How does health promotion work?: evidence from the dirty business of eliminating open defecation

We investigate the mechanisms underlying health promotion campaigns designed to eliminate open defecation in at-scale randomized field experiments in four countries: India, Indonesia, Mali, and Tanzania. Health promotion works through a number of mechanisms, including: providing information on the r...

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Autores principales: Gertler, Paul, Shah, Manisha, Alzúa, María Laura, Cameron, Lisa, Martínez, Sebastián, Patil, Sumeet
Formato: Articulo Documento de trabajo
Lenguaje:Inglés
Publicado: 2015
Materias:
Acceso en línea:http://sedici.unlp.edu.ar/handle/10915/127609
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id I19-R120-10915-127609
record_format dspace
institution Universidad Nacional de La Plata
institution_str I-19
repository_str R-120
collection SEDICI (UNLP)
language Inglés
topic Ciencias Económicas
Health, education, and welfare health
Development and growth
Children
Development economics
Health economics
Public economics
spellingShingle Ciencias Económicas
Health, education, and welfare health
Development and growth
Children
Development economics
Health economics
Public economics
Gertler, Paul
Shah, Manisha
Alzúa, María Laura
Cameron, Lisa
Martínez, Sebastián
Patil, Sumeet
How does health promotion work?: evidence from the dirty business of eliminating open defecation
topic_facet Ciencias Económicas
Health, education, and welfare health
Development and growth
Children
Development economics
Health economics
Public economics
description We investigate the mechanisms underlying health promotion campaigns designed to eliminate open defecation in at-scale randomized field experiments in four countries: India, Indonesia, Mali, and Tanzania. Health promotion works through a number of mechanisms, including: providing information on the return to better behavior, nudging better behavior that one already knows is in her self-interest, and encouraging households to invest in health products that lower the marginal cost of good behavior. We find that health promotion generally worked through both convincing households to invest in in-home sanitation facilities and nudging increased use of those facilities. We also estimate the causal relationship between village open defecation rates and child height using experimentally induced variation in open defecation for identification. Surprisingly we find a fairly linear relationship between village open defecation rates and the height of children less than 5 years old. Fully eliminating open defecation from a village where everyone defecates in the open would increase child height by 0.44 standard deviations. Hence modest to small reductions in open defecation are unlikely to have a detectable effect on child height and explain why many health promotion interventions designed to reduce open defecation fail to improve child height. Our results suggest that stronger interventions that combine intensive health promotional nudges with subsidies for sanitation construction may be needed to reduce open defecation enough to generate meaningful improvements in child health.
format Articulo
Documento de trabajo
author Gertler, Paul
Shah, Manisha
Alzúa, María Laura
Cameron, Lisa
Martínez, Sebastián
Patil, Sumeet
author_facet Gertler, Paul
Shah, Manisha
Alzúa, María Laura
Cameron, Lisa
Martínez, Sebastián
Patil, Sumeet
author_sort Gertler, Paul
title How does health promotion work?: evidence from the dirty business of eliminating open defecation
title_short How does health promotion work?: evidence from the dirty business of eliminating open defecation
title_full How does health promotion work?: evidence from the dirty business of eliminating open defecation
title_fullStr How does health promotion work?: evidence from the dirty business of eliminating open defecation
title_full_unstemmed How does health promotion work?: evidence from the dirty business of eliminating open defecation
title_sort how does health promotion work?: evidence from the dirty business of eliminating open defecation
publishDate 2015
url http://sedici.unlp.edu.ar/handle/10915/127609
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