Sustainability of Hygiene Behaviours in Indian Slums

Last registered on August 22, 2025
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Pre-Trial

Trial Information

General Information

Title
Sustainability of Hygiene Behaviours in Indian Slums
RCT ID
AEARCTR-0015896
Initial registration date
August 21, 2025

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
August 22, 2025, 6:10 AM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

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Primary Investigator

Name
Debayan Pakrashi
Affiliation
Economic Research Unit, Indian Statistical Institute Kolkata
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Other Primary Investigator(s)

Additional Trial Information

Status
On going
Start date
2021-09-01
End date
2030-12-31
Keywords
Behavior, Education, Gender, Health, Welfare
Additional Keywords
health and hygiene, food security, spillover, child development
JEL code(s)
I12, I14, I15, I25
Secondary IDs
Prior work
This trial is based on or builds upon one or more prior RCTs.
Abstract
There has been a rise in incidence of malnutrition in India between 2018 and 2019 (Vir & Suri, 2020). The pandemic has made matters worse, putting those already vulnerable at most risk. The main objective of this project is to understand whether raising awareness among mothers (the primary caregiver) can help improve the health and wellbeing of both the mothers as well as their young children. Moreover, since mothers are primarily responsible for child care, we also plan to see if improving mental health and wellbeing of mothers have an added effect. The original project funded by JPAL-South Asia started in 2021 and we are following the mothers and their young children (original study participants) again over several rounds of surveys to understand the effects of the original intervention on both the mothers as well as their children (focusing on overall childhood development). While the initial project focused on the effect of the interventions on health and hygiene and other outcomes in the short run, captured immediately after the intervention, the over-arching aim of the current project (being conducted in 2025) is to understand the sustainability of hygiene behaviours through three key objectives:

1. To produce new evidence on medium-term effects of health and hygiene interventions on behaviours and health status in these urban slums 3-years post intervention;
2. To understand the factors influencing sustainability of behaviours, with a focus on the role of social interactions; and
3. To develop protocols for novel measurements of hygiene behaviours.

The current project therefore is a follow-up study to understand the medium term effects of the interventions on the original participants, the role of social networks in sustaining the effects and resulting in spillover effects and identifying novel measurement techniques to capture the effect of the interventions on sustained hygiene behaviour.
External Link(s)

Registration Citation

Citation
Pakrashi, Debayan. 2025. "Sustainability of Hygiene Behaviours in Indian Slums." AEA RCT Registry. August 22. https://doi.org/10.1257/rct.15896-1.0
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Experimental Details

Interventions

Intervention(s)
The original study raised awareness among mothers (the primary caregiver) about how to improve their health, hygiene and wellbeing as well as that of their young children. Moreover, since mothers are primarily responsible for childcare, we also provided them with an additional mental health support so as to improve the growth and overall development of the children.
Intervention Start Date
2021-11-01
Intervention End Date
2022-04-30

Primary Outcomes

Primary Outcomes (end points)
We are interested in studying the medium-term effects of the intervention on maternal and child outcomes (of the original study participants) including maternal knowledge and beliefs about hygiene and children’s health, actual hygienic practices, and child health and development outcomes.
Primary Outcomes (explanation)
We will capture child health and hygiene outcomes using five different survey modules: (1) respondent survey questionnaire focusing on questions related to food security, hygiene, maternal knowledge related to the interventions, health outcomes, time-intensive parental investments, etc; (2) random visits by enumerators to objectively assess sustained hygiene practices; (3) a detailed neighbour survey to capture interactions of the participants with the neighbours and also develop a new technique to capture participant's hygiene outcomes using neighbour reports; (4) a child survey to capture child's learning, anthropometric and other developmental outcomes and finally (5) conduct a number of lab-in-the-field experiments such as public goods game, dictator game, list experiment, and capture responses on a series of revealed preference questions.

Secondary Outcomes

Secondary Outcomes (end points)
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
The original study conducted between 2021-2022 focused on about 1,300 mother-child pairs (one pair from each household) randomly selected from 60 slums in the state of Uttar Pradesh. Randomization was conducted at the slum-level. Mothers at the time of listing and baseline were aged 15-49 years and their children were below the age of five years.

The sample was randomly assigned to two treatments and one control group. The design of the original RCT is as follows: the first treatment is the information intervention while the second treatment is the information treatment along with a wellbeing intervention. The rest of the sample (one-third of the total) assigned to the control group did not receive any intervention.

While the initial endline surveys were conducted in 2022 and 2023 to assess short term effects. The current follow-up surveys via five separate modules and rounds will be conducted in 2025 (August onwards) to understand the medium term effects of the original interventions (conducted in 2021-2022) on the original 1,300 study participants (mother-child pairs) from those 60 slums. The original study conducted in 2021-22 had 1,300 mother-child pairs, however, during the follow-up surveys in 2025, we expect to have some attrition in the sample size due to migration, or absence during surveys, etc.
Experimental Design Details
Not available
Randomization Method
Randomization of the original study was conducted using a computer and STATA. This is only a follow-up study of the original participants.
Randomization Unit
Randomization of the original study was done at the slum level.
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
The original study had 60 slums.
Sample size: planned number of observations
The original study was conducted with a total of 1,300 mother-child pairs from 60 slums in 2021-22. The original study had 1,300 mother-child pairs, but while conducting the follow-up surveys in 2025, we expect to have attrition in the sample size due to migration, or absence during surveys, etc.
Sample size (or number of clusters) by treatment arms
About 20 slums and about 430 mother-child pair per treatment/control arm.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Supporting Documents and Materials
IRB

Institutional Review Boards (IRBs)

IRB Name
IIT Kanpur Institutional Ethics Committee
IRB Approval Date
2024-06-20
IRB Approval Number
IITK/IEC/2024-25/I/6
Analysis Plan