Intervention villages will receive chlorine dispensers at spring water sources. After filling their plastic jerry can of water from the source, users can place the jerry can under the dispenser, and turn a knob to release 3 mL of chlorine. Behavior change messages will focus on the consistent provision of treated water to all children living in the household.
The Kenya sanitation intervention will include three hardware components: 1) a sani-scoop hoe dedicated to the removal of human and animal feces from the compound, 2) plastic child potties for children ages 6 months and older until they are using the latrine, and 3) a new or upgraded pit latrine for each household in the compound. If participants have a latrine, its structure will be improved if necessary. Plastic slabs will be installed to improve mud or wood floors, and the intervention delivery team will make sure that all latrine structures have walls, doors, roofs that ensure safety and privacy. The behavior change components of the intervention will emphasize the use of the latrine for defecation and the safe disposal of feces in the compound courtyard to prevent contact with young children.
The Kenya study will install two handwashing stations in the compound of each respondent, one near the latrine, and one by the cooking area. The handwashing stations are constructed from locally available materials and are of a dual tippy-tap design with independent pedals attached to 5L jerry cans of clean water and jugs of soapy water. The behavior change component of the intervention will focus messaging for handwashing at two critical times: after defecation and before food preparation.
Mothers will be encouraged to exclusively breastfeed their children through age 6 months. When newborns reach 6 months of age, mothers will be encouraged to continue breastfeeding their children until 24 months, and will receive education about supplementing breastfeeding with healthy complementary foods following infant and young child feeding best practice guidelines from Unicef and WHO. From ages 6 – 24 months, study children will receive a daily lipid-based nutritional supplement (LNS) has been developed and tested through the iLiNS project.