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RRC APPLICATION FORM

RESEARCH PROTOCOL NUMBER: PR- 11024

FOR OFFICE USE ONLY

RRC Approval: Yes / No Date: ERC Approval: Yes / No Date: AEEC Approval: Yes / No Date: External IRB Approval: Yes / No Date: Name of IRB: 3ie

Protocol Title: Testing Disgust and Shame based Safe Water and Handwashing Promotion in Urban Dhaka

Short title (in 50 characters including space): Disgust and Shame based Safe Water and Handwashing PromotionTheme: (Check all that apply)

Nutrition Emerging and Re-emerging Infectious Diseases Population Dynamics Reproductive Health Vaccine Evaluation HIV/AIDS Environmental Health

Health Services Child Health Clinical Case Management Social and Behavioral Sciences Gender Human Rights Others (please specify___________________)

Key words: behavior change, handwashing, water treatment, disgust, shame, neighbour, willingness to payRelevance of the Protocol:

An estimated 2.2 million children under the age of 5 years die from diarrheal disease each year. Most of the burden of diarrheal disease is thought to be preventable with improvements in sanitation, water quality, and hygiene. Large scale interventions promoting these behaviours have either not been rigorously tested or have not produced sufficient change to warrant being rolled out at scale.

Research into the determinants of hand washing and sanitation behaviours has identified disgust and shame as key motivators. Furthermore, hand washing promotion that emphasizes disgust and studies that observe the effects of shame have shown that both are significantly more effective than traditional germs and health education when administered to individuals. It is thus reasonable to expect that incorporating disgust and shame messages in a hand washing intervention in a developing country could significantly increase effectiveness, but this has not been rigorously tested. Using a randomized controlled trial, we will test this hypothesis in Urban Dhaka. We will also test a similar hypothesis for point of use water treatment. That is, we will develop interventions that utilize disgust and shame eliciting messages to promote hand washing with soap and point of use water treatment and we will test the efficacy of these interventions against more traditional public health interventions based on increasing knowledge of health risks and germ transmission.

Centre’s Priority (as per Strategic Plan, to be imported from the attached Separate Word Sheet):Bangladesh is a country considered to be at high risk for emerging and re-emerging infectious diseases. With this in mind, ICDDR,B will research and gather information and data that could be used to provide equitable health solutions that will reduce the associated risks of such infections and provide tangible benefit to the poor of Bangladesh and other developing countries.

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Programmes: Child Health Programme Nutrition Programme Programme on Infectious Diseases & Vaccine Science Poverty and Health Programme Health and Family Planning Systems Programme

Population Programme Reproductive Health Programme HIV/AIDS Programme Gender, Hunman Rights and Health Programme Others (please specify___________________)

Principal Investigator (Should be a Centre’s staff) Stephen LubyAddress (including e-mail address): ICDDR,B [email protected]

DIVISION:

CSD LSD HSID PHSD Centre for Communicable Diseases

Co-Principal Investigator(s): InternalLeanne Unicomb, PhD, Program On Infectious Disease and Vaccine Sciences, ICDDR, B, [email protected], FemaleCo-Principal Investigator(s): External: (Please provide full official address including e-mail address and Gender)David Levine, PhD, Haas School of Business, University of California, Berkeley CA 94720-1900, USA, [email protected], Male Co-Principal Investigator(s): External: (Please provide full official address including e-mail address and Gender)Raymond Guiteras, PhD, Department of Economics, University of Maryland, USA, [email protected], MaleCo-Investigator(s): Internal: Kaniz Jannat, MBBS, MPH, Program On Infectious Disease and Vaccine Sciences, ICDDR, B, [email protected], Female

Co-Investigator(s): External Michael Kremer, PhD, Department of Economics, Harvard University, USA [email protected], MaleCo-Investigator(s): External (Please provide full official address including e-mail address and Gender)Minhaj Mahmud, PhD, Bangladesh Institute of Development Studies (BIDS), E-17, Agargaon, Sher-e-Bangla Nagar, Dhaka-1207, [email protected], MaleCo-Investigator(s): External (Please provide full address of educational institution and Gender) Tom Polley, B.A., Innovations for Poverty Action, 101 Whitney Ave, New Haven, CT 06510, USA 101, [email protected], Male

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mailto:[email protected]







Collaborating Institute(s): Please Provide full address

Institution # 1

Institution # 2

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Country USA

Contact person David Levine

Department(including Division, Centre, Unit) Haas School of Business

Institution(with official address)

University of CaliforniaBerkeley CA 94720-1900 USA

Country USA

Contact person Raymond Guiteras

Department(including Division, Centre, Unit) Department of Economics

Institution(with official address) University of Maryland, College Park, Maryland 20742 USA

Directorate(in case of GoB i.e. DGHS) N/A

Ministry (in case of GoB) N/A

Institution # 3

Country USA

Contact person Michael Kremer

Department(including Division, Centre, Unit) Department of Economics

Institution(with official address) Harvard University; Littauer Center; Cambridge MA 02138

Directorate(in case of GoB i.e. DGHS) N/A

Ministry (in case of GoB) N/A

Note: If more than 3 collaborating institutions are involved in the research protocol, additional block(s) can be inserted to mention its/there particular(s).

Population: Inclusion of special groups (Check all that apply):

Sex Male Female

Age 0 – 4 years 5 – 10 years 11 – 17 years 18 – 64 years 65 +

Pregnant Women Fetuses Prisoners Destitutes Service Providers Cognitively Impaired CSW Others (specify ) Animal

NOTE It is the policy of the Centre to include men, women, and children in all research projects involving human subjects unless a clear and compelling rationale and justification (e.g. gender specific or inappropriate with respect to the purpose of the research) is there. Justification should be provided in the `Sample Size’ section of the protocol in case inclusiveness of study participants is not proposed in the study.

Project/study Site (Check all the apply):

Dhaka Hospital Matlab Hospital Matlab DSS Area Matlab non-DSS Area Mirzapur Dhaka Community Chakaria Abhoynagar

Mirsarai Patyia Other areas in Bangladesh Outside Bangladesh

Name of Country: Multi Centre Trial

(Name other countries involved):

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Type of Study (Check all that apply):

Case Control Study Community-based Trial/Intervention Program Project (Umbrella) Secondary Data Analysis Clinical Trial (Hospital/Clinic) Family Follow-up Study

Cross Sectional Survey Longitudinal Study (cohort or follow-up) Record Review Prophylactic Trial Surveillance/Monitoring Others:

NOTE: Does the study meet the definition of clinical studies/trials given by the International Committee of Medical Journal Editors (ICMJE)? Yes No

Please note that the ICMJE defined clinical trial as “Any research project that prospectively assigns human

subjects to intervention and comparison groups to study the cause-and-effect relationship between a medical intervention and a health outcome”.

If YES, after approval of the ERC, the PI should complete and send the relevant form to provide required

information about the research protocol to the Committee Coordination Secretariat for registration of the study into websites, preferably at the https://register.clinicaltrials.gov/. It may please be noted that the PI would require to provide subsequent updates of the research protocol for updating protocol information in the website.

Targeted Population (Check all that apply):

No ethnic selection (Bangladeshi) Bangalee Tribal group

Expatriates Immigrants Refugee

Consent Process (Check all that apply):

Written Oral None

Bengali Language English Language

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https://register.clinicaltrials.gov/

Proposed Sample Size:Sub-group (Name of subgroup (e.g. Men, Women) and Number

Name Number Name Number(1) Typical Public Health Intervention 210 (3) (2) Disgust and Shame Intervention 210 (4)

Total sample size: 420

a) Will the specimen be stored for future use? Yes No NA

b) If yes, how long the specimens be preserved? _____ years.

c) Will consent be obtained from study participants Yes No NA for the specimen be stored for future, for unrelated use without further taking consent?

d) What types of tests will be carried out with the preserved samples? __________________________________________

____________________________________________________________________________________________

e) Will the samples be shipped to other country(ies)? Yes No NA f) If yes, name of institution(s) and country(ies): ___________________________________________________________

g) Will the surplus/unused specimen be returned to the Centre? Yes No NA

h) Who will be the custodian of the specimen at the Centre and when shipped outside of the country(ies)?: _________________________________________________________

i) Who will be the owner(s) of the samples? : __________________________________________________________

j) Has a MoU been made for the protocol covering the specimen collection, storage, use and ownership? Yes No NA

k) If yes, please attach a copy.

Determination of Risk: Does the Research Involve (Check all that apply): Human exposure to radioactive agents? Fetal tissue or abortus? Investigational new device?

(specify: ) Existing data available from Co-investigator

Human exposure to infectious agents? Investigational new drug Existing data available via public archives/sources Pathological or diagnostic clinical specimen only Observation of public behaviour

New treatment regime

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Could the information recorded about the individual if it became known outside of the research:

Do you consider this research (Check one):

Greater than minimal risk No more than minimal risk Only part of the diagnostic test

Minimal Risk is the risk when the probability and magnitude of the anticipated harm or discomfort in participating in the proposed research are not greater in and of themselves than those ordinarily encountered in daily life or during the performance of routine physical, psychological examinations or tests, e.g. the risk of drawing a small amount of blood from a healthy individual for research purposes is no greater than the risk of doing so as a part of routine physical examination.

Yes/ No Is the proposal funded?

If yes, sponsor Name: (1) 3IE (International Initiative for Impact Evaluation) (2) Bill and Melinda Gates Foundation

Yes/No/NA (if the proposal is already funded, mark NA) Is the proposal being submitted for funding?

If yes, name of funding agency: (1)

(2)

Do any of the participating investigators and/or member(s) of their immediate families have an equity relationship (e.g. stockholder) with the sponsor of the project or manufacturer and/or owner of the test product or device to be studied or serve as a consultant to any of the above?

IF YES, a written statement of disclosure to be submitted to the Centre’s Executive Director.

Dates of Proposed Period of Support Cost Required for the Budget Period ($)281,986

(Day, Month, Year - DD/MM/YY) Beginning Date : 01/04/11 End Date : 06/01/13

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Yes No Is the information recorded in such a manner that study participants can be identified from information provided directly or through identifiers linked to the study participants?

Yes No Does the research deal with sensitive aspects of the study participants’ behaviour; sexual behaviour, alcohol use or illegal conduct such as drug use?

Yes No Place the study participants at risk of criminal or civil liability?

Yes No Damage the study participants’ financial standing, reputation or employability, social rejection, lead to stigma, divorce etc.?

Years Direct CostIndirect

CostTotal Cost

Year-1 256,351 25,635 281,986Year-2 0Year-3 0Year-4 0

Yar-5

0Total 281,986

Certification by the Principal InvestigatorI certify that the statements herein are true, complete and accurate to the best of my knowledge. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. I agree to accept the responsibility for the scientific conduct of the project and to provide the required progress reports including updating protocol information in the SUCHONA (Form # 2) if a grant is awarded as a result of this application.

___________ ____________Signature of PI Date Approval of the Project by the Division Director of the Applicant

The above-mentioned project has been discussed and reviewed at the Division level as well by the external reviewers. The protocol has been revised according to the reviewers’ comments and is approved.

Name of the Division Director Signature Date of Approval

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Table of Contents

RRC APPLICATION FORM……………………………………………….................................1Project Summary………………………………………………...………………………………10Description of the Research Project………………………………………………......................13

Hypothesis to be Tested:............................................................................................................13Specific Aims:...........................................................................................................................13Background of the Project including Preliminary Observations...............................................14Research Design and Methods...................................................................................................20Sample Size Calculation and Outcome (Primary and Secondary) Variable(s).........................27Facilities Available....................................................................................................................32Data Safety Monitoring Plan (DSMP).......................................................................................32Data Analysis.............................................................................................................................33Ethical Assurance for Protection of Human Rights...................................................................34Use of Animals..........................................................................................................................34Literature Cited..........................................................................................................................35Dissemination and Use of Findings...........................................................................................38Collaborative Arrangements......................................................................................................39

Biography of the Investigators…………………………………………………………………..40Appendix 1: Compound Level Voluntary Consent Form………………………………………..76Appendix 2: Feasible Site Criteria……………………………………………………………….80Appendix 3: Household Survey Form …………………………………………………………..83Appendix 4: Physical Observation Form……………………………………………………….129Appendix 5: Rapid Physical Observation Form………………………………………………..133Appendix 6: Structured Observation Form……………………………………………………..142Appendix 7: Auction Procedure………………………………………………………………...145Appendix 8: Sales Meeting Observation Form………………………………………………....151Appendix 9: Subscription Fee Collection Form………………………………………………..154Appendix 10: External Review……………………..…………………………………………..157Appendix 11:Abstract Summary………………………………………………………………..165Appendix 12: Piloting Check List………………………………………………………………167Budget………………………………………………..…………………………………………174Timeline………………………………………………..……………………………………….177Budget Justifications………………………………………………..…………………………..178

Check here if appendix is included

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Project SummaryBriefly describe the hypothesis, objectives, and the relevant background of the project, and also the experimental design and research methods for achieving the objectives. This description will serve as a succinct and precise and accurate description of the proposed research is required. This summary should be stand alone, and be fully understandable and interpretable when removed from the main application. Principal Investigator: Steve LubyResearch Protocol Title: Testing Disgust and Shame based Safe Water and Handwashing Promotion in Urban DhakaTotal Budget US$: 281,986 Beginning Date : After approval Ending Date: 01 June 2013

An estimated 2.2 million children under the age of 5 years die from diarrheal disease each year. Most of the burden of diarrheal disease is thought to be preventable with improvements in sanitation, water quality, and hygiene. Large scale interventions promoting these behaviours have either not been rigorously tested or have not produced sufficient change to warrant being rolled out at scale.

Research into the determinants of hand washing behaviour has identified disgust and shame as key motivators. Evidence supports the theory that disgust is a natural behavioural reaction to objects carrying disease risk, thus it may act as a key motivator for other health related behaviours such as water treatment. Whether this knowledge can be harnessed to increase the efficacy of hand washing and safe water campaigns in Bangladesh or elsewhere has yet to be rigorously tested.

We will develop an intervention that utilizes disgust and shame eliciting messages to promote hand washing with soap and point of use water treatment in low income housing compounds of urban Dhaka. We will test the efficacy of this intervention against a more traditional public health intervention based on increasing knowledge of health risks and germ transmission using a randomized controlled trial. Our study sample will be broken into the following four arms.

1. Standard Public Health Intervention with Water Treatment

2. Standard Public Health Intervention with Water Treatment & Hand Washing

3. Disgust and Shame Based Intervention with Water Treatment

4. Disgust and Shame Based Intervention with Water Treatment & Hand

This design will allow us to compare outcomes for hand washing and water treatment between both standard public health interventions and disgust and shame based interventions as well as test the overall efficacy of the program comparing with the control. Data will be collected from all compounds at baseline, three month midline and at the six month endline giving us the practical and analytical benefits of a longitudinal dataset.

Compounds will participate in interactive, educational safe water and/or hygiene promotion meetings. For the Disgust and Shame group, these meetings will emphasize disgust and shame related to unsafe water and/or hygiene practices, whereas the Standard group’s meetings will resemble a more typical public health intervention explaining the risks and methods of contamination.

At the first meeting, compounds will receive a one month free trial of the latest compound based chlorine dispenser model to treat their drinking water. A randomly selected half will also receive a one month free trial of the latest compound based handwashing station. At the end of the month, there will be a sales meeting in which we will measure compound members’ willingness to pay for the trialled products by giving them the

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opportunity purchase and keep the hardware in a Becker-DeGroot-Marschek (BDM) style auction.

In assessing the impact of our interventions, we are primarily interested in whether the prevalences of safe water and hygiene behaviours differ by treatment arm and over time. Our best measurements for approximating behaviour prevalence are physical observations (presence of residual chlorine, hand cleanliness inspections), structured observation of behaviour, rapid physical observations (physical state of hardware/drinking water), self-report of water treatment and hand washing behaviour and willingness to pay for necessary products. We will also attempt to measure and track changes in personal determinants of behaviour such as feelings of disgust and shame related to hand washing and water treatment behaviours.

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KEY PERSONNEL (List names of all investigators including PI and their respective specialties)

Name Professional Discipline/ Specialty Role in the Project1. Steve Luby Medical Epidemiology Coordinate collaborators; assign project

implementation, analytic, report and manuscript writing responsibilities.

2. David Levine Behavioural Economist Outline the intervention and its theory. Ensure that the implementation leverages insights from the 2009 end user point of use water treatment intervention study in Mirpur, and is consistent with the current understanding within behavioural economics. Suggest approaches to optimize and evaluate the intervention.

3. Leanne Unicomb Epidemiology Assist in optimizing the intervention and evaluation to the Bangladesh context. Supervise the Bangladesh based project implementation team, ensuring coordination and collaboration among research investigators, supporting project management.

4. Raymond Guiteras

Economics Will develop the studydesign; guide development of the intervention and data collectiontools; oversee econometric analysis. He will lead one manuscript fromthis work.

5. MichaelKremer Economics Advise on design of intervention, design of data-collection andanalysis of data, contribute to academic economics papers and policybriefs written on the basis of the research.

6. Minhaj Mahmud

Economics Develop and test the economic instruments of the study; design the auction instrument and WTP survey, assist and train the field team in conducting the experiment and survey; Contribute to manuscripts; lead at least one manuscript

7. Qualitative RI (to be named)To be named

Anthropologist/ Social scientist Study instrument development, supervision of data collection, assist in data analysis, report writing .Assist in optimizing the intervention and evaluation to the Bangladesh context.

8. Kaniz Jannat Epidemiology Research investigator who will write the protocol, implement the study, including

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oversees study site selection; develops data collection tools; recruits, coordinates and supervises the data collection teams

9. Tom Polley Economics Assist the Research investigators in all tasks and ensure smooth communication between local team and Investigators abroad.

Description of the Research ProjectHypothesis to be Tested:

Please briefly list the Hypothesis to be tested and provide the scientific basis of the hypothesis, critically examining the observations leading to the formulation of the hypothesis.

1. Residents of communities which have participated in an intervention emphasizing disgust and shame related to unsafe water procurement behaviours will...

a. be more likely to regularly drink treated water than residents of communities which have received a standard public health intervention.

b. have higher willingness to pay for water treatment products than residents of communities which have received a standard public health intervention.

2. Residents of communities which have participated in an intervention emphasizing disgust and shame related to unsafe hand hygiene behaviours will...

a. be more likely to regularly wash hands with soap at key times than residents of communities which have received a standard public health intervention.

Specific Aims:

Describe the specific aims of the proposed study. State the specific parameters, biological functions, rates, processes etc. that will be assessed by specific methods.

1. Develop an intervention which uses disgust and shame eliciting messages to promote treating drinking water in low income urban housing compounds.

2. Develop a modified version of the intervention which promotes hand washing with soap as well as water treatment.

3. Develop a group version of the Becker-DeGroot-Marsckek (BDM) Auction which allows us to measure willingness to pay of compound members for shared hardware.

4. Develop a survey instrument which allows us to measure behavioural determinants of hand washing and water treatment.

5. Pilot and if successful, incorporate new methods for measuring hand washing behaviour and water treatment behaviour.

6. Compare the effectiveness of the disgust and shame based interventions with high quality standard public health interventions using the following outcomes:

a. For water treatment behaviouri. Primary Outcome

1. Presence of residual chlorine in household’s stored drinking water at baseline, midline, endline and the structured observation meeting.

ii. Secondary Outcomes1. Willingness to pay for marketed compound level chlorine dispenser2. Observed behaviour during 5 hours structured observation.

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3. Self reported use4. Physical status of water treatment hardware during each compound visit.

b. For hand washing behaviouri. Primary Outcomes

1. Child hand cleanliness inspections2. Mother’s hand washing demonstration, observing whether soap is used3. Self reported hand washing after defecation and before eating4. Observed behaviour during 5 hours structured observation.5. Physical status of hand washing hardware during each compound visit.

7. Measure demand for compound-based liquid chlorine dispensers, and differences in demand between the standard health treatment and the disgust and shame treatment.

Background of the Project including Preliminary Observations

Provide relevant background of the proposed study, and discuss the previous works on the research topic by citing specific references. Describe in a logical way how the present hypothesis is supported by the relevant background observations including any preliminary results that may be available. Provide scientific validity of the hypothesis on the basis of background information Critically analyze available knowledge in the field of the proposed study and discuss the questions and gaps in the knowledge that need to be fulfilled to achieve the proposed goals.. If there is no sufficient information on the subject, indicate the need to develop new knowledge. Also include the significance and rationale of the proposed work by specifically discussing how these accomplishments will bring benefit to human health in relation to biomedical, social, and environmental perspectives.

An estimated 2.2 million children under the age of 5 years die from diarrheal disease each year [1]. Children who survive multiple episodes of diarrhea and enteric infections commonly develop tropical enteropathy, an inflammatory disorder of the intestines that compromises nutrient absorption [2]. Repeated episodes of diarrhea and chronic tropical enteropathy in early childhood reduce growth and cognitive function, and impair school performance [3-7]. This in turn can reduce income later in life [8]. Thus, repeated episodes of childhood diarrhea and enteric infection may exact a long-run toll, perpetuating a cycle of poverty and ill health.

Most of the burden of diarrheal disease is thought to be preventable with improvements in sanitation, water quality, and hygiene [9,10]. Specifically, both water treatment with dilute chlorine solution and handwashing with soap reduce self-reported diarrhea [11-13]. This result is well established for hand washing with soap, with one meta-analysis showing a mortality risk reduction factor of 48% [14]. In the same paper, it is explained that the effectiveness of point of use water treatment is less certain given that four blinded studies found no significant diarrhea risk reduction; still the much larger body of contrary evidence led them to estimate a risk reduction factor of 17% [14]. These encouraging results come from small-scale studies that couple intense interventions and low-cost (typically free) handwashing and water treatment supplies [15-18]. Unfortunately, the behavior change approaches used in these studies are too costly to apply at larger scale. Efforts to achieve sustained behavior change and improved public health with large water or hygiene interventions have either not been rigorously evaluated or have resulted in limited uptake [19-23]. Both treating drinking water [24] and handwashing with soap [25] remain uncommon among the world’s poor.

The failure to achieve widespread adoption of these behaviours has inspired much research into the individual factors that affect health behaviour change. A meta-analysis of 18 health interventions based on the Health Belief Model found that increased levels of perceived susceptibility and perceived severity

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of an illness was not associated with increased preventative behaviours as the model predicts; however, increasing perceived benefits and reducing perceived barriers of preventative behaviours was associated with safer behaviour [26]. Thus, for interventions to be successful at changing behaviour, it is clear that they will need to go beyond basic health education about germs and disease [27,28].

Curtis, Danquah and Aunger argue that “...a broader disciplinary approach to behaviour change, which embraces emotional, habitual and cultural factors, as well as rationality is needed [29-31].” In their review of 13 studies from 11 nations, they group behavioural determinants into the three categories: habitual, motivated and planned [32]. They identify four motivations that could be particularly useful for behaviour change interventions: disgust, affiliation (social norms), comfort and nurture [32].

Below we define and describe three behavioural determinants—inspired by the four motivations above—which form the impetus for our study: disgust, shame and positive identity.

Disgust

The Oxford English Dictionary defines disgust as “a feeling of revulsion or strong disapproval aroused by something unpleasant or offensive.” Evidence has been presented to support the theory that disgust is an evolved psychological system for protecting organisms from infection through disease avoidant behavior [33]. Using this understanding, Curtis et al. identify disgust as a motivation for hand washing and as a potential tool for increasing the effectiveness of hand washing promotion [32].

We know of four studies that combine disgust components with hand hygiene interventions: two at-scale developing country interventions,two studies that tested the effect of including disgust in hand hygiene promotion to individuals. The first was a full scale national campaign conducted in Ghana using a television advertising campaign. The focus was the transfer of contaminants from a mother to her child, following a visit to the toilet. Assessment of this intervention suggested that reported hand washing after toileting increased by 13%, and before eating by 41% [34]. The second study was a social marketing campaign conducted in Burkina Faso which used disgust in components of its intervention. Here hand washing after using the toilet increased by 16% [35]. The third study, carried out in Sydney, Australia comprised two parts. The first tested a brief (3-min) video-based intervention using disgust and education to improve hand hygiene in subjects compared to those viewing a video including only education alone or to control subjects. The second part examined whether the findings from the first study could be replicated in the field. Disgust-based interventions were significantly better at promoting hand-hygiene [36]. The fourth tested the effect of various text only messages on soap use in highway service station restrooms. Disgust based messages proved most effective for males, increasing soap use by 9.8%. For females disgust messages increased use by 5% (this was not statistically significant)1 [37].

1 This difference in effect by gender is interesting and worth further investigation, but we will likely not have

statistical power to detect variation. Furthermore, in the Judah paper, it is recommended that interventions utilize

different promotional material for males and females. Though this would also be interesting to test, it would not be

feasible in our compound intervention in which we seek to test the intervention’s effectiveness on households within

the compound. 15

Though the above studies show promise for the potential of disgust to improve hand washing promotion, there still has been no rigorous test of disgust in a developing country intervention. Furthermore, there have been no studies which evaluate the use disgust to motivate other life saving behaviors such as point of use water treatment.

Shame

Definitions of shame are less agreed upon than those for disgust; we will use the definition given by sociologist Thomas Scheff : a large family of emotions that involve the feeling of a threat to the social bond [38]. He explains that shame is “Especially important for social control…” because “…although members may only occasionally feel shame, they are constantly anticipating it…” and correcting their behavior to avoid it. This definition differs from that in common psychology literature which uses shame for feelings related to status or social rank [39]. In this literature, tendency to conform to social norms is considered a separate domain of emotion. Here however, since the tendency to optimize social rank and the tendency to conform are both levels of avoiding social sanction, we lump them together.

The definition of affiliation used by Curtis, Danquah and Aunger is one aspect of the definition of shame we have chosen[32]. Regarding this ‘motivation’ they write, “Being a good member of society by joining in and by doing what everyone else is perceived to be doing is an important motive for handwashing. This helps ensure membership in the social group. Conformity with local social norms is known to be a powerful driver of behavior [40]” [32] . Conversely, because these behaviors are not established norms in most intervention communities, there is a risk that shame or affiliation motives will discourage handwashing with soap and water treatment. That is, people may be ostracized for attempting to be “too clean” [32]. For hand washing with soap at least, we believe there is a low risk of this occurring because hand washing without soap and generally cleanliness are already highly valued, so the addition of soap won’t be extremely different. For water treatment there may be greater risk.

Status, another aspect of our shame is also identified by Curtis, Danquah and Aunger as a motivator of hand washing behaviour. They’re reports showed that being seen as clean could lead to being admired and respected and that people were driven to enhance their social status. However, this aspect also carries the risk of motivating the opposite behaviour. If hand washing is considered a behaviour only practiced by those with much higher social status, then poor individuals trying this behaviour might be seen as “trying to get above themselves” [32].

A number of other studies have rigorously demonstrated the importance of shame for increasing hand-washing behaviours. For example, in rich nations, both citizens in public restrooms [41-43] and doctors in hospitals [44] are much more likely to wash their hands if they know someone is observing them. This result in hospitals was significantly more effective than education regarding germs and transmission [44].

Like disgust, shame appears to have great potential for improving hand washing interventions in developing countries, but has not been rigorously evaluated in this setting and has not been studied in conjunction with water treatment.

Positive Identity

Just as people avoid disgusting and shameful behaviours, they aspire to positive identities. At the same time, the content of these positive identities varies by culture, gender, age, and other characteristics.

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Through a review of the literature and discussions with ICDDR,B staff and researchers in Bangladesh we have narrowed the list to four positive identities worth piloting in Bangladesh: good Muslim, strong father, nurturing mother, and well-mannered child.

Good Muslims practice good hygiene, which we now know includes the use of soap. This identity builds directly on religious injunctions from the Qu’ran [45] that stress that contact with feces is unclean and that it is important to wash (even if only symbolically) after defecation.

Strong fathers protect their families from danger and make sure their family members are behaving properly, (not in a dangerous or disgusting way). Fathers behaviour can have a large affect on childrens’ health behaviour [46].

Nurturing mothers would never risk feeding crap to their children and want their children to be clean, healthy and strong. (Curtis, Danquah and Aunger refer to this motive as nurture in their description of [32] motivations for hand washing behaviour.}

Good children are well mannered and respectful. This identity has been recommended as a means for parents to instil hand washing as a habit in children [32].

In short, there is substantial theory and some evidence that disgust, shame, and positive identities could significantly improve water treatment and hand washing interventions, but their true causal impact is still unknown. Thus, we propose to develop and test scalable interventions which use disgust and shame—and pending piloting, positive identities—to promote water treatment alone and water treatment coupled with hand washing.2 In order to infer causality, we propose testing interventions against high-quality traditional public health interventions using a randomized controlled trial.

We propose rolling out this project in poor urban housing compounds where multiple households share a common water source. The compound setting is an ideal place for using shame to affect behaviour, since many water and hygiene behaviours will be visible. The details of our proposal can be found in the research design and methods section below. Here we list the justification for the products and measurements we have chosen.

Products

We will promote a wall-mounted dispenser of dilute liquid chlorine modelled after the one that has achieved high take-up in sub-Saharan Africa (WASH Benefits Preliminary findings). Included with the dispenser will be a 40 liter water reservoir with tap and a stand. For hand washing we have chosen to promote soapy water as a convenient, cheap alternative to bar soap. This decision is based on evidence that providing more convenient products can be a very effective way to increase take up [47-50]. Soapy water is prepared in reused 1.5 liter water bottles. After puncturing a hole in the cap and mixing inexpensive local laundry detergent powder with water, the bottle can be used as a hand soap dispenser. Though efficacy studies have not been completed yet for this product, there is no reason to believe that

2 Hereafter we refer to the interventions as disgust and shame based when it is implied that positive identities will be

included should they prove successful in piloting. 17

the soapy water would perform differently than bar soap. Bar soap has good evidence of effectiveness when used [51], but concerns about theft and cost make it inappropriate for our setting.

Outcomes

We are interested in the effect of our intervention on the proportion of people who drink treated water and the proportion of people who wash their hands with soap after fecal contact and before eating. We will infer changes in these proportions based on direct observation and multiple proxy measurements outlined below.3

Water Treatment

Primary Outcome

o Chlorine residual test of stored drinking water in the home. This is a downward biased but reliable measure [52].

Secondary Outcomes

o Willingness to pay for compound based chlorine dispenser (see below)

o Structured Observation

Though the validity of the magnitude of structured observation measurements has been called into question [53], the difference between the measurement in the two interventions might have higher validity. Still, if members of one intervention are more aware of the goals of the intervention, then their observed behaviour might be higher even though their true behaviour is the same as the other group. Thus, it is important to supplement structured observation with a range of alternative measurements

o Self-Report of water treatment behaviour [54]. This is an upward biased measure but is believed to be reliable [52].

o Physical condition of water treatment station: Present, usable, filled. This is a valid detector of non-users.

Hand Washing

*Since we have no measures with highly established validity, like chlorine testing for water treatment, we will rely on all of our proxies as primary outcomes.

Primary Outcomes*

o Hand washing indicators which have been shown to be independently associated with less self reported diarrhoea in [55].

Hand Inspection: Child’s finger pads are visibly clean.

3 We will not measure health outcomes because their connection with these behaviours is fairly well established and

such measurement would require a larger and more costly study. 18

Hand washing demonstration: Mother uses soap when demonstrating how she washes her hands.

Self report by mothers of washing hands with soap before feeding children.

o Structured Observation

o Physical condition of hand washing hardware: Present, usable, filled.

This is a valid detector of non-users.

Willingness to Pay

Willingness to pay is an important measure for determining the scalability of an intervention. How willingness to pay for water treatment and hand washing products effects use of these products is unclear; our study will provide data for willingness to pay along with usage, allowing for exploration of this relationship.

To measure willingness to pay we will use a group version of a Becker-DeGroot-Marschek auction (more on this in the methods section). This auction has proven to be a reliable albeit downward-biased measure of willingness to pay of individuals [56], but it has not been tested on groups. We will develop, field test, and validate a version of the auction appropriate for groups before implementation.

This auction will emphasize male attendance because previous willingness to pay measurement in Dhaka has demonstrated that most women in the study communities don’t feel comfortable making these decisions [56].

Comparing these outcomes across treatment arms will give us the causal effect of our disgust and shame based messages relative to more traditional germs-based messages. Our willingness to pay data will provide hard evidence to the question of whether a water treatment and hand washing intervention can be cost effective enough to justify rolling out at scale. If we find that neither of our interventions is cost-effective, then the case for these compound-level solutions is considerably weakened. Such results would emphasize the importance of continued exploration of ways to improve the safety of piped water.

Research Design and MethodsDescribe in detail the methods and procedures to be used in accomplishing the objectives and specific aims of the project. Discuss the alternative methods that are available and justify the use of the method proposed in the study.

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Justify the scientific validity of the methodological approach (biomedical, social, or environmental) as an investigation tool to achieve the specific aims. Discuss the limitations and difficulties of the proposed procedures and sufficiently justify the use of them. Discuss the ethical issues related to biomedical and social research for employing special procedures, such as invasive procedures in sick children, use of isotopes or any other hazardous materials, or social questionnaires relating to individual privacy. Point out safety procedures to be observed for protection of individuals during any situations or materials that may be injurious to human health. The methodology section should be sufficiently descriptive to allow the reviewers to make valid and unambiguous assessment of the project.

Study Design

To rigorously test our main study hypotheses we are using a stratified, cluster randomized trial. Sample compounds will be divided into four strata based on compound size and presence of gas and will then be randomly assigned to one of four study arms4. Thus the proportion of compounds in each arm will be the same within each stratum.

Strata

1. Gas & Fewer than 8 households per compound

2. Gas & 8 households per compound or more

3. No Gas & Fewer than 8 households per compound

4. No Gas & 8 households per compound or more

Study Arms

1. Standard Public Health Intervention with Water Treatment

2. Standard Public Health Intervention with Water Treatment & Hand Washing

3. Disgust and Shame Based Intervention with Water Treatment

4. Disgust and Shame Based Intervention with Water Treatment & Hand Washing

Via randomization, half of compounds will be assigned to standard treatment groups one and two and half to disgust and shame groups three and four. Within these halves, one third will receive water treatment only and two thirds will receive water treatment and hand washing.

Randomization will allow us to infer causality when analyzing the differences in outcomes and stratification will increase the statistical power of our inference.

Field Staff

We will have three field staff designations, Field Research Assistants (FRAs), Field Intervention Specialists (FISs) and Field Assistants (FAs). FRAs will be responsible for baseline, midline and endline data collection as well as structured observation. FAs will be responsible for fee collection visits. FISs will be responsible for all remaining visits.

4 Should an additional $8k become available, we will add a control group that receives no intervention. 20

Site SelectionBased on our literature review and hypotheses to be tested, we determined that our study would be most feasible and would provide the most benefit in poor housing compounds of Dhaka city. To identify specific sites where the intervention would take place, we created a list of feasibility criteria (see appendix 2) and received recommendations from ICDDR,B Research Investigators with experience in urban Dhaka. We then sent two FRAs to evaluate the recommended sites using the list. With their evaluation we selected six communities: Mohammedpur, Mirpur, Badda, Korail, Khilgaon and Bashabo.

Piloting PhaseThe first five of our specific aims, all involving development of new techniques, are the subject of our piloting phase.

Aims One and TwoTo develop our disgust and shame intervention for water treatment and for water treatment and hand washing we will refine a long list of potential intervention script contents. Our Qualitative Research Investigator and members of his/her team will field test and review all items from this list, systematically changing, removing and adding items until the list has become a feasible intervention script that is culturally appropriate and appears to be effective. The Qualitative team will use focus group discussions and in depth interviews as primary tools to assess field tests.

Aim ThreeTo develop a group version of the Becker-DeGroot-Marsckek (BDM) auction our staff Economist along with the Qualitative Research Investigator and a team of FRAs will field test and review different variations of the auction to determine which is most feasible and which appears to produce the most accurate measurement of true willingness to pay in our communities. The Qualitative team will use focus group discussions and in depth interviews as primary tools to assess field tests.

Aim FourTo develop a survey instrument which allows us to measure behavioural determinants of hand washing and water treatment, we will perform multiple pilots and revisions of our questionnaire on small sample groups similar to our sample. Revisions will be made based on qualitative review of subjects’ impressions and a quantitative review of gathered data. In the quantitative review we will perform principal components analysis and factor analysis of data to refine scales for behavioural determinants already defined and/or to investigate whether there are other determinants worth measuring.

Aim FiveWe have a short list of new measurement ideas that we will field test and review prior to implementation. For more details on this list, see the “Data Collection” section below.

Implementation

Visit 1: Sample Enrolment, Baseline Data Collection and Set-up of Promotion Meeting

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Within the chosen field sites, FRAs will search for compounds which, match all the essential criteria (see below), match at least 2 of the preferred criteria (see below) and which are located at least 75 footsteps5

apart from each other. Managers of such compounds will be asked for written consent to participate in the study. If they do not agree, then FRAs will move to the next suitable compound. If they agree and sign the form, then FRAs will record stratification data and perform baseline data collection which consists of two household questionnaires and six household physical observation forms (see “Data Collection” below for more details on questionnaire and physical observation). Later, FROs will use stratification data to determine the stratum and randomly assign the treatment arm for each compound.

Household representatives who will participate in baseline data collection will be randomly selected from the pool of compound members present at visit 1. To ensure random selection, the FRA will first arbitrarily assign numbers to the households with members present. He/she will then write the numbers on small plastic balls and drop the balls into a cup. He/she will then shake the cup and pour out one ball. The number on the ball corresponds to the first household to approach for data collection. The FRA will ask the present members of the household who is responsible for collecting water. This person will be asked to participate, if he/she declines, the FRA will pour another ball out of the cup and repeat the procedure. These steps will be repeated until six consenting compounds have been selected. The first two will be given the questionnaire and physical observation form and the last four, only the physical observation.

Essential compound criteria Between 3 and 15 Housholds Shared water source Physical space exists to hold a compound meeting here or nearby No other interventions going on at this time Population is all Bangalee

Preferred criteria

Use of water source is visible to others

Shared kitchen

Shared toilets visible from common area

Visit 2: First Meeting- Promotion and Free Trial

FISs will conduct a three hour integrated behaviour change/product promotion program taking place in the compound or at a convenient meeting place nearby. The content of the program, which will vary by treatment arm, will be developed during piloting and is briefly described below under “Meeting Content and Hardware”.

5 Footsteps were determined to be the most intuitive unit of distance for our FRAs to use. 22

At the end of the program, compounds will be offered a one month free trial of the hardware specific to their study arm (see “Meeting Content and Hardware”).

Visit 3: Reminder Visit

Roughly two weeks after the first meeting compounds will receive a check-up and reminder visit. FISs will meet with available individuals in two smaller groups. The FIS will reiterate messages from the first meeting and discuss understanding and agreement with these messages in order to further understanding and reduce perceived barriers to the new behaviours.

Visit 4: Setup of Second Meeting and BDM Auction Coaching

Roughly three weeks after the first meeting, FISs will visit compounds to set up a time and date for the second compound meeting and to prepare the compound members for the auction. FISs will meet with groups of two to four prospective bidders for an hour each and will explain in detail the process and hold multiple mock auctions.

Visit 5: Second Meeting- Promotion and Sales

Roughly one month after the first meeting, as the free trial is ending, FISs will return to treatment compounds to conduct the promotion and sales meetings.

The promotion segment will be a one and a half hour behaviour change/product promotion program similar to the first meeting but containing fresh material.

In the second one and a half hour segment of the meeting, FISs will measure compound members’ willingness to pay for the trialled products by giving them the opportunity purchase and keep the hardware in a Becker-DeGroot-Marschek (BDM) style auction. Compounds not willing to pay the offered price will be offered other options to keep the hardware assuring that at least 75% of compounds keep the products until endline (more details on this in Auction section below).

Fee Collection Visits

Every month for a year after the sales meeting, compounds will be visited by an FA who will collect fees and take rapid observation data (detailed under “Data Collection” belew).

Visit 6: Midline Data Collection

Three months after baseline data collection, FRAs will return to compounds to collect midline data which consists of two household questionnaires and six household physical observation forms (see “Data Collection” below for more details on questionnaire and physical observation). FRAs will attempt to use the same households as before, but if they are not present after returning to the compound for a second attempt, then FRAs will use the randomization strategy from the first visit to select new households.

Visit 7: Structured Observation

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Half way between midline and endline data collection a separate team of FRAs will perform 5 hour structured observations of hand washing and water treatment behaviour in a representative subgroup of our sample. More on this under “Data Collection” below.

Visit 8: Endline Data Collection

Six months after baseline data collection, FRAs will return to compounds to collect endline data which consists of two household questionnaires and six household physical observation forms (see “Data Collection” below for more details on questionnaire and physical observation). FRAs will attempt to use the same households as before, but if they are not present after returning to the compound for a second attempt, then FRAs will use the randomization strategy from the first visit to select new households.

Meeting Content and Hardware:

Hardware

Water Treatment

o One wall mounted liquid chlorine dispenser

o One 40 liter reservoir with tap

Hand Washing

o One reused 1.5 liter water bottle to be filled with soapy water (laundry detergent mixed with water)

Meeting Content

All compounds:

All will receive water treatment promotion interventions, whether standard or disgust and shame based. Two thirds will be randomly selected to receive hand washing promotion along with water treatment.

Standard Public Health Intervention:

The standard public health intervention meetings will be modelled after typical pre-existing high quality water treatment and/or hand washing interventions. The content will include explaining/demonstrating how germs can enter into our body via untreated water and/or unwashed hands, how they can make us sick and lead to death, and how these risks can be reduced by practicing safe water and/or hand hygiene behaviour.

Disgust and Shame Based Intervention:

The disgust and shame meetings will contain similar explanations/demonstrations of contamination mechanisms and risk, but will place most emphasis on the presence of fecal matter in or on contaminated objects. FIS’ will use more vivid or harsh local terms

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equivalent to “crap” or “shit” to try to elicit a stronger reaction from participants. They will try to communicate the information that we sometimes unknowingly serve feces to our family by not washing hands with soap or by not treating our drinking water. They will emphasize how fecal matter can spread between people, especially neighbours, to try to encourage people to care about other’s behaviours and what others think of their behaviours. Pending piloting, the meetings will also contain promotion of positive identities—being a good mother, a strong father or a good Muslim—to stand in contrast with shameful and disgusting activities. The content and terms used will be determined by qualitative investigation with community members.

Data Collection

Questionnaire

All compounds will be surveyed at baseline, a three month midline and a six month endline. The questionnaire for each of these instances will be largely the same excepting corrections made during implementation and small changes for administering at different times. The questionnaire will measure self-reported usage, reports of neighbours’ usage, knowledge and practice pertaining to hand washing and safe water, perceptions of risk and severity of diarrhoea, norms/ beliefs/ feelings/ reactions relating disgust and shame, social networking, and demographic information. These measurements will allow us to study the differences in behaviour and of behavioral determinants over time and between groups.

Physical Observation

One of each of the following is taken in 6 households per compound each time the questionnaire is administered and also during the structured observation.

Chlorine residual testing of stored drinking water (not taken at baseline)

Hand cleanliness inspections of child (see scoring sheet in appendix 4)

Hand washing demonstration by mother

o We will ask her to demonstrate how she washes her hands after defecation. We will evaluate her performance as outlined in appendix 4.

Others we are considering include: Hand rinse testing via

o H2S tests Other finger cleanliness checks

o Wiping fingers on a white material and evaluating darknesso Wiping fingers on oil blotter paper

H2S tests of water quality

Rapid Physical ObservationRapid observations will take place in all compound visits and consist of identifying the location and usability/usage status of hand washing and water treatment hardware.

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Structured observation

There will be one structured observation visit halfway between the midline and endline data collection visit. FRAs will conduct 5 hour structured observations of hand washing and water treatment behaviours in a sub-group of compounds which is representative of our sample. Hand hygiene and water treatment behaviours will be assessed using the score sheet in appendix 6.

Auction/Willingness to Pay

After the courtyard meeting, we will conduct an experimental auction to elicit individual households willingness to pay (WTP)for a monthly rent-to-own subscription to the chlorine dispenser and the reservoir. We will use Becker-DeGroot-Marschek (BDM) procedure to elicit WTP, whereby participants bid against a pre-determined randomly assigned price confidentially kept in an envelope. We will collect individual bids and list them to find the lowest of these bids, which will then be compared with the price in the envelope. In this auction, if the lowest of participants bid exceeds the pre-assigned price, participants as a group win the auction but each pay the price in the envelope. We assume the mechanism is incentive compatible for participants to bid truthfully as their bid does not affect the transaction price. We aim to keep the actual sales price very low so that most compounds have the opportunity to keep the dispenser.

