with other households ("individual"), ii) whose pit is not collapsed and not full ("functional"), and iii) with four walls (or circular walls) and a roof of any materials ("full superstructure").	Approximately 18 months
Secondary	Percentage of households reporting practicing open defecation	Self report by the respondent of not always using a toilet to defecate when at home.	Approximately 18 months
Secondary	Percentage of households owning an individual, functional latrine with full superstructure and durable superstructure	Household ownership (yes/no) of a latrine that is i) not shared with other households ("individual"), ii) whose pit is not collapsed and not full ("functional"), iii) with four walls (or circular walls) and a roof of any materials ("full superstructure"), iv) with a concrete/plastic slab and pit lining with plastic/rocks/bricks/concrete ("durable substructure").	Approximately 18 months
Secondary	Percentage of households reporting satisfaction with latrine	Self report by the respondent of being satisfied with the latrine (s)he uses for defecation.	Approximately 18 months