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. 2021 Feb 15;18(4):1880. doi: 10.3390/ijerph18041880

Table 3.

Samples, measures, and results of reviewed articles.

Author(s) Sample Reported Measures Results
WASH Behaviors
Waterkeyn, Okot, and Kwame (2005)
  • –

    Census of 15,522 participants from 116 CHCs in 15 Internally Displaced Camps
  • –

    Observations of constructed latrines and hygiene facilities
  • –

    CHC participants constructed 8583 latrines

  • –

    CHC participants constructed 6062 bathing shelters

  • –

    Two camps where all CHC households (100%) constructed pot racks plus spill-over to non-CHC households resulted in a percent increase (above CHC households) in households with pot racks of 159% and 146%
Waterkeyn and Cairncross (2005)
  • –

    Survey and observations

  • –

    Random sample of 736 participants from 50 of 297 CHCs in two districts

  • –

    Random sample of 172 respondents from 2 matched comparison villages in two districts
  • –

    20 observable indicators of good hygiene practices focused on defecation, drinking water, hand washing, kitchen hygiene, and environmental hygiene behaviors
  • –

    District 1: significant differences between intervention and comparison households on 16 WASH behaviors (p < 0.001)

  • –

    District 2: significant differences between intervention and comparison households on 9 WASH behaviors (p < 0.01)
Waterkeyn (2006)
  • –

    Random sample of 736 participants from 50 of 297 CHCs in two districts

  • –

    Random sample of 172 respondents from 2 matched comparison villages in two districts
  • –

    20 observable indicators of good hygiene practices focused on defecation, drinking water, hand washing, kitchen hygiene, and environmental hygiene behaviors
  • –

    Significant differences between intervention and comparison households on 20 WASH behaviors (p < 0.01)
Azurduy, Stakem, and Wright (2007)
  • –

    Purposive sample of participants from 7 of 56 CHCs, program staff, and community leadership in 1 district

  • –

    Purposive sample of respondents from 5 comparison communities in 1 district
  • –

    Self-reported childcare practices and observations of household environment
  • –

    CHC participants observed to have more clotheslines, pot racks, and cleaner home environments than comparison sample
Rosenfeld (2008)
  • –

    Census of 995 participants from 9 CHCs in 1 rural municipality
  • –

    Self-reported drinking water treatment behaviors
  • –

    59% of participants reported treating their drinking water at home by boiling or using chlorine after 6 months (41% increase from baseline)
Waterkeyn, Matimati, and Muringaniza (2009)
  • –

    Census of 14,282 participants from 116 CHCs in 15 Internally Displaced Camps
  • –

    Observations of constructed latrines and hygiene facilities
  • –

    CHC participants constructed 11,932 latrines

  • –

    58% of CHC participants constructed pot racks

  • –

    43% of CHC participants constructed bathing shelters

  • –

    25% of CHC participants constructed hand washing facilities
Waterkeyn and Rosenfeld (2009)
  • –

    2501 participants from 37 CHCs in Zimbabwe

  • –

    311 participants from 3 CHCs in South Africa
  • –

    17 observable indicators (Zimbabwe) and 12 observable indicators (South Africa) of good hygiene practices focused on defecation, drinking water, hand washing, kitchen hygiene, and environmental hygiene behaviors
  • –

    80% (44% average change from baseline to final) of CHC participants practiced 17 observable WASH behaviors in Zimbabwe

  • –

    76% (36% average change from baseline to final) of CHC participants practiced 12 observable WASH behaviors in South Africa
Maksimoski and Waterkeyn (2010)
  • –

    Random sample of 89 heads of household in 1 community

  • –

    52 participants (census) from 1 CHC in 1 community
  • –

    10 observable indicators of household health, sanitation, and hygiene
  • –

    75.6% increase in CHC households reporting zero open defecation at mid-line

  • –

    79.2% of CHC households categorized as practicing high WASH behaviors compared to 36.9% of non-CHC households at mid-line
Whaley and Webster (2011)
  • –

