02041nas a2200193 4500000000100000008004100001653007000042100001500112700001400127700001400141700001400155700001500169700001300184245012600197300001100323490000800334520149100342022001401833 2016 d10aChild faeces; Diarrhoea; Faecal exposure; India; Sanitation; WASH1 aFreeman MC1 aMajorin F1 aBoisson S1 aRoutray P1 aTorondel B1 aClasen T00aThe impact of a rural sanitation programme on safe disposal of child faeces: a cluster randomised trial in Odisha, India. a386-920 v1103 a

BACKGROUND: Unsafe disposal of child faeces is persistent and may lead to considerable impact on the health of young children. Research is limited on the impact of sanitation or hygiene interventions to improve child faeces disposal practices.

METHODS: In the context of a randomised controlled trial to assess the health impact of a programme in Odisha, India, to promote rural sanitation under the Government of India's Total Sanitation Campaign, we explored whether the intervention affected the safe disposal of faeces of children under-5 years of age.

RESULTS: At baseline, 1.1% of households practised 'safe' disposal of child faeces, either disposing it in a toilet or by burial. The intervention increased safe disposal of child faeces to 10.4% in intervention households, compared to 3.1% in the control households (RR 3.34; 95% CI 1.99-5.59). This increase in safe disposal is attributable to increases in latrine presence in the intervention communities; the intervention did not change safe disposal practices above and beyond the increase in latrine coverage.

CONCLUSIONS: The very modest increase in safe disposal, while statistically significant, is not likely to have consequential health benefit. To achieve open defecation free communities, sanitation interventions will need to develop behaviour change approaches to explicitly target safe disposal behaviours.

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