ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Health Education and Promotion
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1676981
This article is part of the Research TopicNudge Theory: Advancing Health Promotion and Disease PreventionView all 5 articles
Effect of the SHINE (Sanitation, Hygiene, Information, and Education) Intervention on WaSH Practices and related Health Outcomes Among Children in Rural Anganwadi Centers: A Non-Randomized Cluster Trial pilot tested in Odisha, India
Provisionally accepted
- 1Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, India
- 2Kalinga Institute of Medical Sciences, Bhubaneswar, India
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Background: Inadequate water, sanitation, and hygiene (WaSH) facilities in Anganwadi centers, critical components of India's Integrated Child Development Services (ICDS), adversely affect child health. The SHINE (Sanitation, Hygiene, Information, and Education) intervention aimed to improve WaSH practices and related health outcomes in rural Anganwadis of Odisha. Methods: This was a quasi-experimental, non-randomised cluster study conducted between April and October 2024 across four Anganwadi centres under the Rural Health Training Centre (RHTC), Kalinga Institute of Medical Sciences (KIMS), Odisha. Clusters defined geographically: centres within 5 km of RHTC were assigned to the intervention arm, while those beyond 5 km served as controls. This distance criterion was selected to reduce the contamination risk of the intervention. Due to the nature of the intervention, blinding was not feasible. Results: Forty-five children were enrolled (intervention: 23, control: 22). The intervention group showed significant improvements in safe drinking water usage (from 0% to 60.9%, AOR=6.88), footwear use in toilets (17.4% to 78.3%, AOR=5.18), and handwashing before meals (0% to 82.6%, AOR=6.85). Infection symptoms declined markedly (from 39.1% to 4.4%, AOR = 5.18). Improvements in food hygiene and school infrastructure were observed. Absenteeism decreased, but not significantly. Control schools showed modest improvements, possibly due to the Hawthorne effect. Conclusion: The SHINE intervention significantly improved WaSH practices and reduced illness among Anganwadi children. The findings support integrating behavior-centered WaSH interventions into early childhood education programs to promote health and reduce preventable disease in low-resource settings.
Keywords: Wash practices, AWC, Diarrhea, Ari, Sanitation, Hygiene, information, Education
Received: 31 Jul 2025; Accepted: 13 Oct 2025.
Copyright: © 2025 Kar, Singh, Ray, Pattnaik, Das, Das and Nayak. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Sonali Kar, sonali.kar@kims.ac.in
Snigdha Singh, snigdha.singh1@kims.ac.in
Angana Ray, 2287021@kims.ac.in
Baishnabi Pattnaik, 2387025@kims.ac.in
Sumelika Das, 2387024@kims.ac.in
Ayesha Das, 2387027@kims.ac.in
Rosy Nayak, 2287024@kims.ac.in
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