Handwashing Behavior Change at Scale : Evidence from a Randomized Evaluation in Vietnam
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World Bank, Washington, DC
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Handwashing with soap, which has been
shown to reduce diarrhea in young children by as much as 48
percent, is frequently mentioned as one of the most
effective and inexpensive ways to save children's
lives. Yet rates of handwashing remain very low throughout
the world. Handwashing with soap campaigns are de rigueur in
developing countries, but little is known about their
effectiveness. Few have been rigorously evaluated, and none
on a large-scale. This paper evaluates a large-scale
handwashing campaign in three provinces of Vietnam in 2010.
Exposure to the campaign resulted in a slight increase in
the availability of handwashing materials in the household,
and caregivers in the treatment group were more likely to
report washing hands at some of the times emphasized by the
campaign. However, observed handwashing with soap at these
times is low, and there isn't any difference between
the treatment and control groups. As a result, no impact on
health or productivity is found. These results suggest that
even under seemingly optimal conditions, where knowledge and
access to soap and water are not main constraints, behavior
change campaigns that take place on a large scale face
tradeoffs in terms of intensity and effectiveness.
Palabras clave
ACUTE RESPIRATORY INFECTION, ACUTE RESPIRATORY INFECTIONS, ANEMIA, APPROPRIATE INCENTIVES, AVIAN INFLUENZA, BABY, BEHAVIOR CHANGE, BREASTFEEDING, BULLETIN, CAPACITY BUILDING, CARE FOR CHILDREN, CAREGIVERS, CHILD DEATHS, CHILD DEVELOPMENT, CHILD HEALTH, CHILD MORTALITY, CHILD MORTALITY RATES, CHILD NUTRITION, CHILD SURVIVAL, CLEANLINESS, COMMUNICATION CAMPAIGN, COOKING, DEFECATION, DEVELOPING COUNTRIES, DEVELOPMENT EFFORTS, DEVELOPMENT POLICY, DIARRHEA, DIARRHEAL DISEASES, DIARRHOEA, DISEASE, DISEASE BURDEN, DISEASE PREVENTION, DRINKING WATER, ECONOMIC GROWTH, EDUCATIONAL ATTAINMENT, ENVIRONMENTAL HEALTH, ENVIRONMENTAL SANITATION, EPIDEMIOLOGY, ETHNIC GROUP, ETHNIC GROUPS, FAMILY MEMBERS, FEMALES, FEVER, FOCUS GROUP DISCUSSIONS, FOOD PREPARATION, GAUGE, GENDER NORMS, GERM THEORY, GERMS, GOVERNMENT AGENCIES, HAND WASHING, HANDS WITH SOAP, HANDWASHING, HEALTH EDUCATION, HEALTH FACILITIES, HEALTH INDICATORS, HEALTH MESSAGES, HEALTH OUTCOMES, HEALTH WORKERS, HIV/AIDS, HOME VISITS, HOUSEHOLD ASSETS, HOUSEHOLD LEVEL, HYGIENE, HYGIENE BEHAVIOR, HYGIENE BEHAVIOUR, HYGIENE EDUCATION, HYGIENE PRACTICES, HYGIENE PROMOTION, HYGIENE PROMOTION PROGRAM, ILLNESS, IMPACT ON HEALTH, IMPAIRMENTS, INFANT, INFECTION, INFECTIONS, INFLUENZA, INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, INTERPERSONAL COMMUNICATION, INTERVENTION, LIVING CONDITIONS, LOCAL CAPACITY, LOCAL TELEVISION, MALARIA, MALNUTRITION, MARKETING, MASS MEDIA, MILLENNIUM DEVELOPMENT GOALS, MINISTRY OF HEALTH, MINORITY, MORBIDITY, MORTALITY, MOTHER, NATIONAL GOVERNMENT, NATIONAL GOVERNMENTS, NATIONAL LEVEL, NAUSEA, NUMBER OF HOUSEHOLDS, NUTRITION, PATHOGENS, POLICY DISCUSSIONS, POLICY RESEARCH, POLICY RESEARCH WORKING PAPER, POOR HYGIENE, POPULATION ESTIMATES, POPULATION SIZE, POSTERS, PRACTITIONERS, PRETESTING, PREVALENCE, PREVENTABLE DISEASES, PRIMARY CAREGIVERS, PROGRESS, PROMOTIONAL MATERIALS, PSYCHOLOGY, PUBLIC HEALTH, QUALITY CONTROL, RADIO, RURAL AREAS, RURAL POPULATION, RURAL WATER SUPPLY, SAFE DRINKING WATER, SAFE WATER, SANITATION, SANITATION FACILITIES, SEX, SEXUALITY, SOAP, SOCIAL DEVELOPMENT, SOCIAL SCIENCE, SOCIAL SCIENCES, SUSTAINABLE DEVELOPMENT, SYMPTOMS, TELEVISION, TOUCH, TRANSMISSION OF DISEASE, TREATMENT, TROPICAL MEDICINE, TUBERCULOSIS, TV, UNION MEMBERS, URBAN AREAS, VACCINE, VOMITING, WASH HANDS WITH SOAP, WASHING HANDS, WATER SOURCE, WATER TREATMENT, WORKERS, WORLD HEALTH ORGANIZATION, YOUNG CHILDREN, Microdata Set