Impact Evaluation of Large-Scale Sanitation and Hygiene Interventions

Summary

This study consists of an impact evaluation (IE) of the Scaling up Handwashing with Soap (HWWS) and Total Sanitation and Sanitation Marketing (TSSM) projects of the Water and Sanitation Program (WSP) of the World Bank. The objective of this study is to estimate the causal impact of the HWWS and TSSM interventions on the health and welfare of the rural poor in six developing countries: Peru, Tanzania, Senegal, Vietnam, Indonesia, and India. The IE will assess the impact of exposure to the HWWS and TSSM promotion on individual-level hygiene and sanitation practices, and on the health and welfare of children 0-5 years old. By introducing exogenous variation in handwashing and sanitation practices (through exposure to the HWWS and TSSM promotion), the IE will also answer a number of important questions related to the effect of the intended behavioral change (handwashing and improved sanitation) on health and welfare, thus providing information on the extent to which these behaviors alter intended development outcomes. This study uses a cluster-randomized experimental design, whereby the geographic units called clusters (e.g. village, commune, ward, depending on administrative structure of country) are randomly assigned to receive certain components of the Handwashing and Sanitation interventions in the case of treatment arms, and no Handwashing or Sanitation intervention in the case of control arms. . The final sample for the evaluation will consist of approximately 14,000 households, randomly selected, with at least one child between 0 and 24 months of age at baseline. Data will be collected from these 14,000 households (approximately 54,781 subjects) through household surveys, anthropometric measurements, blood and stool samples, direct observations of behaviors, and community surveys. The data collected will be analyzed using a differences in differences approach, where possible, and the results will be disseminated to country officials and others stakeholders.

Conditions

• Infant Diarrhea

Interventions

BEHAVIORAL

Total Sanitation and Sanitation Marketing

Total Sanitation and Sanitation Marketing (TSSM) program is designed to promote demand for and supply of improved sanitation. On the demand side, it includes "Community-Led Total Sanitation" (CLTS). On the supply side, TSSM incorporates sanitation marketing interventions. Both CLTS and sanitation marketing draw heavily on the behavior-change communication and social marketing approaches that have been well developed in other sectors. The basic TSSM approach also builds sustainability and scalability through the strengthening of the national level sanitation sector enabling environment.

BEHAVIORAL

Scaling Up Handwashing Behavior Change

The Handwashing with soap (HWWS) behavior change program expands and improves existing hygiene behavior change efforts with new and innovative promotional approaches in order to generate widespread and sustained improvement in handwashing with soap practices. These approaches include social marketing to deliver handwashing messages; broad and inclusive partnerships with government, private commercial marketing channels, and concerned consumer groups and NGOs.

Sponsors & Collaborators

• Water and Sanitation Program, World Bank

  lead OTHER

Principal Investigators

• Paul J Gertler, PhD · UC Berkeley - Haas School of Business

• Bertha Briceno, MPA/ID · World Bank - Water and Sanitation Program

• Alexandra Orsola-Vidal, MSc · World Bank - Water and Sanitation Program

• Claire Chase, MSc · World Bank - Water and Sanitation Program

• Sebastian F Galiani, PhD · Washington University School of Medicine

• Sebastian W Martinez, PhD · Inter-American Development Bank

• Paul M Wassenich, MPA · UC Berkeley

• Alicia L Salvatore, MPH, PhD · Stanford University

• Sumeet Patil, MA · Network for Engineering and Economics Research and Management

• Manisha B Shah, PhD · UC Irvine

• Lisa A Cameron, PhD · University of Melbourne

• Jack M Colford, MD, MPH, PhD · UC Berkeley - School of Public Health

• Ben Arnold, PhD · UC Berkeley

• Lia CH Fernald, MBA, PhD · UC Berkeley - School of Public Health

• Patricia K Kariger, PhD · UC Berkeley

• Christine Stauber, PhD · Georgia State University - Institute of Public Health

• Pavani K Ram, MD · University of Buffalo - SUNY

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Model

PARALLEL

Eligibility

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2007-11-30

Primary Completion

2010-12-31

Completion

2012-07-31