We employed a cluster-randomized trial design to measure the impact of a school-based water, sanitation and hygiene (WASH) improvement on pupil enrolment and on gender parity in enrolment, in primary schools in Nyanza Province, Kenya (2007–2009). Among schools with poor water access during the dry season, those that received a water supply, hygiene promotion and water treatment (HP&WT) and sanitation improvement demonstrated increased enrolment (β = 0.091 [0.009, 0.173] p = 0.03), which translates to 26 additional pupils per school on average. The proportion of girls enrolled in school also increased by 4% (prevalence ratio (PR) = 1.04 [1.00, 1.07] p = 0.02). Among schools with better baseline water access during the dry season (schools that did not receive a water source), we found no evidence of increased enrolment in schools that received a HP&WT intervention (β = 0.016 [–0.039, 0.072] p = 0.56) or the HP&WT and sanitation intervention (β = 0.027 [–0.028, 0.082] p = 0.34), and there was no evidence of improved gender parity (PR = 0.99 [0.96, 1.02] p = 0.59, PR = 1.00 [0.97, 1.02] p = 0.75, respectively). Our findings suggest that increased school enrolment and improved gender parity may be influenced by a comprehensive WASH programme that includes an improved water source; schools with poor water access during the dry season may benefit most from these interventions.
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Research Article|
June 10 2013
A cluster-randomized trial assessing the impact of school water, sanitation and hygiene improvements on pupil enrolment and gender parity in enrolment
Joshua V. Garn;
Joshua V. Garn
1Department of Epidemiology, Rollins School of Public Health and Laney Graduate School, Emory University, 3rd floor CNR, 1518 Clifton Rd NE, Atlanta, Georgia 30322, USA
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Leslie E. Greene;
Leslie E. Greene
2Department of Environmental Health, Center for Global Safe Water, Rollins School of Public Health, Emory University, CNR 2027, 1518 Clifton Rd NE, Atlanta, Georgia 30322, USA
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Robert Dreibelbis;
Robert Dreibelbis
3Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA and Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, Maryland 21205, USA
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Shadi Saboori;
Shadi Saboori
2Department of Environmental Health, Center for Global Safe Water, Rollins School of Public Health, Emory University, CNR 2027, 1518 Clifton Rd NE, Atlanta, Georgia 30322, USA
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Richard D. Rheingans;
Richard D. Rheingans
4Department of Global and Environmental Health, University of Florida, PO Box 100188, Gainesville, Florida 32610, USA
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Matthew C. Freeman
2Department of Environmental Health, Center for Global Safe Water, Rollins School of Public Health, Emory University, CNR 2027, 1518 Clifton Rd NE, Atlanta, Georgia 30322, USA
E-mail: mcfreem@emory.edu
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Journal of Water, Sanitation and Hygiene for Development (2013) 3 (4): 592–601.
Article history
Received:
January 21 2013
Accepted:
April 09 2013
Citation
Joshua V. Garn, Leslie E. Greene, Robert Dreibelbis, Shadi Saboori, Richard D. Rheingans, Matthew C. Freeman; A cluster-randomized trial assessing the impact of school water, sanitation and hygiene improvements on pupil enrolment and gender parity in enrolment. Journal of Water, Sanitation and Hygiene for Development 1 December 2013; 3 (4): 592–601. doi: https://doi.org/10.2166/washdev.2013.217
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