Approximately one billion people live in homes with a dirt floor. Young children who are learning to sit, crawl, and walk spend a significant amount of time on household floors and frequently play on floors. In households with inadequate water, sanitation, and hygiene infrastructure, dirt floors can harbor harmful pathogens that may cause illness and impair children's cognitive development. 

Concrete floors may substantially reduce young children's exposure to pathogens in their home because they are easier to clean than dirt floors. The Cement flooRs AnD chiLd hEalth (CRADLE) randomized trial will generate rigorous, policy-relevant evidence about the impacts of replacing household soil floors with concrete floors on maternal and child health.  The study will measure whether concrete floors reduce child infections with soil-transmitted helminths in the first two years of life as well as a range of other maternal and child health outcomes. Our findings will provide rigorous, policy-relevant evidence about whether concrete floors should be delivered as a public health intervention to improve child health. 

The trial is registered at ClinicalTrials.gov (NCT05372068), and the study rationale and design have been published in BMJ Open.