    Random sample of 115 participants from 2 randomly sampled CHC communities in 2 districts

  • –

    Random sample of 118 participants from 1 randomly sampled and 1 purposively sampled CLTS communities in 2 districts
  • –

    11 observable indicators of good hygiene practices focused on defecation and hand washing
  • –

    Households in CHC communities had significantly greater reduction in open defecation and use of hand washing facilities compared to CLTS communities (p < 0.0001)

  • –

    Households in CLTS communities more likely to have a latrine than CHC communities (44% vs. 26%)

  • –

    CHC households more likely to sustain use of hand washing facilities than CLTS households (37% vs. 2%)
Ncube (2013)
  • –

    Random sample of 175 participants from 3 CHCs in 1 peri-urban district

  • –

    Random sample of 60 respondents from 1 comparison community in 1 peri-urban district
  • –

    Self-reported defecation and hand washing practices

  • –

    Observations of household hygiene, latrines, drinking water, and hand washing behaviors
  • –

    30–40% increase in observable clean yards, toilets, and water points

  • –

    92% of CHC respondents correctly demonstrated hand washing using pour to waste compared to 35% of comparison respondents
Waterkeyn and Waterkeyn (2013)
  • –

    Random sample of 1124 participants from 76 of 382 CHCs in 3 districts

  • –

    Random sample of 276 respondents from 3 matched comparison villages in 3 districts
  • –

    10 observable indicators of good hygiene practices focused on defecation, drinking water, hand washing, kitchen hygiene, and environmental hygiene behaviors
  • –

    CHC participants were significantly more likely to practice 10 WASH behaviors than the comparison group (p < 0.001)

  • –

    93.4% of CHC participants practiced safe sanitation compared to 43.2% of comparison sample (p < 0.001)
Chingono (2013)
  • –

    Random sample of 60 participants from 6 of 39 CHCs in 1 district

  • –

    Random sample of 20 respondents from 2 comparison villages in 1 district
  • –

    Observations of household drinking water, defecation, and hand washing behaviors
  • –

    CHC participants demonstrated a 15% increase in use of borehole water, 18% increase in latrine ownership, and 22% increase in the presence of hand washing facilities

  • –

    The majority of CHC households observed to have clotheslines and pot racks
Brooks et al. (2015)
  • –

    Census of 52 participants from 3 of 23 purposively sampled urban CHCs

  • –

    Random sample of 146 non-CHC heads of household from 3 purposively sampled urban neighborhoods
  • –

    Self-reported and household observations of drinking water, defecation, hand washing, and environmental management practices
  • –

    Comparison respondents were 7.1 times more likely to report open defecation than CHC respondents (p < 0.02)

  • –

    CHC participants were more likely to practice improved hand washing, drinking water storage, and environmental management practices than comparison respondents
Rosenfeld and Taylor (2015)
  • –

    Random sample of households (participants and non-participants) in 5 communities with CHC intervention
  • –

    20 observable indicators of good hygiene practices focused on defecation, drinking water, hand washing, kitchen hygiene, and environmental hygiene behaviors
  • –

    CHC participants showed no significant change in observable behaviors from baseline to final

  • –

    No significant difference in observable behaviors between CHC participants and comparison respondents at final
Beesley and Feeny (2016a)
  • –

    Participants from 1 CHC in 1 rural village

  • –

    Program staff
  • –

    Perceived changes in participants’ water, sanitation, and hygiene behaviors
  • –

    CHC participants reported constructing garbage pits and latrines with hand washing facilities
Beesley and Feeny (2016b)
  • –

    Participants from 1 CHC in 1 rural village

  • –

    Program staff
  • –

    Perceived changes in participants’ water, sanitation, and hygiene behaviors
  • –

    CHC participants reported construction of latrines, hand washing facilities, garbage pits, and pot racks

  • –

    CHC participants reported improved kitchen hygiene practices
Ndayambaje (2016)
  • –

    Random sample of 50 participants from 1 “classic” CHC in 1 village from 1 district

