Sanitation interventions of the WASH Benefits trial
MINOR
The sanitation intervention was implemented at the compound level (group of households shared by extended families). All households in the enrolled compound received upgrades to double-pit pour-flush latrines, with labor and minor financial contributions provided by households. If the index household (household where the index child lived) did not have a latrine, a latrine was constructed; for non-index households in the compound, existing latrines were upgraded. The latrines included two pits with five concrete rings per pit, a slab, water seal and a superstructure for privacy. The dual-pit design allows alternating use of pits so that the contents of the inactive pit can undergo pathogen inactivation and be safely emptied by household members and/or used as soil amendment. The slab and the water seal provide a barrier between latrine users and fecal material and also minimize flies. In the enrolled compounds, each household with children <5 years also received one child potty, and each household received one sani-scoop for removal and safe disposal of child and animal feces. Further details of the interventions have been described elsewhere (Hardware was delivered within a behavior change program, which consisted of periodic household visits from local community health promoters trained by the trial staff. The promotion visits primarily targeted the index household but other households in enrolled compounds were encouraged to attend. The visits included sharing messages using pictorial guides and conversations with the index child's caregivers. These activities were designed to encourage participants to correctly and consistently use the provided sanitation hardware and adopt safe sanitation practices in their daily lives (Promoters visited intervention households intensively during the first two years after intervention initiation, with six visits per month on average. Promotion frequency was reduced to one visit per month at the end of the second year, gradually tapered down during the third year and ceased at the end of the third year. Promoters did not visit households in the control arm. Further details of intervention implementation have been described elsewhere (