. 2020 Jul 12;10(7):e034812. doi: 10.1136/bmjopen-2019-034812

Table 1.

Characteristics of included studies in the meta-analysis

Author, year/quality of evidence	Design	Country	Setting	Population	WASH alone and/or combined with nutrition	Outcome	Effect size
Author, year/quality of evidence	Design	Country	Setting	Population	WASH alone and/or combined with nutrition	Outcome	MD	95% CI
Arnold et al, 2010 Quality: very low²⁵	Non-RCT	India	Rural	Children <5 years	Water supply and improvements+sanitation and hygiene behaviour change	HAZ	−0.04	−0.35 to 0.30
						WAZ	−0.05	−0.26 to 0.18
						WHZ	−0.10	−0.19 to 0.10
Arnold et al, 2009 Quality: very low⁴²	Non-RCT	Guatemala	Rural	Children <5 years	Water boiling, water solar disinfection and chlorination using dilute beach+handwashing promotions using soap or detergent and scrubbing	HAZ	0.04	−0.31 to 0.33
						WAZ	−0.05	−0.33 to 0.21
						WHZ	−0.07	−0.25 to 0.12
Bowen et al, 2012 Quality: low³⁰	RCT	Pakistan	Rural	Children <5 years	Handwashing promotion with soap flocculent-disinfectant and sodium hypochlorite solution for drinking water treatment	HAZ	0.08	−0.29 to 0.27
Bowen et al, 2012 Quality: low³⁰	RCT	Pakistan	Rural	Children <5 years		WAZ	−0.06	−0.27 to 0.17
Briceño et al, 2015 Quality: low²⁹	RCT	Tanzania	Rural	Children <5 years	Total sanitation and sanitation marketing+handwashing with soap	HAZ	−0.01	−0.12 to 0.10
Briceño et al, 2015 Quality: low²⁹	RCT	Tanzania	Rural	Children <5 years		WAZ	−0.08	−0.15 to 0.00
Cameron et al, 2013 Quality: medium²⁶	RCT	Indonesia	Rural	Children <5 years	Total sanitation and sanitation marketing (community-led total sanitation+sanitation marketing+enabling environment)	HAZ	0.01	−0.01 to 0.03
						WAZ	0.03	−0.09 to 0.15
						WHZ	0.06	−0.06 to 0.18
Clasen et al, 2014 Quality: good²⁷	RCT	India	Rural	Children <5 years	Latrine promotion and construction which combines social mobilisation with post hoc subsidy	HAZ	−0.01	−0.22 to 0.02
Clasen et al, 2014 Quality: good²⁷	RCT	India	Rural	Children <5 years		WAZ	0.02	−0.04 to 0.08
Du Preez et al, 2011 Quality: medium³³	RCT	Kenya	Pre-urban and rural	Children<5 years	Water disinfection using solar disinfection and chlorination	HAZ	0.11	−0.19 to 0.41
						WAZ	−0.01	−0.23 to 0.21
						WHZ	−0.11	−0.30 to 0.08
Fenn et al, 2012 Quality: low⁴³	Non-RCT	Ethiopia	Rural	Children <5 years	Hygiene educational, free drug provision, free primary healthcare services, material provisions for pit latrines and safe water sources construction.	HAZ	0.33	0.08 to 0.59
Galiani et al, 2012 Quality: very low²⁸	RCT	Peru	Rural	Children <2 years	Handwashing promotion using mass media plus direct consumer contact	HAZ	−0.02	−0.24 to 0.19
						WAZ	−0.01	−0.23 to 0.20
						WHZ	0.06	−0.11 to 0.22
Humphrey et al, 2019 Quality: good³⁷	RCT	Zimbabwe	Rural	Pregnant women	Behaviour change modules delivery, standard of care messages, information dissemination on WASH and child feeding, latrine construction+handwashing stations+monthly supply of soap and chlorine+child feeding nutrient-rich foods+lipid-based nutrient	HAZ	0.06	−0.01 to 0.12
						WAZ	0.00	−0.06 to 0.06
						WHZ	−0.04	−0.11 to 0.03
Langford et al, 2011 Quality: very low³¹	Non-RCT	Nepal	Urban Slum	Children 3–12 months	Handwashing promotion	HAZ	−0.26	−0.66 to 0.13
						WAZ	−0.19	−0.62 to 0.23
						WHZ	0.09	−0.23 to 0.42
Lin et al, 2013 Quality: very low³⁹	non-RCT	Bangladesh	Rural	Children <4 years	Education on water, sanitation and handwashing	HAZ	0.54	0.06 to 1.01
						WAZ	0.04	−0.48 to 0.55
						WHZ	−0.19	−0.61 to 0.24
Luby et al, 2018 Quality: good⁴⁰	RCT	Bangladesh	Rural	Pregnancy in first two trimester and children <3 years	Individual water, sanitation and hygiene and combined WASH and WASH+nutrition	HAZ	0.02	−0.09 to 0.19
						HAZ	0.13	0.02 to 0.24*
						WAZ	0.00	−0.09 to 0.10
						WAZ	0.13	0.04 to 0.22*
						WHZ	0.00	−0.10 to 0.11
						WHZ	0.09	0.00 to 0.18*
Muhoozi et al, 2017 Quality: medium³²	RCT	Uganda	Rural	Children 20–24 months	Combined nutrition with simulation, sanitation and hygiene education	HAZ	0.10	−0.17 to 0.36*
						WAZ	0.01	−0.27 to 0.29*
						WHZ	−0.05	−0.33 to 0.22*
Nair et al, 2017 Quality: medium³⁶	RCT	India	Rural	Pregnancy in third trimester and children <2 years	Counselling on maternal nutrition, growth promotion for children through young child feeding, illness prevention, education on water, sanitation and hygiene	HAZ	0.11	−0.01 to 0.23*
						WAZ	0.07	−0.02 to 0.16*
						WHZ	0.02	−0.08 to 0.11*
Null et al, 2018 Quality: good⁴¹	RCT	Kenya	Rural	Women in second or third trimester and children 6–24 months	Individual water, sanitation and hygiene or combined WASH intervention and combined with nutrition	HAZ	−0.03	−0.14 to 0.08
						HAZ	0.16	0.05 to 0.27*
						WAZ	−0.02	−0.12 to 0.08
						WAZ	0.14	0.04 to 0.25*
						WHZ	−0.02	−0.10 to 0.07
						WHZ	0.09	0.00 to 0.19*
Patil et al, 2014 Quality: medium³⁸	RCT	India	Rural	Children <5 years	Total sanitation campaign	HAZ	−0.04	−0.22 to 0.14
						WAZ	−0.09	−0.25 to 0.06
						WHZ	0.03	−0.14 to 0.20
Pickering et al, 2015 Quality: medium³⁵	RCT	Mali	Rural	Children <5 years	Community-led total sanitation	HAZ	0.24	0.09 to 0.40
Pickering et al, 2015 Quality: medium³⁵	RCT	Mali	Rural	Children <5 years	Community-led total sanitation	WAZ	0.16	0.01 to 0.31

*Results of WASH+nutrition.

HAZ, Height-for-age z-score; I, Intervention; MD, mean difference; non-RCT, an experimental study comparing an intervention and control group, where the allocation method was not random; RCT, randomised controlled trial; WASH, water, sanitation and hygiene; WAZ, weight-for-age z-score; WHZ, weight-for-height z-score.