None listed
Conditions
Brief summary
Access to a safe, reliable, and continuous supply of water for drinking, sanitation and hygiene is an essential requirement for good health. Diarrhoea is a leading cause of death and disease globally, and almost 90% of diarrhoea-related deaths occur as a result of unsafe drinking water and sanitation. India has the highest burden of childhood death and disease related to diarrhoea in Asia. Many people in rural India still cannot access improved water sources and gross disparities in coverage exist across the country. Affordable water treatment solutions that have beneficial human health effects and that can be maintained and sustained using local resources are needed. Riverbank filtration technology (RBF) is an inexpensive community-level water treatment technique that can improve water quality. RBF systems use auto-regenerative, natural treatment processes, so properly engineered systems can remain effective indefinitely. This study aims to investigate whether a community-based hygiene education program and water quality intervention using RBF technology reduces diarrhoeal prevalence in India over and above hygiene education plus improved access to water. We also aim to evaluate the feasability and acceptability of RBF technology in this setting.
Interventions
The study will be conducted over an 18-month period. As per the stepped wedge trial design, each of the four villages recruited for the trial will spend time in the control arm and the intervention arm of the study. Prior to the start of the control arm, a baseline survey will be conducted to collect baseline demographics and health data.
The control arm will involve delivery of a community-level hygiene education program and improved access to water at a community level (improved water quantit
The study will be conducted over an 18-month period. As per the stepped wedge trial design, each of the four villages recruited for the trial will spend time in the control arm and the intervention arm of the study. Prior to the start of the control arm, a baseline survey will be conducted to collect baseline demographics and health data. The control arm will involve delivery of a community-level hygiene education program and improved access to water at a community level (improved water quantity). The intervention arm will involve delivery of a community-level hygiene education program and access to water treated using riverbank filtration technology (RBF) at a community level (improved water quality). The intervention will be implemented by the non-governmental organisation The Energy and Resources Institute (TERI) in India. Hygiene education including posters relating to hand hygiene and safe water storage will be delivered to individual households and public places and trained field workers will provide house-by-house education on hygiene practices. House-to-house education will consist of a verbal discussion of hygiene practices with the householder using educational posters. This will take approximately 10 minutes per household and will be delivered along with the baseline survey. Hygiene education messages will be reinforced by a trained field worker at each subsequent survey. RBF-treated water will be delivered via newly built water delivery systems. RBF is an inexpensive water treatment technique that uses auto-regenerative, natural treatment processes to improve water quality. Contractors working with TERI will install new pipes, covered storage tanks and taps throughout each of the study villages. RBF wells will also be installed in each village. All villages will start in the control arm and will receive piped unfiltered river water via new water delivery systems. Villages will then be randomised to receive the RBF intervention at three monthly intervals (3, 6, 9 and 12 months after the start of the control arm). Once a village is randomised to receive the intervention, piped RBF-treated water will be delivered to that village for the remainder of the study period.
Sponsors
Professor Karin Leder
Study design
Allocation
Randomised controlled trial
Intervention model
Other
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Healthy volunteers
Yes
Inclusion criteria
Inclusion criteria for village selection: - Villages in rural India currently using untreated river water as a primary source of drinking water - Hydrogeologic conditions allowing construction of RBF systems - Availability of suitable land for RBF system installation - Community receptiveness to installation of RBF systems and commitment to ongoing operation and maintenance
Exclusion criteria
- Villages with less than 500 households - Villages where untreated river water was not a primary source of drinking water for most households - Villages where hydrogeologic conditions were unsuitable or land was not available for RBF system installation
Outcome results
None listed