Global S&T Development Trend Analysis Platform of Resources and Environment
DOI | 10.1289/EHP10443 |
The Impact of Pro-Poor Sanitation Subsidies in Open Defecation-Free Communities: A Randomized, Controlled Trial in Rural Ghana | |
John T. Trimmer; Joyce Kisiangani; Rachel Peletz; Kara Stuart; Prince Antwi-Agyei; Jeff Albert; Ranjiv Khush; Caroline Delaire | |
2022-06-08 | |
发表期刊 | Environmental Health Perspectives |
出版年 | 2022 |
英文摘要 | AbstractBackground:According to the World Health Organization/United Nations International Children’s Fund Joint Monitoring Program, people practice open defecation globally. After achieving open defecation-free (ODF) status through efforts such as Community-Led Total Sanitation (CLTS), communities (particularly vulnerable households) may revert to open defecation, especially when toilet collapse is common and durable toilets are unaffordable. Accordingly, there is increasing interest in pro-poor sanitation subsidies. Objectives:This study determined the impacts of a pro-poor sanitation subsidy program on sanitation conditions among the most vulnerable households and others in the community. Methods:In 109 post-ODF communities in Northern Ghana, we conducted a cluster randomized controlled trial to evaluate a pro-poor subsidy program that identified the most vulnerable households through community consultation to receive vouchers for durable toilet substructures. We surveyed households to assess toilet coverage, quality, and use before and after the intervention and tracked program costs. Results:Overall, sanitation conditions deteriorated substantially from baseline to endline (average of 21 months). In control communities (not receiving the pro-poor subsidy), open defecation increased from 25% (baseline) to 69% (endline). The subsidy intervention attenuated this deterioration (open defecation increased from 25% to only 54% in subsidy communities), with the greatest impacts among voucher-eligible households. Noneligible households in compounds with subsidized toilets also exhibited lower open defecation levels owing to in-compound sharing (common in this context). CLTS followed by the subsidy program would benefit more households than CLTS alone but would cost 21–37% more per household that no longer practiced open defecation or upgraded to a durable toilet. Discussion:Sanitation declines, often due to toilet collapse, suggest a need for approaches beyond CLTS alone. This subsidy program attenuated declines, but durable toilets likely remained unaffordable for noneligible households. Targeting criteria more closely aligned with sanitation inequities, such as household heads who are female or did not complete primary education, may help to generate greater and more sustainable impacts in Northern Ghana and, potentially, other contexts facing toilet collapse and limited market access. https://doi.org/10.1289/EHP10443 |
领域 | 资源环境 |
URL | 查看原文 |
引用统计 | |
文献类型 | 期刊论文 |
条目标识符 | http://119.78.100.173/C666/handle/2XK7JSWQ/351457 |
专题 | 资源环境科学 |
推荐引用方式 GB/T 7714 | John T. Trimmer,Joyce Kisiangani,Rachel Peletz,et al. The Impact of Pro-Poor Sanitation Subsidies in Open Defecation-Free Communities: A Randomized, Controlled Trial in Rural Ghana[J]. Environmental Health Perspectives,2022. |
APA | John T. Trimmer.,Joyce Kisiangani.,Rachel Peletz.,Kara Stuart.,Prince Antwi-Agyei.,...&Caroline Delaire.(2022).The Impact of Pro-Poor Sanitation Subsidies in Open Defecation-Free Communities: A Randomized, Controlled Trial in Rural Ghana.Environmental Health Perspectives. |
MLA | John T. Trimmer,et al."The Impact of Pro-Poor Sanitation Subsidies in Open Defecation-Free Communities: A Randomized, Controlled Trial in Rural Ghana".Environmental Health Perspectives (2022). |
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