Payment dataAfter the sales meeting we will measure continued enrolment and maintenance of the safe water (or safe water and hand-washing) station on a monthly basis.

Qualitative Data Collection:During implementation our qualitative team will regularly visit a representative sub-group of our sample to gather data on how the intervention is going, how it is perceived and to give us an idea of what needs to be changed in our meetings or our survey. The standards we’re using to determine the frequency of qualitative work are as follows: Roughly one in every five compounds will participate in in-depth interviews and one in every 18 compounds will take place in focused group discussions. These numbers may vary depending on data redundancy.

____________________________________________________

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Sample Size Calculation and Outcome (Primary and Secondary) Variable(s)

The following sample size calculations were obtained using the Optimal Design software form the William T. Grant Foundation.

Our primary outcomes of interest are the proportion of people who drink treated water and the proportion of people who wash their hands with soap after faecal contact and before eating. Direct measures of water and hygiene behaviours (in the absence of an observer) are not available to us, thus we will use structured observation in conjunction with proxy measures. Willingness to pay for water treatment hardware is also of primary interest for generating demand curves, but its role as a secondary outcome for evaluating water treatment behaviour requires a larger sample so it is included below in the water treatment section.

Water Treatment Behavioral Proxies and Observation

Primary:

Chlorine Residual Tests (of stored drinking water)

Proportion with chlorine residual in Arm 1: 0.278Using data from the Gates-CBC 10-5 pilot, we determined that given a standard public health intervention, the proportion with residual chlorine should be around 0.278 with a plausible interval from 0.03 to 0.6

Proportion with chlorine residual in Arm 2: 0.358Using data from Najnin et al, we estimated that at 10 percentage point increase in usage would correspond to an 8 percentage point increase in the proportion with residual chlorine. This is our minimum practically significant effect size.

Sample size needed: 202 to 380 compounds per treatment arm given 6 and 2 households per compound

Setting significance to 0.05, we find that to measure this increase in proportions with 80% power we need 380 compounds with 2 households each or 202 compounds per arm with 6 households each.

Secondary:

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Willingness to Pay (for compound based chlorine dispenser)

Approximating as a continuous, normally distributed variable shifting uniformly

Minimum Practically significant Effect size: 0.3 standard deviationsUsing data from Najnin et al, we calculated the approximate mean shift in WTP given a 10 percentage point increase in the number of people willing to pay the expected retail price to be ~0.7 standard deviations. Repeating this process with data from Guiteras et al we estimated a standardized effect size of 0.35 standard deviations. We use a 0.3, a very conservative estimate, in our calculations.

Intra-cluster Correlation Coefficient: 0.3We chose 0.3 as a conservative estimate*.

Sample size needed: 80 to 115 compounds per treatment arm required given 5 and 2 households surveyed per compound respectively

Setting significance to 0.05, we find that to measure a 0.3 standardized effect size with 80% power we need 115 compounds with 2 households each or 80 compounds per arm with 5 households each.

*If ICC is much higher, say 0.8 due to bids directly influencing each other, then we would need 159 compounds per arm with 2 households each or 150 per arm with 5 households each.

Approximating as a binary variable: Is WTP >= Expected retail price

Proportion willing to pay Expected Retail Price in Treatment Arm 1: 0.42Using data from Nanjin et al, we determined that given a standard public health intervention, the proportion willing to pay the expected retail price should be around 0.42 with a plausible interval from 0.1 to 0.5.

Proportion willing to pay Expected Retail Price in Treatment Arm 2: 0.52 Here we set the proportion to 10 percentage points greater than that in Treatment arm 1. This is our minimum practically significant effect size.

Sample size needed: 110 to 230 compounds per treatment arm given 5 and 2 households surveyed per compound respectively


Self Report28

Proportion who report using using chlorine dispenser children Arm 1: 0.44Using data from the Gates-CBC 10-5 pilot, we determined that given a standard public health intervention, the proportion who will report using the chlorine dispenser to treat their water will be 0.33 with a plausible interval of 0.05 to 0.85.

Proportion who use soap when demonstrating hand washing in Arm 2: 0.54Here we set the proportion to 10 percentage points greater than that in Treatment arm 1. This is our minimum practically significant effect size.

Sample size needed: 186 compounds per treatment arm given 2 households per compoundSetting significance to 0.05, we find that to measure this increase in proportions with 80% power we need 186 compounds with 2 households each.

Structured Observation

Proportion of users in Arm 1: 0.46Using data from the Gates-CBC 10-5 pilot, we determined that given a standard public health intervention, the proportion appear to be users during structured observation will be 0.46 with a plausible interval from 0.05 to 0.8

Proportion who wash hands with soap in Arm 2: 0.56Here we set the proportion to 10 percentage points greater than that in Treatment arm 1. This is our minimum practically significant effect size.

Sample size needed: 186 compounds per treatment arm given 6 households per compoundSetting significance to 0.05, we find that to measure this increase in proportions with 80% power we need 186 compounds with 6 observations per compound.

Hand Washing Behavioral Proxies and Observation (All are primary measures)

Hand Washing IndicatorsThe following measurements were found to be independently associated with lower rates of child diarrhea (Luby et al, SHEWAB Hand Washing Indicators, not published)

Hand Inspection: Child’s finger pads are visibly clean. Proportion who have visibly clean finger in Arm 1: 0.73

Using data for Luby et al.’s rapid indicators for diarrhea, we determine that after a standard public health intervention, the proportion of children who will have visibly clean finger pads will be 0.73 with a plausible interval of 0.10 to 0.90.

Proportion who have visibly clean finger pads in Arm 2: 0.83Here we set the proportion to 10 percentage points greater than that in Treatment arm 1. This is our minimum practically significant effect size.

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Hand washing demonstration: Mother uses soap when demonstrating how she washes herhands after defecation.

Proportion who use soap when demonstrating hand washing in Arm 1: 0.66Using data for Luby et al.’s rapid indicators for diarrhea, we determine that after a standard public health intervention, the proportion of mothers who will use soap while demonstrating how to wash hands after defecation will be 0.66 with a plausible interval of 0.10 to 0.90.




Self Report: Mothers report washing hands with soap before feeding children. Proportion who report using soap to wash hands before feeding children Arm 1: 0.04

Using data for Luby et al.’s rapid indicators for diarrhea, we determine that after a standard public health intervention, the proportion of mothers who will report washing hands with soap before feeding children will be 0.04 with a plausible interval of 0.005 to 0.80.




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Structured Observation

Observation of hand washing after defecationProportion who wash hands with soap in Arm 1: 0.85

Using data from Luby et al, 2010 (HWWS vs sanitizer), we determined that given a standard public health intervention, the proportion who will wash hands with soap after defecation during structured observation will be around 0.85 with a plausible interval from 0.10 to 0.95



Setting significance to 0.05, we find that to measure this increase in proportions with 80% power we need 99 compounds with 2 observations per compound or 51 compounds per arm with 5 observations.

Observation of hand washing before eatingProportion who wash hands with soap in Arm 1: 0.26

Using data from Luby et al, 2010 (HWWS vs sanitizer), we determined that given a standard public health intervention, the proportion who will wash hands with soap before eating during structured observation will be around 0.26 with a plausible interval from 0.01 to 0.50




Conclusion:Using the largest needed sample size—202 compounds per arm for Chlorine residual testing—and comparing sample configurations for cost effectiveness, we have chosen to enrol 420 compounds total (210 in standard treatment and 210 in disgust and shame). Given that the largest sample size needed for detecting a difference in hand washing behaviour is 138 compounds per arm—for mother’s hand washing demonstrations—we have decided to enrol 280 compounds (140 per arm), two thirds of the total sample in the hand washing with soap combined intervention.

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Facilities AvailableDescribe the availability of physical facilities at site of conduction of the study. For clinical and laboratory-based studies, indicate the provision of hospital and other types of adequate patient care and laboratory support services. Identify the laboratory facilities and major equipment that will be required for the study. For field studies, describe the field area including its size, population, and means of communications.

We will be enrolling compounds from selected six communities of Dhaka city: Mohammedpur, Mirpur, Badda, Korail, Khilgaon and Bashabo. Communication between the field team and the community will primarily be through face to face communication. All field workers will have mobile phones. Scientific and administrative support for the study will be provided through the Moyeen Centre office at Gulsgan-1 and two field site offices. Communication among the broader scientific team will be through face to face communication, regular telephone conversations, and email. The limited laboratory work for the study, chlorine detection tests and H2S bacterial tests are simple tests that the field team will conduct on site.Regular liaison with the laboratory team on logistics, progress and reporting will occur.

Data Safety Monitoring Plan (DSMP)

All clinical investigations (biomedical and behavioural intervention research protocols) should include the Data and Safety Monitoring Plan (DSMP) to provide the overall framework for the research protocol’s data and safety monitoring. It is not necessary that the DSMP covers all possible aspects of each element. When designing an appropriate DSMP, the following should be kept in mind.

a) All investigations require monitoring;b) The benefits of the investigation should outweigh the risks;c) The monitoring plan should commensurate with risk; andd) Monitoring should be with the size and complexity of the investigation.

Safety monitoring is defined as any process during clinical trails that involves the review of accumulated outcome data for groups of patients to determine if any treatment procedure practiced should be altered or not.

We do not expect the low risk activities of this study to put the study population at increased risk of adverse outcomes, however any human activity can have unforeseen untoward consequences. We will actively monitor the impact of the intervention on the population both quantitative and qualitative approaches. The primary objective of these evaluations is to understand practices, knowledge, and attitudes towards the interventions. We will include questions in the evaluations that ask if they have noted any adverse outcomes. In addition, the presence of the study workers regularly in the community, and the open ended nature of qualitative evaluation provide regular opportunities to learn of any unintended adverse outcome. If the field team learns of any adverse outcomes they will be trained to report them to the study team the same day they learn of them. If any of the adverse outcomes are serious they will be reported to the ethical review committee within 72 hours.

Potential risks for the participants are accidental direct contact to high concentration chlorine solution and ingestion of chlorine or soapy water by children. Chlorine will be distributed in child-proof containers. We will inform adults and children about danger of ingesting high concentrations. We will include this information in our communication messages and make sure they know how to use the technology and follow the precautions

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Data Analysis

Describe plans for data analysis. Indicate whether data will be analysed by the investigators themselves or by other professionals. Specify what statistical software packages will be used and if the study is blinded, when the code will be opened. For clinical trials, indicate if interim data analysis will be required to determine further course of the study.

We will estimate the program impact controlling for the above factors using a regression to predict outcomes (Y) for person i in compound c: Yci = F[ α + β2 T2c + β3 T3c + Σk γk Xick ] + εci (1)

The dependent variable will be one of the outcomes specified above (self-reported and objectively verified safe water or hand-washing behaviors, etc.) of household i in courtyard c. For product adoption and other binary outcomes we will use a logistic link function F[.], while for continuous variables we will use the identity function (that is, ordinary least squares). The right hand side variables include a variable indicating the treatment arm of the compound. The coefficients b2 and b3 estimate the effect of the treatment arms on the outcomes relative to the control compound or to the other treatment arm in comparison.

We will enhance the statistical power of the analysis by controlling for family- and individual-level characteristics (Manning, et al. 1982), the X’s. These characteristics vary across households such as demographic structure.

Our treatment occurs at the compound level; in addition, unobserved factors (the εci in equation 1) are more similar within courtyards than between courtyards. A large proportion of published analyses based on data with clustered randomization do not appropriately take into account the effects of clustering (Simpson et al., 1995; Donner et al., 1990). We will use appropriate statistical techniques (e.g., the bootstrap estimators in Stata’s “survey” commands) that take into account the hierarchical nature of the error structures.

We will repeat the analysis in equation 1 for each step of the causal chain we posit. Our goal is to understand not only why behaviour changes (or fails to change) but what causal mechanism is important. For example, if we see no effect, we will use both qualitative and quantitative data to understand if the interventions failed to change knowledge, if knowledge did not change attitudes, if safe behaviors were not visible to neighbors, and so forth. The goal will be to determine where along the causal chain our intervention failed. This analysis may enable future interventions succeed.

More optimistically, if we see increases in product usage in treatment arm 3 (with courtyard-level incentives and products), we will again combine all methods we to understand whether the disgust, shame, positive identities or convienient products made the largest difference. This analysis will help us understand how to generalize results from this setting to other communities, cultures and products.

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Ethical Assurance for Protection of Human Rights

Describe the justifications for conducting this research in human participants. If the study needs observations on sick individuals, provide sufficient reasons for using them. Indicate how participants rights will be protected, and if there would be benefit or risk to each participants of the study.

This study engages human subjects because changing human behavior is its objective and, the objective cannot be achieved without working directly with human subjects. The study does not target sick individuals.

This is a minimal risk study. The public health promotion activities, encouraging home water treatment is a widely accepted public health goal. The research component involves developing and evaluating approaches to effectively reach these goals. We will discuss the objectives of the research with community leaders and participants in delivering the intervention. For all persons who we will be collecting data from, the study team will request written informed consent. Individually identified information will be kept confidential.

Potential benefits to the study population include the potential for more regular treatment of home drinking water with a resultant decrease in diarrheal and respiratory disease. The adopted habits may be sustained. The illnesses prevented by this activity could be lifesaving. Potential harms of the study include that people will give time to the study that would be better given to address other issues. We will address this risk by securing informed consent, and clarifying that study participants can drop out at any time, even in the middle of an interview or group discussion. A second potential harm is that intervention community residents may spend money that would otherwise be allocated for food or other essential need for point of use water treatment. We think this is an unlikely harm, because the study population is experienced in allocating their scarce monetary resources to meet a priority of family needs. Indeed, part of the reason we believe that there is so little investment in improving drinking water quality is because low income communities do not understand the full range of benefits. Social humiliation is another potential harm. During piloting we will work to design an intervention which minimizes this risk. During implementation we will conduct ongoing qualitative data collection which can be used to monitor and further reduce this risk.

Potential risks for the participants are accidental direct contact to high concentration chlorine solution and ingestion of chlorine or soapy water by children. Chlorine will be distributed in child-proof containers. We will inform adults and children about danger of ingesting high concentrations. We will include this information in our communication messages and make sure they know how to use the technology and follow the precautions.

Use of Animals

Describe if and the type and species of animals to be used in the study. Justify with reasons the use of particular animal species in the experiment and the compliance of the animal ethical guidelines for conducting the proposed procedures.

Not applicable.

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Literature Cited

Identify all cited references to published literature in the text by number in parentheses. List all cited references sequentially as they appear in the text. For unpublished references, provide complete information in the text and do not include them in the list of Literature Cited. There is no page limit for this section, however, exercise judgment in assessing the “standard” length.

1. World Health Organization. Global Burden of Disease, 2004 Update. Geneva: World Health Organization, 2008.

2. Haghighi P, Wolf PL. Tropical sprue and subclinical enteropathy: a vision for the nineties. Crit Rev Clin Lab Sci 1997 Aug;34(4):313-41.

3. Alderman H, Hoddinott J, Kinsey B. Long term consequences of early childhood malnutrition. Oxford Economic Papers-New Series 2006 Jul;58(3):450-74.

4. Checkley W, Buckley G, Gilman RH, et al. Multi-country analysis of the effects of diarrhoea on childhood stunting. Int J Epidemiol 2008 Aug;37(4):816-30.

5. Lorntz B, Soares AM, Moore SR, et al. Early childhood diarrhea predicts impaired school performance. Pediatr Infect Dis J 2006 Jun;25(6):513-20.

6. Niehaus MD, Moore SR, Patrick PD, et al. Early childhood diarrhea is associated with diminished cognitive function 4 to 7 years later in children in a northeast Brazilian shantytown. Am J Trop Med Hyg 2002 May;66(5):590-3.

7. Petri WA, Jr., Miller M, Binder HJ, Levine MM, Dillingham R, Guerrant RL. Enteric infections, diarrhea, and their impact on function and development. J Clin Invest 2008 Apr;118(4):1277-90.

8. Boissiere M, Knight JB, Sabot RH. Earnings, schooling, ability, and cognitive skills. American Economic Review 1985;75(5):1016-30.

9. Ezzati M, Hoorn SV, Rodgers A, Lopez AD, Mathers CD, Murray CJ. Estimates of global and regional potential health gains from reducing multiple major risk factors. Lancet 2003 Jul 26;362(9380):271-80.

10. Pruss-Ustun A, Bonjour S, Corvalan C. The impact of the environment on health by country: a meta-synthesis. Environ Health 2008;7:7.

11. Clasen T, Schmidt WP, Rabie T, Roberts I, Cairncross S. Interventions to improve water quality for preventing diarrhoea: systematic review and meta-analysis. Bmj 2007 Apr 14;334(7597):782.

12. Ejemot R, Ehiri J, Meremikwu M, Critchley J. Hand washing for preventing diarrhoea. Cochrane Database Syst Rev 2008(1):CD004265.

13. Rabie T, Curtis V. Handwashing and risk of respiratory infections: a quantitative systematic review. Trop Med Int Health 2006 Mar;11(3):258-67.

14. Cairncross S, Hunt C, Boisson S, et al. Water, sanitation and hygiene for the prevention of diarrhoea. International Journal of Epidemiology. 2010;39(Supplement 1):i193-i205.

15. Khan, M. U. (1982) Interruption of shigellosis by hand washing. Trans R Soc Trop Med Hyg, 76, 164-8.16. Stanton, B. F. & Clemens, J. D. (1987) An educational intervention for altering water-sanitation behaviors

to reduce childhood diarrhea in urban Bangladesh. II. A randomized trial to assess the impact of the intervention on hygienic behaviors and rates of diarrhea. Am J Epidemiol, 125, 292-301.

17. Quick, R. E., Venczel, L. V., Mintz, E. D., Soleto, L, Aparicio, J., Gironaz, M., Hutwagner, L., Greene, K., Bopp, C., Maloney, K., Chavez, D., Sobsey, M. & Tauxe, R. V. (1999) Diarrhoea prevention in Bolivia through point-of-use water treatment and safe storage: a promising new strategy. Epidemiol Infect, 122, 83-90.

18. Chiller, T. M., Mendoza, C. E., Lopez, M. B., Alvarez, M., Hoekstra, R. M., Keswick, B. H. & Luby, S. P. (2006) Reducing diarrhoea in Guatemalan children: randomized controlled trial of flocculant-disinfectant for drinking-water. Bull World Health Organ, 84, 28-35.

19. Clasen, T. (2009) Scaling Up Household Water Treatment Among Low-Income Populations. Geneva, World Health Organization.

20. Scott, B. E., Schmidt, W. P., Aunger, R., Garbrah-Aidoo, N. & Animashaun, R. (2008) Marketing hygiene behaviours: the impact of different communication channels on reported handwashing behaviour of women in Ghana. Health Educ Res, 23, 392-401.

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21. Luby, S. P., Mendoza, C., Keswick, B. H., Chiller, T. M. & Hoekstra, R. M. (2008) Difficulties in bringing point-of-use water treatment to scale in rural Guatemala. Am J Trop Med Hyg, 78, 382-7.

22. Olembo, L., Kaona, F., Tuba, M. & Burnham, G. (2004) Safe water systems: An evaluation of the Zambia CLORIN Program (Final Report) Washington, DC, U.S. Agency for International Development through the Environmental Health Project

23. Luby, S. P., Halder, A. K., Tronchet, C., Akhter, S., Bhuiya, A. & Johnston, R. (2009c) Household characteristics associated with handwashing with soap in rural Bangladesh. Am J Trop Med Hyg, In Press.

24. Rosa G, Clasen T. Estimating the Scope of Household Water Treatment in Low- and Medium-Income Countries. Am J Trop Med Hyg. 2010;82(2):289-300.

25. ICDDR,B (2008a) "Handwashing behavior in rural Bangladesh." Health and Science Bulletin. Vol. 6, pp. 1-6.

26. Carpenter CJ. A meta-analysis of the effectiveness of health belief model variables in predicting behavior. Health Commun. 2010;25(8):661-669.

27. Bolam A, Manandhar DS, Shrestha P, Ellis M, de L Costello AM. The effects of postnatal health education for mothers on infant care and family planning practices in Nepal: a randomised controlled trial. BMJ. 1998;316(7134):805 -811.

28. Naikoba S, Hayward A. The effectiveness of interventions aimed at increasing handwashing in healthcare workers - a systematic review. Journal of Hospital Infection. 2001;47(3):173-180.

29. Curtis VA, Biran A, Deverell K et al. Hygiene in the home: relating bugs to behaviour. Soc Sci Med 2003; 57: 657–72.

30. Curtis VA. Hygiene: how myths, monsters and mothers-in law can promote behaviour change. J Infect 2001; 43: 75–9.

31. Aunger R. Tooth-brushing as routine behaviour. Int Dent J 2007; 57: 364–76.32. Curtis VA, Danquah LO, Aunger RV. Planned, motivated and habitual hygiene behaviour: an eleven

country review. Health Education Research. 2009;24(4):655 -673.33. Curtis V, de Barra M, Aunger R. Disgust as an adaptive system for disease avoidance behaviour.

Philosophical Transactions of the Royal Society B: Biological Sciences. 2011;366(1563):389 -401.34. Curtis, V., Garbrah-Aidoo, N., & Scott, E. (2007). Masters of marketing: bringing private sector skills to

public health partnerships. American Journal of Public Health, 97(4), 634–641.35. Curtis, V., & Biran, A. (2001). Dirt, disgust, and disease: is hygiene in our genes? Perspectives in Biology

and Medicine, 44(1), 17–31.36. Porzig-Drummond R, Stevenson R, Case T, Oaten M. Can the emotion of disgust be harnessed to promote

hand hygiene? Experimental and field-based tests. Social Science & Medicine. 2009;68(6):1006-1012.37. Judah G, Aunger R, Schmidt W-P, et al. Experimental Pretesting of Hand-Washing Interventions in a

Natural Setting. Am J Public Health. 2009;99(S2):S405-411.38. Scheff TJ. Shame and the Social Bond: A Sociological Theory. Sociological Theory. 2000;18(1):84-99.39. Fessler, D.M.T., Shame in two cultures: Implications for evolutionary approaches. Journal of Cognition

and Culture, 2004. 4(2): p. 207-262.40. Verplanken B. Beyond frequency: habit as mental construct. Br J Soc Psychol 2006; 45: 639–56.41. Harris, S.J. and K. Munger (1989) “Effects of an Observer on Hand Washing in Public Restrooms.”

Perceptual and Motor Skills. No. 69, pp. 733-73542. Gaby, Judah, Robert Aunger, Wolf-Peter Schmidt, Susan Michie, Stewart Granger, and Val Curtis (2009)

“Experimental Pretesting of Hand-Washing Interventions in a Natural Setting.” American Journal of Public Health. Vol. 99, No. S2 S405-S411

43. Drankiewicz, D., & Dundes, L. (2003). Handwashing among female college students. American Journal of Infection Control, 31(2), 67–71.

44. Pittet, Didier, Anne Simon, Stephane Hugonnet, Carmen Lucia Pessoa-Silva, Valerie Sauvan, and Thomas V. Perneger (2004) “Hand Hygiene among Physicians: Performance, Beliefs, and Perceptions” Annals of Internal Medicine. Vol. 141, pp.1-8. http://infectioncontrol.ucsfmedicalcenter.org/Hand_Hygiene_among_physicians.pdf

45. The Holy Qu’ran, English Translation by MG Farid – 1969

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http://infectioncontrol.ucsfmedicalcenter.org/Hand_Hygiene_among_physicians.pdf

46. Jaffee SR, Moffitt TE, Caspi A, Taylor A. Life With (or Without) Father: The Benefits of Living With Two Biological Parents Depend on the Father’s Antisocial Behavior. Child Development. 2003;74(1):109-126.

47. Kaplan LM, McGuckin M. Increasing handwashing compliance with more accessible sinks. Infect Control 1986 Aug;7(8):408-10.

48. Bischoff WE, Reynolds TM, Sessler CN, Edmond MB, Wenzel RP. Handwashing compliance by health care workers: The impact of introducing an accessible, alcohol-based hand antiseptic. Archives of internal medicine 2000 Apr 10;160(7):1017-21.

49. Luby SP, Mendoza C, Keswick BH, Chiller TM, Hoekstra RM. Difficulties in bringing point-of-use water treatment to scale in rural Guatemala. The American journal of tropical medicine and hygiene 2008 Mar;78(3):382-7.

50. Sallis JF, Owen N, Fisher EB. Ecological Models of Health Behavior. In: Glanz K, Rimer BK, Viswanath K, eds. Health Behavior and Health Education. 4th ed. San Francisco: Josey-Bass, 2008:465-85.

51. B I. Diarrhoeal Diseases Research. ICDDR, B; 1996: 85-952. Luoto J, Najnin N, Mahmud M, et al. What Point-of-Use Water Treatment Products do Consumers Use and

Value? Evidence from the Urban Poor in Bangladesh. Available at: faculty.haas.berkeley.edu/levine/.../POU%20Use%20and%20Value%2024.doc.

53. Ram PK, Halder AK, Granger SP, et al. Is structured observation a valid technique to measure handwashing behavior? Use of acceleration sensors embedded in soap to assess reactivity to structured observation. Am. J. Trop. Med. Hyg. 2010;83(5):1070-1076.

54. Van de Mortel TF. Faking it: social desirability response bias in selfreport research. Australian Journal of Advanced Nursing. 2009;25(4):40-49.

55. Stephen P. Luby, Amal K. Halder, Tarique M.N. Huda, Leanne Unicomb, Richard B. Johnston. Using child health outcomes to identify meaningful measures of handwashing. (In review)

56. Berry J, Fischer G, Guiteras R. Incentive Compatibility in the Wild: Field Implementation of the Becker‐DeGroot‐Marschak Mechanism. Available at: http://mitsloan.mit.edu/neudc/papers/paper_390.pdf.

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http://mitsloan.mit.edu/neudc/papers/paper_390.pdf

Dissemination and Use of Findings

Describe explicitly the plans for disseminating the accomplished results. Describe if and how the research findings would be shared with stakeholder, identifying them if known, and the mechanism to be used. Also describe what type of publication is anticipated: working papers, internal (institutional) publication, international publications, international conferences and agencies, workshops etc. Indicate, if the project is linked to the Government of the People’s Republic of Bangladesh through a training programme or a collaborative arrangement.

Overview of the communications strategy:

For practitioners and policy-makers:o We will write up these results in a format useful for organizations who want to replicate the

interventions we describe or otherwise adjust their marketing and distribution model to incorporate the lessons we learn.

o Our write-up will be useful for NGOs, for private-sector companies making and distributing safe water and hygiene supplies (e.g., P&G, HLL), and for other stakeholders (e.g., Government of Bangladesh, World Bank)

o We will disseminate the results in appropriate publications and at conferences.

For academics:

We will write an article for publication in a refereed academic journal. We will present our study design on the project Web site, followed by posting results, the

datasets, and the policy brief.

Level Audience Communication Objective(s)

Format of Information

Means of Dissemination

District / Province

Distributors of safe water and hygiene products (for-profit, NGO, and government)

Explain managerial implications of the research and how to turn it into more successful distribution.

Policy Brief Marketing materials in Bangla

Web site and briefings by ICDDR,B

National Distributors of safe water and hygiene products (for-profit, NGO, and government)


Policy Brief Marketing materials in Bangla

Web site and briefings by ICDDR,B

Global Distributors of safe water and hygiene products (for-profit, NGO, and government)


Policy Brief Marketing materials in English

Web site Publications

Global Donors and policy-makers

Explain implications of the research and how findings apply to both safe water and hygiene products and other goods (e.g., bed nets).

Policy Brief Web site PublicationsConference presentations

Global Academic Explain implications of the research and how findings

Research article Conference and academic presentations

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shed light on decision-making by the poor.

Refereed journal publications

Global Academic Permit replication.

Facilitate studies by others measuring similar constructs

Stata dataset and PDF documentation of methods and data

Website

Collaborative Arrangements

Briefly describe if this study involves any scientific, administrative, fiscal, or programmatic arrangements with other national or international organizations or individuals. Indicate the nature and extent of collaboration and include a letter of agreement between the applicant or his/her organization and the collaborating organization.

ICDDR,B has a signed agreement with the Bill and Melinda Gates Foundation that includes roughly half of the activities of this protocol. The other half come from the International Initiative for Impact Evaluation. These funds will go to Innovations for Poverty Action with which ICDDR,B has a sub-agreement. This contract is in negotiations.

The ICDDRB implementation team will be supported by scientists from University of California, Berkeley, University of Maryland, and Harvard University. Consultant agreements are being developed between ICDDR,B and these institutions to support the time and professional contribution of their faculty.

Biography of the Investigators Give biographical data in the following table for key personnel including the Principal Investigator. Use a photocopy of this page for each investigator.

(Note: Biography of the external Investigators may, however, be submitted in the format as convenient to them)

1 Name: Stephen Luby

2 Present Position: Head, Programme on Infectious Diseases and Vaccine Sciences

3 Educational background: (last degree and diploma & training relevant to the present research proposal)

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University of Texas Southwestern Medical School at Dallas MD 1986 University of Rochester Strong Memorial Hospital Internship and residency in Internal Medicine.

Centers for Disease Control -- Epidemic Intelligence Service 1990 Completed Preventive Medicine Residency 1993

4.0 List of ongoing research protocols (start and end dates; and percentage of time)

4.1. As Principal Investigator

Protocol Number Starting date End date Percentage of time2006-043 1 Nov 2006 31 July 2008 52003-024 1 Sep 2003 31 Dec 2008 52007-003 1 Feb 2007 12 Dec 2009 32007-002 March 2007 Sep 2009 52007-010 June 2007 Sep 2009 32007-030 Sep 2007 Sep 2008 5

4.2. As Co-Principal Investigator

Protocol Number Starting date End date Percentage of time

4.3. As Co-Investigator


5 Publications

Types of publications Numbersa) Original scientific papers in peer-review journals 132b) Peer reviewed articles and book chapters 9c) Papers in conference proceedings 1c) Letters, editorials, annotations, and abstracts in peer-reviewed

journals 3

d) Working papers 0

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b) Monographs 0

6 Five recent publications including publications relevant to the present research protocol

1) Luby SP, Agboatwalla M, Feikin DR, Painter J, Billhimer W, Altaf A, Hoekstra RM. Effect of handwashing on child health: a randomised controlled trial. Lancet. July 15, 2005; 366:225-33.

2) Luby SP, Agboatwalla M, Painter J, Altaf A, Billhimer W, Keswick B, Hoekstra RM. Combining drinking water treatment and handwashing for diarrhea prevention, a cluster randomized controlled trial. Tropical Medicine and International Health. 2006 April; 11(4):479-489.

3) Islam MD, Brooks WA, Kabir Md, Jahid I, Islam MD, Goswami D, Nair GB, Larson C, Wagatsuma Y, Luby S. Faecal contamination of drinking water sources of Dhaka city during 2004 flood in Bangladesh and use of disinfectants for water treatment. Journal of Applied Microbiology. 2007 Jul;103(1):80-7.

4) Luby SP, Mendoza C, Keswick BH, Chiller T, Hoekstra RM. Difficulties in bringing point-of-use water treatment to scale in rural Guatemala. American Journal of Tropical Medicine and Hygiene. 2008; 78 382-387.

5) Norton, DM, Rahman M, Shane AL, Hossain Z, Kulick RM, Bhuiyan M, Wahed MA, Yunus M, Breiman RF, Henderson A, Keswick BH, Luby SP. Flocculent-disinfectant point-of-use water treatment for reducing arsenic exposure in rural Bangladesh. International Journal of Environmental Health Research. 2009;1(19)

Biography of the Co Investigators

1 Name: Leanne Unicomb

2 Present Position: Scientist

3 Educational background:

4.0 List of ongoing research protocols


Protocol Number Starting date End date Percentage of time09048-Gates cholera Sept 2009 Aug 2011 25%

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PhD in Epidemiology, National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia

09053-Gates WASH benefits

January 2010 December 2014 50%

Shewab-2 September 2010 March 2012 15%

5 Publications

Types of publications Numbersa. Original scientific papers in peer-review journals 62b. Peer reviewed articles and book chapters 1c. Papers in conference proceedings 1d. Letters, editorials, annotations, and abstracts in peer-reviewed journals 1e. Working papers f. Monographs


1. Nasreen S, Azziz-Baumgartner E, Gurley ES, Winch P, Unicomb L, Sharker MAY, Southern D, Luby SP. Prevalent high risk respiratory hygiene practices in urban and rural Bangladesh Trop Med Int Health 2010; Jun;15(6):762-71

2. Hall GV, Kirk MD, Becker N, Gregory JE, Unicomb L, Millard G, Stafford R, Lalor K and the OzFoodNet Working Group. Estimating foodborne gastroenteritis, Australia. Emerg Infect Dis 2005; 11:1257-1264.

3. Unicomb LE, Ferguson J, Stafford RJ, Ashbolt R, Kirk MD, Becker N, Patel MS, Gilbert GL, Valcanis M, Mickan L, and the Australian Campylobacter Subtyping Study Group. Low Level Fluoroquinolone Resistance among Locally Acquired Campylobacter jejuni Isolates in Australia. Clin Infect Dis 2006; 42:1368-1374.

4. Stafford RJ, Schulter P, Kirk M, Wilson A, Unicomb L, Ashbolt R, Gregory J and the OzFoodNet Working Group. A multicentre prospective case-control study of campylobacter infection in persons aged 5 years and older in Australia. Epidem Infect 2007; 135:978-988.

Unicomb LE, Dalton CB, Gilbert GL, Becker NG, Patel M. Risk factors for sporadic Campylobacter infection in the Hunter Region New South Wales, Australia. Foodborne Path Dis 2008;5:79

42

Biography of the InvestigatorsGive biographical data in the following table for key personnel including the Principal Investigator. Use a photocopy of this page for each investigator.


DAVID I. LEVINE

Haas School of Business (510)642-1697University of California [email protected] CA 94720-1900

http://faculty.haas.berkeley.edu/levine/

EDUCATION

1987 Ph.D. Harvard University: Economics 1985 A.M. Harvard University: Economics 1982 B.A. University of California, Berkeley: Economics and Computer Science

EMPLOYMENT

Haas School of Business, University of California, Berkeley: Eugene E. and Catherine M. Trefethen Professor of Business Administration, 2006-present

o Previously Professor 2002-06, Associate Professor 1993-2002, and Assistant Professor 1987-1993

Council of Economic Advisers: Senior Economist, 1994-1995 Office of the American Workplace, U.S. Department of Labor: Senior Research

Economist, 1994 Sloan School, MIT: Visiting Scholar, Industrial Relations Group, 1991 Harvard University: Teaching Fellow, 1983-86 NBER: Research assistant for Professor Lawrence Summers, 1984 Programmer for Intermetrics (1982), Apple Computer (1979-81) and Intel (1978)

OTHER AFFILIATIONS

Economic Analysis and Policy Group, Haas School of Business, University of California, Berkeley: chair, 2008-present.

WE CARE Solar: Scientific Advisory Board, 2008-present. Graduate Group in Health Services and Policy Analysis (HSPA), University of

California, Berkeley: Executive Committee, 2008-present. Goodguide: Scientific Advisory Board, 2007-present. Center on Evaluation for Global Action (CEGA), University of California: Founding

chair of the Advisory Board, 2005-present.

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Center for Responsible Business, Haas School of Business, University of California, Berkeley: Faculty Advisory Board, 2003-present

o Research Director, 2004-2006. Center for Health Research, University of California, Berkeley: Chair, 2005-2008. NERA Economic Consulting: Special consultant, 2005-2008. Industrial Relations: Editor, 1993-2005 Institute of Industrial Relations, U.C. Berkeley: Associate Director, 1997-2005 Center for Labor Research and Education, U.C. Berkeley: Executive Committee and

Advisory Board, 1995-2005 Institute for Labor and the Economy, University of California: Research Committee,

2001-2003 Center for Organization and Human Resource Effectiveness: Founding Director of

Research, 1996-2000 Labor Center Reporter: Faculty Mentor, U.C. Berkeley, 1998-1992 Dollars and Sense: Editorial Associate, 1985-1990

BOOKS AND MONOGRAPHS

Global Challenges in Responsible Business, editor, with C.B. Bhattacharya, Craig Smith and David Vogel, Cambridge University Press, 2010.

Carve-outs in Workers’ Compensation Programs in California Construction, with Cristian Echeverria, Frank Neuhauser, Richard Reuben, and Jeffrey S. Petersen, Upjohn Institute, Kalamazoo MI, 2003.

How New is the “New” Employment Contract? with Dale Belman, Gary Charness, Erica Groshen, and K.C. O’Shaughnessy, Upjohn Institute, Kalamazoo MI, 2002. (Listed as “Noteworthy” by the Princeton Industrial Relations Section.)

The American Workplace: Skills, Pay, and Employee Involvement, editor, with Casey Ichniowski, Craig Olson, and George Strauss, Cambridge University Press, 2000.

Working in the 21st Century: Government Policies to Promote Opportunity, Learning and Productivity in the New Economy, M.E. Sharpe, Armonk NY, 1998.

Reinventing the Workplace: How Business and Employees Can Both Win, Brookings Institution, Washington DC, 1995.

REFEREED ARTICLES (Most articles are on my web site.)

“The Economics of International Refugee Law” with Ryan Bubb and Michael Kremer. Forthcoming, Journal of Legal Studies.

“Do Race, Age, and Gender Differences Affect Manager-Employee Relations? An Analysis of Quits, Dismissals, and Promotions at a Large Retail Firm,” with Laura Giuliano and Jonathan Leonard. Journal of Human Resources. 46, 1, Winter 2011, 26-52.

“End-User Preferences for and Performance of Competing POU Water Treatment Technologies among the Rural Poor of Kenya,” with Jeff Albert and Jill Luoto, Environmental Science &

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Technology, 44 (12), 2010 pp 4426–4432. (Editor’s Choice Award as ES&T’s Best Policy Analysis Paper of 2010.)

“When Is Employee Retaliation Acceptable at Work? Evidence From Quasi-Experiments.” With Gary Charness. Industrial Relations. 49, 4, October 2010: 499-523.

“Quality Management and Job Quality: How the ISO 9001 Standard for Quality Management Systems Affects Employees and Employers,” with Michael Toffel. Management Science. 56, 6, June 2010. (Working paper version was Top Ten download list for MRN Operations Research Network and OPER Subject Matter eJournals, Sept. 2010.)

“Customer Discrimination,” with Laura Giuliano and Jonathan Leonard. Review of Economics and Statistics. 92, 3, August 2010: 670-678.

“Industrialization, Pollution and Infant Mortality” (June 2010). With Maya Environment and Development Economics, 15, 05, pp. 557-584.

“Manager Race and the Race of New Hires,” with Laura Giuliano and Jonathan Leonard. Journal of Labor Economics. 27, 4, 2009: 589-631.

“Do Microfinance Programs Help Families Insure Consumption Against Illness?” with Paul Gertler and Enrico Moretti. Health Economics, 18, 3, 2009: 257-273.

“How Well Do Social Ratings Actually Measure Corporate Social Responsibility?” with Aaron K. Chatterji and Michael W. Toffel. Journal of Economics, Management and Strategy, Spring 2009, 18, 1: 125-169. (Working paper was on SSRN's Top Ten download list for Environmental Economics, August 2008.)

“Investment Following a Financial Crisis: Does Foreign Ownership Matter?” with Garrick Blalock and Paul Gertler. Journal of Monetary Economics. 55, 3, April 2008: 568-591.

“Are measured school effects just sorting? Causality and correlation in the National Education Longitudinal Survey,” with Gary Painter. Economics of Education Review, 27, 4, August 2008: 460-470.

“The Acceptability of Layoffs and Pay Cuts: Comparing North America with Germany,” with Knut Gerlach, Gesine Stephan, and Olaf Struck. Cambridge Journal of Economics. Dec. 2007, 1-19.

“Intention and Stochastic Outcomes: An Experimental Study,” with Gary Charness. Economic Journal, 117 July 2007: 1051–1072.

“The Growing Importance of Family and Community: An Analysis of Changes in the Sibling Correlation in Earnings,” with Bhashkar Mazumder. Industrial Relations, 46, 1, January 2007: 7-21.

“Growth, Industrialization, and the Intergenerational Correlation of Advantage,” with Jon R. Jellema. Industrial Relations, 46, 1, January 2007: 130-170.

“Is Social Capital the Capital of the Poor? The Role of Family and Community in Helping Insure Living Standards Against Health Shocks,” with Paul Gertler and Enrico Moretti. CESifo Economic Studies, September 2006. no. 52: 455 - 499

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“The Effect of Diversity on Turnover: A Large Case Study,” with Jonathan S. Leonard. Industrial and Labor Relations Review, 39, 4, July 2006: 457-572.

“Does Trade Affect Health?” with Dov Rothman. Journal of Health Economics. 25, 2006: 538–554.

“Breaking Down The Wall Of Codes: Evaluating Non-Financial Performance Measurement,” with Aaron Chatterji, California Management Review, 48, 2, winter 2006: 29-51.

“Did Industrialization Destroy Social Capital in Indonesia?” with Paul Gertler and Ted Miguel. Economic Development and Cultural Change, 54, 2, winter 2006: 287-318.

“Does Social Capital Promote Industrialization? Evidence from a Rapid Industrializer,” with Ted Miguel and Paul Gertler, Review of Economics and Statistics, 87, 4, November 2005: 754-762.

“The Effect of Industrialization on School Enrollment: Evidence from Indonesia,” with Maya Federman, Contributions to Macroeconomics, B.E. Journals in Macroeconomics, 5, 1, Article 1, 2005.

“Size, Skill and Sorting,” with Dale Belman. Labour, Dec. 2004, vol. 18, issue 4, pages 515-561.

“Do Birds of a Feather Shop Together? The Effects of Employees’ Similarity with each Other and With Customers on Performance,” with Jonathan Leonard and Aparna Joshi, Journal of Organizational Behavior, 25, 6, August 2004: 731-754.

“Daddies, Devotion, and Dollars: How Do They Matter for Youth?” With Gary Painter, American Journal of Economics and Sociology, 63, 4, October 2004: 813 - 850.

“Schooling and Parental Death,” with Paul Gertler and Minnie Ames. Review of Economics and Statistics, 86, 1, Feb. 2004: 211-225.

“The Costs of Teenage Out-of-Wedlock Childbearing: Analysis with a Within-School Propensity Score Matching Estimator,” with Gary Painter, Review of Economics and Statistics, 85, 4, Nov. 2003: 884-900.

“The Effects of Diversity on Business Performance: Report of a Feasibility Study of the Diversity Research Network,” with Thomas Kochan, and others. Human Resource Management, 42, 1, Spring 2003: 3-23. Winner of the Ulrich & Lake Award for Excellence in HRM Scholarship, 2004.

“Are Investments in Daughters Lower When Daughters Move Away? Evidence from Indonesia,” with Michael Kevane. World Development, 31, 6, June 2003.

“‘Carve-outs’ from the Workers’ Compensation System,” with Jeffrey S. Petersen and Frank Neuhauser. The Journal of Policy Analysis and Management. 21, 3, Summer 2002: 467-483.

“Employee Involvement and Pay at American Auto Suppliers,” with Susan Helper and Elliot Bendoly. Journal of Economic Management and Strategy, 11, 2, Summer 2002: 329-377.

“Changes in the Employment Contract,” with Gary Charness. Journal of Economic Behavior and Organization. Apr 2002, 47, 4: 391-405.

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“Changes in Managerial Pay Structures 1986-1992: Tests of Human Capital and Other Explanations,” with K.C. O’Shaughnessy and Peter Cappelli. Oxford Economics Papers, 3 (2001), 482-507.

“Family Structure and Youth Outcomes: Which Correlations are Causal?” With Gary Painter, Summer 2000, Journal of Human Resources, XXXV, 3, pp. 524-549.

“When are Layoffs Acceptable? Evidence from a Quasi-Experiment,” with Gary Charness. April 2000, Industrial and Labor Relations Review, 53, 3, pp. 381-400.

“The NELS Curve: Replicating The Bell Curve with the National Educational Longitudinal Survey,” with Gary Painter, Industrial Relations, July 1999, pp. 364-406.

