Primary Outcomes (explanation)
A. Household Beliefs
1. Forecasts of own daily handwashing behavior are collected biweekly in efforts to elicit how each intervention impacts household beliefs about future behavior. Respondents are asked to forecast how many days in the coming week they anticipate themselves and their children washing their hands with soap prior to dinner time.
2. Willingness to pay for the liquid handsoap device is elicited using a standard BDM mechanism at midline. We present households with a series of sequentially increasing monetary amounts, and ask them to choose between taking the amount in cash or taking (keeping) the dispenser. We then `randomly' choose a number in the range; if the number is lower than the switching point of the household, the household keeps the dispenser; if it is higher, they receive the cash. Given the potential endowment effect, we recognize that WTP estimates in the pure control are not comparable to those in the remaining arms, but among those households who received a dispenser in Phase I, the WTP six months later serves as an informative measure of how effective or useful households believe the product to be over time.
B. Household Behavior
Handsoap dispenser data was collected every two weeks during surveyor visits. Although it was not possible to identify the identity of the user at any given press, we proxied for separate users by collapsing presses that happened two or fewer seconds apart into a single press. In other words, if the device was used in seconds 34, 35, 37,45, and 46, the first three presses were considered a single use by one household member, and the later two presses as a single use by another member. Though not exact, observations from pilots made clear that a user would press several times in quick succession and rarely return for more soap during a single handwashing event, since the water source (usually a bucket right outside the front porch) was not within reach of the dispenser, unlike the familiar setting of sink, soap, and running water common to more developed contexts.1. Daily handwashing rates are calculated as the sum of all `individual' uses over the course of each twenty-four hour period.
2. Mealtime-specific handwashing rates are calculated as the total number of `individual' uses in the interval of 90 minutes before and after the household's reported start of the evening meal time. If a family reported eating dinner every day at 8:00 PM, for example, this outcome would be the sum of all individual presses observed between 7:00 PM and 8:30 PM.
3. Family use at mealtime is derived from the above and is a binary variable which equals one if at least three `individual' uses were observed in the dinner time interval.
4. Evening handwashing rates are calculated as the total number of `individual' uses any time 5pm or later. Use of the dispenser during this time of day is almost surely tied to use before eating, since all other potential uses (laundry, shampoo, or hand washing after defection or cleaning the house) have all been completed by this time. Since we rolled out in the winter season, children often ate earlier than their parents due to the cold, so the reported mealtime is not a consistent measure of child eating habits. This broader measure allows us to capture all handwashing-before-eating events in the evening.
C. Child Health
1. Incidence of child diarrhea and respiratory illness is collected every two weeks by surveyors, and consists of self reports in which mothers are asked how many days each child has experienced diarrhea in the past two weeks, and likewise for respiratory illness (cough, cold). When possible, the surveyor examines the child in person and asks him/her directly about symptoms.
2. Anthropometric outcomes were collected at baseline, at the four month mark, and at the eight month mark. These included child weight, height, and mid-arm circumference.
3. Bacteria cultures of hand swabs were collected during random, unannounced visits to households two months after the distribution of the dispensers. Subject to budget constraints, a subset of households will randomly be chosen for the audits.
4. Child blood and stool analysis is conducted for a small subset of children whose parents consent to the process.