RANDOMISED CONTROL TRIAL IN RUSIZI DISTRICT
Courtesy of Kris Cox, Country Director of Innovation for Poverty Action in Rwanda. Presentation at the CBEHPP Workshop for Scale up, March 2015.
The Randomised Control Trial Started in June 2013 and will continue until June 2016. This is an independent evaluation by Innovation for Poverty Action who have been contracted by the Bill & Melinda Gates Foundation.
The implementation (the treatment) is being done by Ministry of Health assisted by Africa AHEAD who is providing support for training and monitoring to ensure the project is executed as designed in the manual.
Rusizi District in Western Province was selected for the RCT as it is one of least developed areas of Rwanda. It had one of the lowest coverages of CHCs in the country prior to this project and there were no other NGOs working in the wash sector, so confounding was minimised. The villages for treatment were randomly selected after a base line survey to ensure each arm of the trial was well matched.
The Classic CHC entailed atext book training with all recommended inputs as well as 20 sessions over a six month time frame
The Lite version is limited in inputs, has only 8 sessions on WASH topics over two months and is more like the PHAST Methodology.
The Control group will receive full Classic Training within 2 years.
Impact on Water Quality
Impact on Child Growth
As stunting of children at an early age is a particular concern in Rwanda the RCT will measure if the increased hygiene and better knowledge on child care and nutrition which members supposedly receive through the weeking health sessions in CHCs may impact on early child growth. Over 4,000 under 2’s were identified in the base line as new borns and these children are being tracked in all 3 arms over the 3 year period.
Impact on income
As the CHC Model claimed to develop social cohesion and reciprocity due to regular interaction between members the RCT will measure any increase in ‘social capital’.
Hygiene behaviour change will be measured to see if the key indicators which are the focus of the training have been improved. This includes sanitation, handwashing, cleanliness of latrines, food and water handling and storage. All of these key practices are know to affect diarrhoea and other preventable diseases.