From Knowledge to Action: The Power of Goal-Setting and Monitoring for Sustained WASH Practices

There will be two different treatment arms in the proposed study, in addition to the control arm:

Control group: Information and skills training: 800 mother-child pairs (from 40 slums). There will be no pure control group.
Treatment 1: Information and skills training + Individual Monitoring (n=600): 600 mother-child pairs (from 30 slums).
Treatment 2: Information and skills training + Peer monitoring (n=600): 600 mother-child pairs (from 30 slums)

2024-10-28

2025-02-28

The main objective of the proposed project is to help understand the major determinants of going from knowledge to action that is adopting and maintaining (sustained use/regular practice) safe wash, sanitation, and hygienic behavior. We will focus on three sets of outcomes here: respondent and child-assessed subjective outcomes; behavioural outcomes (revealed preference for hygienic behaviours and products) and objective outcomes (evaluator assessed or directly collected).

We want to gauge whether and to what extent the treatments positively improve wash, sanitation, and hygiene related knowledge (a knowledge index constructed from responses to MCQs by mothers), habit/practice indicators (for both mothers as well as their children) and overall health and development captured using health indicators to gauge the immunity and liveliness of the child and mother (frequency of illness, etc). In addition, we will conduct enumerator assessments to asses to what extent the respondent has followed the protocols in terms of keeping self, their child, house and area around the house clean (detailed objective assessments). Hand swabs and revealed preference games will also be conducted on a sub-sample of randomly selected households (and participants/respondents) from both treatment and control clusters to check for cleanliness and assess behavioural or change in preferences/attitudes. We will also focus on household expenditures on cleaning and hygienic products, and substitution if any.

While there will be no spillover from treatment group to control group as we will randomize at the slum level, there may be significant spillover effects within the household, which we will capture via behavioral changes among non-targeted participants from the same household i.e. other household members such as husband of the respondents and other siblings of the targeted child, friends of the mothers and nearest neighbors (i.e. the focus will be on members in the study participant’s social networks).

As part of the secondary outcomes, we will also focus on physical, mental health condition, cognitive, non-cognitive and psychosocial outcomes of both mothers as well as their children. For mothers: we will particularly focus on different aspects of mental health such as perceived stress, anxiety, depression as well as overall wellbeing (satisfaction with life, marital relationship and family), labor market outcomes (employment and income), and time-use (effort, preparation, leisure, socializing, etc). For children, we will also focus on attendance, learning outcomes and also anthropometric outcomes (in the long run via a round of follow-up survey).

We will also focus on empowerment and autonomy related indicators, mobility and decision-making within the household, gender bias, inequality and discrimination, support from family (quality of support), lab-in-the field games to capture risk, time preference and preference for healthy living and other survey based preference indicators such as trust, reciprocity, altruistic behaviour, etc.

This research endeavor encapsulates about 2,000 mother-child dyads hailing from 100 distinct slum clusters situated in the district of Kanpur in Uttar Pradesh, India. We will focus on mothers aged 18-45 years with a child below five years i.e. the focus will be on targeted mothers to see if good hygienic and sanitary practices can be adopted in a more sustained manner. These 2,000 individuals will be randomly assigned to two treatments and one control group. While 1,200 mother-child dyads (from 60 slums) will be randomly assigned to the treatment groups (30 slums in each of the two treatments), 40 slums and the remaining 800 mother-child dyads will be assigned to the control group. Randomization will be done at the slum-level.

Not available

Randomization will be done on an office computer using the STATA software.

Slum

Yes

100 slums

2000 mother-child dyads.

Number of observations: While there will be 600 mother-child dyads (from 30 slums) in treatment 1, there will be another 600 mother-child dyads (from 30 slums) in treatment 2, finally, the remaining 800 mother-child dyads (from 40 slums) will be assigned to the control group.