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Effects of a community‐driven water, sanitation, and hygiene programme on COVID‐19 symptoms, vaccine acceptance and non‐COVID illnesses: A cluster‐randomised controlled trial in rural Democratic Republic of Congo
Author(s) -
Croke Kevin,
Coville Aidan,
Mvukiyehe Eric,
Dohou Caleb Jeremie,
Zibika JeanPaul,
Stanus Ghib Luca,
Andreottola Michele,
Bokasola Yannick Lokaya,
Quattrochi John Paul
Publication year - 2022
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.13799
Subject(s) - covid-19 , hygiene , sanitation , medicine , environmental health , developing country , economic growth , virology , outbreak , infectious disease (medical specialty) , disease , pathology , economics
Objective The government of the Democratic Republic of Congo (DRC) responded to COVID‐19 with policy measures, such as business and school closures and distribution of vaccines, which rely on citizen compliance. In other settings, prior experience with effective government programmes has increased compliance with public health measures. We study the effect of a national water, sanitation, and hygiene programme on compliance with COVID‐19 policies. Methods Prior to the COVID‐19 pandemic, 332 communities were randomly assigned to the Villages et Écoles Assainis (VEA) programme or control. After COVID‐19 reached DRC, individuals who owned phones (590/1312; 45%) were interviewed by phone three times between May 2020 and August 2021. Primary outcomes were COVID symptoms, non‐COVID illness symptoms, child health, psychological well‐being, and vaccine acceptance. Secondary outcomes included COVID‐19 preventive behaviour and knowledge, and perceptions of governmental performance, including COVID response. All outcomes were self‐reported. Outcomes were compared between treatment and control villages using linear models. Results The VEA programme did not affect respondents' COVID symptoms (−0.11, 95% CI −0.55 to 0.33), non‐COVID illnesses (−0.01, 95% CI −0.05 to 0.03), child health (0.07, 95% CI −0.19 to 0.33), psychological well‐being (−0.05, 95% CI −0.35 to 0.24), or vaccine acceptance (−0.04, 95% CI −0.19 to 0.10). There was no effect on village‐level COVID‐19 preventive behaviour (0.03, 95% CI −0.23 to 0.29), COVID‐19 knowledge (0.16, 95% CI −0.08 to 0.39), or trust in institutions. Conclusions Although the VEA programme increased access to improved water and sanitation, we found no evidence that it increased trust in government or compliance with COVID policies, or reduced illness.