# Effects in Middle Childhood of Early Exposure to Water and Sanitation Interventions

> **NIH NIH R03** · UNIVERSITY OF CALIFORNIA BERKELEY · 2020 · $67,390

## Abstract

Project Summary/Abstract
 Hundreds of millions of children worldwide live in poverty, and are consequently exposed to poor water and
sanitation (WASH), inadequate nutrition, and insufficient caregiving. Exposure to these risk factors then causes
delays in physical and mental health, and cognitive development, which can have lifelong consequences. Water,
sanitation and hygiene interventions have the potential to positively affect the developmental trajectories of
children by altering parental care practices and reducing enteric pathogen infection, thereby improving the quality
of the environment in which young children are living.
 This study uses a rigorous approach – a multi-arm randomized-controlled trial (RCT) – to test the
effectiveness of an innovative program promoting water, sanitation and hygiene with combined interventions to
address chronic malnutrition and poor child development in Bangladesh. The scientific premise of the proposed
study is strong because the intervention had consistent short-term impacts on child development outcomes
across multiple domains of development (findings published in Lancet Child and Adolescent Health, 2018), and
thus there is the potential that the study will also result in effects in middle childhood. The study has a high
degree of scientific rigor because we use a cluster-based, randomized controlled trial (cRCT). Furthermore, we
are using data with high quality measurements of child development outcomes at three time points, as well as
information on maternal well-being and intervention uptake.
 We obtained funding for follow-up data collection, and are now seeking funding to cover personnel to analyze
the existing data. The goal of the proposed study is to identify the components of an impactful early intervention
that persist into mid-childhood. Our guiding hypothesis is that interventions that showed early impact will continue
to have improved child outcomes at this follow-up time period. Our goals are to examine the impact of the WASH
and nutrition interventions on child development and growth in children 5-8 years of age. We hypothesize that
all intervention arms will show benefits to child development and growth, but that that the arms with combined
treatments will have greater effects on any of the individual arms. Another goal is to examine the effects of the
WASH and nutrition interventions on intermediate outcomes of caregiver mental health and caregiving practices
when children are 5-8 years of age. We hypothesize that all WASH intervention arms will show benefits to
caregiver mental health and caregiving practices.
 This proposed research is significant because it has the potential to inform interventions, programs, and
policies for the hundreds of millions of children living in low-income countries. The proposed work is innovative
in its examination of longer-term effects of a program, a unique combination of interventions, and high quality
outcome assessments at multiple time points. The s...

## Key facts

- **NIH application ID:** 10040591
- **Project number:** 1R03HD102468-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA BERKELEY
- **Principal Investigator:** LIA C. H. FERNALD
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $67,390
- **Award type:** 1
- **Project period:** 2020-09-01 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10040591

## Citation

> US National Institutes of Health, RePORTER application 10040591, Effects in Middle Childhood of Early Exposure to Water and Sanitation Interventions (1R03HD102468-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10040591. Licensed CC0.

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