WSP Global Scaling up Handwashing Behavior Impact Evaluation, Baseline and Endline Surveys 2009-2011 (Peru)

Abstract

In Peru, the handwashing project targets mothers/caregivers of children under five years old, and it is aimed at improving handwashing with soap practices. Children under five represent the age group most susceptible to diarrheal disease and acute respiratory infections, which are two major causes of childhood morbidity and mortality in less developed countries.

These infections, usually transferred from dirty hands to food or water sources, or by direct contact with the mouth, can be prevented if mothers/caregivers wash their hands with soap at critical times (such as before feeding a child, cooking, eating, and after using a toilet or changing a child’s diapers). In an effort to improve handwashing behavior, the intervention borrows from both commercial and social marketing fields. This entails the design of communications campaigns and messages likely to bring about the desired behavior changes, and delivering them strategically so that the target audiences are “surrounded” by handwashing promotion.

Some key elements of the intervention include:
• Key behavioral concepts or triggers for each target audience
• Persuasive arguments stating why and how a given concept or trigger will lead to behavior change, and
• Communication ideas to convey the concepts through many integrated activities and communication channels.

The objective of the IE is to assess the effects of the project on individual-level handwashing behavior and practices of caregivers and children. By introducing exogenous variation in handwashing promotion (through randomized exposure to the project), the IE also addresses important issues related to the effect of intended behavioral change on child health and development outcomes. In particular, it provides information on the extent to which improved handwashing behavior impacts infant health and welfare.