Trends in sanitation and hygiene behaviors amongst households residing in rural and peri-urban Amhara, Ethiopia – A longitudinal analysis of cluster-randomized trial data Open Access

Xie, Yunbo (Spring 2020)

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Background: Sustained water, sanitation, and hygiene (WASH) behaviors and practices are essential to prevent the spread of infectious diseases. The Andilaye Trial was a parallel cluster-randomized trial carried out in Ethiopia between spring 2017 and summer 2019. And longitudinal analysis was performed on this sub-study paper to compare the effectiveness of the Andilaye intervention, a novel WASH intervention, and the CLTS, government-backed, low-cost and locally acceptable approaches for improving sanitation and hygiene. The effects of the Andilaye intervention on various WASH behaviors were examined over time.

Methods: The data collection process for the parent study, the Andilaye Trial, consists of three-stage data collection processes, baseline, midline and endline. Three WASH behavioral outcomes were selected to conduct longitudinal analysis. They were latrine usage, handwashing practices and facewashing practices. We assessed the associations between the Andilaye intervention arm and these selected WASH behavioral outcomes using generalized estimating equation.

Results: The GEE models revealed that the odds ratio and the corresponding 95% confidence intervals for handwashing practices after defecation among female participants was 1.33 (1.13-1.44). The odds ratio and the 95% confidence intervals for handwashing practices before food preparation among female participants was 1.37 (1.16-1.48). And lastly, the odds ratio and the 95% confidence intervals for facewashing practices among female participants was 1.53 (1.02-1.82).

Conclusions: These results suggest that the Andilaye intervention arm may be associated with higher odds of improved handwshing and facewashing practices among females over time.

Table of Contents


Introduction. 1

Methods. 4

Background. 4

Univariate Analysis. 6

Multivariate Models. 8

Ethics. 10

Results. 10

Sample size. 10

Results from GEE models. 12

Discussion. 13

References. 17

Appendix A

Appendix B

Supplement Table 1

Supplement Table 2

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