A cluster-randomized trial assessing the impact of school water, sanitation and hygiene improvements on pupil enrolment and gender parity in enrolment
Open accessAbstract
We employed a cluster-randomized trial design to measure the impact of a school-based water, sanitation and hygiene (WASH) improvement on pupil enrolment and on gender parity in enrolment, in primary schools in Nyanza Province, Kenya (2007–2009). Among schools with poor water access during the dry season, those that received a water supply, hygiene promotion and water treatment (HP&WT) and sanitation improvement demonstrated increased enrolment (β = 0.091 [0.009, 0.173] p = 0.03), which translates to 26 additional pupils per school on average. The proportion of girls enrolled in school also increased by 4% (prevalence ratio (PR) = 1.04 [1.00, 1.07] p = 0.02). Among schools with better baseline water access during the dry season (schools that did not receive a water source), we found no evidence of increased enrolment in schools that received a HP&WT intervention (β = 0.016 [–0.039, 0.072] p = 0.56) or the HP&WT and sanitation intervention (β = 0.027 [–0.028, 0.082] p = 0.34), and there was no evidence of improved gender parity (PR = 0.99 [0.96, 1.02] p = 0.59, PR = 1.00 [0.97, 1.02] p = 0.75, respectively). Our findings suggest that increased school enrolment and improved gender parity may be influenced by a comprehensive WASH programme that includes an improved water source; schools with poor water access during the dry season may benefit most from these interventions.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Growing evidence suggests the gendered impacts of inadequate WASH facilities in LMIC schools influence the participation of girls.
“Growing evidence suggests the gendered impacts of inadequate WASH facilities in LMIC schools influence the participation of girls [15,16].”
From A Time for Global Action: Addressing Girls’ Menstrual Hygiene Management Needs in Schools (2016) · cites this paper as [16]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 20 · Cited by 71
Research works printed but not linked: 8
- Filmer D 2007 If you build it, will they come? School availability and school enrolment in 21 poor countries Journal of Development Studies 43 5 901 928
- Hayes R Moulton LH Morgan BTJ 2009 Cluster randomized controlled trials Chapman and Hall/CRC Press New York
- Kazeem A Jensen L Stokes CS 2010 School attendance in nigeria: Understanding the impact and intersection of gender, Urban-Rural residence, and socioeconomic status Comparative Education Review 54 2 295 319 PMC4593499 26448653
- Kleinbaum DG Klein M 2002 Logistic Regression: A Self-Learning Text 2nd Springer-Verlag New York
- Mintz ED Reiff FM Tauxe R 1995 Safe water treatment and storage in the home: a practical new strategy to prevent waterborne disease Journal of the American Medical Association 273 948 953 7884954
- Nandrup-Bus I 2009 Mandatory handwashing in elementary schools reduces absenteeism due to infectious illness among pupils: a pilot intervention study Am J Infect Control 37 10 820 826 19850374
- Rabie T Curtis V 2006 Handwashing and risk of respiratory infections: a quantitative systematic review Trop Med Int Health 11 3 258 267 16553905 PMC7169664
- Wells R 2009 Gender and age-appropriate enrolment in Uganda International Journal of Educational Research 48 1 40 50
- Authors
- Garn, J. V., Greene, L. E., Dreibelbis, R., Saboori, S., Rheingans, R. D., & Freeman, M. C.
- Affiliations
- Emory University (US)
- Johns Hopkins University (US)
- University of Florida (US)
- Corresponding author
- Freeman, Matthew C.
- Venue
- Journal of Water, Sanitation and Hygiene for Development
- Publisher
- IWA Publishing
- Published
- 2013-06-10
- Volume
- 3
- Issue
- 4
- Pages
- 592-601
- ISSN
- 2043-9083 (ISSN-L)
- 2408-9362
- PMC
- PMC3876875
- OpenAlex
- W2030162829
- Cited by
- 71
- References
- 20
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 3 · 2023: 4 · 2022: 6 · 2021: 9 · 2020: 5 · 2019: 9 · 2018: 2 · 2017: 7 · 2016: 9 · 2015: 4 · 2014: 2 · 2013: 2
- FWCI
- 5.26
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Water Sanitation and Hygiene for Development (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- UNICEF
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (T32HD052460)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Social Sciences › Safety Research › Poverty, Education, and Child Welfare
- Physical Sciences › Environmental Science › Water Science and Technology › Water Resource Management and Quality
- Keywords
- school water, sanitation and hygiene, student enrollment, elementary school, school water supply, hygiene promotion, water treatment, sanitation improvement, dry season water access
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
