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WASH Benefits

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WASH Benefits/Fecal Pathways Project
WASH Benefits/Fecal Pathways Project
Mymensingh, Bangladesh
Rayhan Mustak, Mir Alvee Ahmed, Mahfuja Alam, Sharmin Islam,
Shariful Islam, Debashis Sen, Laura Kwong, Ayse Ercumen
WASH Benefits/Fecal Pathways Project
WASH Benefits/Fecal Pathways Project
Mymensingh, Bangladesh
Laura Kwong, Debashis Sen, Amira Jahan
WASH-B
WASH-B
Household Survey
WASH-B

Measuring the benefits of sanitation, water quality, handwashing and nutrition interventions for improving health and development

 

Objectives

The study has three primary scientific objectives:

1.  Measure the impact of sanitation, water quality, handwashing, and nutrition interventions on child health and development after 2 years of intervention.

2.  Determine whether there are larger reductions in diarrhea when providing a combined water, sanitation and handwashing intervention compared to each component alone.

3.  Determine whether there are larger effects on growth and development from combining a) daily supplemental nutrition with b) a combined water, sanitation and handwashing intervention compared to each component alone.

The study has three secondary scientific objectives:

1.  Measure the impact of nutritional supplements and household environmental interventions on environmental enteropathy biomarkers, and more clearly elucidate this potential pathway between environmental interventions and child growth and development.

2.  Measure the impact of sanitation, water quality, handwashing and nutritional interventions on intestinal parasitic infection prevalence and intensity.

3.  Measure the association between parasitic infection and other measures of enteric health, including acute diarrhea and environmental enteropathy biomarkers.

 

Rationale

During the first two years of life, children born in low-income countries are at risk for enteric infections due to poor water quality, sanitation conditions, and caregiver handwashing practices (WASH). During this period, children are also at risk for undernutrition.

Beyond the acute morbidity and suffering caused by enteric infections and undernutrition, observational evidence also suggests that repeated infections alone and in combination with undernutrition in the first years of life can have lasting and detrimental effects on longer-term physical growth, cognitive development, and adult human capital.

The WASH Benefits Study provides rigorous evidence on the health and developmental benefits of water quality, sanitation, handwashing, and nutritional interventions during the first years of life. The study includes two, cluster-randomized controlled trials to measure the impact of intervention among newborn infants in rural Bangladesh and Kenya. The studies are large in scope (> 5,000 newborns per country) and will measure primary outcomes after two years of intervention.

Stanford was primarily involved in the WASH Benefits trial conducted in Bangladesh.

 

Project Dates

2013 - 2018

 

Stage of Work

1.  The main project has been completed.

2.  Follow-up on cognitive development is currently ongoing.

 

People

Primary Contacts:  Laura Kwong, Jessica Grembi

Project Website:  WASH Benefits

Stanford University

.   Stephen P. Luby, MD, Principal Investigator, WASH Benefits Bangladesh

.   Jessica A. Grembi, PhD, Post-doctoral researcher, Enteric infection analysis

.    Laura H. Kwong, PhD, Post-doctoral researcher, Exposure to fecal contamination

.   Amy Pickering, PhD, (formerly Research Scientist), Stanford University ; WASH, parasites, environmental sampling

ICDDR,B

.   Md. Mahbubur Rahman, MBBS, MPH, MPS, Principal Investigator (icddr,b); Physician & Project Coordinator, icddr,b; Project management and Implementation, business management, external oversight

.   Leanne Unicomb, PhD, Epidemiologist, icddr,b; Executive Principal Investigator (icddr,b), business management, external oversight

 

 

Funding

The WASH Benefits study was supported by a grant from the Bill & Melinda Gates Foundation to the University of California, Berkeley