“Flexibility versus Efficiency? A Case Study of Model Changeovers in the Toyota Production System,” Organization Science, 10, 1, January-February 1999, pp. 43-68.

“Computer Mediated Communication as Employee Voice: A Case Study,” with Elizabeth Bishop, Industrial and Labor Relations Review, 52, 2, January 1999, pp. 213-233.

“Reinventing Regulation: Letting Employees and Employers Solve their Own Problems,” The California Management Review, vol. 39, no. 4, September, 1997, pp. 98-117.

“Institutional Incentives for Employer Training,” with David Finegold, Journal of Education and Work, 10, 2. June, 1997.

“Ergonomics, Employee Involvement, and the Toyota Production System: A Case Study of NUMMI’s 1993 Model Introduction,” with Paul S. Adler and Barbara Goldoftas, Industrial and Labor Relations Review, 50, 3, April 1997, pp. 416-437. Reprinted in The Fordism of Ford and Modern Management, Huw Beynon, editor, Elgar, 2005.

“What Does it Mean to Be Poor in America,” with Maya Federman, Thesia Garner, Kathleen Short, John Kiely, Duane McGough, and Marilyn McNillen, Monthly Labor Review, May 1996, pp. 3-17.

“A Quality Policy for America,” with Susan Helper, Contemporary Policy Issues, 13, 2, April 1995, pp. 26-37.

“Work Organization, Employment Security, and Macroeconomic Stability,” with Richard Parkin, Journal of Economic Behavior and Organizations, 24, 3, August 1994, pp. 251-271.

“Fairness, Markets and Ability to Pay: Evidence from Compensation Executives,” American Economic Review, 83, 5, December 1993, pp. 1241-1259.

“The Effects of Non-Traditional Attitudes on Married Women’s Labor Supply,” Journal of Economic Psychology, 14, 4, December 1993, pp. 665-679.

“What Do Wages Buy?” Administrative Science Quarterly, 38, 3, September, 1993, pp. 462-483. A short version appeared in the Proceedings of the Industrial Relations Research Association, 1993, pp. 133-141.

“Worth Waiting For? Delayed Compensation, Training and Turnover in the United States and Japan,” Journal of Labor Economics, 4, 3, September 1993, pp. 724-752.

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“Do Corporate Executives have Rational Expectations?” Journal of Business, 66, 2, April 1993, pp. 271-294.

“Long-Term Supplier Relations and Product Market Structure,” with Susan Helper, Journal of Law, Economics and Organization, 8, 3, October, 1992, pp. 561-581.

“Can Wage Increases Pay for Themselves? Tests with a Production Function,” Economic Journal, 102, 414, September 1992, pp. 1102-1115.

“Piece Rates, Output Restriction, and Cohesiveness,” Journal of Economic Psychology, 13, 3, September 1992, pp. 473-479.

“Product Quality and Pay Equity Between Low-Level Employees and Top Management: An Investigation of Distributive Justice Theory,” with Douglas Cowherd, Administrative Science Quarterly, 37, 2, June 1992, pp. 302-320.

“Public Policy Implications of Imperfections in the Market for Worker Participation,” Economic and Industrial Democracy, 13, 3, May 1992, pp. 184-206.

“Just Cause Employment Policies in the Presence of Worker Adverse Selection,” Journal of Labor Economics, 9, 3, July 1991, pp. 294-305.

“Cohesiveness, Productivity, and Wage Dispersion,” Journal of Economic Behavior and Organizations, 15, March 1991, pp. 237-255.

“Just Cause Employment Policies When Unemployment is a Worker Discipline Device,” American Economic Review, 79, 4, September, 1989, pp. 902-905.

“Efficiency Wages in Weitzman’s Share Economy,” Industrial Relations, 28, 3, Fall 1989, pp. 321-334. A short version appeared in Economics Letters, 23, 1987, pp. 245-249.

OTHER ARTICLES AND BOOK CHAPTERS

“The New ‘Managerial Misclassification’ Challenge to Old Wage & Hour Law or What is Managerial Work?” with David Lewin, in Contemporary Issues in Employment Relations, David Lewin, ed., LERA Research Volume, Cornell University Press, 2006: 189-222.

“The Effects of New Work Practices on Workers,” with Michael Handel, in America at Work, Edward E. Lawler III and James O’Toole, editors, Palgrave Macmillan, New York NY: 73-86. (An earlier version appeared in Industrial Relations, 43, 1, January 2004: 1-43.)

“Public Policy Implications,” in The American Workplace: Skills, Pay, and Employee Involvement, edited by Casey Ichniowski and others, Cambridge University Press, 2000, pp. 273-282.

“The Economics of Works Councils,” with Bruce Kaufman, in Nonunion Forms of Employee Representation: History, Contemporary Practice, and Policy, Kaufman and Daphne Taras, eds., M. E. Sharpe, Armonk NY, 2000, pp. 149-175.

“The Quality of Incentives and the Incentives of Quality,” with Katherine Shaw, in The Quality Movement in America: Lessons for Theory and Research, Robert Cole and Richard Scott, eds., Sage, NY, 2000, pp. 367-386.

48

“A Case Study of the Mortgage Application Process,” with Ken Temkin and Diane Levy, in Mortgage Lending Discrimination: A Review of the Evidence, Margery Austin Turner and Felicity Skidmore, eds, Urban Institute Press, Washington DC, 1999, pp. 137-160.

“Stability and Change at NUMMI,” with Paul S. Adler and Barbara Goldoftas, in Robert Boyer, Elsie Charron, Ulrich Jürgens, and Steven Tolliday (eds.), Between Imitation and Innovation: Transfer and Hybridization of Production Models in the International Automobile Industry, New York: Oxford University Press, 1998, pp. 128-160.

“(Attempts at) Replication of The Bell Curve,” editor’s introduction to a symposium, Industrial Relations, July 1999, pp. 245-249.

“They Should Solve Their Own Problems: Reinventing Workplace Regulation,” in Government Regulation of the Employment Relationship: A Critical Appraisal, Industrial Relations Research Association, Madison WI, 1997.

“Team Production,” in The Human Resource Management Handbook, David Lewin, Daniel J.B. Mitchell, and Mahmood Zaidi, editors, JAI Press, Greenwich CN, 1997. pp. 35-61.

“What Works at Work: A Critical Review,” with Casey Ichniowski, Thomas Kochan, Craig Olson, and George Strauss, Industrial Relations, vol 35, no. 3, Summer, 1996, pp. 299-333. (A version appeared in The American Workplace, Cambridge U. Press, 2000, pp. 1-37.)

“The US Labor Market: ‘Institutions’ ≠ Rigid and ‘Unregulated’ ≠ Market-Clearing,” Proceedings of the Industrial Relations Research Association, 1994.

“The Relation between Supplier Participation and Worker Participation,” with Susan Helper, Proceedings of the Industrial Relations Research Association, 1994, pp. 12-25.

“Demand Variability and Work Organization,” in Democracy and Markets: Participation, Accountability, and Efficiency, Samuel Bowles, Herbert Gintis, and Bo Gufstafsson, eds, Cambridge University Press, 1993, pp. 159-175.

“Computer Mediated Communication as Employee Voice: A Case Study,” with Elizabeth Bishop, Proceedings of the Conference on NetWORKing, IFIP WG 9.1, 1993.

“Participation, Productivity, and the Firm’s Environment,” with Laura D’Andrea Tyson, in Paying for Productivity, Alan Blinder, ed., Brookings Institution, 1990, pp. 183-244. (Selected for Frontier Issues in Economic Thought series, The Changing Nature of Work, Global Development and Environment Institute, 1999).

“Employee Participation and Involvement,” with George Strauss, in Investing in People, Report for the Commission on Workforce Quality and Labor Market Efficiency, Background papers, Vol. II, paper 35b, U.S. Department of Labor, September, 1989, pp. 1893-1948.

Efficiency Wage Theories: Micro- and Macroeconomic Implications and Empirical Tests, Ph.D. Dissertation, Harvard University, Cambridge MA, 1987.

Spot and Futures Markets for Natural Gas, Brookhaven National Laboratory Report, 1984.

49

WORKING PAPERS (Available on my Web site.)

“Learning What Works – and What Doesn’t: Building Learning into the Global Aid Industry” March 2006.

“Losing the Presence and Presents of Parents: How Parental Death Affects Children” with Paul Gertler, Sebastian Martinez, and Stefano Bertozzi, 2007. Under review.

“Gender Bias and The Indonesian Financial Crisis: Were Girls Hit Hardest?” David I. Levine and Minnie Ames. University of California, Berkeley Center for International and Development Economics Research (CIDER) working paper C03-130. February 2003.

“The Changing Status of Daughters in Indonesia,” with Michael Kevane. Institute of Industrial Relations working paper 74.

WORK IN PROGRESS

“Industrialization’s effect on Children in Mexico and China,” with Anne Le Brun, Sue Helper Bernie Yeung, Jean Yeung, and Yaohui Zhao.

BOOK REVIEWS AND NON-TECHNICAL PUBLICATIONS

“Quality Management and Job Quality: How the ISO 9001 Standard for Quality Management Systems Affects Employees and Employers,” (Executive Summary) with Michael Toffel, Quality Progress, American Society for Quality, forthcoming, March 2010.

“Health Insurance for the Rural Poor: Evidence from Cambodia,” in Innovations in Insuring the Poor, edited by Ruth Vargas hill and Maximo Torero, International Food Policy Research Institute, Focus 17, Brief 10, Dec. 2009. http://www.ifpri.org/sites/default/files/publications/focus17_10.pdf

“A New Era,” in Obama Reflections from Election Day to Presidency: Social Justice Thought Leaders Speak Out. Kirwan Institute, Ohio State University, 2009: 7.

“Policy Brief: Results of The First Health Centre Survey,” with Rachel Gardner, Gabriel Pictet, Rachel Polimeni and Ian Ramage, August 2009. http://www.basis.wisc.edu/live/Health%20Centre%20Baseline%202009.pdf

“A Note on the Impact of Local Rainfall on Rice Output in Indonesian Districts,” with Dean Yang, 2006. http://www-personal.umich.edu/~deanyang/papers/levineyang_ricerain.pdf

BASIS Brief no. 2007-05. Insuring Health: Testing the Effectiveness of Micro-health Insurance to Promote Economic Wellbeing for the Poor, with Nhong Hema and Ian Ramage. July 2007.

“Perspectives on Corporate Governance: Executive Compensation” Case in Point Concept Paper, Caseplace.org, May 2007 [http://www.caseplace.org/references/references_show.htm?doc_id=484244#Attachment_anchor], last accessed June 5, 2007.

“Social Security Panel,” with Reuel Schiller, Peter Edelman and Thomas Davidoff, Race and Poverty Law Journal, 3 (2), Spring 2006: 185-202.

50

http://www.caseplace.org/references/references_show.htm?doc_id=484244#Attachment_anchor

http://www.caseplace.org/references/references_show.htm?doc_id=484244#Attachment_anchor

http://www.basis.wisc.edu/live/amabrief07-05.pdf

http://www.basis.wisc.edu/live/amabrief07-05.pdf

http://www-personal.umich.edu/~deanyang/papers/levineyang_ricerain.pdf

http://www.basis.wisc.edu/live/Health%20Centre%20Baseline%202009.pdf

http://www.basis.wisc.edu/live/Health%20Centre%20Baseline%202009.pdf

http://www.ifpri.org/sites/default/files/publications/focus17_10.pdf

http://faculty.haas.berkeley.edu/levine/papers/Reforming%20aid%202006%204.doc

“Our opportunity to end poverty -- or fail to even try,” San Francisco Chronicle, Sunday, May 21, 2006: E3.

“The Wheels of Washington: Groupthink and Iraq,” San Francisco Chronicle, Thursday, February 5, 2004, p. A23. [sfgate.com/article.cgi?file=/chronicle/archive/2004/02/05/EDGV34OCEP1.DTL]

Book review of The New Relationship: Human Capital in the American Corporation, Journal of Economic Literature, 40 (2), June 2002: 547-549

Book review of Manufacturing Advantage, Industrial and Labor Relations Review, 55 (1), October 2001: 175-176.

“Gilding the Ghetto,” Across the Board, Oct 1999, 36 (9): 10.

“Knowledge Transfer: Managerial Practices Underlying One Piece of the Learning Organization,” with April Gilbert, COHRE briefing paper, [http://socrates.berkeley.edu/~iir/cohre/ knowledge.html], 1998.

“Editorial: Overt Discrimination by Multinational Firms,” Industrial Relations, 37, 2, April 1998, pp. 121-125.

“Brave New Work” interview with Josh Clark, Mother Jones, July/Aug 1997.

“The OECD’s Role in Measuring Human Capital,” background paper for the OECD, DEELSA/CERI//HCI (96) 6, 1996.

“A Deficit of Clear Thinking,” with Brad DeLong, CalBusiness, Fall 1996, p. 6

“Dole Tax Cuts Ignore Deficits, Investment, Education, Future,” with Brad DeLong, San Jose Mercury News, August 26, 1996, p. 5E.

“Model Changes at NUMMI (A) and (B),” with Paul S. Adler and Barbara Goldoftas, teaching cases, USC, 1995.

“Government Should Take Lead in Quantifying Workplace Skills,” San Jose Mercury News, December 25, 1995, p. 3F.

“Not Such a Capital Idea,” with Brad DeLong, San Francisco Chronicle, December 5, 1995, p. A23.

“Welfare Reform that Makes Poor Kids Poorer Will Never Pay Off,” with Brad DeLong, Los Angeles Times, Sunday Forum, October 15, 1995, p. D2.

Book review of Darcy D’Art, Economic Democracy and Financial Participation, for Journal of Economic Behavior and Organization, 1993.

“The Quality Movement,” Dollars and Sense, September 1992, pp. 20-22. A short version appeared in Cal Business, June 1992.

“Management Education is an Oxymoron,” Cal Business Weekly, May 1992.

Book review of Tom Korver, The Fictitious Commodity: A Study of the U.S. Labor Market 1880-1940 for, Journal of Labor History, 32, 4, Fall 1991, pp. 624-625.

51

http://sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2004/02/05/EDGV34OCEP1.DTL

“Participation, Productivity, and the Firm’s Environment,” California Management Review, Summer 1990, pp. 86-100.

“Japan’s Other Export,” Dollars and Sense, September 1990, pp. 18-21.

“No Voice For Workers,” with Laura D’Andrea Tyson, Dollars and Sense, no. 152, December 1989, pp. 20-22. Reprinted in Microeconomics 91/92, Don Cole, ed., Dushkin Publishing Group, Guilford CN, 1990; Real World Macro, seventh and eighth editions, and Real World Micro, third edition Economic Affairs Bureau, Somerville MA, 1990, 1991, and 1992.

“Sweden: Full Employment in a Free Market Economy,” Labor Center Reporter, no. 251, November 1988.

“Capitalism, Swedish Style,” Dollars and Sense, no. 140, October 1988, pp. 20-22. Reprinted in Real World Macro, sixth edition, Economic Affairs Bureau, Somerville MA, 1989.

“Why Comparable Worth Won’t Upset the Marketplace,” San Francisco Chronicle, March 7, 1988, p. C6.

HONORS

Earl Cheit Outstanding Teaching Award, Haas School of Business, 1990 (undergraduate), 2000 (Evening MBA).

Listed in Who’s Who in Economics, a selection based on citation count.

Listed, Who’s Who of Professionals.

Member, “6.0” Teaching Honor Society (for mean, or more recently median, of 6 out of 7) each year since 1988.

Phi Beta Kappa

Omicron Delta Epsilon Economics Honor Society

University of California Alumni Scholar

GRANTS

“Piloting Novel Sales Contracts,” Goggio Family Foundation, 2009-10.

“Courting Safe Behaviors: Testing Courtyard-based Safe Water and Hygiene Interventions in Urban Bangladesh” (with ICDDR,B), International Initiative for Impact Evaluation (3ie), 2010-2012.

“Improved CookStoves in the Tumu Region of Ghana” (with CSIR and Plan-Ghana), International Initiative for Impact Evaluation (3ie), 2009-2011.

“Preferences for Point-of-Use Water Treatment” (with ICDDR,B), Swedish International Development Agency (SIDA), 2008-9.

“Evaluating a Telecommunications Intervention to Promote Literacy and Fight Poverty in Senegal” (with TOSTAN), UNICEF, 2009-10.

52

“Identification of Appropriate Postharvest Technologies for Improving Market Access and Incomes for Small Farmers in Sub-Saharan Africa and South Asia,” (with UC Davis and the World Food and Logistics Organization), Bill and Melinda Gates Foundation, 2009-10.

“Roundtable on safe stoves,” Berkeley Institute on the Environment, UC Berkeley, 2008-9.

“A Randomized Controlled Trial of Solar Ovens in Senegal,” Sustainable Products and Services, UC Berkeley, 2008-9.

“A Randomized Controlled Trial of Micro-Health Insurance in Cambodia,” grants from BASIS Assets and Market Access Collaborative Research Support (USAID) 2007-2010; AFD (Agence français pour development) 2007-2010, and the Coleman Fung Foundation 2007-2009.

“Choosing and Using Safe Water Products,” (with Jeff Alert of Aquaya.org), The P&G Fund of The Greater Cincinnati Foundation and The Blum Center for Developing Economies, 2007-8.

“Evaluating The Hunger Project’s Scaling-up of Epicenter Strategy in Ghana,” (with Chris Udry, Dean Karlan and John Anarfi), Robertson Foundation, 2007-2015.

“How Industrialization in China has affected the Elderly,” Center on the Economics and Demography of Aging, University of California at Berkeley, 2003-2004.

“Measuring Corporate Responsibility,” Haas Family Fund, 2004-6.

“The Effects of Age Diversity in the Workplace,” Center on the Economics and Demography of Aging, University of California at Berkeley, 2003-2004.

“Diversity at Work: Effects on Workers, Customers and Employers,” Russell Sage Foundation, 2003-4.

“Diversity and Performance,” Sloan Foundation and BOLD, with Jonathan Leonard, 2001.

“A Follow-up Evaluation of the Progresa Child Welfare Program,” National Institute of Child Health and Human Development (NICHD), 2001-2006, with Paul Gertler and others.

“The Effects of Industrialization on Children,” Center on the Economics and Demography of Aging, University of California at Berkeley, 2001-2002.

“Financial and Social Capital as Protection Against Health Shocks in Indonesia,” Center for Health Research, U.C. Berkeley, 2001-02.

“Investments in Children in Indonesia: Lessons to be Learned from the Economic Crisis,” Research Bridging Grant from the Committee on Research, U.C. Berkeley, 1999-2000.

Subcontractor on Mortgage Lending Discrimination: What Do We Know? Urban Institute grant from the U.S. Department of Housing and Urban Development, 1998.

53

COHRE, “Causes and Consequences of Employee Turnover,” with Jonathan Leonard, 1998-99.

54

Sage Foundation, “Perceptions of the Fair Employment Contract: Evidence from a Quasi-Experiment,” with Gary Charness, 1998-99.

Upjohn Institute, “Changes in Careers, Compensation and Internal Labor Markets at Large American Employers,” with Dale Belman and K.C. O’Shaughnessy, 1998-99.

California Commission on Health and Safety and Workers’ Compensation, “Evaluation of Workers’ Compensation Programs Established Pursuant to Labor-Management Agreements in the Construction Industry,” 1997-8.

Committee On Teaching, Office of Educational Development, U.C. Berkeley, Classroom Technologies Grant: 1995-1996.

Sloan Foundation, “What Works at Work,” with the National Center for the Workplace, 1993-5.

Sloan Foundation, “Employee Involvement and Total Quality Management in the 1990’s,” with Edward E. Lawler III, Gerald Ledford, and Susan Mohrman, 1992-4.

Consortium on Competition and Cooperation, “Human Resource Policies and Corporate Performance in the United States and Japan,” 1991-92.

Consortium on Competition and Cooperation, “Cooperative Supplier Relations: An Exit-Voice Approach,” 1990-91.

COURSES TAUGHT

Industrial Relations (Undergraduate and Ph.D.)

Macroeconomics (Undergraduate and MBA)

Bargaining and Negotiation (Undergraduate)

Human Resource Strategies (MBA – new course)

The New Employment Contract (Undergraduate – new course)

Films about Work (Undergraduate – new course)

Business Strategies for Emerging Markets (MBA – new course)

CONSULTANT Government

o U.S. Dept. of Laboro Berkeley Planning Associates (subcontract from Dept. of Health and Human Services)o Urban Institute (subcontract from Dept. of Housing and Urban Development)o CalTranso OECD

Private sectoro Conocoo San Francisco Electrical Contractors Associationo NERAo Filene Research Instituteo BPIo American Automobile Association o Korean Human Resources Study Group

Legal consultanto Goldman and Goldman

o Morgenstein & Jubelirer LLP Expert Witness

o Leonard Carder, LLP (Roberts, et al., v. Best Buy Co., Inc.)o Gradstein, Luskin & Van Dalsem (Adams v. Home Depot U.S.A., Inc.)o Quisenberry Law Firm (Daniel Sepulveda, Anita Perez and Antonio Prangner vs. Wal-Mart

Stores, Inc.)o Keker & Van Nest LLP (Tjian v. Westamerica Bancorporation)



Raymond P. GuiterasCurriculum VitaeMarch 2011

1. Contact Information:Department of Economics3105 Tydings HallUniversity of MarylandCollege Park, MD [email protected]://www.econ.umd.edu/faculty/profiles/guiteras/

2. Affiliations:Current Affiliations:Assistant Professor, Department of Economics, University of Maryland, August 2008–presentFaculty Associate, Maryland Population Research Center, University of MarylandMember, International Growth CentrePrevious Affiliations:Visiting Scholar, Resources for the Future, Fall 2009Assistant Economist, International Research, Federal Reserve Bank of New York, 2001–2003Associate Consultant, Bain & Company, 1999–2001Research Assistant, White House Council of Economic Advisors, 1998–1999

3. Education:Ph.D., Economics, M.I.T., 2008. Dissertation title: Essays in Empirical Microeconomics.Thesis committee: Prof. Michael Greenstone, Prof. Esther Duflo, Prof. Victor ChernozhukovB.A., Economics and History, magna cum laude, Amherst College, 1998

4. Research Interests:Environmental Economics, Development Microeconomics, Applied Microeconometrics

5. Research Papers:The Short- and Medium-Run Impact of Clean Water and Sanitation on Diarrhea in RuralIndia. Mimeo, December 2010 (with Esther Duflo, Michael Greenstone and Thomas Clasen,under revision)Incentive Compatibility in the Field: A Test of the Becker-Degroot-Marschak Mechanism.Mimeo, March 2011. (with James Berry and Greg Fischer)The Impact of Climate Change on Indian Agriculture. Mimeo, September 2009 (under revisionfor resubmission to Journal of Development Economics)Estimation of Quantile Treatment Effects in a Regression Discontinuity Design. Mimeo, July20081

6. Research in Progress:Clean Water, Health and the Market Mechanism: How Effective is the Market at AllocatingHealth Goods? (with James Berry and Greg Fischer)Impacts of Climate Change on Low-Lying and Flood-Prone Areas: The Case of Bangladesh

(with Rick Hornbeck and A. Mushfiq Mobarak)Barriers to and Impacts of Health Microinsurance: Evidence from a Randomized Trial inNorthern Ghana. (with Harounan Kazianga)Separating Selection and Incentives in Day Labor Markets: Evidence from Rural Malawi.(with Kelsey Jack)Fighting Cholera in Dhaka: Direct Impacts and Externalities of Vaccination andWater Treatment.(with Michael Kremer)Demand Coordination with Strong Complementarities and Externalities: Evidence from SanitationInterventions in Bangladesh. (with James Levinsohn and A. Mushfiq Mobarak)Contracts and Market Design for Land-Based Carbon Offsets. (with Oluyede Ajayi, SamuelBell, Kelsey Jack and Paulina Oliva)

7. Teaching:Empirical Microeconomics (graduate, U. of Maryland Econ 626), 2008, 2009, 2010Theory of Development Economics (undergraduate, U. of Maryland Econ 416), 2009 (Springand Fall), 2010Randomized Evaluation of Social Programs (Jameel Poverty Action Lab Executive EducationCourse), Head Teaching Assistant, 2008, Teaching Assistant, 2006, 2007Development Macroeconomics (graduate, M.I.T. 14.772 and Harvard Econ 2390c), TeachingAssistant, 2007, 2008Microeconometrics (graduate, M.I.T. 14.385), Teaching Assistant, 2006Econometrics I (graduate, M.I.T. 14.382), Teaching Assistant, 2006Probability and Statistics (undergraduate, M.I.T. 14.30), Instructor, 2005

8. Advising:Ermal Hitaj, Ph.D., U. of Maryland, 2011 (expected)Abby Alpert, Ph.D., U. of Maryland, 2011 (expected)Diether Beuermann, Ph.D., U. of Maryland, 2011 (expected)Alessandro Orfei, Ph.D., U. of Maryland, 2011 (expected)Amy Knaup, Ph.D., U. of Maryland, 2012 (expected)Aaron Szott, Ph.D., U. of Maryland, 2012 (expected)

9. Fellowships and GrantsInternational Growth Centre. Contracts and Market Design for Land-Based Carbon Offsets.December 2010, £57,124.Bill & Melinda Gates Foundation. Adoption of Sanitary Practices and Technologies inBangladesh. October 2010, $1,618,047.2International Labor Organization. Barriers to and Impacts of Health Microinsurance: Evidencefrom a Randomized Trial in Northern Ghana. April 2010, $110,000.Dean’s Research Initiative, College of Behavioral and Social Sciences, University of Maryland.Impacts of Climate Change on Low-Lying and Flood-Prone Areas: The Case of Bangladesh,March 2010, $19,617.Maryland Population Research Center Seed Grant Program. Clean Water, Health and theMarket Mechanism: How Effective is the Market at Allocating Health Goods? December2009, $15,000.International Growth Centre, Impacts of Climate Change on Low-Lying and Flood-ProneAreas: The Case of Bangladesh, September 2009, £17,859International Growth Centre, Household Clean Water Technology in Northern Ghana: Valuation,Use and Impact, September 2009, £24,055George and Obie Schultz Fund Grant, 2005 & 2006Martin Fellowship for Sustainability, M.I.T. Laboratory for Energy and the Environment,2005–2006National Science Foundation Graduate Research Fellowship, 2003–2005, 2007–2008

10. Professional Service:Referee (alphabetical): American Economic Journal: Applied Economics; Environment and

Development Economics; Environmental and Resource Economics; Journal of DevelopmentEconomics; Journal of Environmental Economics and Management; Journal of Public Economics;Quarterly Journal of Economics; Review of Economic Studies

11. Invited Presentations:2010–2011: Millenium Challenge Corporation; University of California Santa Barbara2009–2010: Columbia University; Georgetown University; RAND; Resources for the Future2008–2009: Harvard University Center for International Development; University of MarylandDepartment of Agricultural and Resource Economics; University of Maryland Earth SystemScience Interdisciplinary Center2007–2008: Smith College; Williams College; University of British Columbia; Colgate University;Resources for the Future; University of Maryland; University of North Carolina;University of California – Merced

12. Conferences:2010: AEA/ASSA Annual Meetings (Session: Access to Clean Water in Developing Countries);Northeast Universities Development Consortium (NEUDC)2009: AAEA / ACCI Joint Annual Meetings2008: NBER Summer Institute, Environmental Economics (discussant)

13. Honors and AwardsGraduate TA of the Year, Department of Economics, M.I.T., 2005-2006Nelson Memorial Award (Top Senior Economics Major), Amherst College, 19983FBK, Amherst College, 1997Economics Junior Class Prize, Amherst College, 1996

Biography of the Investigators

Give biographical data in the following table for key personnel including the Principal Investigator. Use a photocopy of this page for each investigator.


MINHAJ MAHMUDResearch FellowBangladesh Institute of Development StudiesE-17 AGARGAON, SHER-E-BANGLA NAGARDHAKA 1207Email: [email protected]. 88029118855, 8801732763436(cell)EducationPh.D. in Economics, University of Gothenburg, Sweden, 2005.

M. A. in Economics, University of Manitoba, Canada, 1999.

M.Sc. in Economics, Jahangirnagar University, Dhaka. 1992.

B.Sc. (Honours) in Economics, Jahangirnagar University, Dhaka. 1991.Full time Positions Associate Professor of Economics, BRAC University, Dhaka, Bangladesh 2009-10

Lecturer (Grade B), Environmental Economics, Queens University Belfast, UK 2006- 09

Lecturer, Economics, Keele University, Staffordshire, UK 2005-2006

Lecturer/Assistant Professor, Economics, Jahangirnagar University, Bangladesh 1994-1997Visiting/Part time Positions Consultant Economist, Water and Sanitation Cluster, ICDDR, B, Dhaka 2008- 2011

Part time Faculty, Department of Economics and Social Sciences, Brac University, Dhaka, 2010- 2011

Visiting Faculty, Centre for International Trade and Development, Jawaharlal Nehru University, New Delhi, February-March 2010

Adjunct Faculty, James P Grant School of Public Health, BRAC University, Dhaka, June 2009

Visiting Researcher, Environmental Economics Unit, University of Gothenburg, Sweden, July-August 2007

Teaching/Research Assistant, Economics, University of Gothenburg, Sweden 2005

Academic Intern, International Institute for Environment and Development (IIED), London, August 2000

Teaching Assistant, Economics, University of Manitoba, Canada 1997-1999

Research Officer, Bangladesh Institute of Development Studies, 1993-94Research Areas and InterestsBehavioural and Experimental Economics, Health Economics, Environmental Economics, Development IssuesPublications PhD Thesis:

Measuring Trust and the Value of Statistical Lives: Evidence from Bangladesh, 2005. Economic Studies 145, University of Gothenburg, Sweden, ISBN 91-85169-04-8, ISSN 1651-4289


Refereed Journal Articles

1. Saving lives versus life years in rural Bangladesh: An Ethical Preferences Approach (with O. Johansson-Stenman and P. Martinsson), 2011, Health Economics, Wiley InterScience, 20(6), June.

2. Trust and Religion: Experimental Evidence from Bangladesh (with O. Johansson-Stenman and P. Martinsson), 2009, Economica, Blackwell Publishing, 76(3):462-485, July.

3. On the Contingent Valuation of Mortality Risk Reductions in Developing Countries, 2009, Applied Economics, Taylor and Francis Journals, 41(2):171-181, January.

4. Does Stake Size Matter in Trust Games (with O. Johansson-Stenman and P. Martinsson), 2005 Economics Letters, Elsevier, 88(3): 365-369, September.

Revise and Re-submit

1. Trust, Trust Games and Stated Trust: Evidence from Rural Bangladesh (with O. Johansson -Stenman and P. Martinsson), Journal of Economic Behavior and Organization, Elsevier.

2. What Point-of-Use Water Treatment Products do Consumers Use and Value? Evidence from a Randomized Controlled Trial among the Urban Poor in Bangladesh (with, Jill Luoto, Nusrat Najnin Jeff Albert, Sirajul Islam, Steve Luby, Leanne Unicomb and David Levine), 2011, PLoS ONE (eISSN-1932-6203)

Working Papers1. Provision of Microinsurance: The Choice among Delivery and Regulatory Mechanisms (with

Syed M Ahsan), Institute of Microfinance , Dhaka

2. Background Paper on Sixth Five Year Plan 2011-2015: The Challenges of Good Governance, Implementation Capacity, and Monitoring and Evaluation in Implementing the Plan, paper prepared for the Planning Commission, Government of Bangladesh, December 2010

3. Lessons from Health Care Financing Programs (NGOs) in Bangladesh. Prepared for the Bangladesh Health Watch Report 2010, April 2011

Ongoing Research 1. An Inquiry into the Nature and Causes of Delinking of Local Wholesale Prices with International Prices:

The Case of Rice Market in Bangladesh, funded by the South Asian Network on Economic Institutes(SANEI)(Principal Investigator)

2. Food Security and Mitigation in Bangladesh Agriculture: Searching for a Low Carbon Path of development (Co Investigator)

3. Planning for Pro-Poor Sustainable Environment and Climate Change Sensitive Analysis of Annual Development Programs of Selected Sectors, funded by the UNDP (Co-Investigator)

4. Piloting Home Water Treatment and Handwashing in Dhaka (External Co-Investigator), funded by the Bill Gates and Melinda Foundation, in collaboration with the ICDDR, B (Dhaka) 2009-2011

Professional AffiliationsMember, Editorial Advisory Board, Lahore Journal of Economics, Lahore School of Economics, Pakistan,

2010-

Member, Economic Research Group, Dhaka

Member, Association for Economic and Development Studies on Bangladesh, USA

Research Associate, Environmental Economics Unit, University of Gothenburg

Member, Economic Science Association (USA)

Member, European Association of Environmental and Resources Economics

Professional ServiceProgramme Committee Member, European Conference on Environmental and Resource Economics

(EAERE) 2011Programme Committee Member, European Conference on Environmental and Resource Economics

(EAERE) 2008Ad-hoc Referee for Journals (Alphabetically): Applied Economics, Environment and Development

Economics, Environmental and Resource Economics, International Journal for Sustainable Development, Journal of Socioeconomics

External Reviewer of Research Protocol (Health Economics), ICDDRBReviewer, ASCON Conference 2011External Examiner, Master’s Thesis, Masters in Governance and Development, BRAC University, Dhaka Academic Presentations in Conferences, Workshops, SeminarsSeminar presentation, Centre for International Trade and Development, Jawaharlal Nehru University, New

Delhi, March 26, 2010

Invited Speaker, Economic Approaches to Climate Change and Poverty: Workshop for policymakers and researchers in Bangladesh, organized by the UNDP, UNEP, the Planning Commission of Bangladesh and SANDEE 13-14 October 2009, Dhaka

Invited Discussant at the Symposium in Economics, Economic Research Group, Dhaka, 20 August, 2008

Invited Seminar presentation at the University of Reading Business School, UK, January 2008.

3rd Asia Pacific Meeting of Economic Science Association (ESA), Shanghai Jiao Tong University, China, 3-5 August 2007

69th Health Economists Study Group (HESG) Meeting, York University, UK July 26-28, 2006

6th European Conference on Health Economics, Budapest, Hungary July 6-9, 2006

Workshop on Trust and Democracy: Multidisciplinary Perspective, Göteborg University, 19-20 May 2005.

5th European Conference on Health Economics, London School of Economics, London, September 2004.

2nd Budapest Workshop in Behavioural Economics, Central European University, Budapest, July 2004.

Beijer PhD workshop in Environmental Economics, The Royal Swedish Academy of Sciences, Stockholm, August 2004

3rd Nordic Conference in Development Economics, University of Gothenburg, June 18-20 2004.

Workshop on Contingent Valuation Method in Developing Countries, University of Gothenburg, May 12-16, 2003.

Beijer Research Seminar in Environmental Economics, organised by The Royal Swedish Academy of Sciences, Stockholm, Malaysia May 1997

Teaching Experience Postgraduate Courses: Behavioral Economics; Environmental Economics; Public Economics; Public Finance; Health Economics; Advanced Econometrics; Econometrics; Economic Development

Undergraduate CoursesLaw and Economics(Level 3); Environmental Economics(Level 2, 3 & 4); Health Economics(Level 3); Economics for Finance(Level 1); Microeconomic Theory and Application (Level 2); Macroeconomic Theory and Application (Level 2); Principles of Economics (Level 1), Economic Development (Level 3 ); Quantitative Methods in Economics (Level 3); Microeconomics(Level 1); Mathematics for Economics (Level 1 & 2); Statistics for Economics and Finance( Level 1); Statistics for Economics (Level 1 & 2).

References Available on Request




Michael KremerHarvard University, Department of Economics, Littauer Center M-20, Cambridge, MA 02138Tel: 617/495-9145. Fax: 617/495-7730. E-mail: [email protected]

EDUCATIONHarvard University. Ph.D. in Economics, 1992.Harvard College. A.B. in Social Studies, Magna cum laude, Phi Beta Kappa, 1985.

EXPERIENCEGates Professor of Developing Societies 2003-Professor of Economics, Harvard University, 1999-2003.Research Associate, National Bureau of Economic Research, 1999-Present.Senior Fellow, The Brookings Institution, 1998-Present.Faculty Fellow, Center for International Development, 1998-Present.Faculty Associate, Harvard Institute for International Development, 1997-2000.Professor of Economics, MIT, 1998-1999.Pentti Kouri Career Development Associate Professor of Economics, MIT, 1996-1998.Research Associate, Harvard Institute for International Development, 1995-1997.Pentti Kouri Career Development Assistant Professor of Economics, MIT, 1994-1996.Faculty Research Fellow, National Bureau of Economic Research, 1993-1999.Assistant Professor of Economics, MIT, 1993-1994.Visiting Assistant Professor, University of Chicago, Spring 1993.Postdoctoral Fellow, MIT, 1992-1993.Executive Director, WorldTeach, 1986-1989. Founded and directed non-profit organizationplacing three hundred volunteer teachers annually in developing countries.Teacher and Administrator, Eshisiru Secondary School, Kakamega District, Kenya, 1985-1986.

HONORS AND AWARDSScientific American 50 Award. Named one of the 50 researchers of the year, 2006.Michael Kremer 2Kenneth J. Arrow Award for Best Paper in Health Economics in 2004 by the International HealthEconomics Association, 2005.Association of American Publishers Award for the Best Professional/Scholarly Book in MedicalScience for Strong Medicine, 2004.Young Global Leader, the World Economic Forum, 2004Fellow, American Academy of Arts and Sciences, 2003.MacArthur Fellowship, 1997.Presidential Early Career Award for Scientists and Engineers, 1996.Health and Aging Fellow, National Bureau of Economic Research, 1996-1997.National Fellow, Hoover Institution, Stanford University, 1994-1995.Review of Economic Studies dissertation award recipient, 1992.Wells Prize for economics dissertation at Harvard, 1992.National Science Foundation Fellowship, 1989-1992.

OTHER ACTIVITIESCo-chair, Co-founder, BREAD (The Bureau for Research and Economic Analysis ofDevelopment), 2001-Present. BREAD organizes conferences in development economics,focusing on microeconomic issues.Non-resident Fellow, Center for Global Development, 2002-Present.Associate Editor, Journal of Development Economics, 1999-2004Associate Editor, Quarterly Journal of Economics, 1998-2008Member Board of Editors, American Economic Journal: Applied Economics, 2007-Consultant, Development Economics Research Group (DECRG), The World Bank

PUBLICATIONS

BOOKSStrong Medicine: Creating Incentives for Pharmaceutical Research on Neglected Diseases, withRachel Glennerster, Princeton and Oxford: Princeton University Press, 2004.

ACADEMIC ARTICLES AND BOOK CHAPTERS“Spring Cleaning: Rural Water Impacts, Valuation and Property Rights Institutions,”with JessicaLeino, Edward Miguel, and Alix Peterson Zwane. Forthcoming Quarterly Journal of Economics(National Bureau of Economic Research, NBER Working Papers: 15280, 2009.)Michael Kremer 3“Are Educational Vouchers Only Redistributive?” with Eric Bettinger and Juan E. SaavedraThe Economic Journal: 120 (August 2010): F204–F228. doi: 10.1111/j.1468-0297.2010.02374.x"Teacher Incentives," with Paul Glewwe and Nauman Ilias. American Economic Journal:Applied Economics :2:3 (July 2010): 205-27 (National Bureau of Economic Research, Inc,NBER Working Paper 9671, 2003.)“Self-Control and the Development of Work Arrangements,” with Supreet Kaur and SendhilMullainathan. American Economic Review: 100: 2 (May 2010): 624-28“Early-Life Malaria Exposure and Adult Outcomes: Evidence from Malaria Eradication inIndia,” with David Cutler, Winnie Fung, Monica Singhal, and Tom Vogl. American EconomicJournal: Applied Economics 2:2 (April 2010): 72-94. (“Mosquitoes: The Long-term Effects ofMalaria Eradication in India,” National Bureau of Economic Research, Inc, NBER WorkingPapers: 13539, 2007)..“Economic transformation, population growth and the long-run world income distribution,” withMarcos Chamon. Journal of International Economics 79:1 (September 2009): 20-30.International Monetary Fund, IMF Working Papers: 06/21, 2006 and National Bureau ofEconomic Research, Inc, NBER Working Papers: 12038, 2006.“Pricing and Access: Lessons from Randomized Evaluations in Education and Health,” withAlaka Holla in Jessica Cohen and William Easterly (eds.) What Works in Development?Thinking Big and Thinking Small. Washington, DC: Brookings Institution Press, 2009.“Improving Education in the Developing World: What Have We Learned from RandomizedEvaluations?” with Alaka Holla in Kenneth J. Arrow and Timothy F. Bresnahan, eds., AnnualReview of Economics, Volume 1, 2009. Palo Alto, California: Annual Reviews.“Public-Private Schools in Rural India,” with Karthik Muralidharan in Rajashri Chakrabarti andPaul E. Peterson, eds., School-Choice International: Exploring Public-Private Partnerships.Cambridge (Mass): The MIT Press, 2009."Estimating the Impact of the Hajj: Religion and Tolerance in Islam’s Global Gathering," withDavid Clingingsmith, Asim Ijaz Khwaja.. Quarterly Journal of Economics 124:3 (August 2009):1133-1170. (John F. Kennedy School of Government, Working Paper Series, 2008 andWeatherhead Center for International Affairs, Working Paper Series, 2008).“Teacher Incentives in the Developing World,” with Paul Glewwe, and Alaka Holla in Springer,Matthew, ed., Performance Incentives: Their Growing Impact on American K-12 Education,

Washington, DC: Brookings Institution Press, 2009."Incentives to Learn,” with Edward Miguel and Rebecca Thornton, Review of Economics andStatistics (lead article) 91:3 (August 2009): 437-456. (National Bureau of Economic Research,Inc, NBER Working Papers: 10971, 2004).Michael Kremer 4“A Biological Model of Unions,” with Ben Olken. American Economic Journal: AppliedEconomics 1:2 (April 2009): 150-175. (NBER Working Paper 8257, 2001.)“Deworming and development: asking the right questions, asking the questions right,” withDonald Bundy, Hoyt Bleakley, Matthew Jukes, and Edward Miguel. January 2009. PLoSNeglected Tropical Diseases(http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0000362).“Many Children Left Behind? Textbooks and Test Scores in Kenya,” with Paul Glewwe andSylvie Moulin. American Economic Journal: Applied Economics 1:1 (January 2009): 112-135.(National Bureau of Economic Research, Inc, NBER Working Papers: 13300, 2007).“Cambios en los hábitos y los sistemas sanitarios: algunas evidencias a partir de evaluacionesaleatorizadas” in José García Montalvo, ed., El análisis experimental de la ayuda al desarrollo.Bilbao: Fundación BBVA, 2008."Incentives in Markets, Firms, and Governments," with Daron Acemoglu and Atif Mian. Journalof Law, Economics, and Organization 24:2 (October 2008): 273-306. (NBER Working Paper9802, 2003).. (NBER Working Paper 9802, 2003).“Outside Funding and the Dymanics of Particpation in Community Associations,” with MaryKay Gugerty. American Journal of Political Science 52:3: (July2008) 585-602.("OutsideFunding of Community Organizations: Benefiting or Displacing the Poor?" with Mary KayGugerty, NBER Working Paper 7896, 2000.)"Peer Effects and Alcohol Use among College Students," with Dan Levy, Journal of EconomicPerspectives 22:3 (Summer 2008): 189 - 206 (NBER Working Paper 9876, 2003).“How High Are Rates of Return to Fertilizer? Evidence from Field Experiments in Kenya,” withEsther Duflo and Jonathan Robinson. American Economic Review Papers and Proceedings. 98:2(May 2008):482-488.“Using Randomization in Development Economics Research: A Toolkit,” with Esther Duflo andRachel Glennerster, in T. Schultz and John Strauss, eds., Handbook of Development Economics,Volume 4. Amsterdam and New York: North-Holland, 2008. (Centre for Economic PolicyResearch, CEPR Discussion Papers: 6059, 2007; National Bureau of Economic Research, Inc,NBER Technical Working Paper No. 333, December 2006.)“Making Vaccines Pay,” in William Easterly, ed., Reinventing Foreign Aid, Cambridge (Mass.):The MIT Press, 2008.“Use of Randomization in the Evaluation of Development,” with Esther Duflo, in WilliamEasterly, ed., Reinventing Foreign Aid. Cambridge (Mass.): The MIT Press, 2008.“Globalisation and Inequality within Countries,” in Poverty in Focus: The Challenge ofInequality Brasilia: International Poverty Center, June 2007: 10 – 11.Michael Kremer 5“What Works in Fighting Diarrheal Diseases in Developing Countries? A Critical Review,” withAlix Peterson Zwane. World Bank Research Observer 22:1, (Spring 2007): 1-24. 2007. (NationalBureau of Economic Research, Inc, NBER Working Paper: 13539, 2007).“Cost-Effective Prevention of Diarrheal Diseases: A Critical Review,” with Alix PetersonZwane, Center for Global Development Working Paper #117, 2007. http://www.cgdev.org/files/“Advance market commitments for vaccines against neglected diseases: Estimating costs andeffectiveness,” with Ernst Berndt, Rachel Glennerster, Jean Lee, Ruth Levine, GeorgWeizsäcker, and Heidi Williams. Health Economics 16:5 (May 2007): 491-511. (Center forGlobal Development Working Paper # 98, August 2006)"The Illusion of Sustainability," with Edward Miguel. Quarterly Journal of Economics 122(3)(August 2007): 1007-1065. Reprinted in Reinventing Foreign Aid, ed., William Easterly.Cambridge (Mass.): The MIT Press, 2008 (NBER Working Paper 10324, 2004.)

