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The problem
Intervention: Water, sanitation and hygiene (WASH) infrastructure and programming in schools
Who it was tested with: 353 children aged 5-18 attending six primary schools in Ogun State, Nigeria (three with WASH interventions, three without).
Children or communities are compared with a group that did not receive the intervention, or followed over years. This is the design that best separates what the intervention did from everything else that changed.
"A total of 353 children across six schools (three interventions and three non-interventions) participated in this study. WASH conditions were assessed using WHO standardized tools and anthropometric data of children were analysed in WHO AnthroPlus and R Software." The study includes a comparison group and anthropometric measurements, but the cross-sectional design without randomisation and the small number of schools limit causal inference to the experimental tier.
Cross-sectional design prevents causal inference. Only six schools sampled. No measurement of WASH implementation quality or fidelity. Confounding factors such as household socioeconomic status, dietary intake, and other health programmes not controlled for. The paradoxical finding of higher wasting in intervention schools suggests potential unmeasured differences between school populations.
Across countries and designs
1 study · 1 country
