We employed a cluster randomized trial design to measure the impact of a school based water, sanitation, and hygiene (WASH) improvement on pupil enrollment and on gender parity in enrollment, in primary schools in Nyanza Province, Kenya (2007-2009). Among schools with poor water access during the dry season, those that received a water supply, hygiene promotion and water treatment (HP&WT) and sanitation improvement, demonstrated increased enrollment (β=0.091 [0.009, 0.173] p=0.03), which translates to 26 additional pupils per school on average. The proportion of girls enrolled in school also increased by 4% (prevalence ratio (PR)=1.04 [1.00, 1.07] p=0.02). Among schools with better baseline water access during the dry season (schools that didn't receive a water source), we found no evidence of increased enrollment in schools that received a HP&WT intervention (β=0.016 [-0.039, 0.072] p=0.56) or the HP&WT and sanitation intervention (β=0.027 [-0.028, 0.082]p=0.34), and there was no evidence of improved gender parity (PR=0.99 [0.96, 1.02] p=0.59, PR=1.00 [0.97, 1.02] p=0.75, respectively). Our findings suggest that increased school enrollment and improved gender parity may be influenced by a comprehensive WASH program that includes an improved water source; schools with poor water access during the dry season may benefit most from these interventions.

中文翻译：

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一项评估学校用水、环境卫生和个人卫生改善对学生入学率和入学性别均等影响的整群随机试验。

我们采用整群随机试验设计来衡量基于学校的水、环境卫生和个人卫生 (WASH) 改进对肯尼亚 Nyanza 省小学的学生入学率和入学性别均等的影响（2007-2009 年）。在旱季供水不足的学校中，那些接受供水、卫生促进和水处理 (HP&WT) 和卫生改善的学校表现出入学率增加（β=0.091 [0.009, 0.173] p=0.03），这意味着每所学校平均增加 26 名学生。女童入学比例也增加了 4%（患病率 (PR)=1.04 [1.00, 1.07] p=0.02）。在旱季有更好的基准水供应的学校（没有获得水源的学校）中，我们没有发现接受 HP&WT 干预（β=0.016 [-0.039, 0.072] p=0.56）或 HP&WT 和卫生干预（β=0.027 [-0.028, 0.082] p=0.34）的学校入学率增加的证据，以及没有证据表明性别平等（分别为 PR=0.99 [0.96, 1.02] p=0.59，PR=1.00 [0.97, 1.02] p=0.75）。我们的研究结果表明，提高入学率和改善性别平等可能会受到包括改善水源在内的综合 WASH 计划的影响；旱季供水不足的学校可能会从这些干预措施中受益最多。我们的研究结果表明，提高入学率和改善性别平等可能会受到包括改善水源在内的综合 WASH 计划的影响；旱季供水不足的学校可能会从这些干预措施中受益最多。我们的研究结果表明，提高入学率和改善性别平等可能会受到包括改善水源在内的综合 WASH 计划的影响；旱季供水不足的学校可能会从这些干预措施中受益最多。