Promoting Handwashing Behavior: The Effects of Large-scale Community and School-level Interventions.

This paper analyzes a randomized experiment that uses novel strategies to promote handwashing with soap at critical points in time in Peru. It evaluates a large-scale comprehensive initiative that involved both community and school activities in addition to communication campaigns. The analysis indicates that the initiative was successful in reaching the target audience and in increasing the treated population's knowledge about appropriate handwashing behavior. These improvements translated into higher self-reported and observed handwashing with soap at critical junctures. However, no significant improvements in the health of children under the age of 5 years were observed. Copyright © 2015 John Wiley & Sons, Ltd.

Optimal recall period for caregiver-reported illness in risk factor and intervention studies: a multicountry study.

Many community-based studies of acute child illness rely on cases reported by caregivers. In prior investigations, researchers noted a reporting bias when longer illness recall periods were used. The use of recall periods longer than 2-3 days has been discouraged to minimize this reporting bias. In the present study, we sought to determine the optimal recall period for illness measurement when accounting for both bias and variance. Using data from 12,191 children less than 24 months of age collected in 2008-2009 from Himachal Pradesh in India, Madhya Pradesh in India, Indonesia, Peru, and Senegal, we calculated bias, variance, and mean squared error for estimates of the prevalence ratio between groups defined by anemia, stunting, and underweight status to identify optimal recall periods for caregiver-reported diarrhea, cough, and fever. There was little bias in the prevalence ratio when a 7-day recall period was used (<10% in 35 of 45 scenarios), and the mean squared error was usually minimized with recall periods of 6 or more days. Shortening the recall period from 7 days to 2 days required sample-size increases of 52%-92% for diarrhea, 47%-61% for cough, and 102%-206% for fever. In contrast to the current practice of using 2-day recall periods, this work suggests that studies should measure caregiver-reported illness with a 7-day recall period.

Preschool and maternal labor market outcomes: evidence from a regression discontinuity Design.

In developing countries, employment rates for mothers with young children are relatively low. This study analyzes how maternal labor market outcomes in Argentina are affected by the preschool attendance of their children. Using pooled household surveys, we show that 4-year-olds with birthdays on June 30 have sharply higher probabilities of preschool attendance than children born on July 1, given enrollment-age rules. Regression-discontinuity estimates using this variation suggest that preschool attendance of the youngest child in the household increases the probability of full-time employment and weekly hours of maternal employment. We find no effect of preschool attendance on maternal labor outcomes for children who are not the youngest in the household.

Effects of land titling on child health.

This paper examines the impact of urban land titling on child health. We hypothesize that land titling may translate into positive effects on health through its impact on housing investments and household structure. To address selection concerns, we take advantage of a natural experiment of land occupation in a suburban area of Buenos Aires, Argentina, that ensures that the allocation of property rights is exogenous to the characteristics of the squatters. Our results show that in the titled parcels children enjoy better weight-for-height scores (but similar height-for-age scores), and teenage girls have lower pregnancy rates than those in untitled parcels.