  • –

    Random sample of 50 participants from 1 “lite” CHC in 1 village from 1 district

  • –

    Purposive sample of 44 program administrators and trainers
  • –

    10 observable indicators of household water, sanitation, and hygiene practices

  • –

    Perceived impact of “classic” and “lite” arms on household hygiene, waste management, environmental management, community wellness, malaria control, and drinking water practices

  • –

    Perceived effectiveness of “classic” and “lite” arms on household hygiene, waste management, environmental management, community wellness, malaria control, and drinking water practices
  • –

    Greater improvement in WASH behaviors from baseline to final in the “classic” arm than the “lite” arm: hygienic latrine (14.4% vs. 2.4%), hand washing facility (41% vs. 5.1%), household water treatment (15.6% vs. 3.7%)

  • –

    CHC participants (classic and lite) rated the intervention as having the greatest impact on malaria control (use of mosquito nets and treatment), community wellness (participate in wellness programs), and household hygiene (hand washing facilities) practices

  • –

    Key informants rated the “classic” arm as more effective than the “lite” arm on achieving change in all behavioral outcomes
Munyoro (2016)
  • –

    Purposive sample of 15 participants from 6 of 12 CHCs in 1 urban area

  • –

    Convenience sample of 90 project staff and town leaders
  • –

    Perceived changes in participant WASH behaviors
  • –

    Respondents reported increased personal hygiene practices, including brushing teeth, combing hair, bathing, washing clothes, and cutting nails

  • –

    Respondents observed to stop using the common bowl method of hand washing and begin using the pour to waste method

  • –

    CHC participants observed to increase storing drinking water in covered containers

  • –

    CHC households observed to have garbage pits, compost pits, clean latrines, and clean yards after the intervention
Sinharoy et al. (2017)
  • –

    Random sample of 2729 participants from 50 “classic” CHCs with children under 5 years in 1 district

  • –

    Random sample of 2482 participants from 50 “lite” CHCs with children under 5 years in 1 district

  • –

    Random sample of 2723 respondents from 50 control communities with children under 5 years in 1 district
  • –

    Observations of household latrines and hand washing facilities

  • –

    Self-reported drinking water source, drinking water treatment, child feces disposal practices

  • –

    Colony-forming units of fecal coliforms per 100 mL of water
  • –

    Households in the “classic” CHC arm were significantly more likely to treat their drinking water (p = 0.003) and have a latrine than control households (p = 0.017)

  • –

    Participants in the “classic” arm who completed 20 CHC sessions were significantly more likely to report treating their drinking water and have a structurally complete latrine than controls

  • –

    No significant differences in behaviors between households in the “lite” CHC arm and control households
Ntakarutimana and Ekane (2017)
  • –

    Random sample of 407 participants from 2 CHCs (1 peri-urban and 1 rural) in 2 districts

  • –

    Random sample of 391 respondents from 2 control communities (1 peri-urban and 1 rural) in 2 districts
  • –

    Observations of household latrines and hand washing practices
  • –

    Peri-urban (p = 0.0001) CHC households were significantly more likely at final to have an improved toilet (89.4% vs. 74.2%), clean toilet (69.5% vs. 28%), functional hand washing facility (74.2% vs. 13.7%), and soap (38.4% vs. 7.7%) than controls

  • –

    Rural (p = 0.0001) CHC households were significantly more likely at final to have an improved toilet (95.2% vs. 14.2%), clean toilet (98.1% vs. 45%), functional hand washing facility (91.4% vs. 43.3%), and soap (92.4% vs. 4.2%) than controls
Matimati (2017)
  • –

    Random sample of 30 adult household members from 10 communities with a CHC in 1 district
  • –

    Self-report and observations of household drinking water, kitchen hygiene, defecation, hand washing, and solid waste management practices
  • –

    Statistically significant associations between the number of CHC sessions attended and treating drinking water (p < 0.0001), having a clean toilet (p = 0.001), and using soap to wash hands (p < 0.0001)

  • –

    50% of CHC participants reported behavioral changes were sustained 2 years after the intervention completed
Pantoglou (2018)
  • –

