Publication: Scaling Up Handwashing Behavior : Findings from the Impact Evaluation Baseline Survey in Peru
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2010-08
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2014-03-12
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In response to the preventable threats posed by poor sanitation and hygiene, the Water and Sanitation Program (WSP) launched two large-scale projects, global scaling up handwashing and global scaling up rural sanitation, to improve the health and welfare outcomes for millions of poor people. Local and national governments are implementing these projects with technical support from WSP. Global scaling up handwashing aims to test whether handwashing with soap behavior can be generated and sustained among the poor and vulnerable using innovative promotional approaches. The primary objectives are to reduce the risk of diarrhea in young children and increase household productivity by stimulating and sustaining the behavior of handwashing with soap at critical times. Overall, the project aims to generate and sustain handwashing with soap practices among 5.4 million people living in Peru, Senegal, Tanzania, and Vietnam, the four countries where the project has been implemented to date. This technical paper presents the findings of the WSP impact evaluation (IE) baseline survey in Peru and is one in a series of papers presenting IE findings from surveys conducted in each project country.
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“Galiani, Sebastian; Orsola-Vidal, Alexandra. 2010. Scaling Up Handwashing Behavior : Findings from the Impact Evaluation Baseline Survey in Peru. Water and sanitation program technical paper. © http://hdl.handle.net/10986/17263 License: CC BY 3.0 IGO.”
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Publication Scaling Up Handwashing Behavior : Findings from the Impact Evaluation Baseline Survey in Senegal(World Bank, Washington, DC, 2011-06)In December 2006, in response to the preventable threats posed by poor sanitation and hygiene, the Water and Sanitation Program (WSP) launched two large-scale projects, global scaling up handwashing and global scaling up rural sanitation, to improve the health and welfare outcomes for millions of poor people. Local and national governments are implementing these projects with technical support from WSP. The goal of the Global Scaling up Handwashing Project (HWWS) is to reduce the risk of diarrhea and therefore increase household productivity by stimulating and sustaining the behavior of handwashing with soap at critical times for 5.4 million people in Peru, Senegal, Tanzania, and Vietnam. The project aims to test whether this handwashing behavior can be improved among the poor and vulnerable using innovative promotional approaches. In addition, it will undertake a structured learning and dissemination process to develop the evidence, practical knowledge, and tools needed to effectively replicate and scale up future handwashing programs.Publication Promoting Handwashing Behavior in Peru : The Effect of Large-Scale Mass-Media and Community Level Interventions(World Bank, Washington, DC, 2012-11)This paper analyzes a randomized experiment that uses novel strategies to promote handwashing with soap at critical times in Peru. It evaluates a large-scale intervention that includes a mass media provincial campaign and a district-level community component. The analysis finds that the mass media intervention alone had no significant effect on exposure to the handwashing promotion campaign messages, and therefore no effect on handwashing knowledge or handwashing behavior. In contrast, the community-level intervention, a more comprehensive intervention that included several community and school activities in addition to the communications campaign, was successful in reaching the target audience with handwashing promotion messages and in improving the knowledge of the treated population on appropriate handwashing behavior. Those improvements translated into higher self-reported and observed handwashing with soap at critical junctures. However, no significant improvements in the health of children under the age of five were observed. The results are consistent with earlier literature, which indicates that substantively changing behavior to improve health is a complex task requiring intensive and more personalized interventions.Publication Scaling Up Handwashing Behavior : Findings from the Impact Evaluation Baseline Survey in Vietnam(World Bank, Washington, DC, 2010-11)The goal of global scaling up handwashing is to reduce the risk of diarrhea and therefore increase household productivity by stimulating and sustaining the behavior of handwashing with soap at critical times in the lives of 5.4 million people in Peru, Senegal, Tanzania, and Vietnam, where the project has been implemented to date. The structure of this report proceeds as follows: In chapter one author provide an overview of the global scaling up handwashing and global scaling up rural sanitation projects, as well as background on the handwashing project in Vietnam. Chapter two details the methodology that underlies the impact evaluation, and provides details on the sampling design, sample selection, and field work protocols. The baseline findings for general household characteristics, handwashing behavior, child health, and child growth are presented in depth in chapter three. In chapter four authors conclude with a summary of the next steps of the impact evaluation study.Publication Scaling Up Rural Sanitation : Findings from the Impact Evaluation Baseline Survey in Madhya Pradesh, India(World Bank, Washington, DC, 2011-03)In India, Water and Sanitation Program's (WSP's) global scaling up rural sanitation program is supporting the Government of India's (GoI) Total Sanitation Campaign (TSC) in two states: Himachal Pradesh and Madhya Pradesh. TSC is an ambitious countrywide, scaled-up rural sanitation program launched by the GoI in 1999, which seeks to attain an Open Defecation Free (ODF) India by 2012. In contrast to earlier, hardware-centric supply approaches to rural sanitation, TSC aims to generate demand for and adoption of improved sanitation at the community level. The program focuses on creating ODF communities rather than bringing about incremental individual changes. The TSC aims not only to achieve ODF communities but also focuses on hygiene, waste management, and sanitation in schools and institutions. The main components of the intervention include: 1) community-led total sanitation, 2) social marketing of sanitation, 3) strengthening the enabling environment, and 4) nirmal gram puraskar awards. Although the data are limited in establishing causality, emerging trends indicate that gains in improved sanitation, likely to be brought about by TSC, could have positive impacts on the health and welfare of rural families, especially young children.Publication Scaling Up Rural Sanitation : Findings from the Impact Evaluation Baseline Survey in Indonesia(World Bank, Washington, DC, 2010-11)The overall purpose of the Impact Evaluation is to provide decision makers with a body of rigorous evidence on the effects of the hand washing and sanitation projects at scale on a set of relevant outcomes. It also aims to generate robust evidence on a cross-country basis, understanding how effects vary according to each country's programmatic and geographic contexts, and generate knowledge of relevant impacts such as child cognitive development, child growth (anthropometric) measures, anemia, acute lower respiratory disease, and productivity of mother's time, among many others. The studies will provide a better understanding of at-scale sanitation and hygiene interventions. The improved evidence will support development of large-scale policies and programs, and will inform donors and policy makers on the effectiveness and potential of the Global Scaling Up projects as massive interventions to meet global needs.
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