What this Trial Is About

Access to safe water remains a pressing public health challenge in Nigeria, where 67% of the population lacks safely managed drinking water and waterborne diseases cause an estimated 70,000 child deaths annually. Building on evidence that point-of-use chlorination is highly cost-effective in reducing diarrheal disease, this study evaluates a scalable, community-based chlorine distribution model through a cluster-randomized controlled trial (RCT) in Kano State. Thirty communities across four Local Government Areas will be randomly assigned to one of three groups: (i) 20 treatment communities receiving community demonstrations and local chlorine redemption points, (ii) 10 control communities where no intervention will be conducted. After 3 months, 5 control communities will receive an individual-level sensitization and a voucher program and 5 will remain pure control communities. The RCT aims to estimate the causal impact of the community-based intervention on household chlorination rates, water quality (E. coli contamination), and knowledge of safe water practices over six months. By rigorously testing a community-led water treatment model, this study contributes new evidence on sustainable and cost-effective approaches to expand safe water access in low-resource settings. The results will inform national and regional strategies for scaling point-of-use chlorination across sub-Saharan Africa.

Expanding Access to Safe Water in Nigeria