    Census of CHC 381 participants from 50 communities receiving the “classic” intervention
  • –

    Average scores on 29 observable WASH indicators grouped into 8 main indicators of household hygiene, drinking water source, drinking water storage, hand washing, sanitation, body hygiene, cooking, and childcare at five time points
  • –

    Statistically significant improvement in observable hygiene indicators from baseline to: mid-line (p = 0.01), end-line (p < 0.05), post-intervention I (p < 0.05), and post-intervention II (p < 0.05)

  • –

    At post-intervention I and II, 86% and 100% of all recommended practices were observed in sampled households
Rosenfeld (2019)
  • –

    Random sample of 381 (baseline) and 284 (final) adult heads of CHC participant households from 15 of 35 randomly sampled CHC communities across 4 communes

  • –

    Random sample of 326 (baseline) and 237 (final) adult heads of household from 6 matched comparison communities across 4 communes

  • –

    Purposive sample of 32 CHC participants and 4 CHC facilitators from 4 purposively sampled CHCs (2 high and 2 low change in knowledge and behavior scores)

  • –

    Purposive sample of 7 program managers and coordinators
  • –

    Hygiene index scores (0–14 points) comprised of 16 observable indicators of household WASH practices in five domains: drinking water, sanitation and defecation, hand washing, kitchen hygiene, and environmental/solid waste management practices

  • –

    Qualitative themes about WASH behaviors and factors that facilitated behavior change
  • –

    No significant treatment effect on WASH behavioral scores (p = 0.80)

  • –

    Discussants described how defecation and hand washing behavioral changes were influenced by the knowledge they gained about the link between disease (diarrhea and cholera) and WASH behaviors

  • –

    Discussants described how behavioral changes became habitual when people realized they avoided diseases such as cholera
WASH Knowledge
Waterkeyn (2006)
  • –

    Random sample of 736 participants from 50 of 297 CHCs in two districts

  • –

    Random sample of 172 respondents from 2 matched comparison villages in two districts
  • –

    Quantitative measure of participant knowledge of recipe for homemade oral rehydration solution, proper childcare, and prevention of diarrhea, malaria, bilharzia, worms, skin diseases, HIV/AIDS, and TB
  • –

    CHC participants provided significantly higher number of correct responses on 9 questions than comparison respondents (p < 0.0001)
Azurduy, Stakem, and Wright (2007)
  • –

    Purposive sample of participants from 7 of 56 CHCs, program staff, and community leadership in 1 district

  • –

    Purposive sample of respondents from 5 comparison communities in 1 district
  • –

    Descriptions of knowledge gained through participation
  • –

    CHC participants were able to list all topics learned from the curriculum
Ncube (2013)
  • –

    Random sample of 175 participants from 3 CHCs in 1 peri-urban district

  • –

    Random sample of 60 respondents from 1 comparison community in 1 peri-urban district
  • –

    Quantitative measures of participant knowledge of oral rehydration solution recipe, childcare, diarrhea, malaria, bilharzia, worms, skin diseases, and HIV/AIDS
  • –

    65% of CHC participants had “good” WASH knowledge, while 65% of comparison respondents had “poor” WASH knowledge
Waterkeyn and Waterkeyn (2013)
  • –

    Random sample of 1124 participants from 76 of 382 CHCs in 3 districts

  • –

    Random sample of 276 respondents from 3 matched comparison villages in 3 districts
  • –

    Quantitative measures of participant knowledge about appropriate childcare and the transmission and prevention of diarrhea, schistosomiasis, worms, skin diseases, malaria, HIV/AIDS, and TB

  • –

    10 observable indicators of good hygiene practices
  • –

    68.3% of CHC participants demonstrated “full knowledge” of diarrhea compared to 38.2% of comparison respondents (p < 0.001)

  • –

    80% of CHC participants practicing 10 recommended WASH behaviors demonstrated “full knowledge” of diarrhea compared to 50% of comparison respondents

