💬In plain words
What the trial is, and whether it could suit you
Karamoja, in north-eastern Uganda, is among the most water-insecure regions in sub-Saharan Africa. Only 24 per cent of households can access the WHO-recommended 20 litres of water per person per day. Only 11.7 per cent have access to improved sanitation. A rapid vulnerability assessment covered all 182 operational primary schools in the sub-region between October and November 2025. It identified 53 schools as severely water insecure and a further 37 as moderately water insecure. Together, these schools serve an estimated 196,000 learners. The assessment also found that 89 schools lacked enough latrines to meet the national pupil-to-latrine ratio. Seventy-eight schools had no functional menstrual health management facilities.
This study is a three-arm, phase-in cluster-randomised controlled trial. It evaluates the causal effects of a climate-resilient school WASH package on children's he
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📋 Eligibility rules (as published)
Inclusion Criteria:
CLUSTER LEVEL (school)
* Government primary school, operational at the time of the October-November 2025 rapid vulnerability assessment, located in one of the nine districts of the Karamoja sub-region (Abim, Amudat, Kaabong, Karenga, Kotido, Moroto, Nabilatuk, Nakapiripirit, Napak)
* Classified in the severe or acutely affected moderate water insecurity tier on the adapted HWISE assessment, and among the 60 highest composite priority scores across all 182 assessed schools
* Hydrological viability confirmed: sub-surface geology and groundwater survey establish the feasibility of a viable water source at or adjacent to the school site
* Head teacher and school administration grant permission for facility observation and school records capture
INDIVIDUAL LEVEL
Pupils:
* Enrolled in grades P2 to P7 at a trial school and appearing on the current enrolment register at the time of sampling
* Selected by systematic random sampling from the enrolment register with proportional representation across grades
* Parent or legal guardian has provided written informed consent, and the pupil has provided assent
* For the menstrual health sub-sample: post-menarche, approximately aged 11 to 17
Caregivers:
* Parent or legal guardian of a sampled pupil, matched one-to-one
* Provides own informed consent
Teachers and head teachers:
* Currently employed and appearing on the staff register of a trial school
* Teachers selected by simple random sampling from the staff register, six per school
* Provide their own informed consent
Community leaders:
* Local council chairperson, religious leader, women's group representative or community elder resident in the catchment area of a trial school
* Provides own informed consent
Exclusion Criteria:
* Schools not confirmed hydrologically viable for a school-site water source
* Schools outside the top 60 composite priority scores
* Pupils not appearing on the current enrolment register at the time of sampling
* Any individual for whom consent (and, for pupils, both guardian consent and pupil assent) is not obtained
* Any individual who declines or withdraws at any point, without requirement to give a reason and without consequence
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