| Author(s) |
Mulusew Belew, MSc, Resom Berhe, MPH, Tina Braccio, MPH, Frederick Goddard, MS, Molly Linabarger, MPH, Katie Micek, MPH, Siraj Muhammed, MPH, Ashlin Rakhra, MPH, Gloria Sclar, MPH, Hiwote Solomon, MPH, Yihenew Tesfaye, MS, Mulat Woreta, BA, PGD, Melkamu |
| Date |
2020-05-19 |
| Country |
Ethiopia |
| Language |
English |
| Description |
This report describes the study design, the intervention implementation, and the impact evaluation methods, as well as reports on the results of the evaluation and provides a discussion of findings. |
| Abstract |
Poor water, sanitation, and hygiene (WASH) behaviors are key drivers of infectious disease transmission and adverse mental well-being. While WASH is seen as a critical enabler of health, there are important knowledge gaps related to the content and delivery of effective, holistic WASH programming. Corresponding impacts of WASH on mental well-being are also underexplored. There is a need for more robust implementation research that yields information regarding whether and how community-based, demand-side interventions facilitate progressive and sustained adoption of improved sanitation and hygiene behaviors and downstream health impacts. The aim of the Andilaye Trial - Amharic for “togetherness/integration” - was to use behavioral theory and evidence from formative research to inform the design of a novel, holistic, community-based WASH intervention (i.e., “Andilaye”) and evaluate its impact on sustained behavior change and mental wellbeing.
Emory University and its consortium partners conducted a three-year study in rural and peri-urban Amhara, Ethiopia. The Andilaye Trial consisted of three phases: (1) formative research and intervention design, (2) intervention implementation and process evaluation, and (3) impact evaluation. The study’s primary research question was: To what extent can Andilaye’s enhanced, demand-side sanitation and hygiene intervention impact sustained behavior change and mental wellbeing, above and beyond community-led total sanitation and hygiene (CLTSH)? We hypothesized that individuals in communities randomized to receive the Andilaye intervention are more likely to sustainably adopt improved sanitation and hygiene behaviors and demonstrate gains in mental wellbeing compared to individuals in communities randomized to the standard of care CLTSH programming. The study was funded by the World Bank’s Strategic Impact Evaluation Fund (SIEF), the International Initiative for Impact Evaluation (3ie), and the Children’s Investment Fund Foundation (CIFF). The trial was registered on clinicaltrials.gov (NCT03075436). |
| Table of contents |
1. Introduction
2. Study Overview
3. Formative Research and Intervention Design
4. Impact Evaluation: Methods
5. Intervention Implementation and Process Evaluation
6. Impact Evaluation: Results
7. Discussion
8. Policy-Relevant Findings and Recommendations |
| Download |
https://microdata.worldbank.org/index.php/catalog/6114/download/70350 |
