The People's Water: A Randomized Control Trial of a Community-Driven Water, Sanitation, and Hygiene Program in the Democratic Republic of Congo

Last registered on April 06, 2023

Pre-Trial

Trial Information

General Information

Title
The People's Water: A Randomized Control Trial of a Community-Driven Water, Sanitation, and Hygiene Program in the Democratic Republic of Congo
RCT ID
AEARCTR-0004648
Initial registration date
September 04, 2019

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
September 06, 2019, 1:51 PM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Last updated
April 06, 2023, 6:00 AM EDT

Last updated is the most recent time when changes to the trial's registration were published.

Locations

Primary Investigator

Affiliation
World Bank

Other Primary Investigator(s)

PI Affiliation
World Bank
PI Affiliation
Harvard School of Public Health
PI Affiliation
Simmons University

Additional Trial Information

Status
On going
Start date
2018-07-16
End date
2023-12-31
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
Rural WASH is inadequate in many developing countries, especially those affected by fragility, conflict and violence, with important implications for human welfare. In the Democratic Republic of Congo (DRC), the setting of this study, 70% percent of the population is rural, and many live in areas that have experienced protracted instability and outright violent conflict. In addition, children under-5 mortality rates are remarkably high, only 31% of rural Congolese nationals have access to an improved water source, and only 29% use improved sanitation facilities.
Against this backdrop, in 2008 the Government of the DRC launched a national program known as the Support to National Healthy Villages and Schools (in French Villages et Ecoles Assainis, VEA), a water and sanitation program financed by DFID and implemented by UNICEF and the Government of DRC’s Ministries of Public Health, and Primary, Secondary, and Professional Education. The VEA’s main objectives are to support communities’ improved access to water, hygiene and sanitation services and practices through the construction of water and sanitation infrastructure in villages and schools, local community involvement, and a village certification mechanism.
Through a cluster-level randomized controlled trial, this study aims to evaluate the causal impact of the VEA program across 332 rural villages in the DRC. The study design involves experimentally varying the provision of the VEA program to a set of villages, to examine the causal impacts on water access, infrastructure development, availability of sanitation services, knowledge of hygiene practices, and child health. This study will present robust evidence to improve policy decisions pertaining to WASH policies and programs in the DRC and beyond.
External Link(s)

Registration Citation

Citation
Coville, Aidan et al. 2023. "The People's Water: A Randomized Control Trial of a Community-Driven Water, Sanitation, and Hygiene Program in the Democratic Republic of Congo." AEA RCT Registry. April 06. https://doi.org/10.1257/rct.4648-2.6
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Experimental Details

Interventions

Intervention(s)
In 2008, the Government of the DRC launched a national program known as the Support to National Healthy Villages and Schools (in French Villages et Ecoles Assainis, VEA), a Water and Sanitation (WASH) program financed by DFID and implemented by UNICEF and the Government of DRC’s Ministries of Public Health, and Primary, Secondary, and Professional Education. The VEA’s main objectives are to support communities’ improved access to Water, Hygiene and Sanitation (WASH) services and practices, especially in rural areas. The VEA supports the construction of water and sanitation infrastructure in villages and schools, facilitates local community involvement in the management of this infrastructure, conducts behavior change activities, and then formally certifies communities as Healthy Villages or Healthy Schools when they successfully achieve a set of water and sanitation norms. The program has now entered a new phase (2013-2018) and will offer an extended VEA program to an additional group of villages in provinces including Kongo Central, Kasai, Kasai Central, and South Kivu, which will be the focus of this evaluation.
Intervention (Hidden)
In 2008, the Government of the DRC launched a national program known as the Support to National Healthy Villages and Schools (in French Villages et Ecoles Assainis, VEA), a Water and Sanitation (WASH) program financed by DFID and implemented by UNICEF and the Government of DRC’s Ministries of Public Health, and Primary, Secondary, and Professional Education. The VEA’s main objectives are to support communities’ improved access to Water, Hygiene and Sanitation (WASH) services and practices, especially in rural areas. The VEA supports the construction of water and sanitation infrastructure in villages and schools, facilitates local community involvement in the management of this infrastructure, conducts behavior change activities, and then formally certifies communities as Healthy Villages or Healthy Schools when they successfully achieve a set of water and sanitation norms. The program has now entered a new phase (2013-2018) and will offer an extended VEA program to an additional group of villages in provinces including Kongo Central, Kasai, Kasai Central, and South Kivu, which will be the focus of this evaluation.
Intervention Start Date
2018-07-16
Intervention End Date
2019-07-31

