Table 4.

Impact pathway related to the direct multiple benefits of interventions

Context	Mechanism	Outcome	Implication for the diarrhoea outcome or its estimation in the study and the Waddington review
Several sources of ill-being, including non-diahorreal infections, are linked to poor access to water and to insanitary environment.	WASH interventions alleviate determinants of these different sources of ill-being.	Multiple benefits (health, time and expense saved by more accessible services), in addition to diarrhoea reduction, may be realized as a direct consequence of the intervention (Huttly et al. 1990; Gasana et al. 2002; Galiani et al. 2008).	Possibly no effect (additional benefits are valued in their own right); may increase beneficiaries’ commitment to supporting and maintaining the intervention, enhancing sustainability.