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

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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.

Acronym: 
WSP-IE 2009-2011
Type: 
Microdata
Topics: 
Topic not specified
Languages Supported: 
English
Geographical Coverage: 
Peru
Reference ID: 
PER_2009-2011_WSP-IE_v01_M_v01_A_PUF
Version Production Date: 
June 1, 2011
Release Date: 
June 11, 2013

Harvest Source

Harvest Source: 
Microdata

Harvest Source ID

Harvest Source ID: 
4216

Last Updated

Last Updated: 
July 22, 2014
Study Type: 

Other Household Health Survey [hh/hea]

Data Editing: 
Baseline: The baseline survey was processed using the assistance of Sistemas Integrales in Chile. A manual for the data entry system is attached under the title of: Data Entry Manual:Baseline. Endline: Kimetrica International was contracted to design the data reduction system to be used during the endline. The data entry system was designed in CSPro (Version 4.1) using the DHS file management system as a standard for file management. Details of the system can be found in the attached manual entitled: Data Entry Manual for the Endline Survey. The data entry system was based on a full double data entry (independent verification) of the various questionnaires. CSPro supports both dependent and independent verification (double keying) to ensure the accuracy of the data entry operation. Using independent verification, operators can key data into separate data files and use CSPro utilities to compare them and produce a report that indicates discrepancies in data entry. The DHS system uses a fully integrated tracking system to follow the stages in the data entry process. This includes the checking in of questionnaires; the programming of logic in what is known as a system controlled environment. System controlled applications generally place more restrictions on the data entry operator. This is typically used for complex survey applications. The behavior of these applications at data entry time has the following characteristics: - Some special data entry keys are not active during data entry. - CSEntry will keep track of the path. - 'Not applicable' or blanks values will not be allowed. Missing values have to be coded. - More appropriate to the heads up methodology of data capture. - Logic in the application is strictly enforced; operator cannot bypass or override. Files were processed using the unique cluster number and then concatenated after a final stage of editing and output to both SPSS and STATA. Furthermore, attempts were made to respect the values and the naming conventions as provided in the baseline. This required using non-conventional values for “missing” such as -99. In most cases the same value sets were applied or during the questionnaire review process the WSP was alerted to such discrepancies.
Disclaimer: 
WSP is a multi-donor partnership created in 1978 and administered by the World Bank to support poor people in obtaining affordable, safe, and sustainable access to water and sanitation services. WSP's donors include Australia, Austria, Canada, Denmark, Finland, France, the Bill & Melinda Gates Foundation, Ireland, Luxembourg, Netherlands, Norway, Sweden, Switzerland, United Kingdom, United States, and the World Bank. The findings, interpretations, and conclusions expressed in this paper are entirely those of the authors. They do not necessarily represent the views of the Water and Sanitation Program, the World Bank and its affiliated organizations, or those of the Executive Directors of the World Bank or the governments they represent.
Estimates of Sampling Error: 
Not applicable
Funding Name, Abbreviation, Role: 
Bill & Melinda Gates Foundation
Other Processing: 
The data files as they are output in CSPro follow the hierarchical structure as established in the data dictionary. These however may not be convenient for the analyst. The WSP requested that the files be integrated into various record level files. The files that are included in the final data base reflect this structure. However, some analysts may still want the hierarchical level data available in its original record form (as it was during data entry). For that reason, these files are also zipped together and provided in the event that they are desired. The final data files are provided in STATA format as requested by the WSP.
Primary Investigator Name, Affiliation: 
Water and Sanitation Program - World Bank
Questionnaires: 