“The Political Economy of Education in Kenya,” in Mark Gradstein and Kai A. Konrad, eds.,Institutions and Norms in Economic Development. Cambridge (Massachusetts): The MIT Press,2006.“Globalization of Labor Markets and Inequality,” in Susan M. Collins and Carol Graham, eds.,Global Labor Markets, Brookings Trade Forum, 2006, Washington, D.C.: Brookings InstitutionPress, 2006.“Schools, Teachers, and Education Outcomes in Developing Countries,” with Paul Glewwe inEric Alan Hanushek and Finis Welch, eds., the Handbook on the Economics of Education,volume 2. Amsterdam and London: North-Holland, 2006.“Long-Term Educational Consequences of Secondary School Vouchers: Evidence fromAdministrative Records in Colombia” with Joshua Angrist and Eric Bettinger. AmericanEconomic Review 96: 3, (June 2006): 847-62. (NBER Working Papers: 10713, 2004).“Odious Debt,” in Jochnick and Preston, eds., Sovereign Debt at the Crossroads. New York:Oxford University Press, 2006."Empathy or Antipathy? The Consequences of Racially and Socially Diverse Peers on Attitudesand Behaviors," with Greg Duncan, Johanne Boisjoly, Dan Levy, and Jacque Eccles. AmericanEconomic Review 96:5 (December 2006): 1890-1906.“The Missing Mandate:Global Public Goods,” in Nancy Birdsall, ed., Rescuing the World Bank:A CGD Working Group Report and Selected Essays. Washington DC: Center for GlobalDevelopment, 2006.“Global Public Goods in Communicable Disease Control,” in Infectious Disease, Expert PaperOne. Stockholm: International Task Force on Global Public Goods, 2006.Michael Kremer 6“Creating Markets for Vaccines,” with Rachel Glennerster and Heidi Williams. Innovations:Technology, Governance, Globalization. 1:1 (winter 2006): 67-79.“Odious Debt,” with Seema Jayachandran, in Ashoka Mody and Catherine Patillo, eds.,Macroeconomic Policies and Poverty Reduction. New York: Routledge, 2006."Odious Debt," with Seema Jayachandran. American Economic Review 96:1 (March 2006):82-92(NBER Working Paper 8953, 2002). Reprinted in Paul Collier and Jan Willlem Gunning, eds.,Globalization and Poverty, Cheltenham: Edward Elgar, 2008.“Asian Growth and African Development,” with Marcos de Carvalho Chamon. AmericanEconomic Review Papers and Proceedings 96:2 (May 2006): 400-404.“Why Are Teachers Absent? Probing Service Delivery in Peruvian Primary Schools,” withLorena Alcazar, F. Halsey Rogers; Nazmul Chaudhury, Jeffrey Hammer, Karthik Muralidharan.International Journal of Educational Research 45:3 (2006): 117-136.“Public Policies to Stimulate Development of Vaccines for Neglected Diseases,” in AbhijitBanerjee, Roland Benabou, and Dilip Mookherjee, eds., Understanding Poverty. New York:Oxford University Press, 2006.“Creating Incentives For Private Sector Involvement In Poverty Reduction: PurchaseCommitments For Agricultural Innovation,” with Alix Peterson Zwane in Inge Kaul and PedroConceição, eds., The New Public Finance Responding To Global Challenges. New York: OxfordUniversity Press, 2006.“Missing in Action: Teacher and Health Worker Absence in Developing Countries” with NazmulChaudhury, Jeffrey Hammer, Karthik Muralidharan, and F. Halsey Rogers. Journal of EconomicPerspectives 20:1 (Winter 2006): 91-116."Advance Market Commitments: A Policy to Stimulate Investment in Vaccines for NeglectedDiseases," with Owen Barder and Heidi Williams. The Economists' Voice. 3:3 (2006)http://www.bepress.com/ev/vol3/iss3/art1/.“Motivation Matters: Merit Scholarships and Student Achievements,” in Innovation inEducation: Proceedings of a Conference held in Cleveland, Ohio, November 17-18, 2005.“Teacher Absence in India: A Snapshot,” with Nazmul Chaudhury, Jeffrey Hammer, KarthikMuralidharan, and F. Halsey Rogers. Journal of the European Economic Association, 3:2-3(April-May 2005): 658-667

“Incentives to Learn,” with Edward Miguel and Rebecca Thornton. Education Next: a Journal ofOpinion and Research, 5:2 (Spring 2005): pp. 57-64.Michael Kremer 7“Peer Effects in Drug Use and Sex Among College Students,” with Greg J. Duncan, JohanneBoisjoly, Dan M. Levy, and Jacque Eccles. Journal of Abnormal Child Psychology 33:3 (June2005): 375–385.“The price of life,” with Rachel Glennerster and Heidi Williams. Foreign Policy, May/June2005: 26-27."Incentives for research on neglected diseases" Letter to the Editor, The Lancet (365), February26, 2005, pp. 753-754.“ ‘Measuring Poverty’: Discussion” The Review of Economics & Statistics 87:1 (February 1,2005): 23-25."Use of Randomization in the Evaluation of Development Effectiveness," with Esther Duflo, inGeorge Keith Pitman, Osvaldo N. Feinstein, and Gregory K. Ingram, eds., EvaluatingDevelopment Effectiveness, Vol. 7 of World Bank Series on Evaluation and Development. NewBrunswick, New Jersey, and London, U.K.: Transaction Publishers, 2005.“Encouraging Private Sector Research for Tropical Agriculture,” with Alix Peterson Zwane.World Development 33:1 (January 2005): 87-105.“On How To Improve World Health,” Daedalus, Summer 2004: 120-123.“Comment on Jeffrey Sachs’ ‘Ending Africa’s Poverty’” in William C. Brainard and George L.Perry, eds., Brookings Papers on Economic Activity, 2004:1: 217-231. Washington, D.C.:Brookings Institution Press, 2004.“Regional Public Goods and Health in Latin America,” (with Jessica Leino) in AntoniEstevadeordal, Brian Frantz, Tam Robert Nguyen, eds., Regional Public Goods: From Theory toPractice, Washington, D.C.: Inter-American Development Bank and Asian Development Bank,2004.“Comments on ‘Assessing the Impact of Globalization on Poverty and Inequality: A New Lenson an Old Puzzle’ (Carol Graham) and on ‘Poverty and the Organization of Political Violence: AReview and Some Conjectures’ (Nicholas Sambanis)” in Susan M. Collins and Carol Graham,eds., Brookings Trade Forum 2004: Globalization, Poverty and Inequality. Washington, DC:Brookings Institution Press, 2004.“Statist Quo Bias: Rejoinder to De Alessi,” Econ Journal Watch 1:2 (August 2004): 277-278.http://www.econjournalwatch.org“An Ivory-Tower Take on the Ivory Trade: Response to De Alessi,” Econ Journal Watch 1:1(April 2004): 55-57. http://www.econjournalwatch.org"Ways to Spur Malaria Vaccine Research," (with Rachel Glennerster), forthcoming in TheEconomics of Malaria.Michael Kremer 8"Retrospective vs. Prospective Analyses of School Inputs: The Case of Flip Charts in Kenya,"with Paul Glewwe, Sylvie Moulin and Eric Zitzewitz. Journal of Development Economics 74:1(June 2004): 251-268. (NBER Working Paper 8018, 2000)"Worms: Identifying Impacts on Education and Health in the Presence of TreatmentExternalities," with Edward Miguel, Econometrica 72:1 (January 2004):159-217. (NBERWorking Paper 8481, 2001)"Elephants: Reply," with Charles Morcom. American Economic Review 93:4 (September 2003):1446-1448."Randomized Evaluations of Educational Programs in Developing Countries: Some Lessons,"American Economic Review 93:2 (May 2003): 102-106.“A Purchase Commitment for Vaccines,” a contribution to "Beyond Communicable DiseaseControl: Health in the Age of Globalization," by Dyna Arhin-Tenkorang and Pedro Conceição,in Inge Kaul, Pedro Conceição, Katell Le Goulven, and Ronald U. Mendoza, eds., ProvidingGlobal Public Goods: Managing Globalization, Oxford University Press, 2003."Vouchers for Private Schooling in Colombia: Evidence from a Randomized Natural

Experiment," with Joshua Angrist, Eric Bettinger, Erik Bloom, and Elizabeth King. AmericanEconomic Review 92:5 (December 2002):.1535-1558. (NBER Working Paper 8343, 2001)"Pharmaceuticals and the Developing World," Journal of Economic Perspectives 16:4, (Fall2002): 67-90."Income Distribution Dynamics with Endogenous Fertility," with Daniel Chen. Journal ofEconomic Growth 7:3 (September 2002):227-258. (NBER Working Paper 7530, 2000)."The Impact of Development Assistance on Social Capital: Evidence from Kenya," with MaryKay Gugerty, in Christian Grootaert and Thierry van Bastelaer, eds., The Role of Social Capitalin Development: An Empirical Assessment. Cambridge (UK): Cambridge University Press, April2002."A Purchase Commitment for Vaccines," in Inge Kaul, Katell Le Goulven, and Mirjam Schnupf,eds., Global Public Goods Financing: New Tools for New Challenges, A Policy Dialogue,United Nations Development Programme, Office of Development Studies, 2002."Does Favorable Tax-Treatment of Housing Reduce Equipment Investment?” with BenBroadbent. Journal of Public Economics 81:3 (September 2001): 369-391. (NBER WorkingPaper 6161, 1997)."Creating Markets for New Vaccines: Part I: Rationale," in Adam B. Jaffe, Josh Lerner, andScott Stern (eds.), Innovation Policy and the Economy, MIT Press, Volume 1, 2001.Michael Kremer 9"Creating Markets for New Vaccines: Part II: Design Issues," in Adam B. Jaffe, Josh Lerner, andScott Stern (eds.), Innovation Policy and the Economy, MIT Press, Volume 1, 2001."Searching for Prosperity," with Alexei Onatski and James Stock, Carnegie-RochesterConference Series on Public Policy (55), 2001, pp. 275-303."A Commitment for Vaccines," with Jessica Leino, translated into French as "Un engagementpour les vaccins," Biofutur 217 December 2001."Elephants," with Charles Morcom, American Economic Review, 90:1 (March 2000): 212-234.(NBER Working Paper 5674, 1996)"Improving School Quality in Developing Countries," in Anne O. Krueger, ed., Economic PolicyReform: The Second Stage, University of Chicago Press, 2000."Income Distribution Dynamics with Endogenous Fertility," with Daniel Chen, AmericanEconomic Review Papers and Proceedings, May 1999, pp. 155-160. (NBER Working Paper7530, 2000)"AIDS: The Economic Rationale for Public Intervention," in Martha Ainsworth, Lieve Fransen,and Mead Over (eds.), Confronting AIDS: Evidence from the Developing World, The EuropeanCommission and the World Bank, 1998."Patent Buyouts: A Mechanism for Encouraging Innovation," Quarterly Journal of Economics,113:4 (November 1998):.1137-1167. (NBER Working Paper 6304, 1997). Reprinted inAlexander Tabarrok (ed.), Entrepreneurial Economics: Bright Ideas from the Dismal Science,Oxford University Press, 2002."On the Effect of Changing Sexual Activity on HIV Prevalence," with Charles Morcom,Mathematical Biosciences 151:1 (July 1998): 99-122."Why Isn't Convergence Instantaneous? Young Workers, Old Workers, and GradualAdjustment," with Jim Thomson, Journal of Economic Growth 3:1 (March 1998): 5-28. (NBERWorking Paper 4827, 1994)"Disorganization," with Olivier Blanchard. Quarterly Journal of Economics, 112:4 (November1997): 1091-1126."AIDS, Behavioral Choice, and the Composition of the Pool of Available Partners," in Advancesin Mathematical Population Dynamics: Molecules, Cells and Man Part II, Chapter 8, WorldScientific Publishing Co., 1997, pp. 487-510."How Much Does Sorting Increase Inequality?” Quarterly Journal of Economics, 112:1(February 1997): 115-139. (NBER Working Paper 5566, 1996)Michael Kremer 10"Integrating Behavioral Choice into Epidemiological Models of the AIDS Epidemic," Quarterly

Journal of Economics, 111:2 (May 1996): 549-573. (NBER Working Paper 5428, 1996)"Research on Schooling: What We Know and What We Don't: A Comment on Hanushek," TheWorld Bank Research Observer (10), August 1995, pp. 247-254."Saving and Growth: a Comment," Carnegie-Rochester Conference Series on Public Policy (40),June 1994, pp. 193 -197."Good Policy or Good Luck? Country Growth Performance and Temporary Shocks," withWilliam Easterly, Lant Pritchett, and Lawrence Summers, Journal of Monetary Economics32(3), 1993. (NBER Working Paper 4474, 1993)"Population Growth and Technological Change: 1,000,000 B.C. to 1990," Quarterly Journal ofEconomics. 108:3 (August 1993): 681-716. Reprinted in Gene Grossman (ed.), EconomicGrowth: Theory and Evidence, Elgar Reference Collection, International Library of CriticalWritings in Economics (68), 1996; and in Julian Simon (ed.), The Economics of Population: KeyModern Readings, Cheltenham. UK ; Lynne, NH: Edward Elgar Publishers, 1997."The O-Ring Theory of Economic Development," Quarterly Journal of Economics, 108:3(August 1993): 551-576. Translated into Portuguese as "A teoria ‘anel em O’ dedesencolvimento econômico," Revista Brasileira de Economia, April/June 1995.Working Papers“Nudging Farmers to Use Fertilizer: Theory and Experimental Evidence from Kenya,” withEsther Duflo and Jonathan Robinson National Bureau of Economic Research, Inc, NBERWorking Papers: 15131, 2009.“Peer Effects and the Impact of Tracking: Evidence from a Randomized Evaluation in Kenya,”with Esther Duflo and Pascaline Dupas National Bureau of Economic Research (NBER)Working Papers: 14475, December, 2008.“Antiquities: Long-Term Leases as an Alternative to Export Bans,” with Tom WilkeningWeatherhead Center for International Affairs Working Papers, Harvard University, 2007.“Peter Singer vs. Charles Dickens: Evaluating Particularist Ethics from a UniversalistStandpoint,” with Daniel Wood, 2007.“The Globalization of Household Production,” with Stanley Watt, 2007.“Contracting for Health: Evidence from Cambodia,” with Erik Bloom, Elizabeth King, InduBhushan, David Clingingsmith, Benjamin Loevinsohn, Rathavuth Hong, J. Brad Schwartz.Brookings Institution, 2006.Michael Kremer 11“Education and HIV/AIDS Prevention: Evidence from a Randomized Evaluation in WesternKenya” with Esther Duflo, Pascaline Dupas; and Samuel Sinei. Washington, D.C.: The WorldBank, Policy Research Working Paper Series: 4024, 2006.“School Meals, Educational Achievement, and School Competition: Evidence from aRandomized Evaluation,” with Christel Vermeersch. Washington D.C.: The World Bank, PolicyResearch Working Paper Series: 3523, 2005"Globalization and Inequality," with Eric Maskin, 2003."Decentralization: A Cautionary Tale," with Sylvie Moulin and Robert Namunyu, 2003."Why Are Drugs More Profitable Than Vaccines?" (with Christopher Snyder), NBER WorkingPaper 9833, 2003."Promoting School Participation in Rural Rajasthan: Results from Some Prospective Trials,"with Abhijit Banerjee and Suraj Jacob, with Jenny Lanjouw and Peter Lanjouw, 2002."Should Taxes be Independent of Age?" under revision for Quarterly Journal of Economics,2001."Globalization and International Public Finance," with Paras Mehta, NBER Working Paper7575, 2000."Why Do Governments Operate Schools?" with Andrei Sarychev, 1998."Why Are Worker Cooperatives So Rare?” NBER Working Paper 6118, 1997."The Quantity-Quality Tradeoff in Education: Evidence from a Prospective Evaluation inKenya," with Sylvie Moulin, David Myatt, and Robert Namunyu, 1997."Wage Inequality and Segregation by Skill," with Eric Maskin, under revision for Quarterly

Journal of Economics. (NBER Working Paper 5718, 1996)"Can Having Fewer Partners Increase the Prevalence of AIDS?" NBER Working Paper 4942,1994.

Reports, Popular Publications, and Comments“Can Tracking Improve Learning? Evidence from Kenya,” with Esther Duflo and PascalineDupas. Education Next. Summer 2009, pp. 64-70.“In Defense of a Good Reputation,” in Michael Kinsley, ed., in Creative Capitalism : AConversation with Bill Gates, Warren Buffett, and other Economic Leaders. New York: Simonand Schuster, 2008.Michael Kremer 12“You Can Make Profits and Save the Poor,” in Michael Kinsley, ed., in Creative Capitalism : AConversation with Bill Gates, Warren Buffett, and other Economic Leaders. New York: Simonand Schuster, 2008.“Water Technologies: What Works Best in Poor Countries?” with Edward Miguel, Clair Nulland Alix Zwane Boston Review 33:5 (September/October, 2008), p. 9.“Promoting Innovation to Solve Global Challenges: Opportunities for R&D in Agriculture,Climate Change, and Health,” with Heidi Williams. German Marshall Fund, Oct 2 2008.“Deciphering the Demand for Safe Drinking Water,” with Edward Miguel, Clair Null, and AlixZwane. Resources for the Future, Weekly Policy Commentary September 1, 2008. Available athttp://www.rff.org/Publications/WPC/Pages/Decipheringthedemandforsafedrinkingwater.aspx“Mecca and moderation,” with Asim Ijaz Khwaha and David Clingingsmith. InternationalHerald Tribune, May 20, 2008.“Education in the Developing World,” American Academy of Arts and Sciences Bulletin 60: 4(Summer 2007) pp. 16-19.“Delivering Health Care,” with David Clingingsmith, Boston Review 31:2 (March/April 2007), p15.“Loan Sanctions,” with Seema Jayachandran. The Washington Post. February 7, 2007.“Expanding Educational Opportunity on a Budget: Lessons from Randomized Evaluations” inJoel E. Cohen, David E. Bloom, and Martin B. Malin, eds., .Educating All Children: A GlobalAgenda. Cambridge, Mass: American Academy of Arts and Sciences: MIT Press, 2006.Reprinted in Improving Education Through Assessment, Innovation, and Evaluation. AmericanAcademy of Arts and Sciences: Project on Universal Basic and Secondary Education: Cambridge(MIT Press), 2006.“Impact Evaluation for Slum Upgrading Interventions,” with Erica Field. Doing ImpactEvaluation Series No. 3 Thematic Group on Poverty Analysis, Monitoring and ImpactEvaluation, The World Bank. Washington D.C., 2006.“HIV/AIDS prevention: the potential of primary education,” Centre Piece, the Centre forEconomic Performance, the London School of Economics. pp. 22-24 Autumn 2006.Making Markets For Vaccines, Ideas To Action with Ruth Levine and Alice Albright. TheReport of the Center for Global Development Working Group Advance Market CommitmentWorking Group. Washington, DC: Center for Global Development, 2005.“Making Vaccines Pay: Saving Lives With Markets,” The Milken Institute Review, First Quarter,2004: 42-53.Michael Kremer 13"Randomized Evaluations of Interventions in Social Service Delivery," with Esther Duflo andRachel Glennerster, Development Outreach 6(1), March 2004.“The Match Game,” Forbes Magazine, September 15, 2003.“A Dictator’s Crippling Debt,” with Seema Jayachandran, Harvard Magazine, July 2003."Make Odious Debt Too Risky to Issue," with Seema Jayachandran, Financial Times, May 8,2003."Odious Debt: When Dictators Borrow, Who Repays the Loans?" with Seema Jayachandran,Brookings Review, 21(2), Spring 2003.

"Regional Public Goods and Health in Latin America," with Jessica Leino, 2003."A World of Junk-Status States," with Seema Jayachandran, The Guardian (London), August 19,2002."Odious Debt," with Seema Jayachandran, Brookings Institution Policy Brief #103, July 2002.Available at http://www.brookings.org/comm/policybriefs/pb103.htm."Odious Debt," with Seema Jayachandran, Finance and Development (IMF), 39(2), June 2002."Creating a Market for Vaccines," with Rachel Glennerster, New York Times, June 1, 2001.“Creating Markets for New Vaccines,” in Christopher D. Gerrard, Marco Ferroni, and AshokaMody, eds., Global Public Policies and Programs:Implications for Financing and EvaluationProceedings from a World Bank Workshop, 2001. . Washington, D.C.: The World Bank."Stimulating Industrial R&D for Neglected Infectious Diseases: Economic Perspectives," withDavid Webber, Bulletin of the World Health Organization, 79(8), 2001, pp. 693-801."A Tax Credit for Sales of HIV, Malaria, and Tuberculosis Vaccines," with Amir Attaran,Jeffrey Sachs, and Sara Sievers, 2000."A Better Way to Spur Medical Research and Development," with Rachel Glennerster,Regulation 23(2), 2000, pp. 34-39."A World Bank Vaccine Commitment," with Rachel Glennerster, Brookings Institution PolicyBrief #57, May 2000. Available at http://www.brookings.edu/comm/policybriefs/pb57.htm."A Cure for Indifference," with Jeffrey Sachs, Financial Times, May 5, 1999."Restructuring Social Security Taxes," Brookings Institution Policy Brief #40, December 1998.Available at http://www.brookings.edu/comm/policybriefs/pb40.htm.




http://www.brookings.edu/comm/policybriefs/pb40.htm

Thomas Harrison Polley

EDUCATION

University of California, Berkeley May, 2010Bachelor of Arts in PhysicsAdditional focus in Economics

Relevant CourseworkIntroduction to EconomicsMicroeconomicsMacroeconomics

EconometricsCase Studies in Economic DevelopmentReal Analysis

Computer Skills STATA, Matlab, Excel

EXPERIENCE

Project Associate, Innovations for Poverty ActionRandomized Evaluation of Safe Water and Hygiene intervention in Bangladesh

December 2010 – Present

Assist in development, implementation and analysis/evaluation

Research Assistant to Professor of Business Administration, David Levine, UC BerkeleyPreparation for Randomized Evaluation of Safe Water and Hygiene intervention in Bangladesh

September 2010 – November 2010

Research Assistant to Professor of Economics, Edward Miguel, UC BerkeleyRandomized Evaluation of Community Driven Development Project (Gobifo) in Sierra Leone

February 2010 – October 2010

Cleaned raw data and assisted with analysis using STATA

Conducted search of scholarly articles and identified related sources

House ManagerUniversity Students Cooperative Association August 2008 to August 2009

Balanced House Budget (~$10k), chaired manager’s meetings, oversaw lower managers, enforced policy, mediated conflict, strengthened emergency preparedness, conducted move-ins/outs of 56 University Students

20 April_kaniz



1 Name: Kaniz Jannat

2 Present Position: Research Investigator

3 Educational background: (last degree and diploma & training relevant to the present research proposal)

4.0 List of ongoing research protocols (start and end dates; and percentage of time)

4.5. As Principal Investigator


4.6. As Co-Principal Investigator




PR-0900419/07/2009 31/10/2010 100%

74

Mymensigh Medical College, Mymensigh, Bangladesh, 1997 MBBSNational Institute of Preventive and Social Medicine, Dhaka, Bangladesh, 2004 MPH

20 April_kaniz

5 Publications

Types of publications Numbersa. Original scientific papers in peer-review journals 1b. Peer reviewed articles and book chapters c. Papers in conference proceedings d. Letters, editorials, annotations, and abstracts in peer-reviewed journals e. Working papers 4f. Monographs


1)

2)

3)

4)

5)

75

20 April_kaniz

Testing Disgust and Shame based Safe Water and Handwashing Promotion in Urban Dhaka

Appendix 1: Compound Level Voluntary Consent Form

Protocol Number: PR-11000Protocol Title: Testing Disgust and Shame based Safe Water and Handwashing Promotion in Urban DhakaPrincipal Investigator: Dr. Stephen LubyOrganization: ICDDR,B

Introduction:

Hello. My name is _______________. I work with ICDDR,B (Cholera Hospital). Your Compound is invited to take part in a research trial to understand what people in Dhaka think about some new water and handwashing products. We are inviting you to help us by enrolling this compound in this study. You and your compound members are free to decide whether or not to take part in the study.

What is expected from the members of your Compound?

If you agree to enrol your Compound in the study we will provide a free trial of new water products: either compound-products for the entire compound or household products to a few randomly chosen households. The product offer is decided randomly.

If your compound is chosen for the compound-level free trial, we will hold a compound meeting to introduce the new product have a free trial of the new product for one month or more hold a meeting where we let the compound members decide if they want to subscribe to

keep the new product If your compound agrees to become a subscriber, we will revisit your compound each

month for up to a year to collect the payment and to refill the product.

If your compound is chosen for the household-level product, in a few months we will offer 1 or 2 households a free trial of a new household-level water product. After the free trial they will have the opportunity to buy the new product.

Regardless of the product, if you participate: We will observe physical characteristics of your Compound related to water and

handwashing. We will also take samples of your stored drinking water and hand rinse water

We will ask some questions to one or two randomly selected households 3 times. On one visit we may stay for three hours to observe your compound’s day-to-day

activities.

Risks & Benefits

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It will not cost your compound anything to participate in the study and have the free trials except for your time. However, we will arrange the meetings at your convenient time. Some participants may choose to purchase the products, but none will have to. The level of risk in this study is minimal – all the products and tests are completely safe. Participants will benefit from the free trial of the new product, but not receive any other payment. There will also be benefits as ICDDR,B learns what people think about the new products.

Confidentiality

The information we obtain from you will only be used in this study. What you say will be kept completely confidential, and will not affect your ability to obtain services at the Cholera Hospital in any way. No one outside of the study staff will have access to your personal information, which we will keep in a locked cabinet.

Right not to participate and withdraw

You may choose to allow your Compound to take part or not to take part in this study. You may also withdraw your Compound from the study at any time. Each individual in your Compound may choose to participate or not participate, and may choose to withdraw from the study at any time. Refusal to participate or withdrawal from the study will involve no penalty or loss of benefits at the Cholera Hospital (ICDDR, B).

Persons to Contact

If you have more questions about the project, you may contact Dr. Kaniz Jannat (Research Investigator) at telephone number 8819419 (119). If you have additional questions, you may call M A Salam, Manager, Research Administration, ICDDR, B at 9886498 .

Agreement to Participate

If you agree to participate in this study, please indicate that by putting your signature or left thumb impression.

Thank you for your cooperation.

________________________________________ ___/___/______Signature or left thumb impression of participants Date

___________________________________________ ___/___/_______ Signature or left thumb impression of the witness Date

_________________________________ ___/___/______Signature of PI or his/her representative Date

_____________________ ________________________Name of representative Designation of representative

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G‡cwÛ· 1 : K¤úvDÛ wfwËK m¤§wZcÎ

cÖ‡UvK‡ji wk‡ivbvg: XvKv kn‡i †Nbœv I j¾v wfwËK wbivc` cvwb cvb I nvZ †avqv Kvh©µ‡gi cixÿvg~jK cÖPvicÖ‡UvKj b¤î: 11000cÖavb M‡elK: Wt w÷‡db wc. jywecÖwZôvb: AvšÍ©RvwZK Dìvgq M‡elbv †K›`ª (K‡jiv nvmcvZvj)cwiwPwZ:Avm&mvjvgyAvjvBKzg, Avwg --------------------------| Avwg AvBwmwWwWAvi,we (K‡jiv nvmcvZvj) -G KvR Kwi| XvKv‡Z gvbyl cvwb I nvZ †avqvi bZzb DcKiY m¤ú©‡K wK fv‡e Zv eyS‡Z Avcbvi K¤úvDÛ‡K GKwU M‡elbv Kvh©µ‡g AskMÖn‡Yi Rb¨ Avgš¿b Rvbv‡bv n‡”Q| Avgiv Avcbv‡K Avgš¿b Rvbvw”Q hv‡Z Avcwb Avcbvi K¤úvDÛ‡K GB M‡elbvq AšÍ©f~³ K‡ib| GB M‡elbvq Ask †bqv ev bv †bqvi e¨vcv‡i Avcwb ev Avcbvi K¤úvD‡Ûi ‡h †Kvb m`m¨ mgú~©b ¯^vaxb |Avcbvi K¤úvD‡Ûi m`m¨‡ì Kv‡Q wK Avkv Kiv n‡”Q ?Avcwb hw` Avcbvi K¤úvDÛ‡K GB M‡elbvq AšÍ©f~³ K‡ib Zvn‡j Avgiv webvg~‡j¨ cvwb weï×Ki‡Yi Rb¨ GKwU bZzb wRwbl wè: nq cy‡iv K¤úvD‡Ûi eënv‡ii Rb¨ A_ev jUvixi gva¨‡g wbev©wPZ K‡qKwU wbw`©ó Lvbvi Rb¨| DcKiY cvIqv bv cvIqv jUvixi gva¨‡g wba©vwiZ n‡e|hw` Avcbvi K¤úvDÛ cy‡iv K¤úvD†Û eënv‡ii gZ DcKiY cv‡e e‡j wba©vwiZ nq, Zvn‡j Avgiv-

bZzb DcKiYwU cwiPq Kiv‡bvi Rb¨ GKUv K¤úvDÛ wgwUs Kie webvg~‡j¨ 1 gvm ev ZviI †ekx eënvi Ki‡Z wè GKwU wgwUs -G Avgiv K¤úvD‡Ûi mKj‡K wm×všÍ wb‡Z eje †h

Zviv wK bZzb DcKiYwU wKb‡Z Pvq wK bv hw` Avcbvi K¤úvDÛ wm×všÍ †bq ‡h Zviv ‡µZv n‡Z Pvq Zvn‡j

Avgiv AvMvgx GK eQi wKw¯Íi UvKv wb‡Z Ges cÖ‡qvRbxq Dcv`vb mieivn Ki‡Z cÖwZgv‡m GKevi Avcbvi K¤úvDÛ cwi`k©b Kie

hw` Avcbvi K¤úvDÛ Lvbv‡Z eënv‡ii gZ DcKiY cv‡e e‡j wba©vwiZ nq, Zvn‡j K‡qK gv‡mi g‡a¨ 1wU ev 2wU Lvbv‡Z webvg~‡j¨ eënv‡ii Rb¨ GKwU bZzb cvwb weï×Kib DcKiY ‡è| webvg~‡j¨ eënv‡ii ci Zviv bZzb DcKiYwU †Kbvi my‡hvM cv‡e|DcKiY QvovI Avcwb hw` AskMÖnY K‡ib:

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Avgiv Avcbvi K¤úvD‡Ûi mv‡_ m¤ú©wKZ kvixwiK welq¸‡jv ch©‡eÿb Kie

jUvixi gva¨‡g wbe©vwPZ 1wU ev 2wU Lvbv‡Z 3wU mg‡q wKQz cÖkœ Kie

GKwU cwi`k©‡b Avgiv Avcbvi K¤úvD‡Û N›Uv wZ‡bK _vK‡Z cvwi Avcbv‡ì ‰`bw›`b KvRKg© ch©‡eÿ‡bi Rb¨

SuzwK Ges myweav mg~n:M‡elbvq AskMÖnY Ges webvg~‡j¨ eënv‡ii Rb¨ Avcbvi K¤úvD‡Ûi †Kvb LiP ‡bB ïaygvÎ mgq †`qv Qvov| Z‡e Avcbvi myweavRbK mg‡qB Avgiv wgwUs¸‡jvi Av‡qvRb Kie|wKQz wKQz AskMÖnYKvix bZzb DcKiYwU wKb‡Z PvB‡Z cv‡ib Z‡e †KDB eva¨ bq/PvB‡ZB n‡e Ggb bq| GB M‡elbvq AskMÖn‡Yi SuywK AwZ bMb¨-mg¯Í DcKiY I cixÿv¸‡jv m¤ú~b© wbivc`|AskMªnYKvixiv webvg~‡j¨ bZzb DcKiYwU eënv‡ii my‡hvM cv‡e | Z‡e GQvov Ab¨ †Kvb ai‡bi UvKv cqmv cv‡e bv| GQvovI Avi GKwU myweav nj †h AvBwmwWwWAvi,we Rvbj †h bZzb DcKiYwU m¤ú‡K© gvbyl wK fv‡e|†MvcbxqZv:Avcbvi KvQ †_‡K msM„nxZ Z_¨ ïaygvÎ GB M‡elbv‡ZB eënvi Kie| Avcwb hv wKQz ej‡eb Zv m¤ú~b© fv‡e †Mvcb ivLv n‡e Ges †Kvb fv‡eB K‡jiv nvmcvZv‡j Avcbvi †mev cvevi AwaKvi‡K ÿwZMÖ¯’ Ki‡e bv| GB M‡elbvq AskMÖnYKvix Kg©x Qvov Ab¨ ‡KD Avcbvi †Kvb e¨w³MZ Z_¨ Rvb‡e bv Ges Zv Avgiv GKwU Zvjve× Avjgvix‡Z msiÿb Kie|AskMÖnY bv Kivi AwaKvi Ges m‡i hvIqv:Avcwb Avcbvi K¤úvDÛ‡K GB M‡elbvq AskMÖnY Ki‡Z w`‡Z A_ev bv w`‡Z PvB‡Z cv‡ibGes Avcwb †h †Kvb mgq Avcbvi K¤úvDÛ‡K M‡elbv †_‡K mwi‡q wb‡Z cv‡ib| Avcbvi K¤úvD‡Ûi †h †KD AskMÖnY Ki‡Z A_ev bv Ki‡Z PvB‡Z cv‡i Ges †h †Kvb mgq M‡elbv †_‡K m‡iI †h‡Z cv‡i| M‡elbvq AskMÖnY Ki‡Z bv PvB‡j A_ev m‡i †h‡Z PvB‡j Avcbv‡ì †Kvb ÿwZc~iY w`‡Z n‡e bv A_ev K‡jiv nvmcvZv‡ji cÖvß myweav †_‡KI ewÂZ n‡eb bv|

†hvMv‡hv‡Mi e¨w³: GB M‡elbv m¤ú‡K© hw` Avcbvi AviI †Kvb cÖkœ _v‡K Zvn‡j †hvMv‡hvM Ki‡Z cv‡ib| Wt KvwbR RvbœvZ (M‡elK), †dvb-8819419 (119) GB b¤^‡I hw` AviI cÖkœ _v‡K Avcwb †dvb Ki‡Z cv‡ib Rbve

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Gg.G.mvjvg,g¨v‡bRvi wimvP© A¨vWwgwb‡óªkb, AvBwmwWwWAvi,we 9886498 GB b¤^‡i|

hw` Avcwb M‡elbvq Ask wb‡Z ivRx _v‡Kb AbyMªn K‡I Avcbvi ¯^vÿi A_ev evg nv‡Zi e„×v½yjxi Qvc w`‡q Zv wb‡`©k Kiæb|Avcbvi mn‡hvMxZvi Rb¨ ab¨ev`|ÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑ -------------------------------¯^vÿi/ evg nv‡Zi e„×v½yjxi Qvc

ZvwiL

ÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑ -------------------------------¯^vÿxi ¯^vÿi/ evg nv‡Zi e„×v½yjxi Qvc

ZvwiL ÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑ -------------------------------cÖavb M‡elK/Zvi cÖwZwbwai ¯^vÿi

ZvwiL ÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑcÖwZwbwai bvg

Appendix 2: Feasible Site Criteria(Used to select sites)

Field Staff Instructions:

A. Before Going to Field:1. Review the Bolded Preferred Criteria on the Compound Details form so you know what

to look for.

B. In Field:1. Choose a compound that appears to meet the preferred criteria.

a. Don’t be too picky, if you visit two and you still haven’t found one you like, then look at one more and pick between the three.

2. Fill out the compound details form for this compound, write 1 for compound number. 3. Search for another compound that appears to meet the preferred criteria at least 75 to 100

steps (or one block) away from the previously included compound(s).

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a. Again, don’t be too picky, if you visit two and you still haven’t found one you like, then look at one more and pick between the three.

4. Fill out the compound details form for this compound, write 2 for the compound number5. Repeat steps 3 and 4, using the appropriate compound number until you have filled out

ten compound details forms.6. Fill out the Site Details form for this site. 7. Move to the next site and repeat the above steps.

C. After returning from the Field1. Fill out the Compounds Summary Form for each site and staple to other forms from that

site in the following order:a. Site Details Formb. Compounds Summary Formc. Compound Details Forms

i. In order from first to last.

Site Details Form:

Date:Names of Field Staff:Name of Site:

Field Questions: 1. At this site, will it be possible to find 100 to 600 compounds which meet most of the

criteria and are separated by at least 75 to 100 steps?: (Yes/No)a. Please give your best estimate of the number of such compounds that we will

find: 2. Knowing the preferred compound criteria, do you think this site is a good match?

a. Perfect/Good/Okay/Not so good/Bad3. If there is anything about this site that you think is relevant that isn’t already included

elsewhere, please write below (Why it would be good, why not so good, other thoughts…).

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Compound Details Form:

Date:Name(s) of Field Staff:Name of Site: Compound Number:

Preferred Criteria:1. Shared Kitchen: Yes/No2. Gas available: Yes/No3. Shared toilet(s): Yes/No

a. How many: 4. Shared water source: Yes/No5. Use of water source is visible to other members of the compound:

a. Highly visible/Slightly Visible/Not Visible6. Number of Households in the compound is between 4 and 12: Yes/No

a. Write number here: 7. Water Supply is intermittent: Yes/No8. There is a suitable place to hold a compound meeting within the compound or nearby:

Yes/Noa. Within/Nearby

9. There is at least one time during the week when most of the Women will be available for a meeting. (Yes/No)

a. When is/are the time(s)?: , 10. There is at least one time during the week when most of the Men will be available for a

meeting. (Yes/No)a. When is/are the time(s)?: ,

11. There are no other interventions from icddrb or other NGOs involving this compound or its neighbors at this time. (Yes/No)

12. Population is Mostly Bengali: Yes/Noa. If no, which other groups are represented?:

13. Most compound members have been here for half a year or more. (Yes/No)a. The people who have not been here this long, did they come from nearby

compounds or far away?b. Do you think most compound members will continue living here for half a year or

more? (Yes/No)Extra Details:

1. Is it in a slum?: Yes/Noa. If yes, what is the name of the slum?:

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2. Please write the address if you know it, or any locating information if there is no address:

3. What is the most common occupation of the compound members? List here from most

common to least common (Answer for Males and Females separately):i. Male: Female:

ii. Male: Female:

iii. Male: Female:


Appendix 3: Household Survey Form

Section 0: IdentificationSection 1: Demographic information of the respondentSection 2: Socio Economic Status of the HouseholdSection 3: Safe Drinking Water Knowledge and Treatment PracticeSection 4: Hand Washing Knowledge and Practice Section 5: Present State of Handwashing Station of the CompoundSection 6: Knowledge about DiarrhoeaSection 7: Feelings/norms/reactions/beliefs relating disgust activitiesSection 8: Feelings/norms/reactions/beliefs relating shame

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Section 9: Social Relationship in the CourtyardSection 10: Uptake of hand washingSection 11: Uptake of the Chlorine dispenser

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‡mKkb 0: mbv³Kib (Section 0: Identification ) GjvKv (Site):

0.1: GjvKvi bvg (Sample Region Name) ______________

0.2: GjvKvi AvBwW (Sample Region ID) _________________

K¤úvDÛ (Compound):

0.3: K¤úvD‡Ûi wVKvbv (we¯ÍvwiZ wVKvbv) Compound Address (detailed address):

____________________

__________________________________________________________

0.4: K¤úvDÛ AvBwW (Compound ID) ___________

0.5: K¤úvDÛ g¨v‡bRv‡ii bvg (Name of Compound Manager) ___________

0.6: K¤úvD‡Û cwiev‡ii msL¨v (Number of HH in Compound )___________

0.7: B›Ui‡fbk‡b i Ae¯’v (Intervention Status )_____________

cwievi (Household):

0.8: cwev‡ii AvBwW(Household ID )_________

0.9: cwievi cÖav‡bi bvg(Name of household head): _____________________________

0.10: cwiev‡ii wVKvbv (Household Address ):______________________

gvVKgx© (Field personnel):

0.11: Z_¨ msMÖnKvixi bvg( Name of the FRA

(Interviewer)________________________________

0.12: Z_¨ msMÖnKvixi AvBwW (FRA ID )_____________

0.13: mv¶vrKvi MÖn‡Yi ZvwiL (Date of interview )(dd/mm/yyyy):___________

0.14: B›Ui‡fbkb †¯úkvwj‡ói bvg (Name of the FIS )(Intervention Specialist/Health

promoter)____________

0.15: B›Ui‡fbkb †¯úkvwj‡ói AvBwW )FIS ID )_____________

0.16: B›Uvi‡fbk‡bi ZvwiL (Date of Intervention done )(dd/mm/yyyy)___________

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‡mKkb 1: DË`i`vZvi জনতাত্ত্বি�ক Z_¨vw` (Section-1: Demographic information of the respondent)

1.1 DËi`vZvi bvg (Name of the respondent)? _________________________

1.2 DËi`vZvi wj½(ch©‡e¶b K‡i †iKW© Kiæb)/ Sex of the respondent (Record by observation)

1. cyiæl (Male)2. gwnjv (Female)

1.3 Avcbvi eqm KZ ermi (Your age in years)?(c~Y© erm‡i) In full Years [----------]

1.4 Avcbvi ˆeevwnK Ae¯’v wK (Your marital status)?

1. weevwnZ (Married) 2.wW‡fvm©/c„_K(Divorced/Separated) 3. weaev/wecZœxK (Widow(er) 4. AweevwnZ (Never married)1.5Avcwb KZw`b hveZ GLv‡b emevm Ki‡Qb (How long have you lived here)?

a) 6 gv‡mi Kg (<6months)b) 6 gvm- 1 ermi (6months-1 year)c) 1 ermi -2 ermi (1year-2 years)d) 2 erm‡ii †ekx (>2 years)e) mwVK g‡b bvB (Not sure)

1.6 Avcwb †Kv_v †_‡K G‡m‡Qb? Avcbvi wbR¯^ †Rjvi bvg D‡jøL Kiæb|( Where did you come from? Mention the name of your home district.)

