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

Abstract
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Hygiene information and practices play a critical role in preventing diseases, particularly among children. Hygiene behaviors practiced in the household have been linked to development outcomes such as socio-emotional skills. The WSP Global Scaling up Handwashing Behavior Impact Evaluation (WSPIE) 2009-2011 was conducted in Senegal, where the randomized design suffered from contamination between comparison groups. The variations in exposure and intensity to hygiene information campaigns captured in the surveys were used to understand contamination biases. Such variations were interacted with the presence of household communication assets to explore potential effects on children’s socio-emotional scores. In the presence of contamination biases, the study exploited the longitudinal sample of children in the surveys to reduce time-dependent biases. For robustness, statistical matching was applied between the impact evaluation surveys and Demographic and Health Surveys conducted in 2008 and 2011. Socio-emotional outcomes were the imputed into Demographic and Health surveys to expand sample sizes. By applying matching techniques and imputing outcomes into a larger sample, impacts were non-negligible. Double-difference estimates showed that children’s socio-emotional scores were higher when intervention status was interacted with the presence of communication assets within households. Without the presence of communication assets in the households the impacts were close to zero. Evaluating the effect of hygiene campaigns on children’s socio-emotional skills is challenging because of the biases from contamination that exist when information flows between comparison groups. Targeted hygiene information to the poorest households is relevant for reducing risks of recurrent infections and enables better conditions for socio-emotional development of children.

Analysis unit
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Household
Person
Caregiver
Child (under 5 and under 2)

Kind of data
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Sample survey data [ssd]

Sampling procedure
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The sampling framework included three stages. In the first stage, the collectivités locales (urban and rural communes) were selected. The selection of collectivités locales was drawn from the universe of urban communes and communautés rurales included in the four selected regions. Two collectivités locales-Commune de Thiès and Touba Mosquée-were excluded from the sampling universe for being larger than the rest (Touba Mosquée was close to 500,000 residents and Commune de Thiès was around 250,000 residents; the population of the next seven largest cities was between 171,000 and 113,000); from the remaining list there was a random selection from the largest collectivités locales. The second stage involved sample cluster selection. The selection of clusters or Census Districts was drawn from the universe of clusters. The last stage of the sampling framework involved household selection. The selection of households was randomly drawn among all households within the selected clusters that had at least one child less than two years of age, and was proportional to the number of households per cluster.

The randomized assignment of comunes was done at the locality level, and it included 110 urban and rural (cluster) villages randomly selected (55 for treatment and 55 for control) among eligible localites distributed across 7 of the 11 regions of Senegal. The evaluation design objective was to test whether handwashing behavior can be improved among the poor through the use of promotional strategies, and assess the effectiveness of the program at improving the health of the population at risk of diarrhea, and incidence of sanitation-related diseases. The program targeted a population of mothers and other caregivers between the ages of 19-49 and infants up to 13 years of age, living in urban and rural areas of the country, with the main objective of delivering the information campaign and hygiene promotion contents to the "stewards" of child health within the household.

While the intervention was designed to improve the health and hygiene practices of the treatment population, the intervention also collected data on children's health and mental development. Taking this information, children's mental development was analyzed using the data collected during the program. Hygiene practices within the household may impact child's mental development through different channels, such as nutrition, health, and high-quality supportive environments. The last channel includes mothers' behavior on health and nutrition, as these factors make mothers more responsive with the child's environment and his/her cognitive and socio-emotional development.

Mode of data collection
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Face-to-face [f2f]

Sampling error estimates
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Not applicable

Data appraisal
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Although there was no formal or independent appraisal of the data, an appraisal was undertaken when the data files for: Peru, India and Vietnam were prepared for a WSP presentation in Mexico. These data were presented in a public forum and scrutinized by various analysts. There was a process of feeding back information which helped correct or format or revise the data.

摘要
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卫生信息与行为在预防疾病，特别是在儿童中，发挥着至关重要的作用。家庭中实施的卫生行为与如社会情绪技能等发展结果相关联。2009-2011年，在塞内加尔进行的WSP全球洗手行为影响评估（WSPIE）中，随机设计受到了比较组之间污染的影响。调查中捕获的卫生信息宣传活动暴露和强度的变化被用来理解污染偏差。这些变化与家庭通信资产的存在相互作用，以探讨其对儿童社会情绪评分的潜在影响。在存在污染偏差的情况下，研究利用调查中的纵向儿童样本来减少时间依赖性偏差。为了增强稳健性，在影响评估调查与2008年和2011年进行的人口和健康调查之间应用了统计匹配。社会情绪结果被纳入人口和健康调查，以扩大样本量。通过应用匹配技术和将结果纳入更大的样本，影响不可忽视。双重差分估计表明，当干预状态与家庭中通信资产的存在相互作用时，儿童的社会情绪评分较高。在没有家庭通信资产的情况下，影响接近于零。由于信息在比较组之间流动时存在的污染偏差，评估卫生运动对儿童社会情绪技能的影响具有挑战性。针对最贫穷家庭的卫生信息有助于降低反复感染的风险，并促进儿童社会情绪发展的更好条件。
分析单元
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家庭
个人
照顾者
5岁以下和2岁以下儿童
数据类型
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样本调查数据 [ssd]
抽样程序
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抽样框架包括三个阶段。第一阶段，选择地方集体（城市和农村公社）。地方集体的选择来自包括在四个选定地区内的城市公社和农村社区。两个地方集体-Thiès公社和Touba清真寺-因规模大于其他集体而被排除在抽样范围之外（Touba清真寺近50万人，Thiès公社约25万人；下七个最大城市的人口在17万到11万之间）；从剩余列表中，从最大的地方集体中进行随机选择。第二阶段涉及样本集群选择。集群或人口普查区的选择来自集群的总体。抽样框架的最后阶段涉及家庭选择。家庭的选择是从所选集群中随机抽取的，这些家庭中至少有一名2岁以下的孩子，并且与集群内的家庭数量成比例。
城市和农村地区的干预旨在改善治疗人群的健康和卫生行为，同时收集关于儿童健康和精神发展的数据。利用这些信息，使用在项目期间收集的数据分析了儿童的精神发展。家庭内的卫生行为可能通过不同的渠道影响儿童的精神发展，例如营养、健康和高质量的支持性环境。最后一个渠道包括母亲在健康和营养方面的行为，因为这些因素使母亲对儿童的环境以及其认知和社会情绪发展更加敏感。
数据收集方式
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面对面 [f2f]
抽样误差估计
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不适用
数据评估
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尽管没有正式或独立的评估，但在为秘鲁、印度和越南的数据文件准备用于墨西哥WSP展示时进行了评估。这些数据在公开论坛上被各种分析师审查，并有一个信息反馈过程，有助于纠正或格式化或修订数据。