  • –

    A greater proportion of CHC participants demonstrated full knowledge of all topics than comparison respondents (20% average difference on all topics)
Chingono (2013)
  • –

    Random sample of 60 participants from 6 of 39 CHCs in 1 district

  • –

    Random sample of 20 respondents from 2 comparison villages in 1 district
  • –

    Self-reported descriptions of knowledge about the CHC curriculum
  • –

    CHC participants reported increased knowledge about disease management, nutrition, personal hygiene, environmental hygiene, and child health (e.g., vaccinations, growth monitoring, and exclusive breastfeeding)
Brooks et al. (2015)
  • –

    Census of 52 participants from 3 of 23 purposively sampled urban CHCs

  • –

    Random sample of 146 non-CHC heads of household from 3 purposively sampled urban neighborhoods
  • –

    Aggregated scores (number of correct responses categorized as low, medium low, medium high, and high) measuring participant knowledge of hand washing, diarrhea, skin diseases, worms, malaria, and dengue
  • –

    CHC participants were significantly more likely to have high preventive WASH knowledge scores (71.2% vs. 4.1%) compared to comparison respondents (p < 0.0001)
Rosenfeld and Taylor (2015)
  • –

    Random sample of households (participants and non-participants) in 5 communities with CHC intervention
  • –

    Total correct responses to questions measuring knowledge of hand washing, diarrhea, skin diseases, worms, and dengue
  • –

    CHC participants knowledge scores increased significantly from baseline to final

  • –

    CHC participants knowledge scores at final were significantly higher than comparison respondent scores
Beesley and Feeny (2016a)
  • –

    Participants from 1 CHC in 1 rural village

  • –

    Program staff
  • –

    Perceived changes in participants’ water, sanitation, and hygiene knowledge
  • –

    CHC participants reported increased awareness about the importance of hygiene practices to prevent disease
Beesley and Feeny (2016b)
  • –

    Participants from 1 CHC in 1 rural village

  • –

    Program staff
  • –

    Perceived changes in participants’ water, sanitation, and hygiene knowledge
  • –

    CHC participants reported increased knowledge about nutrition and kitchen hygiene
Beesley et al. (2016)
  • –

    Participants from 1 CHC in 1 rural village

  • –

    Program staff
  • –

    Perceived changes in participants’ water, sanitation, and hygiene knowledge
  • –

    CHC participants reported increased knowledge about nutrition, kitchen hygiene, and personal hygiene
Munyoro (2016)
  • –

    Purposive sample of 15 participants from 6 of 12 CHCs in 1 urban area

  • –

    Convenience sample of 90 project staff and town leaders
  • –

    Perceived changes in participant knowledge
  • –

    Respondents described increased knowledge about WASH diseases and the importance of personal hygiene, hand washing, and safe drinking water

  • –

    Respondents described increased knowledge about diarrhea, malaria, bilharzia, worms, TB, dysentery, and HIV/AIDS

  • –

    A significant increase in the number of participants who could name the causes and prevention of diarrhea was reported
Matimati (2017)
  • –

    Purposive sample of 43 participants and leaders from 10 CHC communities
  • –

    Perceived changes in the community
  • –

    CHC participants described increases in knowledge about WASH diseases and disease prevention
Rosenfeld (2019)
  • –

    Random sample of 381 (baseline) and 284 (final) adult heads of CHC participant households from 15 of 35 randomly sampled CHC communities across 4 communes

  • –

    Random sample of 326 (baseline) and 237 (final) adult heads of household from 6 matched comparison communities across 4 communes

  • –

    Purposive sample of 32 CHC participants and 4 CHC facilitators from 4 purposively sampled CHCs (2 high and 2 low change in knowledge and behavior scores)

  • –

    Purposive sample of 7 program managers and coordinators
  • –

    Composite knowledge score (0–26 points) comprised of the total number of correct responses to four questions about diarrhea transmission, when to wash hands, prevention of skin diseases, and the ingredients for homemade oral rehydration solution

  • –

    Qualitative themes focused on participant learning and information dissemination through the CHC
  • –

