Evaluating the effectiveness of WASH interventions in primary schools

In partnership with World Vision USA, Stanford University is supporting the evaluation of the WASH UP! program in 200 primary schools in Sitapur district of Uttar Pradesh, India. A four-arm Cluster Randomised Controlled Trial (cRCT) is being undertaken towards assessing the individual and combined effectiveness of the two interventions (curriculum and Operation & Maintenance) in improving WASH-related outcomes. We are the research and evaluation partner to Stanford University on this project.

The two interventions, implemented over around a year, are explained below:   

WASH UP! Curriculum Intervention
A curriculum was designed by Sesame Workshop, India with the goal of inculcating good WASH practices among government primary school students in classes 1 to 4. The curriculum consists of 12 sessions on WASH-related topics designed to be delivered once a week. A variety of educational materials are provided, including a storybook, games, videos, take-home materials, and a teacher guidebook. The curriculum is centred around Raya, a six-year-old girl character who is portrayed as a 'WASH Champion'. Teachers are trained in delivering the program by Sesame Workshop consultants or by teachers who completed the training.

WASH UP! Operations and Maintenance (O&M) Intervention
This intervention involves hiring of a part-time cleaner called a ‘Swachhata Saathi’ in each school who works to keep its WASH facilities functional, clean, and usable. The Swachhata Saathi does not just clean, but also monitors functionality and apprises the school of required repairs. A third-party private company was contracted to hire, train, and oversee the work of Swachhata Saathis in the participating schools; to provide cleaning equipment and supplies; and to address any complaints from schools related to Swachhata Saathis’ performance.  

Challenges

Several factors contribute to poor WASH behaviour. These range from inadequate awareness, to lack of facilities;  inadequately maintained facilities to prevailing social norms. With the Swachh Bharat Mission in India, extensive improvements were made in the provision of WASH infrastructure including in schools. Continuing operation and maintenance of the infrastructure to ensure it remains clean and functional has however been a challenge. Similarly slippage in sustainable behavioural change has also been observed.  

Our approach

The evaluation uses mixed methods involving the collection of quantitative as well as qualitative data to assess the effectiveness of the interventions. Data has been collected at the start, during the middle and at the end of the implementation of the interventions. A theory of change/causal model underpins the analysis to ensure that, in addition to measuring the impact of the interventions on WASH-related outcomes, we also test the causal pathways that we hypothesize lead to such impact. In addition, a process evaluation was undertaken at midline to assess the implementation, adaptations and provide insights towards future scale-up (assuming effectiveness) and sustainability.

The study involves comparison between four different groups of schools with around 50 schools in each group. 50 schools have only the curricular intervention, 50 schools only the O&M intervention, another 50 both, and a group of 50 schools which has no intervention, serves as the control group. This allows a comparison of the effectiveness of each intervention individually, and the combined impact of both compared to no intervention (the control group).

Outcomes

The objective of the evaluation is to measure the individual and combined effect of the interventions on:

i) students’ and teachers’ WASH knowledge, attitudes, and practices, and 
ii) the cleanliness and functionality of school WASH infrastructure. 

It is expected that the findings from the study will be disseminated through journal articles as well as contributing to advocacy related to improving WASH in schools in the state of Uttar Pradesh. 

This assessment was carried out jointly by Oxford Policy Management. The Principal Investigator for this study was Jenna Davis, Professor of Civil and Environmental Engineering, from Stanford University.