Benjamin F. Arnold|Byron Arana|Daniel Mäusezahl|Alan Hubbard|John M. Colford
Evaluation of a pre-existing, 3-year household water treatment and handwashing intervention in rural Guatemala
University of California, Berkeley|Universidad del Valle de Guatemala|Swiss Tropical and Public Health Institute|University of Basel|University of California, Berkeley|University of California, Berkeley
promotion household water treatment handwashing soap led large reductions child diarrhoea randomized efficacy trials currently know little health effectiveness behaviourbased water hygiene interventions conclusion intervention activitieswe present extension previously published design propensity score matching analysis targeted maximum likelihood estimation methods evaluate behavioural health impacts preexisting nonrandomized intervention 3year combined household water treatment handwashing campaign rural guatemala six months intervention conducted crosssectional cohort study 30 villages 15 intervention 15 control included 600 households 929 children 5 years agethe study design created sample intervention control villages comparable across 30 potentially confounding characteristics intervention led modest gains confirmed water treatment behaviour risk difference 005 95 confidence interval ci 002009 found however difference intervention control villages selfreported handwashing behaviour spotcheck hygiene conditions prevalence child diarrhoea clinical acute lower respiratory infections child growthto knowledge first postintervention followup study combined household water treatment handwashing behaviour change intervention first postintervention followup either intervention type include child health measurement lack child health impacts consistent unsustained behaviour adoption findings highlight difficulty implementing behaviourbased household water treatment handwashing outside intensive efficacy trials