Trial reportThe Lancet. Global health2017
Effect of community health clubs on child diarrhoea in western Rwanda: cluster-randomised controlled trial.
Trial report in The Lancet. Global health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01836731 (Health Impact Evaluation of the "Community-Based Environmental Health Promotion Programme" in Rwanda), which is not on this map. Cited by 24 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Health Impact Evaluation of the "Community-Based Environmental Health Promotion Programme" in Rwanda
Who cites it
24 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Interventions to improve sanitation for preventing diarrhoea.The Cochrane database of systematic reviews · 2023Pooled it
- Effectiveness of interventions to improve drinking water, sanitation, and handwashing with soap on risk of diarrhoeal disease in children in low-income and middle-income settings: a systematic review and meta-analysis.Lancet (London, England) · 2022Pooled it
- Hand-washing promotion for preventing diarrhoea.The Cochrane database of systematic reviews · 2021Pooled it
- Faecal contamination of the environment and child health: a systematic review and individual participant data meta-analysis.The Lancet. Planetary health · 2020Pooled it
- Community-level interventions for improving access to food in low- and middle-income countries.The Cochrane database of systematic reviews · 2020Pooled it
- Community-level interventions for improving access to food in low- and middle-income countries.The Cochrane database of systematic reviews · 2020Pooled it
- Interventions to improve disposal of child faeces for preventing diarrhoea and soil-transmitted helminth infection.The Cochrane database of systematic reviews · 2019Pooled it
- The value of monitoring data in a process evaluation of hygiene behaviour change in Community Health Clubs to explain findings from a cluster-randomised controlled trial in Rwanda.BMC public health · 2020Trial
- Trial
- Article
- Improving community health worker treatment for malaria, diarrhoea, and pneumonia in Uganda through inSCALE community and mHealth innovations: A cluster randomised controlled trial.PLOS digital health · 2023Article
- Identifying communication spillovers in lab-in-the-field experiments.Journal of development economics · 2022Article
- Adaptation in rural water, sanitation, and hygiene programs: A qualitative study in Nepal.International journal of hygiene and environmental health · 2022Article
- Effects of adding household water filters to Rwanda's Community-Based Environmental Health Promotion Programme: a cluster-randomized controlled trial in Rwamagana district.NPJ clean water · 2022Article
- Interventions promoting uptake of water, sanitation and hygiene (WASH) technologies in low- and middle-income countries: An evidence and gap map of effectiveness studies.Campbell systematic reviews · 2021Article
- Factors associated with diarrheal disease among children aged 1-5 years in a cholera epidemic in rural Haiti.PLoS neglected tropical diseases · 2021Article
- The Applications of Implementation Science in Water, Sanitation, and Hygiene (WASH) Research and Practice.Environmental health perspectives · 2021Review
- A Review of the Community Health Club Literature Describing Water, Sanitation, and Hygiene Outcomes.International journal of environmental research and public health · 2021Review
- Systems Science Approaches for Global Environmental Health Research: Enhancing Intervention Design and Implementation for Household Air Pollution (HAP) and Water, Sanitation, and Hygiene (WASH) Programs.Environmental health perspectives · 2020Article
- Human fecal contamination of water, soil, and surfaces in households sharing poor-quality sanitation facilities in Maputo, Mozambique.International journal of hygiene and environmental health · 2020Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundCommunity health clubs are multi-session village-level gatherings led by trained facilitators and designed to promote healthy behaviours mainly related to water, sanitation, and hygiene. They have been implemented in several African and Asian countries but have never been evaluated rigorously. We aimed to evaluate the effect of two versions of the community health club model on child health and nutrition outcomes.
methodsWe did a cluster-randomised trial in Rusizi district, western Rwanda. We defined villages as clusters. We assessed villages for eligibility then randomly selected 150 for the study using a simple random sampling routine in Stata. We stratified villages by wealth index and by the proportion of children younger than 2 years with caregiver-reported diarrhoea within the past 7 days. We randomly allocated these villages to three study groups: no intervention (control; n=50), eight community health club sessions (Lite intervention; n=50), or 20 community health club sessions (Classic intervention; n=50). Households in these villages were enrolled in 2013 for a baseline survey, then re-enrolled in 2015 for an endline survey. The primary outcome was caregiver-reported diarrhoea within the previous 7 days in children younger than 5 years. Analysis was by intention to treat and per protocol. This trial is registered with ClinicalTrials.gov, number NCT01836731.
findingsAt the baseline survey undertaken between May, 2013, and August, 2013, 8734 households with children younger than 5 years of age were enrolled. At the endline survey undertaken between Sept 21, 2015, and Dec 22, 2015, 7934 (91%) of the households were re-enrolled. Among children younger than 5 years, the prevalence of caregiver-reported diarrhoea in the previous 7 days was 514 (14%) of 3616 assigned the control, 453 (14%) of 3196 allocated the Lite intervention (prevalence ratio compared with control 0·97, 95% CI 0·81-1·16; p=0·74), and 495 (14%) of 3464 assigned the Classic intervention (prevalence ratio compared with control 0·99, 0·85-1·15; p=0·87).
interpretationCommunity health clubs, in this setting in western Rwanda, had no effect on caregiver-reported diarrhoea among children younger than 5 years. Our results question the value of implementing this intervention at scale for the aim of achieving health gains.
fundingBill & Melinda Gates Foundation.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.