___________________

1.7 Avcwb KZ UvKv fvov †`b?( How much rent do you pay)

a) gv‡m 1000 UvKvi Kg (<1000taka/month)b) gv‡m 1000-1500 UvKv (1000-1500taka/month)c) gv‡m 1500-2000 UvKv (1500-2000taka/month)d) gv‡m 2000 UvKvi †ekx (>2000taka/month)e) Rvwb bv (Don’t know)f) DËi w`‡Z ivRx bv (Refuse to reply)

1.8 Avcwb GLv‡b KZw`b emevm Ki‡Z Pvb (How long do you plan to live here)?a) 6 gvm (6months)

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b) 1 eQi (1year)c) 2 eQi (2years)d) 2 eQ†ii †ekx (>2years)e) Rvwb bv (Don’t know/Not sure)

1.9 Avcwb †Kv_vq †h‡Z Pvb (Where do you think you will go)?a) cv‡ki Ab¨ †Kvb K¤úvD‡Û (Another compound next to this)b) GB GjvKvi Ab¨ †Kvb K¤úvD‡Û (Another compound within this area)c) XvKv kn‡ii Ab¨ †Kvb GjvKvq (Anywhere within Dhaka city)d) XvKv kn‡ii evwn‡i (Outside Dhaka city)e) wbR¯^ GjvKvq wd‡i †h‡Z Pvq (Go back to your home district)f) Rvwb bv (Don’t know/Not sure)

‡mKkb 2: cwiev‡ii Av_©-mvgvwRK Ae¯’v (Section 2: Socio Economic Status of the Household)

2.1 Avcbvi cwievi cÖav‡bi m‡ev©”P wk¶vMZ †hvM¨Zv wK?_________hZ eQi cov‡kvbv K‡i‡Q (What is the highest level of education of the head of the family?_________years of education completed)

2.2 Avcbvi Lvbv‡Z wb†gœi †Kvb wRwbm¸‡jv Av‡Q? (n¨uv=1, bv=2 wjLyb) [ Does your household/family own any of the followings? (WRITE 1=yes and 2=No)]

|____| (A) mvB‡Kj (‡Ljbv mvB‡Kj bq) Bicycle|____| (B) gUi mvB‡Kj Motor cycle|____| (C) †eex †Uw·/wmGb wR Baby taxi/CNG|____| (D) wiKkv/f¨vb Rickshaw/van|____| (E) ‡iwWI/†K‡mU †cqvi/wmwW †cqvi Working radio/Cassette Player/CD player|____| (F) ‡Uwjwfkb/wfwmwW Working television/VCD|___ | (G) Kw¤úDUvi Working computer|____| (H) ‡gvevBj †dvb (Working mobile Phone)

|____| (I) ‡iwd«Rv‡iUi (Working refrigerator) |____| (J) LvU/PwK (Bed/chouki) |____| (K) ‡mvdv †mU (Sofa set) |____| (L) ‡mjvB †gwkb (Working sewing machine) |____| (M) Avjbv [locally made holder for clothings] |____| (N) K¤^j / †jc (Blanket) |____| (O) Avjgvix/IqviWªe (KvV/÷xj) [Almira/wardrobe (wooden/steel)] |____| (P) we`y¨r (Electricity connection)

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2.3 ‡`qvj wbgv©‡bi Dcv`vb(MAIN EXTERIOR Construction materials of the walls):

1. gvwU/jvwV/LvMov( Mud/sticks/reeds)2. ‡jvn/wUb (Corrugated iron/tin)3. BU (Fired bricks)4. KvV (Wood)5. wm‡g›U(Cement/concrete)7. Ab¨vb¨ (wbw`©ó Kiæb) /OTHER (SPECIFY):_________________

2.4†g‡S wbgv©‡bi Dcv`vb (Construction material of the floor):1. gvwU/Kv`v/evwj (Earth/mud/dung/sand)2. wm‡g›U (Cement/concrete)3. KvV (Wood)7. Ab¨vb¨ (wbw`©ó Kiæb) /OTHER (SPECIFY):______________

2.5 Qv` wbgv©‡bi Dcv`vb(Construction material of the roof): 1. gvwU, Mv‡Qi Wvj (Mud, branches)2. KvV (Wood)3. ‡jvnv/wUb (Corrugated iron/tin)4. wm‡g›U (Cement/concrete)7 Ab¨vb¨ (wbw`©ó Kiæb)/ OTHER (SPECIFY):_____________

2.6 Avgv‡ì M‡elYvi myweav‡_© Avcwb wK ej‡eb Avcbvi cwiev‡ii †gvU gvwmK Avq KZ UvKv? (†gvU gvwmK Avq wnmve Kivi mgq Av‡qi mKj †¶Î we‡ePbv Ki‡eb †hgb- ‡eZb, evox fvov, K…wl BZ¨vw`, ÕRvwb bvÕ n‡j 999 wjLyb) _______________UvKv

(For the purpose of our research, would you please tell us your total monthly household income? (Please sum up your income from all sources like wage, rent, agriculture etc.) ______taka)

2.7 ivbœvi Rb¨ wK ai‡bi R¡vjvbx eënvi K‡ib (What kind of fuel do you use for cooking)?

1. KvV/Kqjv (Wood/ charcoal)2. ‡K‡ivwmb (Kerosene)3. M¨vm (Natural gas)4. we`¨r /Electricity (Electric heater)7. Ab¨vb¨( Other )------------------------------

2.8 Avcbv‡ì cwiev‡ii eëüZ cvqLvbv wK ai‡bi? (wRÁvmv Kiæb Ges ch©‡¶b Kiæb ) [What kind of toilet facility does your household use? (ask and Observe)]

1. K¤úvD‡Ûi wfZ‡i m¨vwbUvix cvqLvbv (Water sealed latrine in the compound)2. K¤úvD‡Ûi evwn‡i m¨vwbUvix cvqLvbv (Water sealed latrine outside the

compound)

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3. K¤úvD‡Ûi wfZ‡i wcU cvqLvbv (Pit latrine in the compound)4. K¤úvD‡Ûi evwn‡i wcU cvqLvbv (Pit latrine outside of the compound) 5. SzjšÍ cvqLvbv (Hanging latrine)6. wbw`©ó †Kvb RvqMv bvB (No fixed place)7. Ab¨vb¨ (Other )______________

2.9 G‡Ki †ekx cwievi wK GKB cvqLvbv eënvi K‡i (Does more than one household share the same toilet)?

1. nu¨v (Yes) 2. bv (No)2.10 GB K¤úvD‡Ûi wfZ‡i KqwU cvqLvbv Av‡Q( How many toilets are there within

this compound)? _________________

‡mKkb 3 : weï× cvwb cvb Kiv Ges eënvi m¤úwK©Z Z_¨ (Section 3: Knowledge about Safe Drinking Water and Usage )

3.1wRÁvmv Kiæb :eZ©gv‡b Avcbvi Lvbvq cvwb cvb Kivi cÖavb Drm †KvbwU (Ask: At present which of these is the principal source of drinking water for your household)

a) evm¯nv‡b mievin Kiv cvB‡ci cvwb (Piped water into dwelling) a) AvwObvq mievin Kiv cvB‡ci cvwb (Piped water to yard/plot) b) me©mvavi‡bi eëüZ U¨vc/ `Ûvqgvb cvBc (Public tap/standpipe) c) wUDe‡qj (Tubewell/borehole) d) msiw¶Z Kzqvi cvwb (Protected dug well)e) Amsiw¶Z Kzqvi cvwb (Unprotected dug well)f) msiw¶Z e„wói cvwb (Rainwater collection)g) †evZjRvZ cvwb (Bottled water)h) ‡QvU U¨vsK/Wªvg (Cart with small tank/drum)i) eo Wªv‡gi cvwb (Tanker-truck)j) †Lvjv cvwb (b`x,†Wvev,†jK) (Surface water (river, dam, lake,)k) cyKzi,b`x, Lvj,†m‡Pi cvwb (pond, stream, canal, irrigation)l) Lv‡ji cvwb (channels)m)Ab¨vb¨ (wbw`©ó Kiæb)/ Other (specify)--------------

3.2 cvwbi Drm wK Avevm¯’‡ji g‡a¨ ?Is the water source within compound?a) nu¨v (Yes)..........................1b) bv (No)............................2

If answer to question 3.2 is yes skip question 3.3

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hw` cÖ‡kœi DËi 3.2 nq Zvn‡j w¯‹c cÖkœ 3.33.3cvwb wb‡q wd‡i Avm‡Z KZ mgq jv‡M? KZ wgwbU------------- (How long does it take to go there, get water and come back)? No. of minutes _______________

3.3ch©‡e¶b : Avcwb wK Avgv‡K †`L‡Z cv‡ib wKfv‡e Lvevi cvwb msMÖn I msi¶b K‡ib (Observation: Can you please show me how do you collect drinking water and store)?Kvh©cÖYvjxwU †bvU Kiæb/Zv‡K j¶ Kiæb,wjLyb cÖ‡Z¨KwUi Rb¨ nu¨v =1 Ges bv = 2(Please note the steps s/he follows, write Yes=1 and No=2 for each)

a) cvwb fivi c~‡e úvÎ cwi®‹vi K‡i wKbv (Took vessel and clean it before water collection)__

b) Acwi¯‹vi úv‡Î cvwb msMÖn K‡i wKbv (Collected water in an unclean vessel)___c) Avevm¯’‡ji wfZ‡i U¨vc/wUDe‡qj/ Kzqv †_‡K cvwb msMÖn K‡i(Collected

water from tap/tube-well/ well within compound)____d) Avevm¯’‡ji evB‡i U¨vc/wUDe‡qj/ Kzqv †_‡K cvwb msMÖn K‡i

Collected water from tap/ tube-well/ well outside compound____e) we‡klZ Ab¨ †Kvb Drm †_‡K cvwb msMÖn K‡i(Collected water from other

source, specify)____f) mwVKfv‡e cvwb msMÖn Kiv n‡q‡Q , nv‡Zi ev Ab¨ ‡Kvb e¯‘i ms¯úk©

jv‡Mwb(Water collection is done in a way that it’s not contaminated with hand or any other object)_____

g) cvwb weï× Kivi Rb¨ wKQy K‡iwQ‡jb wK (Mentioned or did something to treat water)_____

h) msiw¶Z cvwbi cv‡Î XvKbv wQj (Stored water with cover)_____i) msiw¶Z cvwbi cv‡Î XvKbv wQj bv (Stored water without cover)_______

3.4wRÁvmv Kiæb: H Lvevi cvwb KZUv cwi¯‹vi ? (1 =nu¨v , 2 =bv) Ask: How clean is the water that you drink? (1=Yes, 2=No)

1. Amnbxq/RNb¨ †bvsiv (Disgustingly dirty)2. †bvsiv Z‡e RNb¨/mnbxq b(Dirty but not disgusting)3. mwVK (Okay)------------------4. cwi¯‹vi, ¯^v` G es MÜ fvj(Clean, taste and smell good)_____5. Ab¨vb¨ (wbw`©ó Kiæb)/Other (specify) __________

3.5 wRÁvmv Kiæb: Avcwb wK g‡b K‡ib Avcbvi Avevm¯’‡j Ab¨vb¨ m`‡m¨‡`i AbyfywZ †Kgb ?Ask: What do you think most of the other members of this compound think?

1. Amnbxq/RNb¨ †bvsiv (Disgustingly dirty)2. †bvsiv Z‡e RNb¨/mnbxq b (Dirty but not disgusting)3. mwVK (Okay)4. cwi¯‹vi, ¯^v` G es MÜ fvj (Clean, taste and smell good)_____5. Ab¨vb¨ (wbw`©ó Kiæb)/ Other (specify) __________

Skip Q 3.4 if Q3.2 is 3, 4 or 5

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3.6 wRÁvmv Kiæb: wK Lvevi cvwb‡K †bvsiv /Amnbxq K‡i ?Ask: What make it dirty or disgusting? [check all that apply]

1. ayjvevwj Ges Kv`vgvwU (Dust and mud)2. gj (Feces)3. ‡ivMRxevby (Rog jibanu)4. ARvbv K¨vwg‡Kj/ivmqwbK c`‡_©i ms®ú‡k© (Unknown chemical substances)5. ‡`L‡Z †bvsiv (Looks dirty)6. Lvivc MÜ (Smells bad) 7. wbivc` bq(Not safe) 8. wbwðZ bq (Not sure )9. Rv‡bb bv (Don’t know)88. Ab¨vb¨ (wbw`©ó Kiæb )/Other (specify) __________

3.7 wRÁvmv Kiæb: wKfv‡e Lvevi cvwb ‡bvsiv /Amnbxq nq ? Ask: How it becomes dirty or disgusting?

a) Rv‡bb bv (Unknown) b) ‡bvsiv Drm (Dirty source) c) cvwb mievi‡ni cvBc wQ`ª n‡j (Leakage in the distribution pipe line)d) cvwbi Dr†mi Kv‡Q †Lvjv †jwUªb _vK‡j(Open latrine near water

source)e) cvwbi Dr†mi Kv‡Q †Lvjv Ave©Rbv/gqjvi ¯‘c _vK‡j(Open defecation near water

source)f) cvwbi Dr†mi Kv‡Q g„Z cï ev eR© _K‡j (Rotten animal body and

other waste near water source)g) Acwi®‹vi nv‡Z nvZ e`j Ki‡j (Handling with unclean hands)h) Lvbvi AbybœZ cvwb msi¶b e¨e¯’v (Poor household storage)i) Ab¨vb¨ (wbw`©ó Kiæb )/Others, specify_______

3.8 AvjP¨ evK¨wU‡Z Avcbvi gZvgZ wgwj‡q wbb Ó U¨v‡ei cvwb cvb Kivi c~‡e weï× Kiv DwPZ|Rate agreement with following statements “Tap water should be treated before drinking”. (Write Yes=1, No=2)

a. ‡Rvov‡jv m¤§wZ (Strongly agree)b. m¤§wZ(Agree)c. m¤§Z bq ,Am¤§Z bq (Neither agree nor disagree) d. Am¤§Z (Disagree)e. ‡Rvov‡jv Am¤§wZ (Strongly disagree)f. Ab¨vb¨ (wbw`©ó Kiæb )/Other (specify) __________

3.9 wRÁvmv Kiæb: Av‡jvP¨ evK¨wU‡Z Avcbvi gZvgZ wK ÓGB cvwb Avgv‡KI Amy¯’ Ki‡Z úv‡i Ó ?Ask: Rate your degree of agreement with the following statement “this water could make me sick”

a. ‡Rvov‡jv m¤§wZ (Strongly agree)

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b. m¤§wZ|(Agree)c. m¤§Z bq ,Am¤§Z bq (Neither agree nor disagree) d. Am¤§Z (Disagree)e. ‡Rvov‡jv Am¤§wZ ( Strongly disagree)f. Ab¨vb¨ (wbw`©ó Kiæb ) /Other (specify) __________

3.10 wRÁvmv Kiæb: AvjP¨ evK¨wU‡Z Avcbvi gZvgZ Avgv‡ì ejyb ÓGB Avevm¯’‡ji AwaKvsk Ab¨vb¨ m`‡mï aviYv GB cvwb Z‡ì‡KI Amy¯’ Ki‡eÓ ?Ask: Rate your agreement with the following statement “most of the other members of this compound think this water could make them sick”?

a. ‡Rvov‡jv m¤§wZ (Strongly agree)b. m¤§wZ(Agree)c. m¤§Z bq ,Am¤§Z bq ( Neither agree nor disagree) d. Am¤§Z (Disagree)e. ‡Rvov‡jv Am¤§wZ (Strongly disagree)f. Rv‡bb bv (Don’t know)g. Ab¨vb¨ (wbw`©ó Kiæb )/Other (specify) __________

3.11 wRÁvmv Kiæb: cvwb cv‡bi c~‡e© Lvevi cvwb weï× K‡ib ? Ask: Do you treat (do something that makes it safe) your water before drinking?

1. nu¨v,memgq Kwi (Yes, always)2. nu¨v, wKš‘ cÖwZw`b bv (Yes but not regular)3. wkï‡ì Rb¨ ïay Kwi (Treat only for child)4. bv (No )5. ej‡Z m¤§Z bv (Refused to reply)9. Rv‡bb bv (Don’t Know)

Skip Q3.12 if Q3.11 is 4, 5 or 9

3.12hw` n¨vu nq,Avcbvi Lvevi cvwb Avcwb wK K‡i weï× Ki‡eb ?If yes, what do you do to make your drinking water safe? (Do not read. Multiple response possible. Probe for answers. Indicate 1=Named, 2= Not named) a. dzUv‡bv (Boiling )

b. cwi‡kvwaZ( Filtration)c. Zjvwb (Sedimentation)d. wdUwKwi( Aluminum sulphate (fitkiri)e. ‡K¬vwib U¨ve‡jU (Chlorine tablets)f. ‡K¬vwib cvDWvi (Chlorine powder)g. wdëv‡ii eënvi (Use filter)h. A¨v‡KvqvU¨ve (Aquatabs)i. ‡iv‡`ª cvwb Zvc †Ìqv 9Leaving water in the sun)j. Ab¨vb¨ (wbw`©ó Kiæb )/ Other [specify]: -----------------------------k. ‡K¬vwib wWm‡cbmvi (Chlorine dispenser)

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3.13 wRÁvmv Kiæb: Lvevi cvwb weï× Kiv Avcbvi Kv‡Q †Kgb KwVb g‡b nq ?Ask: How difficult it is to treat the drinking water?

a. Lye KwVb (Very difficult).....1b. KwVb Difficult).............2c. KwVbI bv mnRI bv (Neither difficult nor easy)......3d. mnR (Easy)...................................................... 4e. Lye mnR(Very easy)............5f. Rv‡bb bv (Don’t know).........6

3.14 wRÁvmv Kiæb: Lvevi cvwb weï× Kiv ‡Kb KóKi ? (n¨vu =1,bv =2) Ask: What makes it difficult to treat drinking water? (1=Yes, 2=No)

a. cvwb dzUv‡bv KóKi/e¨vqeûj(Treating water is costly)_________

b. A‡bK mgq jv‡M (Takes too much time)_________c. A‡bK Kg©`¶Zvi cÖ‡qvRb(Needs too much effort)_________d. cvwb dzUv‡bv c×wZ mPvivPi cÖPwjZ bv (Facilities not

available)____________e. G‡Z †Kvb jvf †bB (Unaware of benefits)_______f. AjmZv (Laziness )_________g. dyUv‡bv cvwbi ¯^v` wfbœ (Taste of the treated water is

different)___________h. h_vh_fv‡e msi¶b Kiv KwVb(Proper storage is difficult)___________i. Ab¨vb¨ (wbw`©ó Kiæb )/Others, specify______________

Section 4: Hand Washing Knowledge and Practice ‡mKkb 4 : nvZ †avqv m¤úwK©Z Ávb Ges Abykxjb

4.1 wRÁvmv Kiæb : mPviPvi KLb Avcwb Avcbvi nvZ ay‡q _v‡Kb ?Ask:When do you usually wash your hands? (This is an open ended question, write Yes=1 and No=2 if any of the listed events mentioned)

a. Lvevi ˆZixi c~‡e© (Before preparing food)b. Lvev†ii c~‡e© (Before eating)c. Lvev‡ii c‡i(After eating)d. ev”Pv‡K Lvevi LvIqv‡bvi c~‡e©|Before feeding a childe. ev”Pv†K ‰kvPv‡bvi c‡i| After cleaning the child’s anus

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f. ev”Pvi gj †d‡j †Ìqvi c‡i|After disposal of child’s faeces g. gjZ¨v‡Mi c‡i|After defecationh. evwni ‡_†K G‡m wekªvg ‡bIqvi c‡i| After returning from outside compoundi. i“g cwi®‹vi Kivi c‡i ev Kv‡Ri c‡i|After sweeping room/ after workj. gvQ ev gvsk KvUvi c‡i|After cutting fish or meatk. kvKmewR KvUvi c‡i| after cutting vegetablesl. Lv`¨ cwi‡ek‡bi c‡i|Before serving foodm. bvgv‡Ri ev cÖv_©bvi c‡i|Before prayern. ‡Mvm‡ji mgq(During bath)o. mKv‡j Nyg †_‡K DVvi c‡i (After getting up in the morning)p. hw` Avcbvi nvZ †bvsiv ‡`Lvq (If the hands get dirty)q. ‡Mvei cwi¯‹vi Kivi c‡i (After handling cow dung )

r. Ab¨vb¨ (wbw`©ó Kiæb )/Other (please specify)___________________

4.2 mPviPvi ,Avcbvi nvZ †avqvi mgq wK cwi®‹viK mvgMÖx eënvi K‡ib| ?What do you usually use to wash your hands? (Please do not mention any of the responses to the respondent. Prompt three times to collect maximum number of possible response) (Multiple responses allowed, 1=Yes, 2=No)a) Kvci †avqvi mvevb|laundry soap___ b) wWUvi‡RÛ cvDWvi|powdered detergent___ c) _vjvevmb †avqv mvevb|dish soap____ d) ïay cvwb|only water___e) Mvq /kix‡i ‡Ìqv mvevbbody/hand soap___ f) QvB |ash____g) Kuv`vgvwU|mud___h) mvevb wgwkªZ cvwb|Soapy water___i) Ab¨vb¨ (wbw`©ó Ki“b ) Other _______

4.3 Avcwb Avgv‡K ejyb †Zv j¨vwUªb †_‡K Avmvi ci ‡klevi KLb Avcwb Avcbvi nvZ ay‡qwQ‡jb ?Can you tell me whether you washed your hands last time you came from latrine?

1. n¨vu -------1Yes...................1

2. bv--------2 No....................2

Skip to Q 3.5 if answer to Q3.2 is 2

4.4 Avcwb wK Avcbvi `y-nvZ ay‡qwQ‡jb ?Did you wash your both hands?

1. n¨vu (Yes)...................1

2. bv(No)....................2

4.5 nvZ †avqvi mgq mvevb eënvi K‡iwQ‡jb ?Did you use soap for washing hands?

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5 n¨vu (Yes)...................1

6 bv (No)...................2

4.6 4.3 Avcwb Avgv‡K ejyb †Zv Avcbvi ev”Pv‡K ˆkvPv‡bvi ci ‡klevi KLb Avcwb Avcbvi nvZ ay‡qwQ‡jb ?Can you tell me whether you washed your hands last time you cleaned your child’s bottom?

1. n¨vu -------1Yes...................1

2. bv--------2 No....................2

3. cÖ‡hvR¨ bq-------3Not applicable............3

Skip to Q 4.5 if answer to Q3.5 is 2 or 3

4.7 Avcwb wK Avcbvi `y-nvZ ay‡qwQ‡jb ? Did you wash your both hands?

1. n¨vu -------1Yes...................1

2. bv--------2 No....................2

4.8 nvZ †avqvi Rb¨ mvevb e¨envi K‡iwQ‡jb ?Did you use soap for washing hands?

5 n¨vu -------1Yes...................1

6 bv--------2 No....................2

4.9 Avcwb Avgv‡K ejyb †Zv ,Avcwb Lvevi ci ‡klevi KLb Avcwb Avcbvi nvZ ay‡qwQ‡jb ?Can you tell me whether you washed your hands last time you took food?

3. n¨vu -------1Yes...................1

4. bv--------2 No....................2

Skip to Q 4.5 if answer to Q3.2 is 2

4.10 Avcwb wK Avcbvi `y-nvZ ay‡qwQ‡jb ? Did you wash your both hands?

7 n¨vu -------1Yes...................1

8 bv--------2 No....................2

4.11 nvZ †avqvi Rb¨ mvevb e¨envi K‡iwQ‡jb ? Did you use soap for washing hands?

5 n¨vu -------1Yes...................1

6 bv--------2 No....................2

If Q4.5, Q4.8 or Q4.11 answer is No skip Q 4.12

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4.12 ch©‡e¶b : Avcwb Avgv‡K †`Lv‡Z cv‡ib, gj Z¨v‡Mi c‡i mvevb w`‡q nvZ †avqvi mgq †Kvb avc Avcwb Ki‡eb ?Observe: Can you show me the steps you follow during hand washing with soap after defecation? (Write Yes=1 and No=2 if any of the listed steps followed)

a) nvZ †fRv‡eb------Wet hands_______ b) nv‡Z mvevb jvMv‡eb ----Leather hands with soap______c) 10 †m‡KÛ nvZ NlvNwm Ki‡eb---Rub hands for 10sec_______d) cvwb w`‡q Avj‡Zv fv‡e nvZ ay‡q‡dj‡eb---Rinse hand with water_________e) nvZ ïKv‡eb---Dry hands______f) Ab¨vb¨ (wbw`©ó Ki“b ) Others, specify______

4.13 mvevb w`‡q nvZ †avqvi d‡j jvf/DcKvi wK ? (n¨vu =1,bv =2) What are the benefits of washing hands with soap? (This is an open ended question, write Yes=1 and No=2 if any of the listed benefit mentioned)

a) wkïi cÖwZcvjb Kiv/wk¶v †`qv Nurture children

b) mgv‡Ri `vwqZ¡evb e¨vw³i weKvk Be a respectable person in the society

c) ‡`L‡Z cwi®‹vi Ges AbyfywZ Feel and look clean

d) Acwi¯‹viZv `~i Remove dirt

e) ¯^v‡¯’¨i DbœwZ Improve health

f) mvgvwRK gh©`v e„w× Increase social status

g) Wvqwiqv †iva/nvi Kgv‡bv Decrease diarrhoea

h) RNb¨ †bvsiv `~i Kiv Remove disgusting, yucky staffs

i) Ab¨vb¨ (wbw`©ó Ki“b ) Others, specify

4.14 mvevb w`‡q nvZ †avqv KZ ¸i“Z¡c~Y©© Avcwb g‡b K‡ib?How important do you think it is to wash your hands with soap .......?

(wfZ‡ii Ackb¸‡jv c‡o ïbvb ÕLye ¸i“Z¡c~Y©Õ, ¸i“Z¡c~Y©, ¸i“Z¡c~Y© Avevi ¸i“Z¡c~Y©bv BZ¨vw`) (Read individual options and ask them to rate it as ‘very

important’, ‘important’, ‘neither important nor unimportant’...etc.) [wjLyb 1=¸i“Z¡c~Y©,2 = wKQy‡¶‡Î ¸i“Z¡c~Y© 3 = ¸i“Z¡c~Y© Avevi

¸i“Z¡c~Y© bv ,4 = wKQy‡¶‡Î ¸i“Z¡c~Y© bv ,5 = me‡¶‡Î ¸i“Z¡c~Y© [Write 1=very important, 2= somewhat important, 3=neither important nor unimportant, 4=

somewhat unimportant, 5=not at all important]

1. Lvevi ˆZixi c~‡e© Before preparing food2. Lvev†ii c~‡e©| Before eating3. Lvev‡ii c‡i|After eating4. ev”Pv‡K Lvevi LvIqv‡bvi c~‡e©| Before feeding a child5. ev”Pv†K ‰kvPv‡bvi c‡i After cleaning the child’s anus6. ev”Pvi gj †d‡j †`Iqvi c‡i After disposal of child’s faeces 7. gjZ¨v‡Mi c‡i After defecation

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8. evwni ‡_†K Gmvi c‡i After returning from outside compound9. gvQ ev gvsk KvUvi c‡i|After cutting fish/meat10. Ni cwi®‹vi Kivi c‡i After sweeping the house

4.15 Ómvevb w`‡q nvZ †avqvi †¶‡Î cÖwZeÜKZv wK Ó?“What are the barriers to you washing your hands with soap?”

hw` ZvwjKvi welq ¸‡jv DËi`vZv n¨vu e‡j _v‡K Zvn‡j LvwjN‡i 1 wjLyb |(If the respondent says the listed item, write “1” for “yes” in the box below. hw` ZvwjKvi welq ¸‡jv DËi`vZv bv e‡j _v‡K Zvn‡j LvwjN‡i 2 wjLyb |If the respondent does NOT say the listed item, write “2” for “no” in the box below.)

GUv Avgv‡`i iæwUb ev Af¨vm bq Not part of routine or habit

G‡Z †Kvb jvf †bB/ch©vß Ávb †bB Unaware of benefits/lack of knowledge

A‡bK ‡ekx kw³/ AjmZv Too much energy/laziness

mvev‡bi LiP A‡bKSoap costs too much................Amy¯’Zv `~i Ki‡Z cvwi bv Won’t prevent illness

nvZ †avqvi RvqMv bvB/ A‡bK `~‡i No handwashing station or too far away

....................................................................................mvevb w`‡q nvZ †avqvi ¸iæZ¡ bvB Don’t care about handwashing with soap

QvB/ gvwU Ash or mud cleans cvwb w`‡qB cwi®‹vi nqWater by itself cleans

A‡bK e¨¯Í/mgq bvB Too busy/no time................mvevb w`‡q nvZ ay‡Z f’‡j hvqForgets to wash hands with soap

mvevb Pzwi n‡e Soap will be stolen Ab¨vb¨ (wbw`©ó Kiæb)Other, specify below ………………………………‡Kvb evav bvB No barriers

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Section 5: GB K¤úvD‡Ûi wfZ‡i nvZ †avqvi ¯’v‡bi eZ©gvb Ae¯’v (Section 5: Present State of Handwashing Station of the Compound)

Avcbviv mvavibZ †Kvb RvqMvq nvZ ay‡q _v‡Kb Zv wK `qv K‡i Avgv‡K †`Lv‡eb(Could you please show me the place where you usually wash your hands)?

5.1 ch©‡e¶b Kiæb: cÖavb nvZ †avqvi ¯’vb †Kv_vq Aew¯’Z Zv wjwce× Kiæb (Observation: Record where the primary handwashing place is located)?

(1=nu¨v, 2=bv)

1. N‡ii wfZ‡i (Indoors )______ 2. N‡ii evB‡i (wbw`©ó ¯’v‡b) (Outdoors in a specific place )______ 3. ‡Kvb wbw`©ó RvqMv bvB (No specific place) ______4. ‡`Lvi AbygwZ wg‡j bvB (No permission to see) ______7. Ab¨vb¨, wbw`©ó Kiæb (Other, specify )_____

5.2 wK nvW©Iqvi Av‡Q? (wjLyb nu¨v =1, bv=2) Presence of Hardware. (Write Yes=1, No=2)

1. U¨vcmn Wªvg Av‡Q (Drum with tap is found) ____2. mvev‡bi cvwb Av‡Q (Soapy Water is found )____

5.3 wRÁvmv Ki“b: cvqLvbvi ci Avcbvi cÖwZ‡ekx nvZ ‡avqv ch©‡e¶b Ki‡Z cv‡i wK (Ask: Is it possible that your neighbours observe you rinse your hands after defecation)?

1. nu¨v, memgq (Yes, always)2. nu¨v, gv‡S gv‡S(Yes, sometimes)3. bv (No)4. wbwðZ bq (Not sure)5. Rvwb bv (Don’t know)

5.4 wRÁvmv Kiæb: cvqLvbvi ci Avcwb Avcbvi cÖwZ‡ekxi nvZ ‡avqv ch©‡e¶b Ki‡Z cv‡ib wK (Ask: Is it possible that you observe your neighbours rinse their hands after defecation)?

1. nu¨v, memgq Yes, always2. nu¨v, gv‡S gv‡S Yes, sometime3. bv No4. wbwðZ bq Not sure5. Rvwb bv Don’t know

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5.5 ch©‡e¶b Kiæb: nv&Z †avqvi Rb¨ †Kvb wbw`©ó ¯’v‡b cvwb Av‡Q wK (Ask: Is it possible that you observe your neighbours rinse their hands after defecation)?

(e‡· †KvW Kiæb) (Avcwb Aek¨B cvwb †`‡L “nu¨v” †KvW Ki“b):

1. nu¨v /YES 2. bv/NO

5.6 ch©‡e¶b Ki“b: wb‡æi †Kvb wRwbl¸‡jv GLb nvZ †avqvi ¯’v‡b Av‡Q? (hw` Avcwb wb‡æi ZvwjKvf~³ †Kvb wKQy †`L‡Z cvb Zvn‡j bx‡Pi e‡· “nu¨v” †Kv‡Wi Rb¨ “1Ó wjLyb| hw` Avcwb wb‡æi ZvwjKvf~³ †Kvb wKQy †`L‡Z bv cvb Zvn‡j ‡· “bv” †Kv‡Wi Rb¨ “2Ó wjLyb ) Observation: Which of the following are present at the handwashing station? (If you observe the listed item, write “1” for “yes” in the box below. If you do not observe the listed item, write “2” for “no” in the box below.)

1. nu¨v /YES 2. bv/NO

|_____| 1. Mv‡q gvLv/ nvZ †avqvi mvevb Body/hand soap |_____| 2. Kvco KvPvi mvevb laundry bar|_____| 3. ¸ov cvDWvi(cvDWvi) Detergent (powder)|_____| 4. nvZ †avqvi Zij mvevb Liquid soap|_____| 5.evmb-‡Kvmb †avqvi Zij mvevb Dishwashing soap|_____| 6. QvB Ash|_____| 7. gvwU/evwj Mud/Sand

|_____| 8. evjwZ Bucket|_____| 9. ‡ewmb Basin|_____| 10. PvcKj/bjK’c hand pump/tubewel|_____|11. ‡Kvb wKQy bvB Nothing is there|_____|12. mvevb cvwb Soapy water |_____|13. U¨vchy³ bxj Wªvg Blue drum with tap |_____|14. Kvcmn e`bv Bodna with cup|_____|15. nvZ †avqvi e¨env‡ii wPÎ m¤^wjZ KvW© Handwashing instruction cue card|_____| 77. Ab¨vb¨, wbw`©ó Ki“b Other, specify ____________________________

5.7 DËi`vZv‡K wRÁvmv Ki“b: “Avcbvi GLv‡b wK nvZ †avqvi ¯’vb Av‡Q?” 7Ask the respondent: “Is there anywhere else you wash your hands?” (Record code in box): (e‡· †KvW Ki“b)

1. nu¨v Yes

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2. bv No

3. bv hw` DËi "bv" n‡q _v‡K Zvn‡j †mKkb 7 G hvb

5.8 ch©‡e¶b Ki“b / cÖ‡qvRb n‡jwRÁvmv Ki“b: wØZxq Ab¨ †Kvb nvZ †avqvi ¯’v‡b Ab¨vb¨ Lvbvi m`m¨‡`i mv‡_ wK GKB ¯’v‡b nvZ ay‡q _v‡Kb? Observation/ask if needed: secondary handwashing place is shared between multiple households?

1. nu¨v 2. bv 9. Rvwb bv

5.9 ch©‡e¶b Ki“b: nvZ †avqvi wØZxq Ab¨ †Kvb ¯’vb _vK‡j wjwce`vaK‡i ivLyb Observation: Record the location of the secondary handwashing place

(1= nu¨v ,2= bv ) 1. wfZ‡i Indoors2. evB‡i, GKwU wbw`©ó ¯’v‡b Outdoors in a specific place 3. ‡Kvb wbw`©ó ¯’vb ‡bB (13.16 cÖ‡kœ P‡j hvb) No specific place (skips to 1316)4. ‡`Lvi Rb¨ AbygwZ ‡`q bvB (13.16 cÖ‡kœ P‡j hvb) . No permission to see (skips to 1316)7. Ab¨vb¨, wbw`©ó Ki“b Other, specify _________________________________________

5.10 ch©‡e¶b Ki“b: nv&Z †avqvi Rb¨ †Kvb wbw`©ó ¯’v‡b cvwb Av‡Q wKbv wjwce× Ki“b? (e‡· †KvW Ki“b) (Avcwb Aek¨B cvwb †`‡L “nu¨v” †KvW Ki“b): Observation: Record if water is present at the specific place for handwashing? (Record code in box) (You must actually see water to record “yes”):

1. nu¨v,2. bv

5.11 ch©‡e¶b Ki“b: wb‡æi †Kvb wRwbl¸‡jv GLb nvZ †avqvi ¯’v‡b e¨eüZ nq? (hw` Avcwb wb‡æi ZvwjKvf~³ †Kvb wKQy †`L‡Z cvb Zvn‡j bx‡Pi e‡· “nu¨v” †Kv‡Wi Rb¨ “1Ó wjLyb| hw` Avcwb wb‡æi ZvwjKvf~³ †Kvb wKQy †`L‡Z bv cvb Zvn‡j ‡· “bv” †Kv‡Wi Rb¨ “2Ó wjLyb ) Observation: Which of the following are present at the handwashing place? (If you observe the listed item, write “1” for “yes” in the box below. If you do not observe the listed item, write “2” for “no” in the box below.)

nu¨v /Yes = 1bv/ No =

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|_____| 1. Mv‡q gvLv/ nvZ †avqvi mvevb Body/hand soap |_____| 2. Kvco KvPvi mvevb laundry bar|_____| 3. ¸ov cvDWvi(cvDWvi) Detergent (powder)|_____| 4. nvZ †avqvi Zij mvevb Liquid soap|_____| 5.evmb-‡Kvmb †avqvi Zij mvevb . Dishwashing soap

|_____| 6. QvB Ash

|_____| 7. gvwU/evwj Mud/Sand

|_____| 8. evjwZ Bucket|_____| 9. ‡ewmb Basin|_____| 10. PvcKj/bjK’c hand pump/tubewel|_____|11. ‡Kvb wKQy bvB Nothing is there|_____|12. mvevb cvwb Soapy water|_____|13. U¨vchy³ bxj Wªvg. Blue drum with tap|_____|14. Kvcmn e`bv Bodna with cup|_____|15. nvZ †avqvi e¨env‡ii wPÎ m¤^wjZ KvW© Handwashing instruction cue card|_____| 77. Ab¨vb¨, wbw`©ó Ki“b Other, specify ____________________________

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‡mKkb 7: Wvqwiqv m¤úwK©Z Ávb( Section 7: Knowledge about Diarrhoea )

Now I am going to ask you some questions about diarrhoea and its prevention. (By diarrhoea I mean three or more loose stools within one day)

7.1 7.1.Avcbvi Lvbvi †KD MZ 24 N›Uvi g‡a¨ Wvqwiqvq AvµvšÍ n‡qwQj wK? Did anyone in your household had diarrhoea within last 48hours? 1.nu¨v,GKvwaK m`‡m¨i Yes, more than one person 2.nu¨v,kyaygvÎ GKRb m`‡m¨i Yes, only one person 3.bv,(cieZx© †mKk‡b P‡j hvb) No

4.Rvwb bv, (cieZx© †mKk‡b P‡j hvb) . Don’t know

7.2 .Avcbvi evwo‡Z cÖwZwU MÖ“‡ci KZRb gvbyl emevm K‡i (GKB nvwo‡Z ivbœv Lvq Ggb e¨vw³)? How many people within each age category live in your house (eat from the same cooking pot)?

1.GK eQ‡ii Kg eqmx <1 year2.GK - cuvP eQi eqmx 1 to 5 years3.Qq - `k eQi eqmx 6 to 104.GMvi - wek eQi eqmx 11 to 205.GKzk - Pwjk eQi eqmx 21 to 406.GKPwjk eQ‡ii †ekx eqmx 41 and above

7.3.GKB eq‡mi KZR‡bi Wvqwiqv n‡qwQj (How many people within each age category had diarrhoea)?

1. 1 eQ‡ii Kgeqmx <1 year2. 1 - 5 eQi eqmx 1 to 5 years3. 6 - 10 eQi eqmx 6 to 10_____4. 11 - 20 eQi eqmx 11 to 205. 21 - 40 eQi eqmx 21 to 405. 41 eQi Ges ZZwaK eqmx21 to 40

7.4. 48N›Uvi g‡a¨ †kl KLb Wvqwiqv n‡qwQj,wbb¥wjwLZ †Kvb KvRwU Avcwb K‡iwQ‡jb? Zvici GKbR‡i weKí DËi¸‡jv co–b Ges DËi `vZvi Reve wjwce× Ki“b|“When _________ had diarrhoea within the last 48 hours, did you do any of the following?” Then read choices one at a time and record the respondent’s responses.

a) Avcwb wK A‡bK NbNb Avcbvi nvZ ay‡qwQ‡jb Did you wash your hands more frequently?

b) Zv‡K wK wK¬wbK ev nvmcvZv‡j †h‡Z n‡qwQj Did s/he have to visit a clinic or hospital?

c) †m wK Kg©¯’‡j Abcw¯’Z wQj Did s/he miss work/school?

d) ‡m wK evwo‡Z Jla †meb K‡iwQj ev Wv³v‡ii civgk© Qvov dvwg©wm †_‡K Jla wK‡bwQj ? Did s/he take medicine from home or bought at a pharmacy without a doctor’s Prescription (self-medicate)?

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e) Avcwb wK Gg we we Gm Wv³vi ev Ab¨ †Kvb Aby‡gvw`Z Wv³v‡ii civgk© wb‡qwQ‡jb ev e¨ve¯’vcÎ MÖnY cye©K Jla †meb K‡iwQ‡jb (Aby‡gvw`Z dvg©vwm÷, c¨viv‡gwWK&m , bvm©, †gwW‡Kj G¨vwmU¨v÷, cwievi Kj¨vb cwi`wk©Kv BZ¨vw`| Did s/he seek help or take medicine prescribed by a MBBS doctor or other certified medical professionals (certified pharmacist, paramedics, nurses, medical assistants, family welfare visitors, etc.)?

f) Avcwb wK †nvwgIc¨vw_K Wv³vi ev mbvZb wPwKrmK KZ©K civgk© ev wPwKrmv MÖnY K‡iwQ‡jb| Did you seek help or medicine from a homeopathic doctor or a traditional healer?

