Trial reportBMC public health2019
The impact of an operation and management intervention on toilet usability in schools in the Philippines: a cluster randomised controlled trial.
Trial report in BMC public health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03204175 (A Randomised Control Trial of a Sanitation Operation and Management Intervention in Elementary Schools in the Philippines), which is not on this map. Cited by 7 papers, 1 of them a synthesis 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.
A Randomised Control Trial of a Sanitation Operation and Management Intervention in Elementary Schools in the Philippines (Fit for School Plus)
Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Necessary conditions for sustainable water and sanitation service delivery in schools: A systematic review.PloS one · 2022Pooled it
- Improving Toilet Usability and Cleanliness in Public Schools in the Philippines Using a Packaged Operation and Maintenance Intervention.International journal of environmental research and public health · 2022Trial
- Impact of a school-based water, sanitation and hygiene programme on children's independent handwashing and toothbrushing habits: a cluster-randomised trial.International journal of public health · 2020Trial
- Determinants of access to waste management services in healthcare facilities in 14 low- and middle-income countries.Waste management & research : the journal of the International Solid Wastes and Public Cleansing Association, ISWA · 2026Article
- Stakeholder priorities for sustaining operations and maintenance of school sanitation facilities in Kampala City, Uganda.Discover public health · 2026Article
- Risk-based prioritization of operation and maintenance indicators for school sanitation decision support in Kampala City, Uganda.Discover water · 2026Article
- Factors enhancing operation and maintenance of sanitation facilities for improved service levels in Kampala Schools.BMC public health · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 4 countries.
Funding
Abstract
backgroundAccess to usable water, sanitation and hygiene provision in schools is included within indicators in the Sustainable Development Goals. Progress towards these indicators is dependent on developing an understanding of which intervention components are most effective to operate and maintain usable services. This study aimed to determine the impact of a school toilet operation and management intervention in the Philippines on toilet usability and student and teacher satisfaction, adjusted for clustering at school level.
methodsIn a non-blinded cluster randomised controlled trial, we compared improvements in usability and cleanliness of school toilets among those schools receiving a low-cost, replicable intervention. Toilet usability was measured based on Sustainable Development Goal indicators related to school sanitation defined by the UNICEF/WHO Joint Monitoring Programme for Water, Sanitation and Hygiene. Intervention schools received consumables, support kits, and structured tools designed to facilitate operation and maintenance of sanitation facilities. The primary outcome, toilet usability and cleanliness, was compared through a difference-in-difference analysis of toilet usability. Secondary outcomes of student and teacher satisfaction were measured through a survey at endline. All outcomes were adjusted for clustering at school level.
results20 eligible schools in the Batangas region of the Philippines were randomly selected and allocated to either control or intervention group. We found that non-classroom toilets were 48% more likely to meet quality benchmarks in intervention schools, but this was not statistically significant. When including in-classroom toilets in the analysis, there were no significant differences in toilet usability - defined as accessible, functional, private and of high quality - between intervention and control schools. When stratified by toilet location, children in the intervention group clusters expressed a minor, but statistically significant increase in overall satisfaction with sanitation facilities (p = 0.035).
conclusionWater, sanitation and hygiene interventions in schools focusing on operation and maintenance showed potential to improve toilet usability, but universal achievement of SDG targets may require additional efforts addressing toilet infrastructure.
trial registrationClinicalTrials.gov NCT03204175, June 2017 prior to participant enrolment.
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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.