Effectiveness of community and school-based sanitation interventions in improving latrine coverage: a systematic review and meta-analysis of randomized controlled interventions

Autor: Satoshi Igaki, Nguyen Tran Minh Duc, Nguyen Hai Nam, Tran Thi Tuyet Nga, Parshal Bhandari, Amr Elhamamsy, Caroline Ibrahim Lotify, Mostafa Elsayed Hewalla, Gehad Mohamed Tawfik, Peterson Gitonga Mathenge, Masahiro Hashizume, Nguyen Tien Huy
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Environmental Health and Preventive Medicine, Vol 26, Iss 1, Pp 1-12 (2021)
Druh dokumentu: article
ISSN: 1342-078X
1347-4715
DOI: 10.1186/s12199-021-00934-4
Popis: Abstract Introduction Approximately 1000 children die each year due to preventable water and sanitation-related diarrheal diseases. Six in 10 people lacked access to safely managed sanitation facilities in 2015. Numerous community- and school-based approaches have been implemented to eradicate open defecation practices, promote latrine ownership, improve situation sanitation, and reduce waterborne disease. Objective Given that current evidence for sanitation interventions seem promising, the aim of this study was to systematically summarize existing research on the effectiveness of community- and school-based randomized controlled sanitation intervention in improving (1) free open defecation (safe feces disposal), (2) latrine usage, (3) latrine coverage or access, and (4) improved latrine coverage or access. Methods Eight electronic databases were searched: PubMed, Scopus, WHO Global Health Library (GHL), Virtual Health Library (VHL), POPLINE, Web of Science, Cochrane, and Google Scholar up to 26 April 2019. Original randomized clinical trials addressing community-based or school-based intervention that reported feces disposal and latrine coverage were deemed eligible. More than two researchers independently contributed to screening of papers, data extraction, and bias assessment. We conducted a meta-analysis by random-effects model. The risk of bias was assessed by the Cochrane risk of bias tool. Results Eighteen papers that matched all criteria and 16 studies were included in the final meta-analysis. Compared to the control, the sanitation intervention significantly increased safe feces disposal (OR 2.19, 95% CI 1.51–3.19, p < 0.05, I 2 = 97.28), latrine usage (OR 3.72, 95% CI 1.71–8.11, p < 0.05, I 2 = 91.52), latrine coverage or access (OR 3.95, 95% CI 2.08–7.50, p < 0.05, I 2 = 99.07), and improved latrine coverage or access (OR 3.68, 95% CI 1.52–8.91, p < 0.05, I 2 = 99.11). A combination of education and latrine construction was more effective compared to educational intervention alone. Conclusion Our study showed strong evidence for both community- and school-based sanitation interventions as effective for the safe disposal of human excreta. The finding suggests major implications for health policy and design of future intervention in developing countries.
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