7.5.Avcbvi Lvbv m`‡mï g‡a¨ KviI wK MZ `yBmßv‡ni g‡a¨ Wvqwiqv n‡qwQj Did anyone in your household had diarrhoea within last two weeks? 1.nu¨v,GKvwaK m`‡mï Yes, more than one person 2.nu¨v,ïaygvÎ GKRb m`‡mï Yes, only one person 3.bv (c‡ii †mKk‡b P‡j hvb) No

9.Rvwb bv (c‡ii †mKk‡b P‡j hvb) Don’t know

7.5.Lvbv m`‡mï‡ì g‡a¨ KZ eQi eqwm m`‡mï Wvqwiqv n‡qwQj ? How many people within each age category had diarrhoea 1. 1 eQ‡ii Kg eqmx <1 year _____2. 1 - 5 eQi eqmx 1 to 5 years _____3. 5 - 10 eQi eqmx6 to 10_4. 11 - 20 eQi eqmx 11 to 20_____5. 21 - 40 eQi eqmx 21 to 40_____6. 41 eQi ev ZZwaK eqmx 41 and above7.6.ÓKLb ---------MZ `yyB mßv‡ni g‡a¨ Wvqwiqv n‡qwQj, wbb¥wjwLZ †Kvb KvRwK Avcwb K‡iwQ‡jbÓ Zvici GKbR‡i weKí DËi¸‡jv co–b Ges DËi `vZvi Reve wjwce× Ki“b|“When _________ had diarrhoea within the last 2 weeks, did you do any of the following?” Then read choices one at a time and record the respondent’s responses.

a) Avcwb wK A‡bK NbNb Avcbvi nvZ ay‡qwQ‡jb Did you wash your hands more frequently?

b) Zv‡K wK wK¬wbK ev nvmcvZv‡j †h‡Z n‡qwQj Did s/he have to visit a clinic or hospital?

c) †m wK Kg©¯’‡j Abcw¯’Z wQj Did s/he have to visit a clinic or hospital?

d) ‡m wK evwo‡Z Jla †meb K‡iwQj ev Wv³v‡ii civgk© Qvov dvwg©wm †_‡K Jla wK‡bwQj ? Did s/he take medicine from home or bought at a pharmacy without a doctor’s Prescription (self-medicate)?

e) Avcwb wK Gg we we Gm Wv³vi ev Ab¨ †Kvb Aby‡gvw`Z Wv³v‡ii civgk© wb‡qwQ‡jb ev e¨ve¯’vcÎ MÖnY cye©K Jla †meb K‡iwQ‡jb (Aby‡gvw`Z dvg©vwm÷, c¨viv‡gwWK&m , bvm©, †gwW‡Kj G¨vwmU¨v÷, cwievi

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Kj¨vb cwi`wk©Kv BZ¨vw`| Did s/he seek help or take medicine prescribed by a MBBS doctor or other certified medical professionals (certified pharmacist, paramedics, nurses, medical assistants, family welfare visitors, etc.)?

f.Avcwb wK †nvwgIc¨vw_K Wv³vi ev mbvZb wPwKrmK KZ©K civgk© ev wPwKrmv MÖnY K‡iwQ‡jb| Did you seek help or medicine from a homeopathic doctor or a traditional healer

7.7.wKQy †jv‡Ki g‡Z Wvqwiqv GKwU gvivZ¥vK ‡ivM |KviI KviI g‡Z Zv bq| ZvB AbyMÖn cye©K Avcwb Avcbvi gZvgZ wbb¥wjwLZ wee„wZi mv‡_ hvPvB K‡i †`Lyb| Some people tell us that diarrhoea is a severe disease; but others tell that it’s not. Please rate your agreement with the following statement ÓWvqwiqv GKwU gvivZ¥vK ‡ivMÓ“ Diarrhoea is a severe disease” -

a) m¤úyb© GKgZ Strongly agree

b) GKgZ Agree

c) GKgZ bb ev wØgZ I bb Neither agree nor disagree

d) GKgZ bb Disagree

e) m¤c~Y© wØgZ Strongly disagree

hw` 401 bs cª‡kœi DËi M ev N nq A_ev I nq Zvn‡j 402 bs cª‡kœ P‡j hvb|7.8.wK Kvi‡b Wvqwiqv‡K gvivZ¥vK †ivM g‡b K‡ib| Avcwb Avcbvi gZvgZ wbb¥wjwLZ wee„wZi mv‡_ hvPvB K‡i †`Lyb| ÓWvqwiqv GKwU gvivZ¥vK ‡ivMÓKviY-------(wjLyb 1=nu¨v, 2=bv, 3=cÖ‡hvR¨ bq)

If answer to the question 401 is c, d, or e skip question 402 What leads you think diarrhoea as severe. Rate your agreement with the following statement

“Diarrhoea is a sever disease, it can cause ________” (Write 1=Yes, 2= No, 3=Not applicable)

welqmg~n Attributes

m¤ú~b© GKgZ

Strongly

GKgZAgree

GKgZ bv wØgZbv

Neither agree

wØgZDisagree

m¤ú~b© wØgZ

Strongly

g„Zz¨ DeathnvmcvZv‡j fwË© HospitalizationAvw_©K ¶wZ Economic lossKg©w`e‡mi ¶wZ Loss of working dayswe`¨vj‡q Abycw¯’wZRwbZ ¶wZ

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¶wZ Loss of school dayswkïiv Le©vK…wZ nq (A_ev †e‡o D‡V bv) Child to grow small (OR: fail to grow)

7.9 Wvqwiqv †_‡K gy³ _vKvi Rb¨ Avcwb wK wK Dcvq Rv‡bb? ( weKí DËi¸‡jv co‡eb bv| Zv‡K wZbevi ej‡Z mvnvh¨/DØy× Ki“b|cv‡k¦ wb‡`©k Ki“b 1=D‡jwLZ, 2= D‡jwLZ bq) What are the ways you know about to avoid getting diarrhoea? (Do not read the choices. Prompt three (3) times. Indicate 1= mentioned; 2 = Not mentioned)

[-----] (a) Lvevi cvwb dzUv‡bv Boil drinking water[-----] (b) ïaygvÎ cwi®‹vi cvwb cvb Kiv Drink only clean water[-----] (c) cvqLvbv eënvi Kiv Use latrine[-----] (d) Lvevi mwVK wbq‡g ivbœv Kiv Proper cooking of food[-----] (e) cPv Lvevi bv LvIqv Don’t eat spoiled food[-----] (f) cwi®‹vi-cwi”Qbœ/†X‡K ivLv/†avqv Lvevi LvIqv Eat

clean/protected/washed food[-----] (g) nvZ †avqv Wash hands[-----] (h) ¯^v¯’¨wewai PP©v Kiv Good hygiene practices[-----] (i) AZ¨waK Lvevi bv LvIqv Don’t eat too much[-----] (j) wPwKrmv MÖnb Kiv Medication[-----] (k) cwi®‹vi evmb/M„n-mvgMx Clean dishes/clean utensils[-----] (l) ey‡Ki `ya LvIqv‡bv Breastfeeding[-----] (n)cvwb †iŠ‡`ª ivLv Leave water in the sun[-----](o)G¨vjywgwbqvg mvj‡dU eënvi Kiv Aluminum sulphate[-----](p) ‡K¬vwib U¨ve‡jU eënvi Kiv Chlorine tablets[-----](q) ‡K¬vwib cvDWvi eënvi Kiv Chlorine powder

[-----](r)Ab¨vb¨ OTHERS:: ---------------------------------------------------------

7.10 wKQy †jv‡Ki g‡Z wbæwjwLZ Kvi‡b Wvqwiqv n‡Z cv‡i| wKš‘ Ab¨ Kvi‡ KviI g‡Z Zv bq| Avcbvi gZvgZ D‡jwLZ evK¨wUi mv‡_ wgwj‡q wbb “Avgvi __________ Gi gva¨‡g Wvqwiqv n‡Z cv‡i” (wjLyb 1= nu¨v , 2=bv, 3= cÖ‡hvR¨ bq) Some people tell us that they might get diarrhoea by the following things, but others tell us that they don’t. Rate your agreement with the statements “I can get diarrhoea by__________”

(Write 1=Yes, 2= No, 3=Not applicable)

welqmg~n Attributes m¤ú~b© GKgZStrongly

agree

GKgZAgree

GKgZ bv wØgZ bv

Neither agree nor disagree

WØgZDisagree

m¤ú~b©

wØgZStrongly

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disagreea) `ywlZ cvwb cvb Kiv

(Drinking untreated water)b) cvqLvbv Kivi ci mvevb

w`‡q nvZ bv †avqv Not washing hands with soap after coming from latrine

c) ev”Pv‡`i †kŠPv‡bvi ci mvevb w`‡q nvZ bv †avqv Not washing hands with soap after cleaning child’s bottom

d) mvevb w`‡q nvZ bv ay‡q Lvevi LvIqv Eating food without washing hands with soap

e) Acwi®‹vi nv‡Z cwi‡ewkZ Lvevi LvIqv Eating food served by unclean hands

f) Acwi®‹vi nv‡Z ‰Zix Kiv Lvevi LvIqv Eating foods prepared by unclean hands

g) `ywlZ Lvevi LvIqv Eating contaminated food

h) Wvqwiqv †ivMxi mv‡_ GKB Mvm I Kvc e¨envi Kiv Sharing glass and cups with a diarrhoea patient

i) AZ¨waK Lvevi LvIqv Eating too many foods

j) evwk/cPv Lvevi LvIqv Eating rotten/spoiled foods

k) wPwKrmv MÖnb Kiv Medication

l) gkjvhy³ Lvevi LvIqv Eating spicy food

m)LvIqvi mgq †KD bRi †`qv Being observed with evil eyes

7.11 Avcbvi gZvgZ wbæwjwLZ evK¨¸‡jvi mv‡_ wgwj‡q wbb: Rate your agreement with the following statements:

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welqmg~nAttributes

m¤ú~b© GKgZStrongly

agree

GKgZAgree

GKgZ bv

wØgZ bv

Neither agree nor disagree

wØgZDisagree

m¤ú~b©

wØgZ

Strongly disagree

7.11.1 †h cvwb †`L‡Z cwi¯‹vi Zv Lvevi Rb¨ wbivc`| (Water that looks clear is safe to drink)

7.11.2 cvwb weï× K‡i Wvqwiqv cÖwZ‡iva Kiv hv‡e (Treating drinking water will protect against diarrhea)7.11.3 Uq‡jU e¨env‡ii ci, cvwb w`‡q nvZ ay‡jB h‡_ó| (After using the toilet, it is okay to just rinse hand with water)7.11.4 Lvevi ci mvevb w`‡q nvZ †avqv Wvqwiqv cÖwZ‡iv‡ai GKUv ¸iæZ¡c~Y© Dcvq (Washing hands with soap after eating food is an important way to protect against diarrhea)7.11.5 Lvevi Av‡M mvevb w`‡q nvZ †avqv Wvqwiqv cÖwZ‡iv‡ai GKUv ¸iæZ¡c~Y© Dcvq (Washing hands with soap before eating food is an important way to protect against diarrhea)7.11.6 ev”Pv‡K †kŠP Kiv‡bvi ci, hw` Avcbvi nv‡Z cvqLvbv †j‡M _v‡K, ïay ZLbB nvZ †avqv DwPr (After cleaning a child’s bottom, it is only important to wash hands if you can see feces on your hands)7.11.7 cuPv Lvevi †L‡j Wvqwiqv n‡e (Eating spoiled foods will cause diarrhea)7.11.8 dj I kvK-kwâ aivi Av‡M nvZ †avqv Ri“ix bq (It is not important to wash hands before touching fruits and vegetables)7.11.9 K‡jiv f¨vKwmb wb‡q Wvqwiqv cÖwZ‡iva Kiv m¤¢e bq (Taking cholera vaccine will not protect against diarrhea)

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7.11.10Lvevi cwi‡ek‡bi Av‡M nvZ †avqv Riæix (It is important to wash hands before touching food that is to be served)7.11.11cvwb w`‡q nvZ ay‡j Wvqwiqv cÖwZ‡iva Kiv m¤¢e (Rinsing hands with water will protect against diarrhea)7.11.12Avcbvi cÖwZ‡ekx "Zv‡`i gqjv nv‡Zi Øviv Avcbvi evox‡Z Wvqwiqv Ab‡Z cv‡i

†mKkb 9: ‡Nbœv m¤úwK©Z Abyf~wZ/g~j¨‡eva/cÖwZwµqv/wek¦vm (Section 9: Feelings/norms/reactions/beliefs relating to disgust )

9.1 Avcbvi kix‡i wbæwjwLZ e¯‘¸‡jv jvM‡j Avcbvi wK iKg Abyf~wZ n‡e?(-2=LyeB †Nbœvi, -1=†Nbœvi, 0=‡Kvb Abyf~wZ bvB, 1=Avb›``vqK, 2= LyeB Avb›``vqK, is w`‡q wb‡`©k Ki“b) How would you rate your feeling about having the following object on your skin?(-2=Very disgusting, -1=Disgusting, 0=No feeling, 1= Pleasant, 2= Very pleasant, please indicate by colour

a. ‡h ZiKvix Avcwb mvavibZ †L‡q _v‡Kb Curry that you usually eatb. eq¯‹ gvby‡li cvqLvbv Adult fecesc. b`xi cvwb River waterd. U¨v‡ci cvwb Tap watere. ev”Pv‡`i cvqLvbv Babies (<2years) fecesf. ‡K¬vwib cvwb Chlorine waterg. GK e¨w³ cvqLvbvi ci Wvb nvZ mvevb w`‡q †avqwb ev ARvbv Right hand

of a person not washed with soap after coming from latrine or unknownh. GK e¨w³ cvqLvbvi ci evg nvZ mvevb w`‡q †avqwb ev ARvbv Left hand of

a person not washed with soap after coming from latrine or unknowni. .GK e¨w³ ev”Pv‡K †kŠPv‡bvi ci Wvb nvZ mvevb w`‡q †avqwb ev ARvbv

Right hand of a person not washed with soap after cleaning child’s bottom or unknownj. GK e¨w³ ev”Pv‡K †kŠPv‡bvi ci evg nvZ mvevb w`‡q †avqwb ev ARvbv

Left hand of a person not washed with soap after cleaning child’s bottom or unknownk. Kv‡iv ewg Someone’s vomit

9.2 wbæwjwLZ wRwbl¸‡jv LvIqv ev cvb Kivi e¨vcv‡i Avcbvi Abyf~wZ wKfv‡e e¨³ Ki‡eb?

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(-2=LyeB †Nbœvi, -1=†Nbœvi, 0=‡Kvb Abyf~wZ bvB, 1=Avb›``vqK, 2= LyeB Avb›``vqK, is w`‡q wb‡`©k Ki“b) How would you rate your feeling about eating/ drinking the following objects?(-2=Very disgusting, -1=Disgusting, 0=No feeling, 1= Pleasant, 2= Very pleasant, please indicate by colour)

a) mvevb w`‡q nvZ ay‡q ivbœv Kiv ZiKvix Curry prepared with hands washed with soap

b) eq¯‹ gvby‡li cvqLvbv w`‡q n‡q‡Q Ggb Lvevi Foods spoiled with adult fecesc) ‡K¬vwibhy³ cvwb Chlorinated waterd) ïay cvwb w`‡q nvZ ay‡q ivbœv Kiv ZiKvix Curry prepared with hands rinsed with

watere) b`xi cvwb River waterf) GgbwK cvwb w`‡q nvZ bv ay‡q ivbœv Kiv ZiKvix Curry prepared with hands not

even rinsed with waterg) U¨v‡ci cvwb Tap waterh) ev”Pvi cvqLvbv w`‡q bó nIqv Lv`¨ Foods spoiled with child fecesi) ïKz‡ii gvsm LvIqv Eating pork

9.3 wbæwjwLZ KvR¸‡jv Avcbv‡K Ki‡Z †`‡L Kv‡iv wK iKg Abyf~wZ n‡Z cv‡i? (-2=LyeB †Nbœvi, -1=†Nbœvi, 0=‡Kvb Abyf~wZ bvB, 1=Avb›``vqK, 2= LyeB Avb›``vqK, is w`‡q wb‡`©k Ki“b) Could you rate how observer might feel seeing you doing the following activities? (-2=Very disgusting, -1=Disgusting, 0=No feeling, 1= Pleasant, 2= Very pleasant, please indicate by colour)

a. ZiKvix jvMv Kvco cov Wearing cloths stained with curry__________ b. Avcbvi kix‡i ev nv‡Z ev”Pv‡`i cvqLvbv jvMv Babies feces on your skin or

hands_____ c. b`xi cvwb cvb Kiv Drinking river water____________d. d. U¨v‡ci cvwb cvb Kiv Drinking tap water____________ e. e. cvqLvbvi ci mvevb w`‡q nvZ †avqwb Ggb e¨w³i mv‡_ nvZ wgjvb

Shaking hands with a person after coming from the latrine and not washing hands with soap ____________

f. f. ‡K¬vwibhy³ cvwb cvb Kiv Drinking chlorinated water____________g. g. ev”Pvi cvqLvbv cwi®‹v‡ii ci mvevb w`‡q nvZ †avqwb Ggb e¨w³i

mv‡_ nvZ ‡gjv‡bv Shaking hands with a person after coming from the latrine and not washing hands with soap _______

h. h. cvqLvb †_‡K G‡m mvevb w`‡q nvZ †avqwb Ggb †Kvb e¨w³i KvQ †_‡K Lvevi †bqv /MÖnb Kiv Taking food from a person not washed hands with soap after coming from latrine _______

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i. i. ev”Pv‡K †kŠPv‡bvi ci mvevb w`‡q nvZ †avqwb Ggb †Kvb e¨w³i KvQ †_‡K Lvevi †bqv /MÖnb Kiv Taking food from a person not washed hands with soap after cleaning child’s bottom___________

j. Avcbvi kix‡i ev nv‡Z eq¯‹ gvby‡li cvqLvbv jvMv Adult feces on your skin or hands _____

9.4 ‡Kvb ch©‡e¶bKvix Avcbv‡K wbævwjwLZ KvR¸‡jv Ki‡Z †`L‡j wK iKg cÖwZwµqv e¨³ Ki‡Z cv‡i ?

9.5 1= ‡Kvb wKQy Ki‡e bv, 2=Avcbv‡K ¯§ib Kwi‡q w`‡Z †Póv Ki‡e, 3= Avcbv‡K †`‡L nvm‡e, 4= mgv‡jvPbv Ki‡e, 5=Avcbv‡K Abymib Kivi †Póv Ki‡e, 6=gZvgZ Rvbv‡Z A¯^xK…wZ , 8=Ab¨vb¨ , wbw`©ó Ki“b How the observer may react seeing you doing the following activities?

1= Do nothing, 2=Try to remind you, 3= Laugh at you, 4= Criticize you, 5=Try to follow you, 6=Refused to reply, 8=Others, specify____________KvR ‡Kvb

wKQy Ki‡e bv Do nothing

Avcbv‡K ¯§ib Kwi‡q w`‡Z †Póv Ki‡e Try to remind you

Avcbv‡K †`‡L nvm‡eLaugh at you

mgv‡jvPbv Ki‡e Criticize you

Avcbv‡K Abymib Kivi †Póv Ki‡eAppreciate you

gZvgZ Rvbv‡Z A¯^xK…wZ Try to follow you

Ab¨vb¨ , wbw`©ó Ki“b Others, specify

9.4.1 ZiKvix jvMv Kvco cov Wearing cloths stained with9.4.2 Avcbvi kix‡i ev nv‡Z ev”Pv‡`i cvqLvbv jvMv Babies feces on your skin or hands_____9.4.3 b`xi cvwb cvb Kiv Drinking river water______

9.4.4 U¨v‡ci cvwb cvb Kiv Drinking tap

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water______9.4.5 cvqLvbvi ci mvevb w`‡q nvZ †avqwb Ggb e¨w³i mv‡_ nvZ wgjvb Shaking hands with a person after coming from the latrine and not washing hands with soap _______ 9.4.6 ‡K¬vwibhy³ cvwb cvb Kiv Drinking chlorinated water____________9.4.7 . ev”Pvi cvqLvbv cwi®‹v‡ii ci mvevb w`‡q nvZ †avqwb Ggb e¨w³i mv‡_ nvZ ‡gjv‡bv Shaking hands with a person after coming from the latrine and not washing hands with soap ____________9.4.8 cvqLvb †_‡K G‡m mvevb w`‡q nvZ †avqwb Ggb †Kvb e¨w³i KvQ †_‡K Lvevi †bqv /MÖnb

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Kiv Taking food from a person not washed hands with soap after coming from latrine9.4.9 ev”Pv‡K †kŠPv‡bvi ci mvevb w`‡q nvZ †avqwb Ggb †Kvb e¨w³i KvQ †_‡K Lvevi †bqv /MÖnb Kiv Taking food from a person not washed hands with soap after cleaning child’s bottom______9.4.10 Avcbvi kix‡i ev nv‡Z eq¯‹ gvby‡li cvqLvbv jvMv Adult feces on your skin or hands

†mKkb 10: j¾v m¤úwK©Z Abyf~wZ/g~j¨‡eva/cÖwZwµqv/wek¦vm (Section10: Feelings/norms/reactions/beliefs relating shame)

10.1 Avcwb wK Abyfe Ki‡eb hw` bx‡Pi KvR¸‡jv Ki‡Z †`‡Lb ________?(1=jw¾Z n‡eb, 0=¸iZ¡ w`‡eb bv, 2= Mwe©Z n‡eb) How would you feel if you’re observed doing the following activities by ________?(1=Ashamed, 0=Don’t care, 2= Proud)

welqe¯‘/Dcv`vb Attributes

cwiev‡ii

AvZ¥xq-

cÖwZ‡ekx

AvMš‘K/

Avcbvi ‡P‡q

Avcbvi ‡P‡q

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m`m¨ Family

members

¯^Rb Relatives

Neighbours ARvbv e¨w³

Stranger or

Unknown person

D”Pghv©`v m¤úbœ †KDSomeone from higher status

wbghv©`v

m¤úbœ †KDSomeone from lower status

a. kix‡i ZiKvix †j‡M hvIqv Skin stained with curry

b. Kvc‡o ZiKvix †j‡M hvIqv Cloths stained with curry

c. b`xi cvwb cvb Kiv Drinking river water

d. U¨v‡ci cvwb cvb Kiv Drinking tap water

e. ‡K¬vwibhy³ cvwb cvb Kiv Drinking chlorinated

f. cvqLvbvi ci mvevb w`‡q nvZ †avqwb Ggb e¨w³i mv‡_ nvZ wgjvb Shake hands with a person not washed hands with soap after coming from latrine

g. cvqLvbvi ci mvevb w`‡q nvZ bv ay‡q Lvevi LvIqv Take food from a person not washed hands with soap after coming from latrine

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h. ev”Pvi cvqLvbv cwi®‹v‡ii ci mvevb w`‡q nvZ †avqwb Ggb e¨w³i mv‡_ nvZ ‡gjv‡bv Shake hands with person not washed hands with soap after cleaning child’s bottom

i. ev”Pv‡K †kŠPv‡bvi ci mvevb w`‡q nvZ †avqwb Ggb †Kvb e¨w³i KvQ †_‡K Lvevi †bqv /MÖnb Kiv Take food from a person not washed hands with soap after cleaning child’s bottom

j. ev”Pvi cvqLvbv kix‡i/nv‡Z jvMv Babies feces on your skin or hands

k. eq¯‹ gvby‡li cvqLvbv kix‡i/nv‡Z jvMv Adult feces on your skin or hands

10.2 Avcwb wK Avgv‡K ej‡eb bx‡Pi cÖ`Ë KvR¸‡jv †`‡L wK cÖwZwµqv ______?10.3 Could you tell me how would you react seeing ______ doing the following activities?

1= wKQyB Kie bv, 2=N„bv Kie Ges Avcbv‡K g‡b Kwi‡q †`Iqvi †Póv Kie, 3= Avcbv‡K †`‡L nvme, 4= Avcbv‡K VvÆv we`ª“c Kie, 5= Avcbv‡K Abymib Kivi †Póv Kie, 6= gZvgZ Rvbv‡Z A¯^xK…wZ, 8= Ab¨vb¨ , wbw`©ó Ki“b______1= Do nothing, 2=Feel disgust and try to remind you, 3= Laugh at you, 4= Criticize you, 5=Try to follow you, 6=Refused to reply, 8=Others, specify______

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welqe¯‘/Dcv`vb cwiev‡ii m`m¨

AvZ¥xq-

¯^Rb

cÖwZ‡ekx

AvMš‘K/

ARvbv e¨w³

a. kix‡i ZiKvix †j‡M hvIqv (Skin stained with curry)b.Kvc‡o ZiKvix †j‡M hvIqv (Cloths stained with curry)c.b`xi cvwb cvb Kiv (Drinking river water)d.U¨v‡ci cvwb cvb Kiv (Drinking tap water)e.‡K¬vwibhy³ cvwb cvb Kiv (Drinking chlorinated water)f.cvqLvbvi ci mvevb w`‡q nvZ †avqwb Ggb e¨w³i mv‡_ nvZ wgjvb (Shake hands with a person not washed hands with soap after coming from latrine)g.cvqLvbvi ci mvevb w`‡q nvZ †avqwb Ggb †Kvb e¨w³i KvQ †_‡K Lvevi †bqv /MÖnb Kiv (Take food from a person not washed hands with soap after coming from latrine)h.ev”Pvi cvqLvbv cwi®‹v‡ii ci mvevb w`‡q nvZ †avqwb Ggb e¨w³i mv‡_ nvZ ‡gjv‡bv (Shake hands with person not washed hands with soap after cleaning child’s bottom)i.ev”Pv‡K †kŠPv‡bvi ci mvevb w`‡q nvZ †avqwb Ggb †Kvb e¨w³i KvQ †_‡K Lvevi †bqv /MÖnb Kiv (Take food from a person not washed hands with soap after cleaning child’s bottom)j.ev”Pvi cvqLvbv kix‡i/nv‡Z jvMv (Babies feces on your skin or hands)k.eq¯‹ gvby‡li cvqLvbv kix‡i/nv‡Z jvMv (Adult feces on your skin or hands)

10.4 bx‡Pi Kg©KvÛ¸‡jv Avcbvi cwiev‡ii m`m¨ A_ev cÖwZ‡ekx‡`i Kv‡Q KZUv MÖnb‡hvM¨ ?

10.5 (-2= ‡gv‡UB MÖnb‡hvM¨ bq, -1= gv‡S gv‡S MÖnb‡hvM¨, 0=¸i“Z¡nxb, 1= cÖksmbxq, 2= D”P cÖksmbxq) Could you tell me how would you react seeing ______ doing the following activities?

1= Do nothing, 2=Feel disgust and try to remind you, 3= Laugh at you, 4= Criticize you, 5=Try to follow you, 6=Refused to reply, 8=Others, specify______

welqe¯‘/Dcv`vb Attributes cwiev‡ii m`m¨ Family

members

cÖwZ‡ekx

Neighbours

a. ev”Pv Avw½bvq cvqLvbv K‡i‡Q Skin stained with curry

b. ev”Pv N‡ii g‡a¨ †g‡S‡Z cvqLvbv K‡i‡Q Cloths stained with curry

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c. ev”Pv‡K †kŠPv‡bvi ci mvevb w`‡q nvZ †avqwb Drinking river water

d. cvqLvbv †_‡K Avmvi ci mvevb w`‡q nvZ †avqwb

e. mvevb w`‡q nvZ bv ay‡q Lvevi cwi‡ekb Kivf. mvevb w`‡q nvZ bv ay‡q Lvevi ‰Zix Kivg. b`xi cvwb cvb Kiv Drinking river waterh. U¨v‡ci cvwb cvb Kiv Drinking tap wateri. ‡K¬vwibhy³ cvwb cvb Kiv Drinking chlorinated

waterj. cvqLvbv †_‡K Avmvi ci mvevb w`‡q nvZ

†avqwb Ggb †Kvb e¨w³i KvQ †_‡K Lvevi †bqv /MÖnb Kiv Take food from a person not washed hands with soap after coming from latrine

k. ev”Pv‡K †kŠPv‡bvi ci mvevb w`‡q nvZ †avqwb Ggb †Kvb e¨w³i KvQ †_‡K Lvevi †bqv /MÖnb Kiv Take food from a person not washed hands with soap after cleaning child’s bottom

l. ev”Pvi cvqLvbv cwi®‹v‡ii ci mvevb w`‡q nvZ †avqwb Ggb e¨w³i mv‡_ nvZ ‡gjv‡bv Shake hands with person not washed hands with soap after cleaning child’s bottom

m. Avcbvi kix‡i ev Kvc‡o ZiKvix †j‡M hvIqv Cloths stained with curry

n. nv‡Z gqjv †`Lv hv‡”Q (a~jv, Kv`v, †Mvei BZ¨vw`)

o. Avcbvi nv‡Z ev”Pvi cvqLvbv †j‡M _vKv Babies feces on your skin or hands

p. Avcbvi nv‡Z eq¯‹ gvby‡li cvqLvbv †j‡M _vKv Adult feces on your skin or hands

‡mKkb11: D‡Vv‡b mvgvwRK m¤úK© (Section 11: Social Relationship in the Courtyard)

11.1 wbæwjwLZ wee„wZ¸‡jv m¤ú‡K© gZvgZ Rate agreement with following statements:

wmwiqvj b¤^i Sl. No

cÖkœQuestion

m¤ú~b©

wØgZStrongly disagree

wØgZDisagree

GKgZ bv wØgZ bvNo response/Confused

GKgZ Agree

m¤ú~b© GKgZStrongly

agree

1. GB Avw½bvq G‡K A‡b¨i cÖwZ

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hZœkxj(In this courtyard we take care of each other)

2. Avwg g~j¨ ‡`B †h Avgvi cÖwZ‡ekx Avgv‡K GKRb fvj gv/evev wnmv‡e †`LyK(I care that my neighbours view me as a good mother/father)

3. Avwg ch©‡eÿb Ki‡Z úvwi mvevb w`‡q A‡b¨i nvZ †avqv ev bv †avqv ev Zviv mvevb wb‡q Av‡m wK bv hLb Zviv cvhLvbv †_‡K Av‡m (I can observe others washing or failing to wash hands with soap (or, if they carry soap) when they leave the latrine)

4. Avwg Lye j¾v‡eva Kie hw` Avgvi †Kvb cÖwZ‡ekx mvevb Qvov Avgv‡K cvqLvbv †_‡K Avm‡Z †`‡L(I would feel ashamed if my neighbours saw me leave the latrine without carrying soap)

11.2 Lvevi cvwb weï× Kivi Rb¨ Avcbvi cÖwZ‡ekx KL‡bv Avcbvi cÖksmv K‡i‡Q wK?(Have your neighbours ever praised you for treating your drinking water?)

nu¨v /yes.........1bv./No..........2

11.3 ¸iæZ¡c~Y© mg‡q †hgb cvqLvbv †_‡K Avmvi ci mvevb w`‡q nvZ ay‡j KL‡bv Avcbvi †Kvb cÖwZ‡ekx Avcbvi cÖksmv K‡i‡Q wK?(Have your neighbours ever praised you for washing hands with soap in important times such as after coming from latrine?

nu¨v /yes.........1bv./No..........2

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11.4 Avcbvi †Kvb cÖwZ‡ekxi wkï cvqLvbv †_‡K Avmvi ci mvevb w`‡q nvZ ay‡Z f’‡j †M‡j Avcwb g‡b Kwi‡q †`b wK?(Have you ever reminded a neighbour’s children to wash hands with soap after coming from latrine when they forgot?)

nu¨v /yes.........1bv./No..........2

11.5 Avcbvi †Kvb cÖwZ‡ekx Avcbvi wkï cvqLvbv †_‡K Avmvi ci mvevb w`‡q nvZ ay‡Z f’‡j †M‡j g‡b Kwi‡q †`q wK?Have your neighbour ever reminded your children to wash hands with soap after coming from latrine when they forgot?

nu¨v /yes.........1bv./No..........2

cÖwZ‡ekx‡ì g‡a¨ †hvMv‡hvM (hviv †KvU© BqvW© wgwUs Dcw¯’Z wQj bv Zv‡ì GKKfv‡e wRÁvmv Kiæb)Communication between neighbours (ask to the individual who were not present in the courtyard meeting)

11.6 Avcwb wK KLbI ï‡b‡Qb `~N©Ubvµ‡g gvbyl Zv‡ì cwievi‡K Ô¸Õ cwi‡ekb K‡i?( Did you ever hear people sometimes accidentally serve feces to their family)

a) nu¨v/yes.........1b) bv/No.........2

11.7 Avcwb GB Z_¨†Kv_v †_‡K †c‡q‡Qb(Where did you get this information)?a) cwiev‡ii m`m¨ (Family members)b) cÖwZ‡ekx (Neighbours )c) K¤úvDÛ g¨v‡bRvi †h Dc¯’vc‡bi mgh Dcw¯’Z wQj (Compound manager who

attended the presentation)d) ICDDR,B ÷vd (ICDDR, B staff)e) Ab¨ †Kvb Drm †_‡K,wbw`©ó Kiæb (Other sources, specify)_________

11.8 Avcwb wK KLbI ï‡b‡Qb Avgv‡ì cÖwZ‡ekxiv Avgv‡ì N‡i AvµgbKvix Avb‡Z cv‡i (Did you ever hear our neighbours could bring some invaders to our family)?

nu¨v/Yes.........1bv /No...........2

11.9 Avcwb GB Z_¨ †Kv_v †_‡K †c‡q‡Qb (Where did you get this information)?a) cwiev‡ii m`m¨(Family members) b) cÖwZ‡ekx (Neighbours )c) K¤úvDÛ g¨v‡bRvi †h Dc¯’vc‡bi mgh Dcw¯’Z wQj Compound manager who

attended the presentationd) ICDDR,B ÷vd (ICDDR, B staff)e) Ab¨ †Kvb Drm †_‡K,wbw`©ó Kiæb (Other sources, specify)_________

GUv wK d‡jv-Avc cwi`k©b? hw` nu¨v nq evKx cÖkœ¸‡jv Kiæb| hw` cÖv_wgK Rixc nq Zvn‡j mvÿvZKvi GLv‡b eÜ Kiæb Ges DËi`vZv‡K

abëv` w`b

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Is it a follow up visit? If yes please continue rest of the questionnaire. If it is a baseline survey stop the interview here and thank the respondent.

‡mKkb 12: nvZ †avqvi ¯’vb cÖm‡½ (Section 12: Uptake of Handwashing Station)

msi¶‡bi cvÎ cybivq fwË© Refilling of the Reservoir:

12.8 U¨vc/Kj mn WªvgwU wK cªwZw`b cvwb w`‡©q c~b© K‡ib? (e‡·i wfZ‡i †KvW Ki“b) Does the “Drum with tap” filled with water regularly? (Write code in the box)

nu¨v............1 Yes............1No..............2

12.11 hw` nu¨v nq †K GUv c~b© K‡i? (e‡·i wfZ‡i †KvW Kiæb) If yes, who will refill it? (Write code in the box)

1. chv©qµ‡g cÖ‡Z¨K cwievi `vwqZ¡ cvjb K‡iEvery household is responsible to do it by rotation

2. K¤úvD‡Ûi g¨v‡bRvi K‡i The compound manager does it3. K¤úvD‡Ûi g¨v‡bRvi wm×všÍ †bq †K Ki‡e The compound manager

decides who will do it4. K¤úvD‡Ûi wfZ‡i GKRb †¯^”Qv‡mex Av‡Q †h me mgq GUv K‡i There

is a volunteer in the compound who always does it5. wbw`©ó †Kvb e¨w³ bvB, †h hLb duvKv †`‡L †m GUv c~b© K‡i There

is no fixed person to do this, whenever someone finds it empty, he/she refills it 7. Ab¨vb¨ (wbw`©ó Kiæb) Other (specify)______________:______________ 9. Rvwb bv Don’t know

12.12 DËi`vZv/`vÎx †K wRÁvmv Kiæb : hLb cvwb msi¶‡bi cvÎ Lvwj _v‡K, †K GUv c~Y© K‡i ? (e‡·i wfZ‡i †KvW Kiæb) Ask the respondent: When the reservoir is empty, who usually refills it? (Write code in the box)

1. chv©qµ‡g cÖ‡Z¨K cwievi `vwqZ¡ cvjb K‡i Every household is responsible to do it by rotation

2. K¤úvD‡Ûi g¨v‡bRvi K‡i The compound manager does it3. K¤úvD‡Ûi g¨v‡bRvi wm×vš— †bq †K Ki‡e The compound manager decides

who will do it

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4. K¤úvD‡Ûi wfZ‡i GKRb †¯^”Qv‡mex Av‡Q †h me mgq GUv K‡i There is a volunteer in the compound who always does it

5. wbw`©ó †Kvb e¨w³ bvB, †h hLb duvKv †`‡L †m GUv c~b© K‡i There is no fixed person to do this, whenever someone finds it empty, he/she refills it

7. Ab¨vb¨ (wbw`©ó Kiæb)/ Other (specify)______________

9. Rvwb bv Don’t know

12.13 hw` bv K‡i _v‡K †Kb msi¶‡bi cvÎ Lvwj wbqwgZLfv‡e c~Y© K‡i bv? If no, describe why the reservoir does not fill with water regularly?

1----------------------------------------------

2________________________________

3________________________________

12.14 Avcbv‡`i K¤úvD‡Ûi bxj WªvgwU KZ Nb Nb c~Y© Kiv nq? ( hw` GB cwievi GKvwaK e¨envi K‡i, Zvn‡j cvqLvbvi Kv‡Q †hUv Av‡Q Zvi DËi wbb)(e‡·i wfZ‡i †KvW Ki“b) 14 How frequently does the blue drum in your compound gets refilled (if there are more than one to be used by this family, take response of the one that is placed near the toilet)? (Write code in the box)

1. me mgq Wªvg Lvwj _v‡K Everytime the drum is empty2.cÖvq mgq /†ekxifvM mgq Wªvg Lvwj _v‡K Most of the time the drum is empty3. gv‡S gv‡S/ wKQy mgq Occasionally or sometimes4.K`vwPZ Rarely9. Rvwb bv Don’t know

12.15 12.15 mvevb cvwb wK wbqwgZ fv‡e c~b© Kiv nq? (e‡·i wfZ‡i †KvW Ki“b) Does “Soapy Water” refilled regularly? (Write code in the box)

nu¨v/ Yes.............1bv/No...............2

12.16 hw` nu¨v nq, †K wbqwgZ fv‡e c~b© K‡i? (e‡·i wfZ‡i †KvW Ki“b) If yes, who refilled the “Soapy water” regularly? (Write code in the box)

1. chv©qµ‡g cÖ‡Z¨K cwievi `vwqZ¡ cvjb K‡i Every household is responsible to do it by rotation

2. K¤úvD‡Ûi g¨v‡bRvi K‡i The compound manager does it3. K¤úvD‡Ûi g¨v‡bRvi wm×vš— †bq †K Ki‡e The compound manager decides

who will do it4. K¤úvD‡Ûi wfZ‡I GKRb †¯^”Qv‡mex Av‡Q †h me mgq GUv K‡i There

is a volunteer in the compound who always does it5. wbw`©ó †Kvb e¨w³ bvB, †h hLb duvKv †`‡L †m GUv c~b© K‡i There

is no fixed person to do this, whenever someone finds it empty, he/she refills it 7. Ab¨vb¨ (wbw`©ó Ki“b) Other (specify):______________ 9. Rvwb bv Don’t know

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12.17 hw` bv nq, †Kb mvevb cvwb wbqwgZ fv‡e c~b© Kiv nq bv? eY©bv Ki“b If no, describe why the Soapy water was not refilled regularly?

1. ________________________________2. ________________________________3. ________________________________

12.18 12.18 GjvKvi RbMb wK GUv mgvav‡bi cÖ¯—ve †`q? (e‡·i wfZ‡i †KvW Ki“b) Solution proposed by the community people? (Write code in the box)

nu¨v/ Yes.............1

bv/No...............2

12.19 hw` nu¨v nq, eY©bv Ki“b If yes, describe _____________________________________________________________________________________________________________________________________________

12.20 ‡kevi K‡e mvevb cvwbi †evZje c~b© Kiv n‡qwQj( How quickly the soapy water bottle was refilled last time)?

1. ‡evZj Lvwj nIqvi mv‡_ mv‡_ (As soon as the the bottle was empty)2. ‡evZj Lvwj nIqvi K‡qKw`‡bi g‡a¨ Within few days the bottle was empty3. ‡evZj Lvwj nIqvi 1 mßv‡ni g‡a¨ Within a week the bottle was empty4. 1 mßv‡ni †ekx wKš‘ 1 gv‡mi Kg Within more than a week but less than a month5. cÖ‡hvR¨ bq Not applicable

12.21 Avcbv‡`i K¤úvD‡Ûi KZ Nb Nb mvevb cvwbi †evZjwU c~Y© Kiv nq? How frequently does the soapy water bottle in your compound gets refilled?

1. me mgq †evZj Lvwj _v‡K Everytime the bottle is empty 2.cÖvq mgq /†ekxifvM mgq †evZj Lvwj _v‡K Most of the time the bottle is empty

3. gv‡S gv‡S/ wKQy mgq Occasionally or sometimes 4.K`vwPZ Rarely 9. Rvwb bv Don’t know

ch©‡e¶b:AvPib cwieZ©b(Observations: Change in behaviour )

. nv‡Zi cwi®‹vi cwi”QbœZv [-----] (Cleanliness of the palms/fingerpads?) May I please look at your hands?

†KvW mg~n (Codes):gqjv ¯úófv‡e †`Lv hvw”Qj (Visible dirt) ....................................................................................1 gqjv ¯úófv‡e †`Lv bv ‡M‡jI Acwi”Qbœfve wQj (No visible dirt but unclean appearance) ........... 2 cwi®‹vi wQj (Clean)................................................................................................................. 3

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ch©‡e¶Y Kiv m¤¢e nqwb/cÖZ¨vLvb (Observation was not possible/refused). ............................... 4

a. nv‡Zi bL (Fingernails) .........................................

b. KiZj (Palms).....................................................

c. Av½y‡ji m¤§yLfvM (Fingerpads).................................

12.23 mv`v KvMR eënvi K‡i ch©‡e¶b: nv‡Zi Zvjy/b‡Li cwi®‹vi-cwi”QbœZv (DËi`vZvi nv‡Zi Qvc †bqvi Rb¨ mv`v KvMR eënvi Ki‡eb) Observation using a white paper: Cleanliness of the palms/finger pads? (FRAs will use a white paper to take a print of the respondent’s hands.

1. cwi®‹vi Clean2. GKUz gqjv A bit dirty3. Lye gqjv A bit dirty

502. hw` evmvq<5 Gi ev”Pv _v‡K, AbymÜvb K‡i ev”Pvi KiZj/Av½y‡ji m¤§yLfvM Gi cwi¯‹vi cwi”QbœZvi Ae¯’v wjLyb| hw` G‡Ki †ekx ev”Pv _v‡K, †QvU ev”PvwUi nvZ ch©‡e¶Y Kiæb| (If there is a child <5 at home, inspect and record the cleanliness of the palms/finger pads of that child. If there are more than one child, inspect the hands of the younger child.)

gqjv ¯úófv‡e †`Lv hvw”Qj (Visible dirt) ....................................................................................1 gqjv ¯úófv‡e †`Lv bv ‡M‡jI Acwi”Qbœfve wQj (No visible dirt but unclean appearance) ......... 2 cwi®‹vi wQj (Clean).................................................................................................................. 3 ch©‡e¶Y Kiv m¤¢e nqwb/cÖZ¨vLvb (Observation was not possible/refused). ............................... 4 cÖ‡hvR¨ bq (Not applicable) ..................................................................................................... 8

a. nv‡Zi bL (Fingernails) .........................................

b. KiZj (Palms).....................................................

c. Av½y‡ji m¤§yLfvM (Fingerpads).................................

12.25 mv`v KvMR eënvi K‡i ch©‡e¶b: nv‡Zi Zvjy/b‡Li cwi®‹vi-cwi”QbœZv (wkïi nv‡Zi Qvc †bqvi Rb¨ mv`v KvMR eënvi Ki‡eb) Observation using a white paper: Cleanliness of the palms/finger pads? (FRAs will use a white paper to take a print of the child.