    Significant treatment effect on composite WASH knowledge scores (p < 0.0001)

  • –

    Discussants described how the focus of the intervention was to increase participants’ knowledge and disseminate information through the community

  • –

    Discussants described how knowledge about diseases such as cholera led to WASH behavioral changes
Social Capital
Waterkeyn and Cairncross (2005)
  • –

    Purposive sample of 20 participants from 10 CHCs in 1 district
  • –

    Perceived personal and social impact of the intervention
  • –

    CHC participants describe increased self-confidence, social bonding, social standing, and respect from husbands
Waterkeyn (2006)
  • –

    Census of participants from 10 CHCs in 1 district

  • –

    Purposive sample of 70 participants from 10 CHCs in 1 district
  • –

    Self-reported reasons for participation and perceived personal and social impact of the intervention
  • –

    CHC participants described increased social bonding, social standing, and respect as a result of participating in the intervention

  • –

    Pair-wise ranking exercises revealed that the third most valued impact of the CHC was the creation of a sense of belonging
Azurduy, Stakem, and Wright (2007)
  • –

    Purposive sample of participants from 7 of 56 CHCs, program staff, and community leadership in 1 district

  • –

    Purposive sample of respondents from 5 comparison communities in 1 district
  • –

    Perceived social impact of the intervention
  • –

    CHC participants described increased collective spirit, unity, and women making decisions as a result of participating in the intervention
Whaley and Webster (2011)
  • –

    Purposive sample of 13 participants from 3 CHCs in 2 districts

  • –

    Purposive sample of 12 CLTS participants from 4 communities in 1 district

  • –

    Purposive sample of 12 CHC and CLTS program staff
  • –

    Factors influencing participation and behavior change
  • –

    CHCs contributed to the formation and strengthening of social bonds where participants reported they were more likely to help each other
Ncube (2013)
  • –

    Purposive sample of 60 participants from 3 CHCs in 1 peri-urban district

  • –

    Purposive sample of 15 district leaders in 1 peri-urban district
  • –

    Factors influencing sustainability, participation, and relevance of the intervention
  • –

    Key informants described increased social cohesion amongst CHC participants, including more social support for members facing difficult situations such as a death in the family
Waterkeyn and Waterkeyn (2013)
  • –

    Census of 750 participants from 10 CHCs in 1 district

  • –

    Purposive sample of 20 participants from 10 CHCS in 1 district
  • –

    Perceived changes in participants’ lives since joining the CHC

  • –

    Reasons participants enjoyed the CHC
  • –

    CHC participants in group discussions ranked themes related to a “Need for Belonging” (social inclusion, social support, consensus) as the third most important change in their life

  • –

    CHC interviewees reported themes related to “social interaction” as the second most common reason they liked the CHCs
Chingono (2013)
  • –

    Purposive sample of CHC participants, program staff, health outreach workers, and local leadership
  • –

    Perceived impact on social cohesion, social support, women’s roles, and engagement with health and development agencies
  • –

    Key informants and discussants reported increased social bonding, social support, and women’s participation in decision making and leadership

  • –

    Key informants and discussants reported the importance of linking relationships and social pressure

  • –

    Key informants and discussants reported increased coordination between CHC communities and the formal health sector
Brooks et al. (2015)
  • –

    Census of 17 CHC facilitators and supervisors in Port-au-Prince
  • –

    Perceived role of collective identity formation on social cohesion
  • –

    Key informants reported an increase in social bonding and cohesion amongst CHC participants as a result of collective identity formation
Beesley and Feeny (2016b)
  • –

    Participants from 1 CHC in 1 rural village

  • –

    Program staff
  • –

    Perceived impact on social aspects of community life
  • –

    CHC participants report increased social support, bonding, and social pressure to adhere to behavioral changes
Rosenfeld (2019)
  • –

    Random sample of 381 (baseline) and 284 (final) adult heads of CHC participant households from 15 of 35 randomly sampled CHC communities across 4 communes

  • –

    Random sample of 326 (baseline) and 237 (final) adult heads of household from 6 matched comparison communities across 4 communes