The following instruments were used to collect the data: • Household questionnaire: The household questionnaire was conducted in all households and was designed to collect data on household membership, education, labor, income, assets, dwelling characteristics,water sources, drinking water, sanitation,observations of handwashing facilities and other dwelling characteristics, handwashing behavior, child discipline, maternal depression, handwashing determinants, exposure to health interventions, relationship between family and school, and mortality. • Health questionnaire: The health questionnaire was conducted in all households and designed to collect data on children’s diarrhea prevalence, ALRI and other health symptoms, child development, child growth, and anemia. • Community questionnaire: The community questionnaire was conducted in 120 districts to collect data on community/districts variables. • Structured observations: Structured observations were conducted in a subsample of 160 households to collect data on direct observation of handwashing behavior. • Water samples: Water samples were collected in a subsample of 160 households, to identify Escherichia coli (E. coli) presence in hand rinses (mother and children), sentinel toy, and drinking water. • Stool samples: Stool samples were collected in a subsample of 160 households to identify prevalence of parasites in children’s feces.
Response Rates: 
Baseline 1 Completed interview -----> 3508 --->94.3 2 Incomplete interview ----->48 --->1.3 3 Not available ----->7 --->.2 4 Rescheduled interview ----->7 --->.2 5 Nobody at home ----->48 --->1.3 6 Temporarily away ----->59 --->1.6 7 Refused to participate ----->44 --->1.2 Total 3721 Endline 1 Completed interview ----->3526 --->99.4 2 Incomplete interview ----->3 --->.1 4 Rescheduled interview ----->7 --->.2 5 Nobody at home ----->7 --->.2 6 Temporarily away ----->4 --->.1 Total 3547 Baseline households in endline are: 3,486.
Sampling Procedure: 
The primary objective of the project is to improve the health and welfare of young children. The sample size (total number of households) was chosen to capture a minimum effect size of 20 percent on the key outcome indicator of diarrhea prevalence among children under two years old at the time of the baseline. The selection of households with children in this age group was made under the assumption that health outcome measurements for young children in this age range are most sensitive to changes in hygiene in the environment. Data was collected for household members of all age ranges and the corresponding data analysis was conducted for older children and adults as well. Power calculations indicated that, in order to capture a 20 percent reduction in diarrhea incidence, around 600 households per treatment arm would need to be surveyed. Therefore, since the evaluation consists of three treatment groups and two control groups, the final sample incorporates approximately 3,000 households, each with children less than two years of age at the time the survey was conducted. An additional 500 households were added to the sample size in order to address potential attrition (loss of participants during the project); thus the minimal necessary sample size was 3,500 households (around 700 households per arm). To select the sample, the IE team used a three-stage sampling methodology: • Stage 1: Province Level From 195 total provinces in Peru, Pisco and Lima were excluded at the request of the implementation team.2 Of the remaining 193 provinces, 80 provinces were randomly chosen. Out of these 80 provinces, two groups of 40 provinces each were randomly formed: Group of Provinces 1 (GP1) and Group of Provinces 2 (GP2). • Stage 2: District Level In order to assess the impact of each of the components of the project in the health of children younger than five years old, the evaluation study has two main treatments, that is, one per component. These are the Mass Media Treatment at the provincial level, also referred to as Treatment 1 (T1), and the Social Mobilization Treatment at the district level, also referred to as Treatment 2 (T2). In order to evaluate and identify the health impacts of each component, a counterfactual to T1 and T2 is needed, which we refer to as the Control (C). The three groups, T1, T2, and C include households with children under two years old at the time of the baseline. Out of the first group of 40 provinces, GP1, 40 districts between 1,500 and 100,000 habitants were randomly chosen to receive T1. From the second group, GP2, 80 districts between 1,500 and 100,000 habitants were selected randomly; 40 of them were randomly assigned to receive T2, and the other 40 districts to serve as C to T1 and T2. • Stage 3: Household Level For each of the three sets of 40 districts (120 districts total) allocated to T1, T2, and C, 15-20 households with children under two years of age were selected at random in each district. Also, in each of the 40 districts
Series Information: 
The IE includes several rounds of household and community surveys: pre-intervention (baseline), concurrent (longitudinal), and post-intervention (endline). The surveys are designed to collect information on the characteristics of the eligible population and to track changes in desired outcomes.
Unit of Analysis: 
- Household- Person- Caregiver- Child (under 5 and under 2)
Version Description: 
Version 1.0: The study includes information on the baseline, longitudunal and endline surveys.

