Evidence map›Paper›PMID 42824887›Full record

ArticleBMJ public health2026

Functionality of school WASH infrastructure: a qualitative observational study of operation and maintenance systems in Uttar Pradesh, India.

Riddhi Banerjee, Kavita Chauhan, Gracie Hornsby, Anvesh Badamikar, Preeti Priya, Dinesh Bhatt, Christine Pu, James Winter, Jennifer Davis, Gary L Darmstadt and 1 more

Abstract read
In one paragraph

Article in BMJ public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Riddhi BanerjeeOxford Policy Management, New Delhi, India.ORCID https://orcid.org/0009-0003-5842-800X
Kavita ChauhanOxford Policy Management, New Delhi, India.
Gracie HornsbyCivil and Environmental Engineering, Stanford University, Stanford, California, USA.ORCID https://orcid.org/0009-0008-3123-7971
Anvesh BadamikarCivil and Environmental Engineering, Stanford University, Stanford, California, USA.
Preeti PriyaOxford Policy Management, New Delhi, India.
Dinesh BhattOxford Policy Management, New Delhi, India.
Christine PuCivil and Environmental Engineering, Stanford University, Stanford, California, USA.
James WinterCivil and Environmental Engineering, Stanford University, Stanford, California, USA.
Jennifer DavisCivil and Environmental Engineering, Stanford University, Stanford, California, USA.
Gary L DarmstadtStanford University, Stanford, California, USA.
Ruhi SaithOxford Policy Management, New Delhi, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: The Government of India has invested substantially in school water, sanitation and hygiene (WASH) infrastructure through the Swachh Vidyalaya Abhiyan (Clean Schools Programme), yet low facility use persists, often due to weak operation and maintenance (O&M).Guided by Pu Methods: 70 in-person interviews and nine WASH facility observations were conducted across nine government primary schools in three administrative blocks of one district in Uttar Pradesh, India. The respondents included, amongst others, headmasters (n=9), teachers (n=18), cleaners (n=7), local officials (n=5) and elected representatives (n=7). Results: Resources: Schools depend heavily on the Gram Panchayat (Village Council) for staff and funds. One cleaner typically serves multiple public spaces and schools within a panchayat, leaving schools with infrequent cleaning support. Education department funds are limited, so schools rely on Panchayat funds for cleaning and repairs. However, Pradhans tend to prioritise visible upgrades, such as infrastructure improvements or wall painting, which offer greater community visibility and electoral value.Information: Cleaners are aware of their roles and responsibilities. However, school headmasters do not formally monitor their activities and there are rarely any penalties for lapses.Accountability: There is a disconnect between the authorities responsible for school WASH services and those overseeing their implementation. Cleaners report to Pradhans 4 under the Panchayati Raj Department rather than the Education Department, creating misaligned accountability. Consequently, inadequate maintenance of facilities often goes unaddressed. Conclusions: Poor O&M of WASH facilities has historically been linked with inadequate financial and human resourcing. However, we argue that this underperformance is exacerbated by poor accountability mechanisms. The study's findings informed the design of an intervention aimed at directly addressing this issue.

Indexed as

Public HealthQualitative ResearchSanitation

Identifiers

PMID42824887
PMCPMC13629971

What OpenQuestion holds

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Registered trials

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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.