IEb19

Does building more toilets stop the spread of disease? Impact evidence from India

Over one-third of the 2.5 billion people worldwide who do not have access to improved sanitation live in India. Nearly 69 per cent of the population practise open defecation. Typically, the government of India’s national sanitation schemes have focused on building more latrines for reducing open defecation, health-related illness and child malnutrition.

A 3ie-funded impact evaluation research team used a cluster-randomised controlled trial to evaluate the government’s Total Sanitation Campaign in Odisha, India to see if latrine coverage did indeed reduce exposure to disease. The intervention mobilised households in villages characterised by high levels of open defecation to build and use latrines. The study was conducted between May 2010 and December 2013, involving more than 50,000 individuals in 100 villages.

Key policy messages 

  • The study results show that the assumption that more latrines will reduce exposure to faecal pathogens, and therefore disease, does not necessarily hold true. 
  • During the study period, latrine coverage in the intervention villages increased from 9 per cent of households to 63 per cent, compared to an increase from 8 per cent to 12 per cent in the control villages.
  • The increase in latrine coverage did not prevent diarrhoea or reduce soil-transmitted helminth infection in the intervention villages. The seven-day prevalence of reported diarrhoea in children younger than 5 years was 8.8 percent in the intervention group and 9.1 percent in the control group.

IEb39, kenya-smallholder-farmer-tw4.2.01-brief.JPG

Capacity building of smallholder dairy farmers in Kenya through extension services and market linkages

Impact evaluation 3ie 2019
This brief is based on the findings of an impact evaluation that examined the effects of the Smallholder Dairy Commercialization Programme in Kenya on farmers’ production, income and food security and on the empowerment of female dairy farmers.

IE female sex workers,IEb38

What works to increase HIV testing for female sex workers in Kenya, Uganda and Zambia

Impact evaluation 3ie 2018

This brief is based on the findings of three impact evaluations that examined the effectiveness of oral HIV self-tests.

IE Self test Zambia, IEb37

Investigating the feasibility of HIV self-testing in Zambia

Impact evaluation 3ie 2018

This brief is based on the findings of an impact evaluation that examines whether HIV self-tests increase HIV testing among female sex workers in

IE TW7, IEb36

Impacts of community delivery of antiretroviral drugs in Dar es Salaam, Tanzania

Impact evaluation 3ie 2018

This evaluation showed that community delivery of drugs by community health workers to clinically stable patients is not inferior to standard care, where patients visit a clinic-based doctor t

Tanzania-IE59, IEb35

A low-cost patient appointment and tracking system for ART at reproductive and child health clinics in Tanzania

Impact evaluation 3ie 2018

This brief is based on the findings of an impact evaluation that looks at whether orienting staff at reproductive and child health clinics improves patient appointment attendance rates.