Title,Url,Last update date,Published at,First registered on,RCT_ID,DOI Number,Primary Investigator,Status,Start date,End date,Keywords,Country names,Other Primary Investigators,Jel code,Secondary IDs,Abstract,External Links,Sponsors,Partners,Intervention start date,Intervention end date,Intervention,Primary outcome end points,Primary outcome explanation,Secondary outcome end points,Secondary outcome explanation,Experimental design,Experimental design details,Randomization method,Randomization unit,Sample size number clusters,Sample size number observations,Sample size number arms,Minimum effect size,IRB,Analysis Plan Documents,Intervention completion date,Data collection completion,Data collection completion date,Number of clusters,Attrition correlated,Total number of observations,Treatment arms,Public data,Public data url,Program files,Program files url,Post trial documents csv,Relevant papers for csv "A Cluster Randomized Control Trial Evaluating the Effectiveness of an Integrated Sanitation and Nutrition Program in Kitui County, Kenya. ",http://www.socialscienceregistry.org/trials/2019,"March 12, 2019",2019-03-12 09:55:23 -0400,2017-02-21,AEARCTR-0002019,10.1257/rct.2019-3.0,Lilian Lehmann lilian.lehmann@idinsight.org,completed,2016-08-01,2017-12-31,"[""health"", ""WASH"", ""Sanitation"", ""Nutrition"", ""Integration"", ""Multisector""]",Kenya (Non-U.S.),Gerishom Gimaiyo (gerishom.gimaiyo@idinsight.org) IDinsight,"","Bill & Melinda Gates Foundation Grant Investment ID: OPP1124645, KEMRI Protocol No. Non-KEMRI 547","While sanitation and nutrition interventions are both associated with better sanitation and nutrition outcomes, these interventions are usually implemented separately. There is limited evidence of programming that has jointly impacted both sanitation and nutrition outcomes. This study seeks to identify the causal impact of an integrated sanitation and nutrition program on knowledge and practices of sanitation and nutrition behaviours in Kitui County, Kenya. Villages will be randomly assigned to either receive the standard Community Led Total Sanitation (CLTS) program or an integrated CLTS+Nutrition intervention. Outcomes of interest include household-level observations of: 1) sanitation practices, including toilet use, handwashing, courtyard cleanliness, child diarrhoea and correct disposal of child faeces; and 2) nutrition practices, including proper breastfeeding, and visits to health facilities. ","","","",2016-08-01,2017-04-01,"The Sannut (Sanitation-Nutrition) intervention is a modified form of the Kenya National Protocol for Community Led Total Sanitation (CLTS). The intervention clarifies with the community the link between open defecation and child malnutrition through (1) the addition of two interactive meetings that sensitize caregivers on proper toddler hygiene and nutrition, and (2) household visits that reinforce these messages. The evaluation is testing the hypothesis of whether additional focus on toddler hygiene and nutrition with community level messaging leads to change in caregiver behaviours/practices that will ultimately reduce the risk of a child becoming malnourished during their first 1000 days. CLTS activities, which are occurring in both treatment and control villages, consist of the following steps: 1. Pre-trigger involving community mobilization 2. Trigger involving a community meeting where the community is taken through their open defecation practices with the aim of eliciting shame and disgust as part of the realization that members of the community are ingesting each other’s feces. This is intended to compel community members to build and use hand washing stations and latrines. 3. Household follow-ups by designated community members to ensure that each household is adhering to the agreed upon commitments 4. The community claims to have stopped open defecation 5. External evaluators verify that the community is indeed not openly defecating 6. The community is then certified Open Defecation Free (ODF) if the above is confirmed and a celebration is held to laud this status. The supplemental activities of Sannut (occurring only in the treatment group) that are overlaid on top of traditional CLTS are summarized below: 1. Addition of two caregiver gatherings following the CLTS trigger session to sensitize mothers and other caregivers of children under 2 on the importance of toddler hygiene and nutrition for the health of their children. 2. Household follow-up visits that include, in addition to standard CLTS messaging, the supplemental messages covered in the two caregiver meetings.","1. Latrine Use 2. Latrine Structure maintenance 3. Courtyard cleanliness 4. Self-reported Disposal of Child Feces 5. Proper Breastfeeding Practice 6. Health Facility Visits 7. Handwashing infrastructure 8. Handwashing practice 9. Child Diarrhea 10. Sanitation Knowledge 11. Nutrition Knowledge","1. Latrine Use. Binary outcome for whether the respondent uses latrine 2. Latrine Structure Maintenance. Score based on observer’s checklist, standardized by control group mean and SD. 3. Courtyard cleanliness. Score based on observer’s checklist, standardized by control group mean and SD. 4. Self-reported Disposal of Child Feces. Binary outcome for whether child feces are disposed of correctly. 5. Proper Breastfeeding Practice. Binary outcome for whether caregiver is properly breastfeeding toddler based on toddler age. 6. Health Facility Visits. (1) Health facility visit in past 2 months, (2) youngest child has received Vitamin A supplement in past 6 months, (3) youngest child has received deworming treatment in past 6 months. 7. Handwashing infrastructure. Binary outcome for whether household has a stocked handwashing facility next to latrine. 8. Handwashing practice. Binary outcome for whether respondent and children are following proper handwashing practice. 9. Child Diarrhea. Each household is assigned a percentage (between 0 and 1) based on the fraction of the children older than 6 months in the household that showed symptoms of diarrhea in the past 2 weeks. 10. Sanitation Knowledge. Score based on observer’s checklist, standardized by control group mean and SD. 11. Nutrition Knowledge. Score based on observer’s checklist, standardized by control group mean and SD.","","","A cluster Randomized Control Trial (RCT) at the level of the village (“kijiji”), where key outcome indicators in the intervention group (receiving supplemental sanitation and nutrition messaging, as an add-on to the standard CLTS) will be compared to a control group (receiving only standard CLTS). Knowledge and practices of both sanitation and nutrition behaviours will be measured. The RCT will yield rigorous, causal estimates of the impact of supplemental nutrition messaging on outcomes of interest. Kijijis are stratified at ward level (unit of administration below the county and above the kijiji).","",Randomization done using Stata software,Village,627 villages,"There will be a maximum of 8 households per cluster for a possible total of 5,016 individuals. ",317 treatment villages and 310 control villages,0.175 standard deviations (8.5pp difference between treatment and control in self-reported proper breastfeeding),"Name: Kenya Medical Research Institute Approval_number: KEMRI/RES/7/3/1 Approval_date: 2016-10-31 ","February 17, 2017",2017-04-30,true,2017-07-05,604 villages,false,"4,436",309 treatment villages and 295 control villages,false,"",false,"","","Abstract: Citation: Gimaiyo G, McManus J, Yarri M, et al Can child-focused sanitation and nutrition programming improve health practices and outcomes? Evidence from a randomised controlled trial in Kitui County, Kenya BMJ Global Health 2019;4:e000973. URL: https://gh.bmj.com/content/4/1/e000973 "