  • –

    Purposive sample of 32 CHC participants and 4 CHC facilitators from 4 purposively sampled CHCs (2 high and 2 low change in knowledge and behavior scores)

  • –

    Purposive sample of 7 program managers and coordinators
  • –

    19 social capital items from the World Bank Social Capital Assessment Tool reduced to four principle factor scores: group participation, social support, trust, and social solidarity

  • –

    Qualitative themes describing the impact of the CHC intervention on social capital factors and the role social capital factors played in facilitating or influencing knowledge dissemination, behavior change, and collective action
  • –

    No significant treatment effect on social capital factor scores (trust, social support, participation, social solidarity)

  • –

    Baseline social solidarity factor scores associated with a significant increase in average WASH behavior scores from baseline to final (p = 0.01)

  • –

    There was a marginally significant interaction between the intervention and participation scores on average WASH knowledge scores (p = 0.08), and a significant interaction between the intervention and social solidarity scores on average hygiene index scores (p = 0.04).

  • –

    Discussants reported the intervention increased trust, social bonding, and social solidarity

  • –

    Discussants described how social pressure, social solidarity, and bridging relationships with other clubs facilitated WASH behavioral changes and engagement in collective action

  • –

    Communities with low trust, weak social solidarity, and limited social networks achieved lower degrees of WASH behavior change
Collective Action
Azurduy, Stakem, and Wright (2007)
  • –

    Purposive sample of participants from 7 of 56 CHCs, program staff, and community leadership in 1 district

  • –

    Purposive sample of respondents from 5 comparison communities in 1 district
  • –

    Perceived changes in collective action
  • –

    CHC participants reported they are more likely to work together after the intervention, specifically to improve roads, conduct outreach education to neighboring communities, and initiate village savings and loan clubs
Rosenfeld (2008)
  • –

    Communal drinking water points for 3 of 9 rural CHCs in 1 municipality
  • –

    Observations of communal water points before and after the intervention
  • –

    CHC participants worked together to improve and protect communal water points using resources available in the community
Maksimoski and Waterkeyn (2010)
  • –

    Observations by program staff and evaluator
  • –

    Communal observations and participant self-reports
  • –

    50% reduction in informal dumping sites, with two converted into communal gardens

  • –

    CHC participants worked together to clean communal latrines and ablution blocks
Ncube (2013)
  • –

    Random sample of 175 participants from 3 CHCs in 1 peri-urban district

  • –

    Random sample of 60 respondents from 1 comparison community in 1 peri-urban district
  • –

    Self-reported and observed communal clean-up campaigns
  • –

    CHC participants engaged in 17 community cleanliness campaigns during the intervention period
Chingono (2013)
  • –

    Purposive sample of CHC participants, program staff, health outreach workers, and local leadership
  • –

    Perceived impact on engagement in collective activities
  • –

    Key informants and discussants reported CHC participants are more likely to self-initiate projects to improve collective well-being, including establishing communal gardens and joining village savings and loan programs
Brooks et al. (2015)
  • –

    Census of 17 CHC facilitators and supervisors in Port-au-Prince
  • –

    Descriptions of CHC participants working together
  • –

    Key informants describe CHC participants working together to clean neighborhoods and remove standing water
Beesley and Feeny (2016a)
  • –

    Participants from 1 CHC in 1 rural village

  • –

    Program staff
  • –

    Perceived impact on engagement in collective activities
  • –

    CHC participants reported working together with NGO partner to construct new safe drinking water points
Munyoro (2016)
  • –

    Purposive sample of 15 participants from 6 of 12 CHCs in 1 urban area

  • –

    Convenience sample of 90 project staff and town leaders
  • –

    Reported changes in collective action around solid waste management and illegal dumping
  • –

    CHC participants reported engaging in community-wide garbage clean-up campaigns and rehabilitating open spaces that had been converted into garbage dumping sites
Ntakarutimana and Ekane (2017)
  • –

    Purposive sample of community leaders, opinion leaders, and community members
  • –

