[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"menstrual-hygiene\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:menstrual-hygiene":27},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,1,0,[8],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":13,"acronym":4,"eligibilityCriteria":14,"healthyVolunteers":15,"sex":16,"minAge":4,"maxAge":4,"enrollmentInfo":17,"targetDuration":4,"studyType":20,"phases":21,"briefSummary":23,"conditions":24,"keywords":29,"overallStatus":35,"whyStopped":4,"lastUpdateSubmitDate":36,"lastUpdatePostDateStruct":37,"startDateStruct":40,"completionDateStruct":42,"leadSponsor":44,"locationsCount":5},"100656201","impact-evaluation-of-accelerating-climate-resilient-water-sanitation-and-hygiene-services-for-schools-and-healthcare-facilities-in-karamoja-100656201",false,"NCT07823231","Impact Evaluation of Accelerating Climate-Resilient Water, Sanitation and Hygiene Services for Schools and Healthcare Facilities in Karamoja","Inclusion Criteria:\n\nCLUSTER LEVEL (school)\n\n* Government primary school, operational at the time of the October-November 2025 rapid vulnerability assessment, located in one of the nine districts of the Karamoja sub-region (Abim, Amudat, Kaabong, Karenga, Kotido, Moroto, Nabilatuk, Nakapiripirit, Napak)\n* Classified in the severe or acutely affected moderate water insecurity tier on the adapted HWISE assessment, and among the 60 highest composite priority scores across all 182 assessed schools\n* Hydrological viability confirmed: sub-surface geology and groundwater survey establish the feasibility of a viable water source at or adjacent to the school site\n* Head teacher and school administration grant permission for facility observation and school records capture\n\nINDIVIDUAL LEVEL\n\nPupils:\n\n* Enrolled in grades P2 to P7 at a trial school and appearing on the current enrolment register at the time of sampling\n* Selected by systematic random sampling from the enrolment register with proportional representation across grades\n* Parent or legal guardian has provided written informed consent, and the pupil has provided assent\n* For the menstrual health sub-sample: post-menarche, approximately aged 11 to 17\n\nCaregivers:\n\n* Parent or legal guardian of a sampled pupil, matched one-to-one\n* Provides own informed consent\n\nTeachers and head teachers:\n\n* Currently employed and appearing on the staff register of a trial school\n* Teachers selected by simple random sampling from the staff register, six per school\n* Provide their own informed consent\n\nCommunity leaders:\n\n* Local council chairperson, religious leader, women's group representative or community elder resident in the catchment area of a trial school\n* Provides own informed consent\n\nExclusion Criteria:\n\n* Schools not confirmed hydrologically viable for a school-site water source\n* Schools outside the top 60 composite priority scores\n* Pupils not appearing on the current enrolment register at the time of sampling\n* Any individual for whom consent (and, for pupils, both guardian consent and pupil assent) is not obtained\n* Any individual who declines or withdraws at any point, without requirement to give a reason and without consequence",true,"ALL",{"count":18,"type":19},16380,"ESTIMATED","INTERVENTIONAL",[22],"NA","Karamoja, in north-eastern Uganda, is among the most water-insecure regions in sub-Saharan Africa. Only 24 per cent of households can access the WHO-recommended 20 litres of water per person per day. Only 11.7 per cent have access to improved sanitation. A rapid vulnerability assessment covered all 182 operational primary schools in the sub-region between October and November 2025. It identified 53 schools as severely water insecure and a further 37 as moderately water insecure. Together, these schools serve an estimated 196,000 learners. The assessment also found that 89 schools lacked enough latrines to meet the national pupil-to-latrine ratio. Seventy-eight schools had no functional menstrual health management facilities.\n\nThis study is a three-arm, phase-in cluster-randomised controlled trial. It evaluates the causal effects of a climate-resilient school WASH package on children's health and school attendance. It also examines adolescent girls' menstrual health self-efficacy. The study covers 60 primary schools that were found to be water-insecure across Karamoja's nine districts. The schools were stratified into three geographic zones. The researchers then used covariate-constrained randomisation to assign schools to three study arms. Phase 1 includes 30 schools receiving the intervention early. Phase 2 includes 20 schools receiving it later. The remaining 10 schools form the pure control group.\n\nThe intervention combines climate-resilient WASH infrastructure with capacity-building and social and behaviour change activities. The infrastructure includes motorised boreholes, sex-disaggregated latrines and handwashing stations built to national standards. A subset of the boreholes will have data loggers for remote monitoring. The package also provides dedicated menstrual health facilities. These include enclosed changing areas and hygienic waste-disposal systems. Community water access points will be installed next to each school. Capacity-building activities will involve School Management Committees, Parent-Teacher Associations, teachers, District Water Officers and School Health Clubs.\n\nData will be collected through three repeated cross-sectional rounds. The baseline will take place in the fourth quarter of 2026. The midline will take place in the first quarter of 2028, and the endline in the first quarter of 2030. Seven instruments will be used. These include pupil and matched caregiver surveys, school WASH facility and classroom roll-call observations, and head teacher and teacher surveys. The study will also digitise school enrolment, attendance and examination records. Community leaders will be interviewed separately. In each round, the sample will include 20 post-menarche girls and 20 general pupils per school. The study will interview one caregiver for each sampled pupil. The study will also interview six teachers, the head teacher and four community leaders in each school catchment.\n\nThe study has three co-primary outcomes. The first is the pupil absence rate, measured using digitised attendance registers. The second is the seven-day prevalence of diarrhoea among pupils. The third is menstrual health self-efficacy among post-menarche girls. We will measure this using the 26-item Self-Efficacy in Addressing Menstrual Needs Scale (SAMNS-26). The primary analysis will estimate the intent-to-treat effect of assignment to Phase 1. At midline, Phase 1 schools will be compared with Phase 2 and pure control schools. We will conduct two comparisons at endline. First, we will compare all treated schools with the pure control group. Second, Phase 1 schools will be compared with Phase 2 schools to test whether effects differ by exposure duration.",[25,26,27,28],"Diarrhea","Respiratory Tract Infections (RTI)","Menstrual Hygiene","Absenteeism",[30,31,32,33,34],"water sanitation and hygiene","cluster randomised controlled trial","menstrual health","absenteeism","Uganda","RECRUITING","2026-09-10",{"date":38,"type":39},"2026-09-16","ACTUAL",{"date":41,"type":19},"2026-10-19",{"date":43,"type":19},"2030-12-31",{"name":45,"class":46},"Elijah Kipchumba","OTHER"]