No Visualizations Available.

Use of the dataset must be acknowledged using a citation which would include: - the Identification of the Primary Investigator - the title of the survey (including country, acronym and year of implementation) - the survey reference number - the source and date of download World Bank Water and Sanitation Program. Peru WSP Global Scaling up Handwashing Behavior Impact Evaluation, Baseline and Endline Surveys 2009-2011. Ref. PER_2009_2011_WSP-IE_v01_M_v01_A_PUF. Dataset downloaded from [website/source] on [date]

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.

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Modified Date
2018-04-11
Release Date
Identifier
680bc566-8932-4e5e-9d12-dba9f938faf6
License
License Not Specified
Contact Email
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Reference ID: 
PER_2009-2011_WSP-IE_v01_M_v01_A_PUF
Acronym: 
WSP-IE 2009-2011
Type: 
Languages Supported: 
Access Authority Name, Affiliation, Email: 
Bertha Briceno, Water and Sanitation Program, [email protected], Alex Orsola-Vida, Water and Sanitation Program, [email protected]
Disclaimer: 
WSP is a multi-donor partnership created in 1978 and administered by the World Bank to support poor people in obtaining affordable, safe, and sustainable access to water and sanitation services. WSP's donors include Australia, Austria, Canada, Denmark, Finland, France, the Bill & Melinda Gates Foundation, Ireland, Luxembourg, Netherlands, Norway, Sweden, Switzerland, United Kingdom, United States, and the World Bank. The findings, interpretations, and conclusions expressed in this paper are entirely those of the authors. They do not necessarily represent the views of the Water and Sanitation Program, the World Bank and its affiliated organizations, or those of the Executive Directors of the World Bank or the governments they represent.
Response Rates: 
Baseline 1 Completed interview -----> 3508 --->94.3 2 Incomplete interview ----->48 --->1.3 3 Not available ----->7 --->.2 4 Rescheduled interview ----->7 --->.2 5 Nobody at home ----->48 --->1.3 6 Temporarily away ----->59 --->1.6 7 Refused to participate ----->44 --->1.2 Total 3721 Endline 1 Completed interview ----->3526 --->99.4 2 Incomplete interview ----->3 --->.1 4 Rescheduled interview ----->7 --->.2 5 Nobody at home ----->7 --->.2 6 Temporarily away ----->4 --->.1 Total 3547 Baseline households in endline are: 3,486.
Estimates of Sampling Error: 
Not applicable
Time Periods: 
August, 2017
Primary Investigator Name, Affiliation: 
Water and Sanitation Program - World Bank
Terms of Use: 
Version Description: 
Version 1.0: The study includes information on the baseline, longitudunal and endline surveys.
Unit of Analysis: 
- Household- Person- Caregiver- Child (under 5 and under 2)
Geographical Coverage: 
Data Classification of a Dataset: 
Version Production Date: 
Wednesday, June 1, 2011
Series Information: 
The IE includes several rounds of household and community surveys: pre-intervention (baseline), concurrent (longitudinal), and post-intervention (endline). The surveys are designed to collect information on the characteristics of the eligible population and to track changes in desired outcomes.
Sampling Procedure: 
The primary objective of the project is to improve the health and welfare of young children. The sample size (total number of households) was chosen to capture a minimum effect size of 20 percent on the key outcome indicator of diarrhea prevalence among children under two years old at the time of the baseline. The selection of households with children in this age group was made under the assumption that health outcome measurements for young children in this age range are most sensitive to changes in hygiene in the environment. Data was collected for household members of all age ranges and the corresponding data analysis was conducted for older children and adults as well. Power calculations indicated that, in order to capture a 20 percent reduction in diarrhea incidence, around 600 households per treatment arm would need to be surveyed. Therefore, since the evaluation consists of three treatment groups and two control groups, the final sample incorporates approximately 3,000 households, each with children less than two years of age at the time the survey was conducted. An additional 500 households were added to the sample size in order to address potential attrition (loss of participants during the project); thus the minimal necessary sample size was 3,500 households (around 700 households per arm). To select the sample, the IE team used a three-stage sampling methodology: • Stage 1: Province Level From 195 total provinces in Peru, Pisco and Lima were excluded at the request of the implementation team.2 Of the remaining 193 provinces, 80 provinces were randomly chosen. Out of these 80 provinces, two groups of 40 provinces each were randomly formed: Group of Provinces 1 (GP1) and Group of Provinces 2 (GP2). • Stage 2: District Level In order to assess the impact of each of the components of the project in the health of children younger than five years old, the evaluation study has two main treatments, that is, one per component. These are the Mass Media Treatment at the provincial level, also referred to as Treatment 1 (T1), and the Social Mobilization Treatment at the district level, also referred to as Treatment 2 (T2). In order to evaluate and identify the health impacts of each component, a counterfactual to T1 and T2 is needed, which we refer to as the Control (C). The three groups, T1, T2, and C include households with children under two years old at the time of the baseline. Out of the first group of 40 provinces, GP1, 40 districts between 1,500 and 100,000 habitants were randomly chosen to receive T1. From the second group, GP2, 80 districts between 1,500 and 100,000 habitants were selected randomly; 40 of them were randomly assigned to receive T2, and the other 40 districts to serve as C to T1 and T2. • Stage 3: Household Level For each of the three sets of 40 districts (120 districts total) allocated to T1, T2, and C, 15-20 households with children under two years of age were selected at random in each district. Also, in each of the 40 districts