Primary Outcomes

Primary Outcomes (end points)
Access to higher quality water; health and nutrition outcomes (e.g., reduced morbidity and mortality from diarrheal disease); education attainment of school-aged children (e.g., improved school attendance rates and learning outcomes; reduced absenteeism); and reduced burden of carrying water for households (in time and effort of carrying water, focusing specifically on women and children).
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Willingness to pay for improved water; broader measures of child illness; knowledge and usage of good hygiene practices; social cohesion; social and economic conditions of women and girls and psychological well-being.
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
We will use a cluster-level randomized controlled trial to evaluate the causal impact of a WASH intervention on various health and socio-economic outcomes (both at the village and household level). The study design involves experimentally varying the provision of the WASH program Villages et Ecoles Assainis (VEA) to a set of villages, to examine the causal impacts on water access, infrastructure development, availability of sanitation services, knowledge of hygiene practices, and child health.

146 villages (grouped in 50 clusters) were randomly assigned to receive the VEA; while 186 villages (grouped in 71 clusters) were assigned to a control group, where no program activities have taken place. The randomization was conducted at the cluster-level.
Experimental Design Details
We will use a cluster-level randomized controlled trial to evaluate the causal impact of a WASH intervention on various health and socio-economic outcomes (both at the village and household level). The study design involves experimentally varying the provision of the WASH program Villages et Ecoles Assainis (VEA) to a set of villages, to examine the causal impacts on water access, infrastructure development, availability of sanitation services, knowledge of hygiene practices, and child health.

146 villages (grouped in 50 clusters) were randomly assigned to receive the VEA; while 186 villages (grouped in 71 clusters) were assigned to a control group, where no program activities have taken place. The randomization was conducted at the cluster-level.
Randomization Method
Computer-based
Randomization Unit
Clusters of villages
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
121 clusters of villages
Sample size: planned number of observations
332 villages (where we will interview in total 664 village leaders and 1,328 household leads).
Sample size (or number of clusters) by treatment arms
The study involves 332 villagesç
- 146 villages (grouped in 50 clusters) were randomly assigned to receive the VEA;
- 186 villages (grouped in 71 clusters) were assigned to a control group, where no program activities have taken place.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB

Institutional Review Boards (IRBs)

IRB Name
Harvard T. H. Chan School of Public Health
IRB Approval Date
2019-09-11
IRB Approval Number
IRB19-1427
IRB Name
SolutionsIRB
IRB Approval Date
2019-12-18
IRB Approval Number
#2019/10/20
Analysis Plan

Analysis Plan Documents

Pre-analysis plan for The People's Water

MD5: fa732c82eebf75ddda8e551b3e20ea38

SHA1: 98b238c38e7544b6d08e5a186f4ba47fc5d62e98

Uploaded At: May 04, 2020

COVID Phone survey pre-analysis plan

MD5: d0ba3ab4023eb7ba502a5a57c6b423f5

SHA1: 5e0d62ff9ea99ca8767dda15a451a6bd9d6a4f01

Uploaded At: July 27, 2021

Three Year Follow up Pre-Analysis Plan

MD5: 7a5c7f34623beddfa0d52f40c3ae773e

SHA1: 26b326f0d364be01bd0f3ee8d16112a6fca2c789

Uploaded At: April 06, 2023

Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
No
Data Collection Complete
Data Publication

Data Publication

Is public data available?
No

Program Files

Program Files
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials