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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. This paper exploits data from impact evaluation surveys of a hygiene information campaign 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.

Cognitive development --- Disease control & prevention --- Education --- Educational sciences --- Health --- Health monitoring & evaluation --- Health, nutrition and population --- Hygiene promotion and social marketing --- Primary education --- Sanitation --- Water supply and sanitation

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Poor sanitation and open defecation are thought to be a major cause of diarrhea and intestinal parasite infections among young children. In 1999, India launched the Total Sanitation Campaign with the goal of achieving universal toilet coverage in rural India by 2012. This paper reports on a cluster-randomized, controlled trial that was conducted in 80 rural villages in Madhya Pradesh to measure the effect of the program on toilet access, sanitation behavior, and child health outcomes. The study analyzed a random sample of 3,039 households and 5,206 children under five years of age. Field staff collected baseline measures of sanitation conditions, behavior, and child health, and re-visited households 21 months later. The analysis finds that implementation of the program activities was slower than the original timeline (only 35 percent of villages were triggered more than six months before the follow-up survey). Nevertheless, the Total Sanitation Campaign successfully increased toilet coverage by 19 percent in intervention villages compared with control villages (41 percent volume 22 percent), while reported open defecation decreased by 10 percent among adults (74 percent volume 84 percent). The intervention also led to some improvements in water quality and protozoan infection, but consistent improvements were not observed across multiple child health outcomes (diarrhea, helminth infections, child growth). However, the exposure period was likely to have been too short to result in any benefit of the sanitation interventions on child health. Given the large improvements in toilet construction documented, an additional follow-up survey with a longer period of exposure would yield valuable information on the effects of improved sanitation conditions on health outcomes.

Anemia --- Diarrhea --- Growth --- Health Monitoring & Evaluation --- Height --- Housing & Human Habitats --- Hygiene Promotion and Social Marketing --- Impact Evaluation --- Macroeconomics and Economic Growth --- Madhya Pradesh --- Open Defecation --- Parasite Infection --- Randomized Controlled Trial --- Toilets --- Total Sanitation Campaign --- Town Water Supply and Sanitation --- Urban Water Supply and Sanitation --- Water Supply and Sanitation --- Weight