1. cwi®‹vi Clean2. GKUz gqjv A bit dirty3. Lye gqjv A bit dirty

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gvVKgx©iv GB cwiev‡ii cÖvß eq¯‹ (17 eQi ev Zvi †ekx A_ev ev”Pvi gv-evev A_ev cwiev‡ii weevwnZ cwievi cÖavb) m`m¨‡K cÖ`k©b Ki‡Z ejyb cvqLvbv †_‡K Avmvi ci mvavibZ: wKfv‡e Zviv Zv‡`i nvZ †avq? gvV Kgx©iv †bvU Ki‡eb| Field workers will ask one adult member (≥17years or parent of children in the household or married member of head of household) of the household to demonstrate how they usually wash their hands after defecation. The field worker will note

12.27 H e¨w³i wj½ wK (‡h mv¶vZKviMÖnbKvixi mvg‡b nvZ †avqv cÖ`©kb Ki‡Z ivRx) ? (e‡·i wfZ‡i †KvW Ki“b) What is the sex of that person (who agreed to demonstrate to wash hands in front of the interviewer) ? (Write code in the box)a) cyi“l( Male).........................1b) gwnjv Female.........................2

12.28 DËi`vZv/`vÎx wK nvZ ay‡qwQj? Did the respondent wash his/her hand(e‡·i wfZ‡i †KvW Ki“b) (Write code in the box)

1. nu¨v/Yes2. bv /No(13.23a cÖ‡kœ P‡j hvb)3. DËi`vZv e¨ZxZ Ab¨ †KD nvZ †avqv cÖ`k©b K‡iwQj Someone else other than the respondent demonstrated washing hands

12.29 ‡m wK Zvi `yB nvZ ay‡qwQj? (e‡·i wfZ‡i †KvW Ki“b) Did he/she wash both the hands? (Write code in the box)

1. nu¨v/ Yes2. bv/ No

12.30 ‡m Zvi nvZ ay‡Z wK e¨envi K‡iwQj. (e‡·i wfZ‡i †KvW Ki“b) What did he/she use to wash his/her hands. (Write code in the box)

1. evi mvevb Bar soap2. ¸ov cvDWvi Detergent powder3. mvevb cvwb Soapy water4. QvB (13.23 cÖ‡kœ P‡j hvb) Ash (skip to 1323)5. ïaygvÎ cvwb (13.23 cÖ‡kœ P‡j hvb) Only water (skip to 1323)6..†`qv‡j jvwM‡q ivLv mvevb Pasted soap on the wall7. mvevb/ mvevb cvwb/ QvB e¨ZxZ Ab¨ †Kvb Dcv`vb ; wbw`©ó Ki“b Material other than soap/soapy water or ash; specify _______

12.31 ‡m nvZ †avqvi Rb¨ †Kv_vq †MwQj? (e‡·i wfZ‡i †KvW Ki“b) From where did he/she use water to wash her hands? (Write code in the box)

1. mivmwi mvcvB-Gi Kj/ PvcKj/ wUDeI‡qj Directly from the municipal tap/hand pump/tubewell

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2. bxj Wªv‡g msiw¶Z cvwb Water stored in blue drum3. cwiev‡ii g‡a¨ msiw¶Z cvwb water stored within household4. Ab¨vb¨ (wbw`©ó Ki“b)_ Other (specify)___________________________

12.32 ‡dbv wK cwigv‡b we¯Z…Z wQj? (e‡·i wfZ‡i †KvW Ki“b) To what extent a lather was formed? (Write code in the box)

1. cÖPzi †dbv A lot of lather2. Aí †dbv A little lather3. †Kvb †dbv †`Lv hvqwb No visible lather

12.33 mvevb /mvevb cvwb †bqvi ci KZ¶b nvZ N‡lwQj (†dv‡gi mgq mn)? (÷cIqv‡Pi mvnv‡h¨ mgq †`Lyb)) ____________†m‡KÛ How long the hands were rubbed after applying the soap/spoapy water (includes lather time)? (timed with a stop watch) _____________sec

12.34 nvZ wK w`‡q ïwK‡qwQj? (e‡·i wfZ‡i †KvW Ki“b) How were hands dried? (Write code in the box)

1. cwi®‹vi †Zvqv‡j Clean towel2. gqjv †Zvqv‡j Dirty towel3. Kvco w`‡qWith clothes4. evZv‡m ev nvZ ïwK‡qwQj bv Air dried or did not dry hand(s)

gvVKgx©iv GB cwiev‡ii GKRb wkï‡K (5 eQi ev Zvi mgvb †_‡K 13 eQi ev Zvi Kg eqmx) cÖ`k©b Ki‡Z ejyb cvqLvbv †_‡K Avmvi ci mvavibZ: wKfv‡e Zviv Zv‡`i nvZ †avq. gvV Kgx©iv †bvU Ki‡eb| Field workers will ask one child (≥5 years to ≤13 years) of the household to demonstrate how he/she usually wash his or her hands after defecation. The field worker will note

12.35 wkïwU wK Zvi nvZ ay‡qwQj? (e‡·i wfZ‡i †KvW Ki“b) Did the child wash his/her hand? (Write code in the box)

1. nu¨v Yes2. bv (13.24 cÖ‡kœ P‡j hvb) . No (Skip to 1324)3. N‡i †Kvb wkï bvB (13.24 cÖ‡kœ P‡j hvb) No child at home (Skip to 1324)

12.36 ‡m wK `yB nvZ ay‡qwQj? (e‡·i wfZ‡i †KvW Ki“b) Did he/she wash both the hands? (Write code in the box)

1. nu¨v Yes2. bv No

12.37 ‡m wK w`‡q Zvi nvZ ay‡qwQj (e‡·i wfZ‡i †KvW Ki“b)1. evi mvevb Bar soap2. ¸ov cvDWvi Detergent powder3. mvevb cvwb Soapy water

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4. QvB (13.23 cÖ‡kœ P‡j hvb) Ash (skip to 1323)5. ïaygvÎ cvwb (13.23 cÖ‡kœ P‡j hvb) Only water (skip to 1323)6..†`qv‡j jvwM‡q ivLv mvevb Pasted soap on the wall7. mvevb/ mvevb cvwb/ QvB e¨ZxZ Ab¨ †Kvb Dcv`vb ; wbw`©ó Ki“b Material other than soap/soapy water or ash; specify _______

12.38 ‡m nvZ †avqvi Rb¨ †Kv_vKvi cvwb eënvi K‡iwQj? (e‡·i wfZ‡i †KvW Ki“b) What did he/she use to wash his/her hands. (Write code in the box)

1. mivmwi wgDwbwmc¨vjwUi U¨vc/PvcKj/wUDeI‡qj Directly from the municipal tap/hand pump/tubewell2. bxjWªv‡g msiw¶Z cvwb Water stored in blue drum3. evoxi g‡a¨ msiw¶Z cvwb water stored within household4. Ab¨vb¨ (wbw`©ó Ki“b)_ Other (specify )___________________________

12.39 wK cwigvb †dbv ‰Zix K‡iwQj(To what extent a lather was formed)? 1. cÖPzi †dbv A lot of lather

2. Aí †dbv A little lather 3. ‡Kvb †dbv †`Lv hvqwb No visible lather

12.40 mvevb/mvevb cvwb nv‡Z wb‡q KZ¶b nvZ N‡lwQj(‡dbv MIqvi mgq mn)? (÷c Iqv‡Pi mvnv‡h¨ mgq †`Lyb) _____________‡m‡KÛ How long the hands were rubbed after applying the soap/soapy water (includes lather time)? (Timed with a stop watch) _____________sec

12.41 wKfv‡e nvZ ïwK‡qwQj? (e‡·i wfZ‡i †KvW Ki“b) How were hands dried? (Write code in the box)

1. cwi®‹vi †Zvqv‡j Clean towel2. gqjv †Zvqv‡j Dirty towel3. Kvco w`‡qWith clothes4. evZv‡m ev nvZ ïwK‡qwQj bv Air dried or did not dry hand(s)

12.42 GB g~û‡Z©, Avcbvi evox‡Z †Kvb mvevb Av‡Q hv Avcwb nvZ †avqvi Rb¨ eënvi Ki‡Qb? (e‡·i wfZ‡i †KvW Ki“b) Right now, do you have any soap in the house that you use for handwashing? (Write code in the box)

1. nu¨v Yes2. bv No(Skips to 812)9. Rvwb bv Don’t know (Skips to 812)

12.43 12.43 Avcwb wK Avgv‡K mvevbwU †`Lv‡Z cv‡ib? (ch©‡e¶b Ki“b) (e‡·i wfZ‡i †KvW Ki“b) Can you show me the soap? (observe) (Write code in the box)

1. nu¨v/ Yes 2. bv, ‡Kvb mvevb †`Lv hvqwb (Ab¨ †Kv_vI eënvi n‡q‡Q, GB evox‡Z bq

BZ¨vw`) No, soap unobservable (in use elsewhere, none in the house, etc.) (Skips to 812) (Skips to 812)

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12.44 mvevb†`Lv‡Z KZ¶b mgq †j‡MwQj? ______________‡m‡KÛ How long did it take to show the soap? ______________seconds

12.45 wK ai‡bi mvevb? (ch©‡e¶‡bi wfwË‡Z c~ib Ki“i, wjLyb 1= nu¨v Ges 2= bv) |_____|1. Kvco KvPv mvevb laundry soap|_____|2. ¸ov mvevb Powdered detergent |_____|3. evmb gvRv mvevb dish soap |_____|4 Mv‡q/ nv‡Z †`qvi mvevb body/hand soap|_____|6. Zij mvevb Liquid soap |_____|7. Ab¨vb¨ Other ____________________

12.46 Avcbvi evox‡Z wK †Kvb AeëüZ mvevb Av‡Q? (wØZxq †Kvb mvevb hv †Lvjv nqwb) (e‡·i wfZ‡i †KvW Ki“b) Do you have any spare unused soap in the house? (a second bar/package that is unopened) (Write code in the box)

1. nu¨v /Yes 2. bv/ No (Skips to 812)9. Rvwb bv/ Don’t know (Skips to 812)

12.47 ch©‡e¶b Ki“b: Avcwb wK Avgv‡K mvevbwU †`Lv‡Z cv‡ib? How long did it take to show the soap? ______________seconds


12.48 mvevbwU †`Lv‡Z KZ¶b mgq †j‡MwQj? ______________‡m‡KÛ What kind of soap is it? (Fill in based on observation. Put 1= Yes and 2=No)

|_____|1. Kvco KvPv mvevb|_____|2. ¸ov mvevb|_____|3. evmb gvRv mvevb|_____|4 Mv‡q/ nv‡Z †`qvi mvevb|_____|6. Zij mvevb|_____|7. Ab¨vb¨ _________________

12.50 24 N›Uvq H2S ‡U‡ói djvdj wK n‡qwQj? What was the result of the H2S test after 24 hours?

1. `ywlZ cvwb †`Lv wM‡qwQj Water was found to be contaminated2. cvwb `ywlZ n‡qwQj bv water was uncontaminated8. cÖ‡hvR¨ bq Not applicable

12.51 48 N›Uvq H2S ‡U‡ói djvdj wK n‡qwQj? What was the result of the H2S test after 48 hours?

1. `ywlZ cvwb †`Lv wM‡qwQj Water was found to be contaminated2. cvwb `ywlZ n‡qwQj bv Water was uncontaminated

12.52 GBGjvKvq mwVK mg‡q wbqwgZ nvZ †avqv GKwU bZzb AvPib wnmv‡e cwiwPwZ †c‡q‡Q| wKQy †jvK Avgv‡ì‡K e‡j‡Q †h,Zviv mwVK mg‡q mvevb w`‡q nvZ †avqvi wel‡q GLbI AvZ¥wek¦vmx bq, †hLv‡b Abïv e‡j‡Q †h Zviv AvZ¥wek¦vmx |Avcwb mwVK mg‡q mvevb w`‡q nvZ †avqvi wel‡q KZUv AvZ¥wek¦vmx (cvqLvbv †_‡K Avmvi ci, ev”Pvi cvqLvbv cwi®‹vi Kivi ci)? Regular washing hands with soap in the key times is a new behaviour being introduced in the area. Some people told us that they are still not confident to regular

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wash their hands with soap in all the key times, while others told us that they are confident. How confident do you feel that you can wash your hands with soap in all the key times (after coming from latrine, after cleaning child’s button)?

1. Lye AvZ¥wek¦vmx Very confident

2. AvZ¥wek¦vmx Confident3. wKQyUv AvZ¥wek¦vmx Somewhat confident

4. Aí AvZ¥wek¦vmx Little confident 5. Av‡`Š AvZ¥wek¦vmx bv Not confident at all9. Rvwb bv Don’t know

‡mKkb 13: ‡K¬vwib wWm‡cÝvi cÖm‡½ Section 13: Uptake of the Chlorine dispenser

GLb Avwg Avcbv‡K †K¬vwib wWm‡cÝvi m¤ú‡K© wKQy cÖkœ Ki‡Z PvB hv Avcwb MZ K‡qKgvm hveZ e¨envi Ki‡QbNow we are going to ask you some questions about Chlorine dispenser, which you were using for last few months.

13.1 wKQy †jvK Avgv‡`i ej‡Q †h †K¬vwib Øviv weï× cvwb Wvqwiqv cÖwZ‡iv‡a mvnvh¨ Kwi , wKš‘ wKQy †jvK ej‡Q †h GUv cÖK…Zc‡¶ †Kvb cv_©K¨ K‡i bv| Avcbvi g‡Z,†K¬vwib Øviv weï× cvwb †_‡K gvbyl KZLvwb DcKvi cvq? Some people tell us that treating water with Chlorine helps a lot to prevent diarrhoea, but others tell us that it doesn’t really make any difference. In your opinion, how much benefit people can get from applying Chlorine to treat their water?

1. A‡bK DcKvi Benefited a lot2. DcKvi Benefited

3. wKQyUv DcKvi Somewhat Benefited4. Aí DcKvi Little benefit5. ‡Kvb DcKvi bq No benefit9. Rvwb bv Don’t know

13.2 ‡KD/wKQy wK Av‡Q hv Avcbv‡K Lvevi cvwb †kl n‡q †M‡j Zv weï× Kivi K_v g‡b Kwi‡q †`q? Is there anyone/anything that reminded you to treat drinking water with Chlorine when it’s finished?

1. nu¨v /Yes2. bv/ No

13.3 cvwb†Z †K¬vwib w`‡Z †K Avcbv‡K g‡b Kwi‡q †`q? What/who reminded you to add Chlorine to water?

1. ¯^vgx/¯¿x Spouse2. mš—vb Child3. AwffveK Parent

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4. k¦ïi-kvïox Parent in law5. fvB-‡evb Sibling6. KwgDwbwU wfwËK weµq Kgx© Community based sales persons7. ‡cvóvi Posters8. Avwg g‡b Kwi bv I don’t remember77. Ab¨vb¨ Other

13.4 Avcwb Rv‡bb †h, GBGjvKvq ‡K¬vwib GKwU bZzb cb¨ wnmv‡e cwiwPwZ †c‡q‡Q. wKQy †jvK Avgv‡ì‡K e‡j‡Q †h,Zviv ‡K¬vwib w`‡q cvwb weï× Kivi wel‡q GLbI AvZ¥wek¦vmx bq, †hLv‡b Abïv e‡j‡Q †h Zviv AvZ¥wek¦vmx | Avcwb KZUv AvZ¥wek¦vmxg‡b K‡ib †h , Lvevi cvwb Avcwb †K¬vwib w`‡q weï× Ki‡Z cv‡ib ? As you know, Chlorine is a new product being introduced in the area. Some people told us that they are still not confident to treat their water using Chlorine, while others told us that they are confident. How confident do you feel that you can use Chlorine to treat your drinking water?

1. Lye AvZ¥wek¦vmx Very confident

2. AvZ¥wek¦vmx Confident3. wKQyUv AvZ¥wek¦vmx Somewhat confident4. Aí AvZ¥wek¦vmx Little confident5. Av‡`Š AvZ¥wek¦vmx bvNot confident at all9. Rvwb bv Don’t know

13.5 Avcbvi cwievi KZ Nb Nb †K¬vwib w`‡q cvwb weï× K‡ib (How often does your household treat your drinking water with Chlorine)?

1) me mgq/me©`v Avgiv cvwb msMÖn Kwi Every time we collect water/always 2) ‡ekxi fvM mgq hLb Avgiv cvwb msMÖn Kwi Most of the time when we collect water

3) gv‡S gv‡S Occasionally/sometimes 4) ï®‹ †gŠmy‡g/MÖx®§Kv‡j Only during dry season/summer 5) ïaygvÎ el©vKv‡j Only during rainy season

7) Ab¨vb¨ (wbw`©ó Ki“b) OTHER (SPECIFY)________ 9) Rvwb bv DON’T KNOW

wbgœwjwLZ e³‡eï mv‡_ Avcwb ZUv GKgZ (To what extent do you agree with the following statements)?

13.6 “‡K¬vwib Øviv weï× cvwb‡Z Lvivc MÜ jv‡M”(Water smells bad if treated with Chlorine)

1. m¤ú~b© GKgZ (Strongly agree)2. wKQzUv GKgZ (Somewhat agree)3. GKgZ I bv wØgZ I bv (Neither agree nor disagree)4. wKQzUv wØgZ (Somewhat disagree)5. m¤ú~b© wØgZ (Strongly disagree)

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13.7 “‡K¬vwib Øviv weï× cvwbi ¯^v` fvj jv‡M”( Water tastes good if treated with Chlorine)

1. m¤ú~b© GKgZ (Strongly agree)2. wKQzUv GKgZ (Somewhat agree)3. GKgZ I bv wØgZ I bv( Neither agree nor disagree)4. wKQzUv wØgZ (Somewhat disagree)5. m¤ú~b© wØgZ (Strongly disagree)

13.8 “GB cY¨wU cvwb weï× Ki‡Z cv‡i Zv wek¦vm Kwi bv” (Don’t believe that the product can purify water)

1. m¤ú~b© GKgZ (Strongly agree)2. wKQzUv GKgZ (Somewhat agree)3. GKgZ I bv wØgZ I bv( Neither agree nor disagree)4. wKQzUv wØgZ (Somewhat disagree)5. m¤ú~b© wØgZ (Strongly disagree)

13.13 cvwb hLb msM„nxZ ZLb Zv †K¬vwib w`‡q weï× bv Kivi cÖavb evav¸‡jv wK(What are the main barriers for not using Chlorine every time water was collected)?co‡eb bv|wb‡`©k Kiæb 1=D‡jøwLZ;2=D‡jøwLZ bq( DO NOT READ. INDICATE 1=NAMED; 2=NOT NAMED.)

|____|(a) ‡K¬vwib w`‡q cvwb weï× Kiv GKUv AwZwi³ KvR wQj( Treating water with Chlorine was an additional task)|____|(b)‡K¬vwib eënv‡ii ci cvwb wbivc` nIqvi Rb¨ A‡bKÿb A‡cÿv Ki‡Z nq(Had to wait for long after using Chlorine to have safe water)|____|(c)weï×K…Z cvwbi ¯^v` fvj jv‡M bv (Didn’t like taste of the treated water) |____|(d) weï×K…Z cvwbi MÜ fvj jv‡M bv Didn’t like smell of the treated water |____|(e) cwiev‡ii m`m¨‡ì ¯^v‡¯’ï cwieZ©b jÿ¨bxq bv (Didn’t notice any changes in health of family) |____|(f) cwiev‡ii ¯^v¯’¨ AviI Lvivc n‡qwQj ( Family’s health deteriorated)|____|(g)wkï‡ì ¯^v‡¯’ï cwieZ©b jÿ¨bxq bv (Didn’t notice any changes in child’s health) |____|(h) ) wkï‡ì ¯^v¯’¨ AviI Lvivc n‡qwQj (Child’s health deteriorated) |____|(i) wek¦vm Kwi bv ‡h †K¬vwib KvR Ki‡e (Don’t believe that Chlorine will work) |____|(j) wek¦vm Kwi bv ‡h Avwg mwVKfv‡e †K¬vwib eënvi Ki‡Z cvie (Don’t believe that I could use Chlorine properly) |____|(k) †Kbvi ci †K¬vwib nvwi‡q †MwQj (Chlorine WAS lost after purchasing) |____|(l) †K¬vwib P‡j †MwQj (Chlorine RAN OUT ) |____|(m) cvwb GLbI gqjv †`Lv‡”Q (Water still looked dirty )|____|(n) Ab¨vb¨ (wbw`©ó Kiæb)Other (specify):_______________|____|(o) ‡Kvb mgm¨v bvB(There is no problem)

13.14 cvwb weï×Ki‡bi c×wZ wnmv‡e Avcwb †K¬vwib cQ›` Ki‡Qb bv †Kb (What are the main reasons why you do not choice Chlorine as a water treatment method)?

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1. GUv †Kv_v †_‡K wKb‡Z nq Rvwbbv Do not know from where to buy it2. UvKv wQj bv (Did not have money)3. Avwg Ab¨ c×wZ‡Z cvwb weï× Kwi Ges †K¬vwib eënv‡ii cÖ‡qvRb bvB (I

use other methods to treat my water and do not need to use Chlorine)4. Wvqwiqv mvavib ; GUv cÖwZ‡iva Kivi †Póv Ges cÖ‡qvRb bvB (Diarrhoea is

natural; there is no need to try and prevent it)5. wek¦vm Kwi bv GUv KvR Ki‡e/‡K¬vwib K‡jiv cÖwZ†iva Ki‡e (Did not believe

it will work/ Chlorine will not prevent cholera)6. mvcøvB-Gi cvwb cvb Kivi Rb¨ wbivc` g‡b Kwi (Believes that the source water is

safe to drink)7. cÖwZ‡ekxi Kv‡Q ï‡bwQjvg †h cY¨wU eënvi K‡i cvwb weï× Ki‡j ¯^v` fvj

nq bv (Heard from neighbour that taste of product treated water is not good)8. cÖwZ‡ekxi Kv‡Q ï‡bwQjvg †h cY¨wU eënvi K‡i cvwb weï× Ki‡j MÜ fvj nq

bv Heard from neighbour that smell of product treated water is not good9. GUv ivLvi †Kvb wbivc` RvqMv †bB (Do not have a safe place to put it)10. Avwg eënvi Ki‡Z PvB wK¯‘ Abïv Pvq bv (I would like to use it, but other people will use it up)88. cÖ‡hvR¨ bq (Not applicable)77. Ab¨vb¨ (wbw`©ó Kiæb)Other (please specify)___________________99. Rvwb bv (Don’t know)

13.15 †K¬vwib eënv‡ii wK Avcbvi me‡P‡q †ekx cQ›` ?co‡eb bv|wb‡`©k Kiæb 1=D‡jøwLZ;2=D‡jøwLZ bq [What did you like best about using Chlorine? [DO NOT READ; INDICATE 1=NAMED; 2=NOT NAMED].

|____|(A) cb¨wU eënvi mnR |____|(b) GB cb¨wU eënvi Lvevi cvwb wbivc` K‡i |____|(c) GB cb¨wU eënvi Wvqwiqv (†ivM) Kgvq |____|(d) cY¨wU Avgvi cwievi Ges wkïi ¯^v¯’¨ DbœwZ K‡i‡Q (The PRODUCT improved my family’s / childrens’ health) |____|(e) cY¨wU cvwbi ¯^v` Dbœqb K‡i‡Q (The PRODUCT improved the taste of water) |____|(f) Water looks better / clear / clean |____|(g) Ab¨vb¨ (wbw`©ó Kiæb):_______________|____|(h) cY¨wUi †Kvb wKQz cQ›` nqwb (Did not like anything of the product)

13.16 wKQz †jvK Avgv‡ì e‡j‡Q †h cÖwZw`b †K¬vwib w`‡q cvwb weï× Kivi LiP Zv‡ì RbÄ‡bK †ekx Ges GB Kvi‡b memgq ‡K¬vwib v`‡q cvwb weï× Ki‡Z cvi‡e bv| wKš‘ Abïv e‡j‡Q †h LiPUv hyw³m½Z Ges ‡K¬vwib w`‡q cvwb weï× Kiv Zv‡ì Rb¨ mnR|Lvevi cvwb cÖwZw`b †K¬vwib w`‡q weï× Kivi LiPUv Avcwb wKfv‡e †`‡Lb? Avcwb wK ej‡eb †h LiPUv, (Some people tell us that the cost of treating water every day with the Chlorine is too high for them and therefore cannot afford to treat water with Chlorine always; but others tell that the cost is reasonable and it is easy for them to keep treating water with Chlorine. How did you find the cost of Chlorine to keep treating your drinking water every day? Would you say the cost is,)

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1. Lye †ekx (Very high)2. wKQzUv †ekx (Somewhat High)3. †ekx I bv Kg I bv (Neither high nor low)4. Kg (Low)5. Lye Kg (Very low)9. Rvwb bv (Don’t know)

13.17 Avcbvi †K¬vwib e¨env‡ii AwfÁZv †_‡K Acgiv wK Rvb‡Z cvie (What else should we know about your experience with Chlorine)?

___________________________________________________________________________

FRA i ¯^v¶i (Signature of the FRA): -------------------------- Date ----/-----/------

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Appendix 4: Physical Observation Form__________________________________________________________________Section 0: Identification

Site:

0.1: Sample Region Name ______________

0.2: Sample Region ID_________________

Compound:

0.3: Compound Address (detailed address): ____________________

__________________________________________________________

0.4: Compound ID___________

0.5: Name of Compound Manager___________

0.6: Number of HH in Compound___________

0.7: Treatment Status_____________

Household:

0.8: Household ID_________

0.9: Name of household head: _____________________________

0.10: Household Address ______________________

Field personnel:

0.11: Name of the FRA (Interviewer)________________

0.12: FRA ID_____________

0.13: Date of interview (dd/mm/yyyy):___________

0.14: Name of the FIS (Intervention Specialist/Health promoter)____________

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0.15: FIS ID_____________

0.16: Date of Intervention done (dd/mm/yyyy)___________

Section 1: Chlorine ResidualHousehold ID Chlorine Residual (Yes/No)

Section 2: Hand Cleanliness InspectionDefinition of appearances:

1… Visible Dirt Dirt/mud/soil/ash or any other material is visible

2… Unclean appearance No dirt is visible on this part of the hand but, in general, this part of the hand appears unclean

3… Clean Observed part of the hand is clean as would appear after someone washes hands or a bath

ASK: “Please show me your hands.” “Please show me {name}’s hands. Both hands should be shown (not just one hand). Record the description that best describes the definitions the level of cleanliness based on the definitions above.

MOTHER 1A. |____| FINGERNAILS1B. |____| PALMS1C. |____| FINGER PADS

CHILD1D. |____| FINGERNAILS1E. |____| PALMS1F. |____| FINGER PADS

Definition of Terms & Training Considerations

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Fingernails include under the nail, the nail, and the skin directly surrounding the nail (cuticles). Palms are the insides of the hands not including the fingers. Finger pads are the top portions of each of the fingers where a finger print would be taken.

During training, use photos, other pictorials or directly observe people’s hands to practice identifying each of the three types of appearances. The enumerators should compare and discuss reasons for variations in coding and attempt to achieve consistent coding.

The program should decide which child’s hands should be observed, whether the index child or an older sibling. We suggest that the index child should be observed since there may be some households without older siblings.

Section 3: Soap used during Hand Washing DemonstrationASK: “Can you show me how you usually clean your hands after defecation?”If respondent must go to another room/place, go with him/her. When respondent starts washing her hands with water alone, or with soap, soapy water, or waterless sanitizer, use a stopwatch to measure duration of rubbing hands with water, soap, or sanitizer.

Record materials used for hand cleansing (1… Yes, 2… No)If the mother cannot demonstrate mark 99 for all questions

4A. |_____|Water

4B. |_____|Bar soap (scented/beauty bar)

4C. |_____|Bar soap (unscented)

4D. |_____|Powdered soap

4E. |_____|Soapy water

4F. |_____|Waterless hand sanitizer

4G. |_____|Wipes hands with cloth or leaves

4H. |_____|Does not clean hands after defecation

4I. |_____|Other (specify) __________________

4J. |_____:_____| Record length of time respondent spends rubbing hands together

4K. |_____| Record whether both hands were washed(1… Yes, both hands washed, 2… No, only one hand washed)

4L. |_____| Record location of handwashing. 1…In/near main house (≤2m to entrance)2…In/near latrine (≤2m to entrance)3…In/near cooking area (≤2m to entrance)4… >2m away from the main house, latrine, and cooking area

Definition of Terms & Training Considerations

“Soapy water from SW shaker” refers to the intervention given by the project. Participants may have soapy water in a basin that was previously used, which should not be considered for this category.

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“Wipes hands with cloth or leaves” is when a participant uses cloth (own clothing or other) or leaves to wipe hands after defecation. This is commonly practiced in some settings. However, the respondent might not demonstrate this because of reactivity. This does not mean drying hands with cloth or leaves after handwashing with water and/or soap.

“Does not clean hands after defecation” means the respondent indicates they do not typically wash their hands after they have defecated. This does not mean that the respondent does not demonstrate at the time of the observation.

Water, Bar soap (scented/beauty bar), Bar soap (unscented), Powdered soap, soapy water and waterless hand sanitizer are defined on p.6.

If discomfort of the respondent is sensed by the enumerator, he/she should reiterate the demonstration is just to learn about practices at the home

Enumerator should practice timing with other team members who should demonstrate different behaviors: washing with water, washing hands with soap, cleaning with leaves, etc.

Enumerator should have stopwatch ready to use before asking respondent to demonstrate hand cleansing.

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ÒXvKv kn‡i †Nbœv I j¾v wfwËK wbivc` cvwb cvb I nvZ †avqv Kvh©µ‡gi cix¶vg~jK cÖPviÓ Testing Disgust and Shame based Safe Water and Handwashing Promotion in

Urban Dhaka

G‡cwÛ· 5: evwn¨K ch©‡e¶b dg©Appendix 5: Rapid Physical Observation Form

_________________________________________________________________‡mKkb 0: mbv³KibSection 0: Identification

GjvKv:

Site:

0.1: GjvKvi bvg______________


0.2: GjvKvi AvBwW_________________

0.2: Sample Region ID_________________

K¤úvDÛ:

Compound:

0.3: K¤úvD‡Ûi wVKvbv (we¯—vwiZ wVKvbv): ____________________


0.4: K¤úvDÛ AvBwW___________

0.4: Compound ID___________

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0.5: K¤úvDÛ g¨v‡bRv‡ii bvg___________


0.6: K¤úvD‡Û cwiev‡ii msL¨v__________


0.7: wPwKsmvi Ae¯’v_____________


cwievi:Household:

0.8: cwev‡ii AvBwW_________


0.9: cwievi cÖav‡bi bvg: ____________________________


0.10: cwiev‡ii wVKvbv ______________________


gvVKgx© :Field personnel:

0.11: Z_¨ msMÖnKvixi bvg________________


0.12: Z_¨ msMÖnKvixi AvBwW _____________

0.12: FRA ID_____________

0.13: mv¶vrKvi MÖn‡Yi ZvwiL (dd/mm/yyyy):___________


0.14: B›Ui‡fbkb †¯úkvwj‡ói bvg (Intervention Specialist/Health promoter)____________


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0.15: B›Ui‡fbkb †¯úkvwj‡ói AvBwW_____________

0.15: FIS ID_____________

0.16: B›Uvi‡fbk‡bi ZvwiL (dd/mm/yyyy)___________


Section 1: nvZ †avqvi ¯’v‡b hš¿vs‡ki Ae¯’v ch©‡e¶bSection 1: Handwashing Station Hardware Status Observation

1.11 Kjmn msi¶‡bi cvÎ wK †`Lv hvw”Qj (e‡·i wfZ‡i †KvW Ki“b) 1.11 Reservoir with tap is found (Write code in the box)


Skip 12.2 if 12.1 is No

1.12 hw` msi¶‡bi cvÎ †mLv‡b _v‡K, †mUv wK Ae¯’vq Av‡Q ? (e‡·i wfZ‡i †KvW Ki“b)1.12 If reservoir is there, what is the status of it? (Write code in the box)

1. msi¶‡bi cvÎ Kvh©Kix Av‡Q The reservoir is functional2. msi¶‡bi cvÎ bó (Kj fv½v, dzUv BZ¨vw`) The reservoir is damaged (tap broken, leaking etc)

3. msi¶‡bi cvÎ Ab¨ Kv‡R e¨envi nw”Qj Reservoir used for other purpose

1.13 Kjmn msi¶‡bi cv‡Îi Ae¯’vb (e‡·i wfZ‡i †KvW Ki“b )

1. D‡Vv‡bi g‡a¨/mvavib †Lvj RvqMv ev Mwj‡Z In the courtyard/common open space or lane

2. ivbœvN‡ii Kv‡Q Near kitchen3. cvqLvbv I ivbœvN‡ii g‡a¨Lv‡b In between toilet and kitchen 4. cvqLvbvi Kv‡Q Near Toilet5. cvqLvbvi wfZ‡i Inside the toilet6. Ab¨ ¯’v‡b_______________ In other place_______________

1.14 hš¿vs‡ki Ae¯’v (e‡·i wfZ‡i †KvW Ki“b )1.14 State of the hardware (Write code in the box)

1. Kjmn msi¶‡bi cvÎ - XvKbvhy³ Reservoir with tap –covered 2. Kjmn msi¶‡bi cvÎ –XvKbv wenxb Reservoir with tap –uncovered

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1.15......................................................................................... cvwb msi¶‡bi cv‡Î cvwb K‡jb †j‡f‡ji Dc‡i Av‡Q wK? (e‡·i wfZ‡i †KvW Ki“b)

1.15 Is there water in the reservoir above the level of the tap? (Write code in the box)

1. nu¨v2. bv

1.16 wK †`‡L Avcbvi g‡b n‡”Q Kjmn msi¶‡bi cvÎ eënvi n‡”Q? (wjLyb nu¨v=1, bv=2)

1.16 What evidence makes you think that the device (reservoir with tap) is in use?

a) msi¶b cv‡Îi wKQzUv K‡g †M‡Q Water in the reservoir has been reduced to some extent____

b) msi¶b cv‡Îi cvwb †`Lv hvw”Qj Water was visible beside reservoir ___c) msi¶‡bi cvÎ eënvi n‡Z †`Lv †M‡Q Reservoir found just being used____d) wb®‹vk‡bi c‡_ ch©vß cvwb Av‡Q ____ There is enough water in the drainage

system ____

1.17.......................................................................................mvevb cvwb wK †`Lv †M‡Q (e‡·i wfZ‡i †KvW Ki“b)

1.17 Soapy water is found (Write code in the box)

1. nu¨v2. bv

a. mvevb cvwbi Ae¯’vb †Kv_vq (e‡·i wfZ‡i †KvW Ki“b)

1.18 Placement of “Soapy Water”. (Write code in the box)

1. wiR©vfv‡ii mv‡_B Found with reservoir2. Ab¨ †Kvb nvZ †avqvi ¯’v‡b In other handwashing place3. ivbœvN‡ii Kv‡Q Near kitchen4. cvqLvbv I ivbœvN‡ii g‡aäv‡b In between toilet and kitchen5. cvqLvbvi Kv‡Q Near Toilet6. cvqLvbvi wfZ‡i Inside the toile7. Ab¨ †Kvb ¯’v‡b In other places___________2.

1.18 mvevb cvwb wK †evZ‡j Av‡Q? (e‡·i wfZ‡i †KvW Ki“b)

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1.18 Is there soapy water in bottle? (Write code in the box)

1. nu¨v2. bv

1.19 wK †`‡L Avcwb g‡b Ki‡Qb‡h mvevb cvwb e¨envi n‡”Q?

1.19 What evidence makes you think that the device (Soapy water) is in use?

(wjLyb nu¨v=1, bv=2)

a. mvevb cvwbi †evZj wKQyUv Lvwj wQj Soapy water bottle became empty to some extent______

b. mvevb cvwbi †evZ‡j ch©vß †dbv Av‡Q There is enough lather in soapy water bottle_____

c. mvevb cvwbi †evZj e¨envi n‡Z †`Lv †Mj Soapy water bottle is found just being used______

1.20 GLb, nvZ †avqvi Rb¨ evox‡Z Ab¨ †Kvb mvevb Av‡Q wK? (e‡·i wfZ‡i †KvW Ki“b)

1.20Right now, do you have any other soap in the house that you use for handwashing? (Write code in the box)

1. nu¨v2. bv 9. Rvwb bv

1.22 Avcwb wK Avgv‡K mvevbwU †`Lv‡Z cv‡ib? (e‡·i wfZ‡i †KvW Ki“b)1.22 Can you show me the soap? (Write code in the box)

1. nu¨v2. bv, mvevb †`Lv hvq wb

1.23 mvevb †`Lv‡Z KZ¶b mgq †j‡MwQj?--------------------------‡m‡K‡Û1.23 How long did it take to show the soap? ______________seconds

1.24 GUv wK ai‡bi mvevb? (e‡·i wfZ‡i †KvW Ki“b)

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1.24 What kind of soap is it? (Write code in the box)

1. Kvco KvPv mvevb Laundry soap2. ¸‡ov mvevb Powdered detergent3. evmb †avqvi mvevb Dish soap4 Mv‡X gvLv/nvZ †avqvi mvevb Body/hand soap6. Zij mvevb Liquid soap7. Ab¨vb¨ Other __________

1.25 Avcbvi evwo‡Z wK †Kvb AwZwi³ Ae¨eüZ mvevb Av‡Q? (wØZxq †Kvb mvevb hv †Lvjv nqwb) (e‡·i wfZ‡i †KvW Ki“b)

1.25 Do you have any spare unused soap in the house? (a second bar/package that is unopened) (Write code in the box)1.263. nu¨v4. bv9. Rvwb bv

1.27 ‡`Lyb: Avcwb wK Avgv‡K mvevbwU †`Lv‡Z cv‡ib? 1.26 Observe: Can you show me the soap?

1.281. nu¨v2. bv

1.27 mvevb †`Lv‡Z KZ¶b mgq †j‡MwQj?--------------------------‡m‡K‡Û1.27 How long did it take to show the soap? ______________seconds

1.25 GUv wK ai‡bi mvevb? (e‡·i wfZ‡i †KvW Ki“b)1.29 What kind of soap is it? (Write code in the box)

1. Kvco KvPv mvevb Laundry soap2. ¸‡ov mvevb Powdered detergent3. evmb †avqvi mvevb Dish soap4 Mv‡X gvLv/nvZ †avqvi mvevb Body/hand soap6. Zij mvevb Liquid soap7. Ab¨vb¨ Other __________7. Ab¨vb¨ __________

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Section 2: ‡K¬vwiY wW‡¯úÝv‡ii Ae¯’v ch©‡e¶bSection 2: Chlorine Dispenser Status Observation

2.01 ‡K¬vwiY wW‡¯úÝv‡ii Kv‡Q/wbw`©ó Kiv ¯’v‡b †Kvb wiRvf©vi Av‡Q (ICDDR,B -i †`qv evjwZ) [Is there a reservoir (bucket given by ICDDR,B) available near the chlorine dispenser/to the designated place?]

1. nu¨v (Yes)2. bv (No)8. cÖ‡hvR¨ bq (Not applicable)

2.02 wiRvf©v‡i wK cvwb Av‡Q? (evjwZ)(FRA-ch©‡e¶Y K‡i wjL‡eb) [Is there water in the reservoir (bucket) (FRA will check and record)]

1. nu¨v (Yes)2. bv (No)8. cÖ‡hvR¨ bq (Not applicable)

2.03 wiRvf©v‡ii cvwb wK weï× Kiv n‡qwQj? (Is the water in the reservoir treated?)1. nu¨v (Yes)............................................................2. bv (No)8. cÖ‡hvR¨ bq (Not applicable)

2.04 KLb Avcwb weï× K‡iwQ‡jb?1. AvR‡K2. MZKvj‡K3. GK mßv‡ni g‡a¨4. GK gv‡mi g‡a¨5. GK gv‡mi Av‡M9. Rvwb bv

2.05 AvbygvwbK KZ mgq Av‡M cvwb weï× Kivi Rb¨ †K¬vwib e¨envi Kiv n‡q‡Q? ______:______ N›Uv : wgwbU Av‡M ( Approximately how long ago was chlorine used to purify water in the reservoir? ______:______hh:mm ago)

2.06 wiRvf©v‡i msi¶bK…Z cvwb‡Z Aewkó †K¬vwi‡bi cwigvb KZ? ________(wgwjMÖvg/wjUvi) [Range:0.01 to 3.5]Level of residual chlorine in the water stored in the reservoir __________ (mg/L) [Range:0.01 to 3.5]

2.07 H2S cix¶vi Rb¨ cvwbi Dr‡mi bgybv msMÖn K‡iwQj wK? FRA collected source water sample for H2S test?

2.08 1. nu¨v2. bv (msMªn bv Kivi Kvib)_______________________

2.09 2.08 24 N›Uvq Dr‡mi cvwbi H2S cix¶v cwRwUf? (e‡·i wfZ‡i †KvW Ki“b) H2S test positive for source water at 24 hours? (Write code in the box)

1.nu¨v2.bv

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2.10 2.09 48 N›Uvq Dr‡mi cvwbi H2S cix¶v cwRwUf? (e‡·i wfZ‡i †KvW Ki“b) H2S test positive for source water at 48 hours? (Write code in the box)

1. nu¨v2. bv

2.11 2.10 AvR‡K Avcbv‡`i evox‡Z msi·bK…Z Lvevi cvwb †K¬vwib w`‡q weï× Kiv n‡qwQj wK Is the drinking water stored in your household today treated with Chlorine?

1. nu¨v,me¸‡jv1. nu¨v, wKQyUv2. bv3. evox‡Z †Kvb cvwb bvB4. Rvwb bv

2.12 2.11 ch©‡e¶b: †K¬vwib Øviv weï×K…Z cvwbi K‡›UBbvi †`Lv‡Z ejybObservation: Ask to show container with Chlorine treated water

1. †K¬vwib Øviv weï×K…Z †Kvb K‡›UBbvi †`Lv †Mj bv No container was found with Chlorine treated water

2. cvwb weï×K…Z Ges XvKv ivLv Av‡Q Water treated with and kept covered3. cvwb weï×K…Z wKš‘ XvKbv ‡`qv bvB Water treated with but kept uncovered4. GB evox‡Z †Kvb cvwb msi¶b Kiv wQj bv No water was stored in the house 7. Ab¨vb¨ Other ______________

2.12 msi¶bK…Z cvwb †X‡K ivLvi Ae¯’v ch©‡e¶b Ki“b(hw` 1 wUi †ekx cvÎ ev K‡›UBbvi msi¶b Kiv n‡q _v‡K,Zvn‡j me‡P‡q eoUvi ‡¶‡Î †iKW© Ki“b) Observe stored water’s covering status (if >1 storage containers, then document the status of the

largest one)

a. m¤ú~b© XvKbvnxb Completely uncovered.................... 1

b. wKQyUv XvKbv †`qv Partially covered............................ 2

c. m¤ú~b© XvKv Completely covered.................................. 3

2.13 evwoi msi¶bK…Z cvwb‡Z Aewkó †K¬vwi‡bi cwigvb KZ? ________(wgwjMÖvg/wjUvi) [Range: 0.01 to 3.5] (hw` 506=2/3 nq,†m‡¶‡Î cÖ‡hvR¨)

(Level of residual chlorine in the household stored water ____)(mg/L) [Range:0.01 to 3.5] (Applicable if 506=2/3 )

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2.14 AvbygvwbK KZ mgq Av‡M cvwb weï× Kivi Rb¨ †K¬vwib e¨envi Kiv n‡q‡Q? ______:______ N›Uv : wgwbU Av‡M ( Approximately how long ago was chlorine used to purify water? ______:_________hh:mm ago)

1.15 2.15 H2S cix¶vi Rb¨ msi¶bK…Z cvwbi bgybv msMÖn K‡iwQj wK? FRA

collected stored water sample for H2S test?

1. nu¨v2. bv (msMªn bv Kivi Kvib)_______________________

1.15 2.16 24 N›Uvq msi¶bK…Z cvwbi H2S cix¶v cwRwUf? (e‡·i wfZ‡i †KvW Ki“b) H2S test positive for stored water at 24 hours? (Write code in the box)

1.nu¨v2.bv

1.16 2.17 48 N›Uvq msi¶bK…Z cvwbi H2S cix¶v cwRwUf? (e‡·i wfZ‡i †KvW Ki“b) H2S test positive for stored water at 48 hours? (Write code in the box)

1.nu¨v2.bv

Z_¨ msMÖnKvixi ¯^v¶i (Signature of the FRA): -------------------------- ZvwiL Date ----/-----/------

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Appendix 6: STRUCTURED OBSERVATION

Section 0: Identification Site:0.1: Sample Region Name ______________0.2: Sample Region ID_________________Compound:0.3: Compound Address (detailed address): ______________________________________________________________________________0.4: Compound ID___________0.5: Name of Compound Manager___________0.6: Number of HH in Compound___________0.7: Treatment Status_____________Household:0.8: Household ID_________0.9: Name of household head: _____________________________0.10: Household Address ______________________Field personnel:0.11: Name of the FRA (Interviewer)________________0.12: FRA ID_____________0.13: Date of interview (dd/mm/yyyy):___________ 0.14: Name of the FIS (Intervention Specialist/Health promoter)____________0.15: FIS ID_____________0.16: Date of Intervention done (dd/mm/yyyy)___________

Before you begin the observation ask about the people that are currently present in the household. This is so you know how to code each person that is present during the observation.Person Index:

Person Age (Person) Code based on Column 4

Notes

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Event type

Fecal contact Events: Food Handling/Feeding Events Water Using Events

1… After toileting 5… Before preparing food 10. Treating water with Chlorine

2… After cleaning child’s anus 6… Before serving food 11. Drinking Chlorinated water 3… After removing child’s

feces from yard7… Before eating 12. Drinking untreated water

8… Before feeding child 13. Collecting Chlorinated water from the reservoir to store in household for drinking

9… Before breastfeeding 14. Collecting source water to store in household for drinking

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Event details:

1. LineNo.

2. Time(24 hr: HH:MM)

3. Event type:SEE ABOVE

4. Person:

1....Primary Caregiver, F

2....Primary caregiver, M

3....Secondary Caregiver F

4....Secondary caregiver, M

5....Index Child

6....<2 child, F

7....< 2 Child, M

8....2-to <5 Child, F

9....2 to <5 Child, M

10.... ≥5-15 Child, F

11.... ≥5-15 Child, M

12.... Other Adult, F

13.... Other Adult, M

5. Were hands cleansed?1.... Yes2.... No9....

Could not observe

If 2 or 9 move to next event

6. Were both hands cleansed?1.... Yes2.... No9....

Could not observe

7. Hand cleansing materials:1....Water only2.... Bar soap

(scented/beauty bar) and Water

3.... Bar soap (unscented) and water

4.... Powdered Soap and water

5.... Soapy water and rinse water

6.... Sanitizer7.... Other,

Specify9....Could not

observe

8. How were hands dried?1.... Not

Dried/Air dried

2.... Towel/Cloth (not clothing)

3.... Clothing4.... Other,

Specify9.... Could not

observe

9. Location Record first option that fits

1…In/near main house (≤2m to entrance)

2…In/near latrine (≤2m to entrance)

3…In/near cooking area (≤2m to entrance)

4… >2m away from main house, latrine and cooking area

Water treatment and drinking behavior

10. Comments:

01 :

02 :

03 :

04 :

05 :

06 :

07 :

08 :

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09 :

Appendix 7: Auction Procedure

After the courtyard meeting, we will conduct an experimental auction to elicit individual households willingness to pay (WTP) for a monthly rent-to-own subscription to the chlorine dispenser and the reservoir. We will use Becker-DeGroot-Marschek (BDM) procedure to elicit WTP, whereby participants bid against a pre-determined randomly assigned price confidentially kept in an envelope. We will collect individual bids and list them to find the lowest of these bids, which will then be compared with the price in the envelope. In this auction, if the lowest of participants bid exceeds the pre-assigned price, participants as a group win the auction but each pay the price in the envelope. We assume the mechanism is incentive compatible for participants to bid truthfully as their bid does not affect the transaction price. We aim to keep the actual sales price very low so that most compounds have the opportunity to keep the dispenser.

