SanDem: Sanitation Demand Creation in Peri-Urban Slums of Lusaka, Zambia
Study Details
Study Description
Brief Summary
This intervention will experimentally test the hypothesis that sanitation can be improved in a peri-urban setting using state-of-the-art behaviour change communications.
Formative research indicated that landlords are the effective decision-makers about investments in sanitation on their plots (which can include a number of tenant households as well). Landlords will therefore be the primary targets of the intervention. The study will take the form of a randomized controlled trial of the intervention evaluated at the plot level. The intervention will invite enrolled landlords to a series of meetings in which various mechanisms will be used, each designed to increase their likelihood of improving the toilet(s) on their plot. These meetings will be the main vehicle for a status-building campaign associated with increasing wealth by improving plot sanitation, understanding tenants' implicit demand, understanding the processes by which toilets can be improved, and a competition rewarding landlords that make the greatest improvements to the improvement of their toilet(s). The desired improvements will be measured via multiple primary outcomes that measure aspects of changes to hardware and software components, including indicators of hygienic quality, psychological desirability, accessibility, and ecological sustainability. This is because the investigators argue that, to have a significant impact on population-level diarrheal disease indicators, any sanitation solution must be:
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effective at reducing exposure to pathogens (i.e., hygienic),
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desirable (i.e., seen as valuable or humane), and
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accessible (i.e., no one excluded), so that it can be used by all
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for a reasonably long time (i.e., sustainable)
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Intervention Landlords on selected plots will receive the "Bauleni Secret" intervention. Landlords and selected tenants will be surveyed in baseline/end-line data collection. |
Behavioral: Bauleni Secret
The intervention will invite enrolled landlords to a series of meetings in which various mechanisms will be used, each designed to increase their likelihood of improving the toilet(s) on their plot. These meetings will be the main vehicle for a status-building campaign associated with increasing wealth by improving plot sanitation, understanding tenants' implicit demand, understanding the processes by which toilets can be improved, and a competition rewarding landlords that make the greatest improvements to the improvement of their toilet(s).
|
| No Intervention: Control Landlords and selected tenants will be surveyed in baseline/end-line data collection only. |
Outcome Measures
Primary Outcome Measures
- Having a hole-cover or water-sealed pan [5 months after intervention begins]
Reduces spread of pathogens by creating barrier between containment and above-ground environment
- Having a latrine door that locks from the inside [5 months after intervention begins]
Provide safety and privacy for toilet users
- Having a latrine door that locks from the outside [5 months after intervention begins]
Exclude those not living on the plot from the toilet
- Having a rotational cleaning system in place [5 months after intervention begins]
To maintain hygienic condition of the toilet interface
Secondary Outcome Measures
- Willingness to pay [5 months after intervention begins]
Change in landlord stated willingness to pay for toilet improvements
- Attitudes towards sanitation [5 months after intervention begins]
Scales measuring landlord attitudes towards the importance of sanitation
- Financial preparation for toilet improvement [5 months after intervention begins]
Landlords report saving money, either individually or by participating in a rotating savings scheme, for toilet improvement
- Partial construction progress towards toilet improvement [5 months after intervention begins]
Landlords have either amassed raw materials on the plot (concrete blocks, wood, etc.) for toilet improvement or new construction/upgrading of toilet began (hole dug for new toilet, new slab poured for flushing toilet, etc.)
- Peri-urban Healthy Toilet Index [5 months after intervention begins]
A theory-based comprehensive index of on-site peri-urban sanitation status including hygienicity, accessibility, desirability, and sustainability of sanitation systems
- Cleaning rota initiated [5 months after intervention begins]
Landlord reports taking any action directed at establishing a rotational cleaning system (e.g., holding a plot meeting explicitly for this purpose, posting a written rota, or otherwise tangibly indicating rota responsibilities)
Eligibility Criteria
Criteria
Plots will be selected for inclusion in the study based on meeting the inclusion criteria. The intervention will be delivered to the landlord on each plot assigned to the intervention arm.
Intervention Inclusion Criteria:
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Plot located in Bauleni compound
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Adult landlord (age 18 or higher) resides on plot
Intervention Exclusion Criteria:
- None
Data will be collected from the landlord and one randomly selected tenant from all eligible adult tenants on each plot.
Data Collection Inclusion Criteria:
- Adult landlord or tenant (age 18 or higher) resides on selected plot most of the time
Data Collection Exclusion Criteria:
- None
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Bauleni Compound | Lusaka | Zambia |
Sponsors and Collaborators
- London School of Hygiene and Tropical Medicine
- Centre for Infectious Disease Research in Zambia
Investigators
- Principal Investigator: Robert Aunger, PhD, London School of Hygiene and Tropical Medicine
- Principal Investigator: Roma Chilengi, MD, Center for Infectious Disease Research in Zambia
- Principal Investigator: Valerie Curtis, PhD, London School of Hygiene and Tropical Medicine
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- QA_840