About this trial
Guaranteeing access to safe drinking water is still a challenge in rural households in developing countries, and unsafe water sources are responsible for millions of deaths each year around the world. Coupons for free dilute chlorine solution are a cost-effective and effective way of ameliorating child health and reducing diarrhea incidence. It is still an empirical challenge, however, to see if the positive health effects will be maintained when the program is implemented at scale. In this study, investigators conduct a randomized controlled trial (RCT) at scale to study the impacts of a chlorine coupon program implemented at health clinics on child health, including self-reported diarrhea, fever, and cough incidence in the previous two weeks. Investigators further investigate the pathway of the impact, such as self-reported and objectively measured use of chlorine and frequency of visits to health clinics.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Currently pregnant women
Women living inside Health and Demographic Surveillance Systems (HDSS) catchment areas.
Disqualifiers
None
Trial design
Parallel
Treatments tested in this trial
Coupons for safe water program: Treatment
Other interventionRandomly selected women in the treatment group will receive coupons for free chlorine solutions to be redeemed at the health facility each month.
Coupons for safe water program: Control
Other interventionRandomly selected women in the treatment group will not receive coupons for free chlorine solutions after enrollment.
Treatment groups
Trial outcomes
Primary outcomes
Verified chlorine usage - 6 months
Presence of free chlorine residual in the drinking water, as observed through water testing using chlorine test strips. Households with a non-zero concentration of residual chlorine are considered to have treated their water.
Verified chlorine usage - 12 months
Presence of free chlorine residual in the drinking water, as observed through water testing using chlorine test strips. Households with a non-zero concentration of residual chlorine are considered to have treated their water.
Verified chlorine usage - 18 months
Presence of free chlorine residual in the drinking water, as observed through water testing using chlorine test strips. Households with a non-zero concentration of residual chlorine are considered to have treated their water.
Verified chlorine usage - 24 months
Presence of free chlorine residual in the drinking water, as observed through water testing using chlorine test strips. Households with a non-zero concentration of residual chlorine are considered to have treated their water.
Secondary outcomes
Child morbidity - 6 months
Child morbidity will include caregiver-reported diarrhea, fever, and cough incidents and cost related to sickness in the previous two weeks. This study will be underpowered to detect impacts on mortality, but investigators will collect data on mortality in any case as this study will contribute to a meta-analysis conducted in the future.
Child morbidity - 12 months
Child morbidity will include caregiver-reported diarrhea, fever, and cough incidents and cost related to sickness in the previous two weeks. This study will be underpowered to detect impacts on mortality, but investigators will collect data on mortality in any case as this study will contribute to a meta-analysis conducted in the future.
Child morbidity - 18 months
Child morbidity will include caregiver-reported diarrhea, fever, and cough incidents and cost related to sickness in the previous two weeks. This study will be underpowered to detect impacts on mortality, but investigators will collect data on mortality in any case as this study will contribute to a meta-analysis conducted in the future.
Child morbidity - 24 months
Child morbidity will include caregiver-reported diarrhea, fever, and cough incidents and cost related to sickness in the previous two weeks. This study will be underpowered to detect impacts on mortality, but investigators will collect data on mortality in any case as this study will contribute to a meta-analysis conducted in the future.
Sponsors and contacts
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University of Chicago
Lead sponsor
Abdul Latif Jameel Poverty Action Lab
Collaborator
Kenya Medical Research Institute
Collaborator