Understanding use characteristics, transitions, and sustainability of child feces management hardware among caretakers and children in a cluster-RCT in rural Odisha, India. Open Access
McKinley, Norah (Spring 2023)
Abstract
Safe child feces management (CFM) is an integral avenue in which sanitation can be improved across the world, as increased access to latrines is often not sufficient in facilitating safer feces disposal practices. This is especially true for young children, who may not be able to control where they defecate or are too small to use the latrine. Safe CFM is often neglected and excluded from water, sanitation, and hygiene (WASH) interventions, even though it can reduce exposure to enteric pathogens for both adults and children and facilitate a cleaner environment. This thesis is working with data from a study conducted in rural Odisha, India, that investigated the impact of hardware that was designed and distributed with the intention of improving CFM across 37 intervention villages enrolled in a cluster-randomized controlled trial. The hardware consisted of a wooden latrine mat to manage toddler feces, and a plastic bucket with a lid and a plastic wash basin to manage baby feces. The latrine mat is a novel hardware item and is an elevated wooden board with a small hole for feces to pass through, with handles attached to each side and front for children to hold onto, and a removable tray underneath to enable safe use inside or outside the latrine. This thesis presents analysis and findings on hardware use characteristics that were observed and recorded during the intervention period, and perceptions of both impact and how the hardware was used by different caregivers and children. It also examines the durability and sustainability of the hardware. An analysis on how the hardware helped facilitate transitions between different defecation practices was also included, as one of the main outcomes of interest in this study is whether this hardware could lead to earlier latrine facilitation by children. This thesis worked with both quantitative and qualitative data to investigate how the hardware was used and if it would be feasible to distribute the hardware in other contexts. The results showed positive receptions of the hardware, with most caregivers interviewed stating that it would lead to earlier latrine use. In addition to this, the latrine mat did appear to contribute to increased comfort in transitioning from open defecation to over the latrine mat or latrine directly. This hardware could easily be adapted to other contexts and should be investigated elsewhere as well.
Table of Contents
Introduction 1
Methods 11
Results 16
Discussion 23
Public Health Implication 28
References 30
Tables 38
Figures 46
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