    Perceived impact on engagement in collective activities
  • –

    Key informants reported CHCs worked together to improve roads and participate in village savings and loan programs
Rosenfeld (2019)
  • –

    Purposive sample of 32 CHC participants and 4 CHC facilitators from 4 purposively sampled CHCs (2 high and 2 low change in knowledge and behavior scores)

  • –

    Purposive sample of 7 program managers and coordinators
  • –

    Qualitative themes describing the impact of the CHC intervention on collective action

  • –

    Qualitative themes describing the role social capital factors played in facilitating or influencing collective action
  • –

    Discussants reported the intervention increased collective action in community development activities such as community clean-up campaigns, water point repairs, road repairs, and provision of street lights

  • –

    Discussants described how increases in collective action were facilitated by enhanced trust, social solidarity, and positive peer pressure
Health
Waterkeyn (2005)
  • –

    All patients in clinical registers from two rural clinics serving CHC intervention areas between 1995 and 2004
  • –

    Annual WASH-related diseases including diarrhea, skin diseases, and acute respiratory illnesses
  • –

    10-fold decrease in all WASH-related communicable diseases in one clinic where 80% of households in the ward participated from pre-intervention to 4 years post-intervention
Azurduy, Stakem, and Wright (2007)
  • –

    Purposive sample of participants from 7 of 56 CHCs, program staff, and community leadership in 1 district

  • –

    Purposive sample of respondents from 5 comparison communities in 1 district
  • –

    Perceived changes in health care utilization and mortality
  • –

    CHC participants increased engagement with formal health care and reported reductions in maternal and child mortality
Beesley and Feeny (2016a)
  • –

    Participants from 1 CHC in 1 rural village

  • –

    Program staff
  • –

    Perceived impact on health of participants and their family
  • –

    CHC participants reported improved health and well-being, with a reduction in disease
Beesley and Feeny (2016b)
  • –

    Participants from 1 CHC in 1 rural village

  • –

    Program staff
  • –

    Perceived impact on health of participants and their family
  • –

    CHC participants reported a reduction in diseases and deaths from sanitation and hygiene
Beesley et al. (2016)
  • –

    Participants from 1 CHC in 1 rural village

  • –

    Program staff
  • –

    Perceived impact on health of participants and their family
  • –

    CHC participants reported a reduction in diseases and deaths from sanitation and hygiene
Sinharoy et al. (2017)
  • –

    Random sample of 2729 participants from 50 “classic” CHCs with children under 5 years in 1 district

  • –

    Random sample of 2482 participants from 50 “lite” CHCs with children under 5 years in 1 district

  • –

    Random sample of 2723 respondents from 50 control communities with children under 5 years in 1 district
  • –

    Caregiver-reported diarrhea within the previous 7 days in children under 5 years

  • –

    Weight for age Z scores, height for age Z scores, and stunting and wasting for children under 5 years
  • –

    No measurable differences in diarrhea and anthropometry in children under 5 years between study arms
Cost
Waterkeyn (2006)
  • –

    Program data
  • –

    Cost per beneficiary
  • –

    Estimated cost of USD 0.35 per beneficiary
Waterkeyn, Matimati, and Muringaniza (2009)
  • –

    Program data
  • –

    Cost per beneficiary
  • –

    Estimated cost of USD 0.76 per beneficiary
Waterkeyn and Rosenfeld (2009)
  • –

    Program data from Zimbabwe and South Africa CHCs
  • –

    Cost per beneficiary
  • –

    Estimated cost of USD 3.30 per beneficiary in Zimbabwe

  • –

    Estimated cost of USD 28.00 per beneficiary in South Africa
Ndayambaje (2016)
  • –

    Purposive sample of program administrators and trainers
  • –

    Actual costs of the “classic” and “lite” intervention arms and perceived cost-effectiveness of each arm
  • –

    The “classic” arm cost USD 3820 per household compared to USD 1196 per household in the “lite” arm

  • –

    Respondents rated the “classic” arm as more “cost-effective” than the “lite” arm