Release Date: 
Tuesday, June 11, 2013
Last Updated Date: 
Tuesday, July 22, 2014
Questionnaires: 
The following instruments were used to collect the data: • Household questionnaire: The household questionnaire was conducted in all households and was designed to collect data on household membership, education, labor, income, assets, dwelling characteristics,water sources, drinking water, sanitation,observations of handwashing facilities and other dwelling characteristics, handwashing behavior, child discipline, maternal depression, handwashing determinants, exposure to health interventions, relationship between family and school, and mortality. • Health questionnaire: The health questionnaire was conducted in all households and designed to collect data on children’s diarrhea prevalence, ALRI and other health symptoms, child development, child growth, and anemia. • Community questionnaire: The community questionnaire was conducted in 120 districts to collect data on community/districts variables. • Structured observations: Structured observations were conducted in a subsample of 160 households to collect data on direct observation of handwashing behavior. • Water samples: Water samples were collected in a subsample of 160 households, to identify Escherichia coli (E. coli) presence in hand rinses (mother and children), sentinel toy, and drinking water. • Stool samples: Stool samples were collected in a subsample of 160 households to identify prevalence of parasites in children’s feces.
Data Editing: 
Baseline: The baseline survey was processed using the assistance of Sistemas Integrales in Chile. A manual for the data entry system is attached under the title of: Data Entry Manual:Baseline. Endline: Kimetrica International was contracted to design the data reduction system to be used during the endline. The data entry system was designed in CSPro (Version 4.1) using the DHS file management system as a standard for file management. Details of the system can be found in the attached manual entitled: Data Entry Manual for the Endline Survey. The data entry system was based on a full double data entry (independent verification) of the various questionnaires. CSPro supports both dependent and independent verification (double keying) to ensure the accuracy of the data entry operation. Using independent verification, operators can key data into separate data files and use CSPro utilities to compare them and produce a report that indicates discrepancies in data entry. The DHS system uses a fully integrated tracking system to follow the stages in the data entry process. This includes the checking in of questionnaires; the programming of logic in what is known as a system controlled environment. System controlled applications generally place more restrictions on the data entry operator. This is typically used for complex survey applications. The behavior of these applications at data entry time has the following characteristics: - Some special data entry keys are not active during data entry. - CSEntry will keep track of the path. - 'Not applicable' or blanks values will not be allowed. Missing values have to be coded. - More appropriate to the heads up methodology of data capture. - Logic in the application is strictly enforced; operator cannot bypass or override. Files were processed using the unique cluster number and then concatenated after a final stage of editing and output to both SPSS and STATA. Furthermore, attempts were made to respect the values and the naming conventions as provided in the baseline. This required using non-conventional values for “missing” such as -99. In most cases the same value sets were applied or during the questionnaire review process the WSP was alerted to such discrepancies.
Other Processing: 
The data files as they are output in CSPro follow the hierarchical structure as established in the data dictionary. These however may not be convenient for the analyst. The WSP requested that the files be integrated into various record level files. The files that are included in the final data base reflect this structure. However, some analysts may still want the hierarchical level data available in its original record form (as it was during data entry). For that reason, these files are also zipped together and provided in the event that they are desired. The final data files are provided in STATA format as requested by the WSP.
Harvest Source: 
Harvest Source ID: 
4216
Citation Text: 
Use of the dataset must be acknowledged using a citation which would include: - the Identification of the Primary Investigator - the title of the survey (including country, acronym and year of implementation) - the survey reference number - the source and date of download World Bank Water and Sanitation Program. Peru WSP Global Scaling up Handwashing Behavior Impact Evaluation, Baseline and Endline Surveys 2009-2011. Ref. PER_2009_2011_WSP-IE_v01_M_v01_A_PUF. Dataset downloaded from [website/source] on [date]
Modified date: 
16273
Study Type: 
Other Household Health Survey [hh/hea]
Primary Dataset: 
Yes
Mode of Data Collection: 

Face-to-face

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