Auction script This protocol is to be used in the field by the sales team members conducting auction for chlorine dispenser plus hand- wash package in Urban Slums in Dhaka.

I am _________________(name). [Introduce yourself as ICCDR, B project staff, showing appropriate identity]

INTRODUCE THE PRODUCT package briefly

We would like to offer you <PRODUCT> for purchase as a special promotion and hence inviting you to attend our sales meeting. Your participation is completely voluntary and any answers you give will be completely confidential. We are interested to know about your real willingness to pay (willingness to contribute) for compound level service of the <PRODUCT>, which will be revealing here on direct purchase (transaction). The information will be used to improve health products and their affordable services for people like you. You can stop participating at any time. Please note that there are no risks to you or your family if you participate. This procedure will take approximately 45 minutes to one hour.

Do you (all) agree to participate?

List all the persons who are definitely interested to participate

1.2.3.4.5.6.7.

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8.9.10.

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READ EXACTLY FROM SCRIPT. DO NOT SAY ANYTHING THAT IS NOT IN SCRIPT.

Here, today, we would like to sell a <<PRODUCT>> that can be used by all households in this compound.

The price that each household will pay is not however fixed yet. This will be determined by an auction type lottery here.

The price together you would pay for the product may not cover the cost of obtaining it but if you all are willing to pay as much as a randomly drawn price-it is likely that you could get the <<PRODUCT>> for your compound for everyone use.

If you meaningfully participate in the auction by stating your maximum willingness to pay (contribution), you as a group may win the auction and pay not more than you really want to – you may even end up paying less than what you really wanted to pay

I will first explain you how this auction works…………. I have with me several envelopes where different prices are written in the range

<<RANDOMIZED FOR DIFFEERENT COMPUND INSERT>> The five envelopes contain 5 prices and we have no idea which contains what prices First, one of you will be allowed to draw one of the envelopes to be kept for use in

the next I will give you a piece of paper and ask you to write your maximum willingness to

pay for getting to use the <<PRODUCT>> at your compound. You cannot discuss with others before writing your bid/ WTP Once you write down your bid, then fold the paper and return to me I will collect the bid sheet from all of you and then write down all the bids I will SHOW YOU ALL the bids collected and we will note the lowest bid The lowest bid will then be compared with the price written in the envelope earlier

drawn by one of you If the lowest bid exceeds the envelope price, you all bidders win the auction

ELSE you lose If you all WIN, all bidders will pay the price that was written in the envelope and

you get the <<PRODUCT>> for your compound This is not hypothetical procedure; if you participate and WIN, you all get to pay

here today to get the <<PRODUCT>> for your compound Before I start the procedure, I will ask you to sign to the next of your name to

confirm your participation. Before you sign your name it is important that you understand the rules and you agree that you will abide by rules.

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CONTINUE ONCE PARTICPANTS CONFIRMS THEIR UNDERSTANDING OF RULES AND OBLIGATIONS

Now continue, with an example of auction with a different product

EXAMPLE: BEFORE WE DO THE AUCTION FOR <<PRODUCT>>, LET US DO SOME PRACTICE WITH SOMETHING ELSE – A BOX OF <<NUMBER>> SOAP BAR [NUMBER equal NUMBER OF PARICPANTS} SO THAT YOU BETTER UNDERSTAND HOW THE AUCTION WILL WORK

I will sell this box of soap bar to your group here (interested participants here) The price you each pay will be determined using the same procedure that I already

described , that is by an auction type lottery I have three different prices written in the these envelopes are 5 Taka, 10 Taka, and

15 Taka First we will draw one of the envelope You will write in a piece of paper, the maximum you would like to pay for your

share of soap( one in this case as the box contains exactly the same number of bars as number of participants)

You should know that each of you will get to pay for the box first then each get one bar – you buy as a group

I will collect all the bids and then write down the lowest bid The lowest bid will then be compared with the price written in the drawn envelope If the lowest bid exceeds or equal to price in the envelope then you all win If you win , you each pay the price written in the envelope and get one soap bar You will not have to spend any more for the product than you really want to. You may even be able to buy it for less. For you the best strategy is to bid your maximum WTP; if you understate your WTP

- bidding lower that what you really wanted to pay- it may happen that your WTP may not match the price in the envelope if that happens to be the lowest bid in your group. On the other hand, if you overstate your WTP and that matches with the envelope price being the lowest BID of all- you will be paying more than you really wanted to spend on this PRODUCT. Moreover, you may not get the opportunity to revise your bid once the price in the envelope known to us. In this kind of situation, therefore, it is the best strategy to express your true maximum WTP – given your own financial situation the maximum amount of money you would be willing to spend for such << PRODUCT>>.

We will practice in one moment, but for now, do you have any questions?

Answer any questions respondent has.

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SHOW THE RESPONDENT SOAP BARS [EQUAL TO THE NUMBER OF PARTICIPANTS] IN A BOX/bagStart the procedureShow the envelopes containing pricesDraw one envelope with help of participantsHandout bid sheets and pen to participants [help them to write privately if needed]Collect the bid sheetsOpen the bid sheets and readout the bids collected- identify the lowestNow open the envelope read out [show] the priceDeclare the resultIF WIN, GIVE THE PRODUCTS IN EXCHANGE OF MONEY

DISCUSS THE RESULT AND THEIR UNDERTSANING OF THE PROCEDURE BEFORE STARTING AUCTION FOR THE ORIGINAL << PRODUCT>>

ANSWER ANY QUESTIONS THEY HAVE ………………………..

WITH FIVE TEN MINUTES BREAK START THE AUCTION FOR THE ORGINAL PRODUCT

REMIND THE RESPONDENT OF THE PRODUCT AND THE SALE

Here, today, we would like to sell a <<PRODUCT>> that can be used by all households in this compound.

The price that each household will pay is not however fixed yet. This will be determined by an auction type lottery here.

The price together you would pay for the product may not cover the cost of obtaining it but if you all are willing to pay as much as a randomly drawn price-it is likely that you could get the <<PRODUCT>> for your compound for everyone use.

If you meaningfully participate in the auction by stating your maximum willingness to pay (contribution), you as a group may win the auction and pay not more than you really want to – you may even end up paying less than what you really wanted to pay

For you the best strategy is to bid your maximum WTP; if you understate your WTP - bidding lower that what you really wanted to pay- it may happen that your WTP may not match the price in the envelope if that happens to be the lowest bid in your group. On the other hand, if you overstate your WTP and that matches with the envelope price being the lowest BID of all- you will be paying more than you really wanted to spend on this PRODUCT. Moreover, you may not get the opportunity to revise your bid once the price in the envelope known to us. In this kind of situation, therefore, it is the best strategy to express your true maximum WTP – given your own financial situation the maximum amount of money you would be willing to spend for such << PRODUCT>>.

Start the procedure Show the envelopes containing prices

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Draw one envelope with help of participants Handout bid sheets and pen to participants [help them to write privately if needed] Collect the bid sheets Open the bid sheets and readout the bids collected- identify the lowest Now open the envelope read out [show] the price Declare the result

IF WIN, COLLECT MONEY AND LEAVE << PRODUCT>> AT COMPUND.

Follow-up questions (individual)[ask individually and write answer on their bid sheet]FIQ1. Did you understand the procedure of the auction?

1. Yes (skip next)2. No

F1Q2. Why did you choose to participate without understanding the procedure?

F1Q3. What was your prime concern when writing a bid? 1. Your own ability to pay2. Your maximum willingness to pay3. Cost of the product?4. Others willingness to pay?5. Others ability to pay?6. None of the above

Follow up questions on Business Model/ Compound manager onlyFBq1. I will now ask several questions that each of you may answer separatelyAs a manager/member of the compound, would you be willing to finance the cost of purchase of the product?

1. Yes2. No

FBq2. As a manager/member, if you would purchase, how would you expect to charge the residents in the compound?

1. Provide free of charge2. Collect monthly equal contribution from each tenant3. Collect contributions based on ability and willingness to pay of the tenants4. Not sure yet

FBq3. How would you perceive the use of the product in your compound?1. All members will use 2. Most will use3. Only some will use4. Very few will use5. None will use

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FBq3. How would agree to the statement that product use and its management will be an issue of dispute in the compound?

Strongly agree because………………………..Strongly disagree because ……………………………..

FBq4. How would you stop someone from the use, who would not pay for it?

FBq5. How would you encourage others to pay and use?

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ÒXvKv kn‡i †Nbœv I j¾v wfwËK wbivc` cvwb cvb I nvZ †avqv Kvh©µ‡gi cix¶vg~jK cÖPviÓTesting Disgust and Shame based Safe Water and Handwashing Promotion in Urban Dhaka

G‡cwÛ· 8: weµq mfv ch©‡e¶b dg©Appendix 8: Meeting Observation Form


GjvKv:Site:

0.1: GjvKvi bvg______________0.1: Sample Region Name ______________

0.2: GjvKvi AvBwW_________________0.2: Sample Region ID_________________

K¤úvDÛ:Compound:

0.3: K¤úvD‡Ûi wVKvbv (we¯—vwiZ wVKvbv): ____________________0.3: Compound Address (detailed address): ____________________

0.4: K¤úvDÛ AvBwW___________0.4: Compound ID___________0.5: K¤úvDÛ g¨v‡bRv‡ii bvg___________0.5: Name of Compound Manager___________0.6: K¤úvD‡Û cwiev‡ii msL¨v__________0.6: Number of HH in Compound___________

0.7: wPwKsmvi Ae¯’v_____________0.7: Treatment Status_____________

cwievi:Household:

0.8: cwev‡ii AvBwW_________0.8: Household ID_________0.9: cwievi cÖav‡bi bvg: ____________________________0.9: Name of household head: _____________________________0.10: cwiev‡ii wVKvbv ______________________0.10: Household Address ______________________


0.11: Z_¨ msMÖnKvixi bvg________________

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0.12: Z_¨ msMÖnKvixi AvBwW _____________0.12: FRA ID_____________

0.13: mv¶vrKvi MÖn‡Yi ZvwiL (dd/mm/yyyy):___________ 0.13: Date of interview (dd/mm/yyyy):___________

0.14: B›Ui‡fbkb †¯úkvwj‡ói bvg (Intervention Specialist/Health promoter)____________0.14: Name of the FIS (Intervention Specialist/Health promoter)____________

0.15: B›Ui‡fbkb †¯úkvwj‡ói AvBwW_____________0.15: FIS ID_____________

0.16: B›Uvi‡fbk‡bi ZvwiL (dd/mm/yyyy)___________0.16: Date of Intervention done (dd/mm/yyyy)___________

‡mKkb 1: Observation

Q1. weµq mfvq KZRb e¨w³ Dcw¯’Z Av‡Q? How many persons present in the sales meeting?

1. cÖvß eq‡¯‹i msL¨v Number of adults……..……..2. wkïi msL¨v Number of child ……………………

Q2. wbjv‡g KZRb AskMÖnb K‡iwQj? How many members participated in the auction? -----------------

Q3. K¤úvD‡Ûi m`mïv wK wbjvg wR‡ZwQj? Did the compound members win the auction?

1. nu¨v2. bv(Skip questions xx to xx next)

Q4. weµqKgx© cÖv_wgK Puv`vi UvKv wKfv‡e msMÖn K‡iwQj? How did the sales person collect money for initial subscription?

1. AskMÖnbKvixiv weµ‡qi ci weµqKgx©i Kv‡Q Zv‡Ì cÖv_wgK Puv`v w`‡qwQj Participants paid their initial subscription right after sales to the sales person(SKIP NEXT)

2. m`m¨‡ì c‡¶ K¤úvDÛ g¨v‡bRvi w`‡qwQj Ges cybivq m`m¨‡ì wbKU ‡_‡K msMÖn K‡iwQj Compound manager paid on behalf of members and would recollect from the members

3. c‡ii Zvwi‡L K¤úvDÛ g¨v‡bRv‡ii wbKU †_‡K UvKv †diZ wb‡Z I msMÖn Ki‡Z weµqKgx©‡K Aby‡iva K‡iwQj Sales person was requested to return and collect the money from the compound manager at a later date

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4. c‡ii Zvwi‡L cÖ‡Z¨K m`‡mï wbKU †_‡K UvKv †diZ wb‡Z I msMÖn Ki‡Z weµqKgx©‡K Aby‡iva K‡iwQj Sales person was requested to return and collect the money from each participants at a later date

Q5. GB ¯’v‡b Puv`vi UvKv w`‡Z ivRx bv nIqvi cÖavi Kvib wK? What was the main reason for not agreeing to pay the subscription on the spot?

1. wØZxq wPš—v †_‡K UvKv w`‡Z cÖZ¨vLvb K‡iwQj; cb¨wU cQ›` wQj bv Refused to pay on a second thought; did not like the product

2. wØZxq wPš—v †_‡K UvKv w`‡Z cÖZ¨vLvb K‡iwQj; cb¨wU eënv‡ii B”Qv wQj bv Refused to pay on a second thought; did not wish to use the product

3. evox‡Z cÖ‡qvRbxq UvKv wQj bv For Not having the required money at home4. cwiev‡ii m`m¨‡ì mv‡_ Av‡jvPbvi Rb¨ For reasons to be discussed with

family members

Q5. cieZx© gvm¸‡jv‡Z Puv`vi UvKU msMÖ‡ni wK eë¯’v Kiv n‡qwQj? arrangements were made to collect subscription fees for the following months?

1. mwVK mg‡q UvKv †`qvi `vw©qZ¡ K¤úvDÛ g¨v‡bRvi GKKfv‡e wb‡qwQj Compound manager took individual responsibility to pay in due time

2. AskMÖnbKvixiv K¤úvDÛ g¨v‡bRvi‡K mwVK mg‡q UvKv w`‡Z ivRx n‡qwQj Participants agreed to pay to compound manager in due time

3. AskMÖnbKvixiv cÖ‡Z¨‡Ki KvQ †_‡K GKK wfwË‡Z UvKv †diZ wb‡Z GesmsMÖn Ki‡Z weµqKgx©‡K Aby‡iva K‡iwQj Participants requested the sales people to return and collect money on an individual basis

4. fwel¨Z wKw¯—i Dci wbw`©ó †Kvb eë¯’v Ki‡Z ivRx wQj bv No particular arrangements were agreed upon for collection of future installments

5. cieZx© wKw¯—i UvKv w`‡Z AskMÖnbKvixiv/ K¤úvDÛ g¨v‡bRvi Awb”Qv †`wL‡qwQj Participants/compound manager showed reluctance to pay further installments

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ÒXvKv kn‡i †Nbœv I j¾v wfwËK wbivc` cvwb cvb I nvZ †avqv Kvh©µ‡gi cix¶vg~jK cÖPviÓ Testing Disgust and Shame based Safe Water and Handwashing Promotion in

Urban Dhaka

G‡cwÛ· 9: wd msMÖn dg© Appendix 9: Fee Collection Form


GjvKv:

Site:

0.1: GjvKvi bvg______________


0.2: GjvKvi AvBwW_________________

0.2: Sample Region ID_________________

K¤úvDÛ:

Compound:

0.3: K¤úvD‡Ûi wVKvbv (we¯—vwiZ wVKvbv): ____________________


0.4: K¤úvDÛ AvBwW___________

0.4: Compound ID___________

0.5: K¤úvDÛ g¨v‡bRv‡ii bvg___________

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0.6: K¤úvD‡Û cwiev‡ii msL¨v__________


0.7: wPwKsmvi Ae¯’v_____________


cwievi:Household:

0.8: cwev‡ii AvBwW_________


0.9: cwievi cÖav‡bi bvg: ____________________________


0.10: cwiev‡ii wVKvbv ______________________



0.11: Z_¨ msMÖnKvixi bvg________________


0.12: Z_¨ msMÖnKvixi AvBwW _____________

0.12: FRA ID_____________

0.13: mv¶vrKvi MÖn‡Yi ZvwiL (dd/mm/yyyy):___________


0.14: B›Ui‡fbkb †¯úkvwj‡ói bvg (Intervention Specialist/Health promoter)____________


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0.15: B›Ui‡fbkb †¯úkvwj‡ói AvBwW_____________

0.15: FIS ID_____________

0.16: B›Uvi‡fbk‡bi ZvwiL (dd/mm/yyyy)___________


‡mKkb 1: wd msMÖnSection 1: Fee Collection

I.1 wKfv‡e weµqKgx© Puv`v msMÖn Ki‡e? How did the sales person collect the subscription fee?

I. K¤úvDÛ g¨v‡bRv‡ii KvQ †_‡K UvKv msMÖn Collect money from the compound managers

II. GKKfv‡e cÖ‡Z¨K AskMÖnbKvixi KvQ †_‡K UvKv msMÖn Collect money from participants on an individual basis

1.2 Puv`v KZ msM„nxZ n‡qwQj? How many subscriptions were collected? …………..…………..

I.3 me AskMÖnbKvix wK Puv`v w`‡q‡Q? Have all participants paid subscription?

II. nu¨v (skip next)III. bv

I.4 Puv`v bv †`qvi cÖavb Kvib wK wQj,Kviv w`‡qwQj bv? What was the main reason

for not paying the subscription, people who did not pay?

II. eënvi eÜ K‡i w`‡qwQj Ges Puv`v w`‡Z PvBwQj bvIII. N‡i UvKv wQj bvIV. Gi Rb¨ UvKv LiP Kivi DcKvwiZv Luy‡R cvw”Qj bv

1.5 Puv`v ‡Ìqvi †¶‡Î hw` †Kvb Am¤§wZ _v‡K Z‡e K¤úvDÛ g¨v‡bRvi/Ab¨vb¨ m`mïv wK Puv`v Pvwj‡q †h‡Z ivRx Av‡Q? In case of some non-compliance to subscription whether the compound manager/other members agree to continue subscription?

a) nu¨v b) bv ( skip next)

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I.6 Zviv (K¤úvDÛ g¨v‡bRvi) Avw_©K LiP wKfv‡e w`‡Z Avkv K‡iwQj? How would they (compound manger) expect to finance the cost?

I. ‡QvU MÖ“‡ci g‡a¨ mgnv‡i Puv`v e„w×i cwigvb Increasing their subscription fee equally among a smaller group?

II. Amgnv‡i Puv`v cÖ`vb Pay subscription unequally II. Enforce all to pay by peer pressure

III. Enforce all to pay by raising the rent proportionally


Appendix 10: External Review

Review of study protocol:Testing Disgust and Shame based Safe Water and Handwashing Promotion in Urban Dhaka Dr Val Curtis, LSHTM. April 2011

Overall this is a welcome study, looking, as it does, at some of the most important drivers of hygiene behaviour. There are a number of weaknesses in the protocol that I believe that the study team should address before the study proceeds.

1. Summary a. The primary and secondary outcome measures should be precisely defined. Are the

BDM auctions primary outcomes?i. RESPONSE: The project summary, specific aims, and background have

been updated to more clearly define and distinguish primary and secondary outcomes.

b. The sub-study design or purpose is not described clearly. i. RESPONSE: The sub-study has been removed from the protocol.

c. “Point of use water treatment and hand washing with soap could save a million lives a year in Bangladesh” This is not possible.

i. RESPONSE: “In Bangladesh” has been removed from this sentence. d. “Furthermore, hand washing promotion that emphasizes disgust and shame has

proven to be significantly more effective than traditional germs and health education when administered to individuals.” This is true of disgust, not shame. Plus both studies that I know of (Drummond, Judah) actually found disgust to work only in males, though you have to dig in the Drummond paper to find this.

i. RESPONSE: The above sentence was changed to, “Furthermore, hand washing promotion that emphasizes disgust and studies that observe the effects of shame have shown that both are significantly more effective than traditional germs and health education when administered to individuals.” This is correct given our definition of shame which includes feelings related to social norms and status. The Judah article has been included in the

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background and a footnote has been added explaining why we will likely not be able to address the gender variation in our study.

e. “It is thus reasonable to expect that incorporating disgust and shame messages in safe water and hygiene promotion campaigns could significantly increase effectiveness, but this has not been rigorously tested.” I would say that Drummond and Judah were rigorous in testing disgust-based messages, but not shame. Neither hypothesis has been rigorously tested in a developing country environment. RESPONSE: “...in developing countries...” was added to make the sentence correct.

2. Hypotheses to be testeda. The hypotheses are described, but not the scientific basis for them nor critical

analysis, as requested i. RESPONSE: Though this is requested in the section prompt, we have been

asked to leave it out by our PI since this discussion is mostly covered in the background section.

3. Aimsa. I’m not sure that these are study aims. Most of these refer to methods

i. RESPONSE: This outline of the studies goals, which could be seen as a rough outline for the methods section is what is typically presented in ICDDR,B protocols.

b. Why make the handwashing intervention a modified version of the HHWT intervention?

c. RESPONSE: We are combining the hand washing intervention with the water treatment intervention for reasons described below. Some of the households will get only water treatment, so we will have an intervention designed for water treatment alone. For the households that get both, it makes most sense to use the same intervention, but modify it to include messages promoting hand washing. Why add HW to HHWT? More might be learnt from this study if they were separate interventions

i. RESPONSE: We don’t have the budget to separate them and coupling them together produces more information than choosing one. We must do water treatment since one of the grants is to measure willingness to pay for the dispenser and we want to answer the novel question of whether disgust will effect this behaviour. We want to keep hand washing since it is cheap and there is more evidence that the intervention will be effective at changing hand washing behaviour than water treatment behaviour.

4. Background a. References to Tropical Enteropathy-this still remains hypothetical and should be

presented as suchi. RESPONSE: We have written that children surviving multiple episodes of

diarrhea commonly develop tropical enteropathy, as is supported in Haghighi et al.

b. “Behaviours such as drinking unsafe water and failing to wash hands with soap are responsible for millions of diarrheal disease related deaths each year in Bangladesh” again I doubt these numbers-appears somewhat unscientific!

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i. RESPONSE: This mistake has been corrected.c. “Research into the determinants of hand washing and sanitation behaviour has

identified disgust and shame as key motivators” again-not shame to my knowledge, nor sanitation.

i. RESPONSE: “...and sanitation” has been removed and using our definition of shame which includes social norms and status, there is evidence and theory that it is a key motivator for hand washing.

d. Need to refer to the controversy about the effectiveness of HHWT: blinded studies show no effect on diarrhoea.

i. RESPONSE: The background section has been updated with this information.

e. One study that used disgust messaging to change HWWS has been missed [1]lf. RESPONSE: The background section has been updated with this information.Note

that both Judah and Drummond found the disgust effect only in men.i. RESPONSE: As explained above, this has been addressed in the background

section. g. Shame. Whilst disgust is well-defined, with an emerging consensus as to its origin

and functions, shame remains controversial. It has yet to be studied within the same paradigm or in the same detail as disgust. Dan Fessler is probably the best source here, though Haidt has also written about shame. Also Gintis [2]. According to Fessler “The available data are consistent with the proposition that shame evolved from a rank-related emotion and, while motivating prestige competition, cooperation, and conformity, nevertheless continues to play this role in contemporary humans. “[3]. In my view there are several self-directed emotions that are the corollaries to other-directed emotions. So when one has attempted to take a higher rank than warranted and failed, one feels shame, which serves as a punishment that teaches one to modify subsequent behaviour. This is the corollary to status. In the case of disgust one feels embarrassed when one inflicts a disease threat on others, disgusting them, and risking social ostracism. However, this overlaps with shame because it can affect social position. Hence shame can be a corollary to disgust. Hence, unless you can really support that the two are distinct, I would suggest that you confine the study to a disgust-based intervention and not try to study both shame and disgust at once.

i. RESPONSE: Shame as it is defined in our background section is not restricted to rank-related emotion, but encompasses all emotion relating to prospective loss of social bond. With this definition, we agree that shame can be a corollary to disgust. We do not claim to know whether the two are distinct and we feel it is satisfactory to test the combined intervention which we believe will be more effective than the disgust only intervention, even though this method sacrifices the ability to say what the true effect is of disgust alone.

h. Your suggestion that shame is the corollary to affiliation is interesting. Though possible, this is not well supported in the literature (see above, where it is the corollary to status) and you may be attacked for this. Another way of characterising

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affiliation is social norms, which is much better supported in the health psychology literature. So if you wish to study the effect of the copying of what others around one are doing, then I would suggest you choose this construct. However, trying to mix two emotions/motivations in one study is problematic, as I said above, and I counsel against it.

i. RESPONSE: Our definition of shame includes feelings related to social norms/affiliation. Regarding testing multiple emotions/motivations, see response to comment above.

i. Further, from what you say in the protocol, shame could operate in two directions at once, people could be shamed into not doing the behaviour because it is not what everyone else does, or they could be shamed into doing it, because failing to carry out hygienic behaviours risks giving an infection to others. Overall the picture on shame that emerges from this protocol needs much clarification, or dropping.

i. RESPONSE: Changes have been made to the background addressing the issue of our less used definition of shame and the potential problem of it working in both directions.

j. Positive identities. This is yet another, and different, driver of hygiene behaviour. Though it may be true that positive identities could assist in promoting good hygiene, how will you know which of the three drivers has been effective in changing practices? Perhaps the study should just be a test of the best approaches you can come up with and not a test specifically of disgust, or of disgust and shame, as it is billed.

i. RESPONSE: The study is essentially a study of best approaches in the way it is described above. It is not a rigorous test of disgust alone, or shame alone. Our best approach is to use disgust and shame together, and we will test them together as one intervention. Given more funding, we will conduct a sub-study after endline in which we will study the effects of disgust while minimizing shame.

k. Use of soapy water is a completely new idea for Bangladesh. Yet every household has bar soap, usually lots of varieties, (Lux is preferred, even in poor households, showing that cost is not a major constraint to HWWS) and most have good or reasonable access to water. Having studied the complexity of hand hygiene in Bangladesh (see our FR report) I deeply doubt that mothers, who have so many complex tasks to achieve in a day, will be willing to take on a new task of regularly making soapy water and replenishing it continually, not to mention ensuring that family members use it. (BTW I imagine that funnels would also be needed to make filling bottles easier). I would be highly sceptical of such apparently simple ‘solutions’ until consumer tests have shown that sustained use is possible and popular. Our conclusion was that adaptations of existing local practice might work better, such as nailing a soap dish to a wall or suspending soap in the mesh bags that are commonly used already in the appropriate HW place.

i. RESPONSE: We have proposed use of soapy water based on evidence that convenience is important and based on advice from field staff who believe

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the soapy water bottle will be more convenient. If we find otherwise in piloting, then it will not be costly to change to another product.

l. Outcome measures. The protocol should state at the outset which are the primary outcome measures, this is to avoid the temptation to just report those which come out the way you want them to. There are a number of ways you can ask questions about handwashing which might give better results[4]. Better to specify the HHWT outcomes and not say ‘and so forth’.

i. RESPONSE: Primary and secondary outcome measures have been more clearly specified and outlined in the sample size, specific aims, background and methods section.

m. Willingness to pay. It’s a good idea-however, I’m sceptical that a meaningful group measure can be developed, or that you will find anything of interest in asking people to pay for an old bottle with a hole in it (should you use this-see above)!

i. RESPONSE: We will only be measuring willingness to pay for the compound based chlorine dispenser. BDM is well established and gives meaningful information with individuals (Guiteras et al.) , though this will be its first test at the group level, it appears to be working well in piloting

n. Germs-based messages. The design of the ‘traditional’ health education measure is not well specified. The validity of the study is dependent on this being a plausible intervention. How will you ensure that the germs based-messages do not engender disgust (germs and contamination are disgusting!)?

i. RESPONSE: We will model the germ based intervention after what has been done in previous studies by ICDDR,B. Though there will be some “disgusting” aspects, it will not be an intervention which was designed to emphasize disgust, so they will be distinctly different. As explained above, we will not be able to say we have measured the effectiveness of disgust alone, because of this issue and because we are combining other factors such as shame in the intervention design.

5. Research design and methodsa. I don’t understand how the interventions will be developed, how will you select

those that ‘appear to be’ effective’?i. RESPONSE: Our qualitative research and team will perform focus group

discussions and in depth interviews to analyze this data. The will use a checklist which addresses relevant effectiveness factors to systematically compare each aspect tested.

b. How will you know which version of the BDM is most accurate?i. RESPONSE: Same as above.

c. Handwashing measure-lots of work has already been done on this-please talk to Micheal deBarra. We still don’t believe that we have a good measure.

i. RESPONSE: We have used advice from experts to chose the best methods given out budget.

d. Sampling, this seems impractical, given that many compound members will not be present

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i. RESPONSE: As long as there are six household representatives present on average during the visits then it is practical. Experienced field staff believe this is reasonable to expect.

e. It would be useful to present a flow diagram for the interventions in the study armsi. RESPONSE: There are only four arms now, so this may nolonger be

necessary. It was unclear before, but I seems more clear now. f. The shame based intervention content is not specified

i. RESPONSE: We have specified that the disgust and shame based intervention will emphasize neighbours behaviour to try to increase the level to which people care about their neighbour’s behaviour. More will be developed in piloting.

g. It seems that the same people (FRAs) will deliver the intervention and carry out the structured observation. It is VITAL NOT TO DO THIS. The intervention and data collection should be completely separate, both to avoid courtesy bias and observer bias.

i. RESPONSE: They are separated. h. I have not reviewed your sample size calculation, but it should be remembered that

the study should be powered to find differences between EACH arm. I strongly doubt that you will have the power to do this.

6. RESPONSE: We have power to detect our minimum practical effect size, roughly 10 percentage points, for all primary outcome variables. See sample size section. This small minimum practical effect size was chosen given the comparison between arms. References:

a. The reference list is not standardised, mixing different citation styles.

Refs1. G Judah, et al., Experimental Pretesting of Hand-Washing Interventions in a Natural

Setting. . American Journal of Public Health, 2009. 99(S2): p. S405-411.2. Gintis, H., The hitchhiker's guide to altruism: Gene-culture coevolution, and the

internalization of norms. Journal of Theoretical Biology, 2003. 220(4): p. 407-418.3. Fessler, D.M.T., Shame in two cultures: Implications for evolutionary approaches. Journal

of Cognition and Culture, 2004. 4(2): p. 207-262.4. Biran, A., et al., Comparing the performance of indicators of handwashing practices in rural

Indian households. Tropical Medicine and International Health, 2008. 13(2): p. 278-85.

Review by Richard J. Stevenson, BSc (Hons), MSc, DPhil, Professor of ExperimentalPsychology, Macquarie University, Sydney, Australia.

Personnel: The study includes a range of experts of international standing. The only apparent weakness in the personnel available was the absence of a psychologist, although I note that the study team intends to employ a social scientist. I note this absence solely because a social psychologist in particular – perhaps one local to the study – might be able to suggest ways and means of maximizing in-group pressures to enhance the magnitude of the shame and disgust manipulations. Similarly, a broader acquaintance with the social psychology and group processes literature, and with the emotion literature, might provide the team with further ideas to assist the project.

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RESPONSE: We are employing one social scientist, our qualitative researcher. Though we would like to have a staff psychologist, our budget will not permit.

Design: The design is very well thought through and I have only minor comments that the team may wish to reflect upon. (1) For the piloting phase, it was not clear to me how effectiveness would be judged re the Aims 1 & 2 piloting. This seemed to me to rather gloss over the difficulty in establishing how degree of disgust and shame will be assessed for the particular material that the team wishes to develop.

RESPONSE: To assess the effectiveness of our various intervention in field testing, the qualitative researcher and team will conduct focus group discussions and in depth interviews. Also teams administering the pilot interventions will take rigorous notes. Using this qualitative data we will make the decision of which ideas to include.

(2) For the intervention, it struck me that the social status of the person leading the intervention might be crucial to its success (i.e. local vs. westerner; gender; ‘expertise’ – health professional etc).

RESPONSE: The people leading the interventions, though not locals of the communities we will be visiting, are locals of Dhaka city and have a lot of experience in similar communities. We feel they achieve the best balance between being able to relate to the subjects and being able to consistently carry out the complex tasks they will be assigned.

(3) For the meeting content, the disgust literature seems to suggest two things that the team might wish to reflect upon. First, that disgust manipulations may differ in their effectiveness by gender. Second, that the disgust manipulation must make ‘painfully’ visible the link between the behaviour to be modified and the negative consequence (e.g. we used a picture of a piece of faeces in a bread roll [shit sandwich] to make visible the association between not cleaning ones hands after using the toilet and effectively eating this if the hands were not washed).

RESPONSE: Gender: We have addressed this issue in the background section.

Ethical issues: Will the study (especially the disgust/shame arms) offend local sensibilities? I do not personally see this as an issue because the aims of the study are clearly beneficial, but how would the study team deal with complaints of this nature and would this adversely affect the proposed work?

RESPONSE: The purpose of piloting will be to design an intervention which maximizes the disgust eliciting level of the intervention without causing people to tune out or leave. Even if we are successful at creating an intervention which achieves this in for most subjects, there will likely be some who are offended. In this case will follow typical ICDDR,B protocol.

Is a no treatment control group appropriate, when treatment is likely (even health intervention) to be effective? Is not the key comparison between the standard health intervention versus the emotion augmented intervention?

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RESPONSE: Control group has been dropped

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Check-List

CHECK-LIST FOR SUBMISSION OF RESEARCH PROTOCOLFOR CONSIDERATION OF RESEARCH REVIEW COMMITTEE (RRC)

[Please check (X) appropriate box]

1. Has the proposal been reviewed, discussed and cleared at the Division level?

Yes No

If No, please clarify the reasons:

2. Has the proposal been peer-reviewed externally?

Yes No

If the answer is ‘No’, please explain the reasons:

If yes, have the external reviews’ comments and their responses been attached

Yes No

3. Has the budget been cleared by Finance Department?

Yes No

If the answer is ‘No’, reasons thereof be indicated:

4. Does the study involve any procedure employing hazardous materials, or equipments?

Yes No

If ‘Yes’, fill the necessary form.

5. Has the Ethics Certificate(s) been attached with the Protocol?

Yes No

If the answer is ‘No’, please explain the reasons:

_______________________________ _________ Signature of the Principal Investigator Date

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Appendix 11: ERC Abstract Summary

Below, we summarize the purpose of the study, the methods and procedures to be used. If an item is not applicable, we note accordingly:PurposeWe seek to test the effect emphasizing disgust and shame in hand washing and water treatment promotion and to measure the demand for compound based liquid chlorine dispensers. Methods and ProceduresWe will conduct a stratified, cluster randomized controlled trial in which compounds are randomly assigned to a standard public health intervention or a disgust and shame based intervention. Within these groups, all compounds will receive safe water promotion and two thirds of compounds will receive hand washing promotion as well. Randomization will allow us to infer causality when analyzing the differences in outcomes and stratification will increase the statistical power of our inference. 1) Requirements and rationale for study population

a) Our study sites were first selected based roughly on their adherence to our list of feasibility criteria found in appendix 2. Within the selected sites, study compounds will be selected that meet all of the essential criteria (see below) and at least 2 of the preferred criteria. Also sites must be at least 75 foot-steps apart. i) Essential compound criteria

(1) Between 3 and 15 Housholds(a) With fewer than 3 households we will have only two or one households,

which is more of a duplex or a single house than a compound. With greater than 15 households we would have trouble conducting promotion meetings.

(2) Shared water source(a) This is essential for the compound based chlorine dispenser to be of use.

(3) Physical space exists to hold a compound meeting here or nearby(a) This is essential for us to have meetings.

(4) No other interventions going on at this time(a) This is essential for maintaining validity of our study.

(5) Population is all Bangalee(a) This is essential for our intervention material to be culturally relevant.

ii) Preferred criteria(1) Use of water source is visible to others(2) Shared kitchen(3) Shared toilets visible from common area

(a) According to theory, these three should contribute to the shame effect. They are not essential because we don’t know if we can find enough compounds where they are all present, and having some variation will be okay. At least two is essential to make sure some shame effect is plausible.

b) For hand cleanliness inspections we will be targeting only children because this has been shown to be independently associated with reduced child diarrhea.

2) Potential risks and procedures for minimizing thema) Time: People may give time to the study that would be better given to address other

issues.

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i) We will address this risk by securing informed consent, and clarifying that study participants can drop out at any time, even in the middle of an interview or group discussion.

b) Financial: Intervention community residents may spend money that would otherwise be allocated for food or other essential need for point of use water treatment.i) This risk will also be addressed by the consent form and clarification of

participants rights. c) Social humiliation: Since our intervention is based on disgust and shame, it is likely

that some people will feel offended. i) During piloting we will work to design an intervention which minimizes this risk.

During implementation we will conduct ongoing qualitative data collection which can be used to monitor and further reduce this risk.

ii) This risk will also be addressed by the consent form and clarification of participants rights.

d) Physical: Direct contact with high concentration chlorine solution and ingestion of chlorine or soapy water by children is a risk. To minimize, chlorine will be distributed in child-proof containers. We will inform adults and children about danger of ingesting high concentrations of chlorine and soap. We will include this information in our communication messages and make sure they know how to use the technology and follow the precautions.

3) Safeguarding of confidentiality and anonymity.a) Though personally identifying data will be collected, it will only be viewed by the

research investigators and their research assistant and only during times when it is necessary for analysis. For all other individuals viewing the data set and for viewing during times when this identifying data is not needed, it will be replaced by codes and scrambled so that individuals’ information cannot be discerned.

4) Informed Consenta) General consent for compound level activities will be obtained from the compound

manager as is the precedent in previous ICDDR,B studies (see general consent form above in appendix 1).

b) When individuals are approached for data collection, verbal consent will be obtained. c) Before children are approached for data collection, verbal consent from their parents

or legal guardians will be obtained.

5) Study Interviewsa) The study involves a survey questionnaire which will be one to one and a half hours

long. This will be administered to a representative of a selected household and will be administered in the place where the participant prefers.

b) The qualitative team will conduct focus group discussions and in depth interviews in compounds. These will take place wherever the compound members prefer. They will include a check list of questions to answer but will be partially open ended as well.

6) Benefits of the studya) Uptake in the behaviours being promoted will result reduced risk of diarrhea and other illnesses

transmitted via fecal contamination and via untreated water. The reduction in relative risk is thought to be around 48-65% (Cairncross et al 2010). Given the large number of deaths occurring from diarrhea, believe this prospective benefit greatly outweighs the risks which we perceive to be quite low.

7) Recordsa) The study does not use any past records.

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20 April_kanizAppendix 12: Piloting check list

Identification:

Site name:

Compound name (if any):

Compound ID:

Compound address:

Name of the compound manager:

Respondent: Name-

Age-

Sex-

Role in the family-

FRA code:

Date of interview (dd/mm/yyyy):

1. Ask: At present which is the principal source of drinking water for your household? ______________________________________________________________________________________

2. Ask: Is the water that you drink clean? Yes..........................1No............................2

3. Ask: What make it dirty? _______________________________________________________

4. Ask: How it becomes dirty? _____________________________________________________

5. Do you think this water could make you sick?

y

y

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20 April_kanizYes..........................1No............................2Not sure...................3

6. If yes, do you do to anything to make your drinking water safe? Yes..........................1No............................2

7. If yes, what do you do to make your drinking water safe? _______________________________________

8. Ask: Is it difficult to treat the drinking water?Yes..........................1No............................2

9. Ask: What makes it difficult to treat drinking water?____________________________________________

10. Ask: When do you usually wash your hands?______________________________________________________________________________________________________________________________________________________________________________________________________

11. Is there anything that you usually use to wash your hands?Yes..........................1No............................2

12. What do you usually use to wash your hands?________________________________________________

13. Do you think there are benefits of washing hands with soap? Yes..........................1No............................2

y

y

y

y

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20 April_kanizNot sure...................3

14. If yes, what are the benefits of washing hands with soap? _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

15. Do you find/experience any barrier to wash hands with soap?Yes..........................1No............................2

16. If yes, what are the barriers washing your hands with soap? _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

17. Do you know about diarrhoea?Yes..........................1No............................2

18. If yes, what are the ways you know about getting diarrhoea? _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

19. Is there anything that people around here find disgusting?Yes..........................1No............................2

y

y

y

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20 April_kaniz20. If yes, what are the things people usually find disgusting?

___________________________________________________________________________________________________________________________________________________________________________________________________

21. Around here, are there compound rules or polite behaviours that you expect your neighbours to follow? Yes..........................1No............................2

22. If yes, what are those? ______________________________________________________________________________________________________________________________________________________________________________________________________

23. What would happen if a neighbour failed to follow that rule and lots of people saw? ________________________________________________________________________________________________________________________________________________________________________________________________________

24. Do you think neighbours here care about each other?Yes..........................1No............................2

25. If yes, what are the issues that you address together? ____________________________________________________________________________________________________________________________________________________________________________________________________

y

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Have you attended the meeting we conducted 3 days before? If yes, I’m going to ask you few questions about different items we presented there. I would like to know about your feeling and thoughts regarding those presentations/meetings. There is no right or wrong answer, Feel free to communicate and express your feelings.

Event/Item

How was the session? Interesting...........1 Not interesting.....2(why or why not)

Was the session easy to understand?Yes.....1No......2(why or why not)

Do you have any recommendation /suggestion how it could be improved?

Can you tell me in short what was shown there?

What you have learnt/understand from that session?

Do you think most of your compound members found it interesting? Yes, most of them....1No, only

Can you show/tell me the flip chart/ story/role play/games/quiz that you liked most

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20 April_kanizfew of them........2None........3

Flip charts- disgust messagesFlip charts- shame messagesFlip charts- identity messagesFlip charts- unity is strength messagesStorytelling- unity is strength

Storytelling- Akbar and BirbalStorytelling- Serving poop to kidsStorytelling- Serving poop to neighbour Role play- Busy

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20 April_kanizmotherRole play- Neighbours roleGamesQuiz

FRA Signature________________________________________

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20 April_kanizBudget:

Name of the Project/Protocol: Compounds- Disgust -Shame-WTPSource of Fund: 3IE, Gates Supplemental

Period: Jan. 1, 2011 - June 1, 2013

Items Details Total Cost (USD)

Covered by 3IE

Remains to be covered

Personnel Cost and Benefits: Pay level Month Rate (S)

# of Staff % Time # of

Month Office Staff

Team Leader, Steve Luby 270001 0.0 27.0

-

-

Project subervisor, Leanne Unicomb 55001 6.7 27.0 9,

900 9,

900 -

Economist, Minhaj Mahmud 18001 15.0 15.0 4,

050 12,

956 (8,9

06)

Research Investigator: Qualitative 13001 75.0 10.0 9,

750 11,

866 (2,1

16)

Research Investigator: Quantitative, Kaniz Jannat 13001 75.0 27.5 26,

813 11,

866 14,

947

Admin Officer: Zahid bhai GS-6/1, FT 7101 25.0 12.0 2,

130 2,

638 (5

08)

Research Officer (GS-5/1) Fixed Term GS-5/1 5751 25.0 12.0 1,

725 6,

954 (5,2

29)

10,043

(10,043)

Field Staff

-

Field Research Officer -Fixed Term for FIS GS-5/3 668 1 100.0 7.5 5,010

4,066

944

Field Research Officer -Fixed Term for FIS (additional) GS-5/3 668 1 100.0 4.5 3,

006 3,006

Field Research Officer- Fixed Term for FRA GS-5/3 668 1 100.0 8.5 5,

678 4,

066 1,

612

Field Research Assistance CSA - FIS GS-3/3 437 6 100.0 8.5 22,287

18,031

4,256

Field Research Assistance CSA -Additional FIS GS-3/3 437 16 100.0 4.5 31,

464 31,464

Field Research Assistance CSA- FRA GS-3/3 437 8 100.0 11.3 39,

549 39,549

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Field Research Assistance CSA -Additional FRA GS-3/3 437 6 100.0 4.5 11,799 11,

799

Field Assistants GS-1/1 283 3 100.0 13.0 11,037 11,

037

-

Subtotal 184,197

92,386

91,811

Travel and PerdiemUnit cost Units/month

Monthly cost

# of Months

Local transport for field staff 100 20 2,

000 1,

800

200

Field Visits by Office Staff 50 1.5 20 1,500

1,000

500

International Travel and Perdiem 3,

000 3,

000 -

15,000

(15,000)

Subtotal 6,500

20,800

(14,300)

Supplies & Materials Unit Cost No. Intervention Materials Materials used in promotional meetings (flip

charts, fake poop, disgusting box, etc…)50

5

250

250

Supplies for Field Staff (umbrella, bag, etc…)20

28

560

560

Video Presentation/Equipment200

4

800

800

Hardware to be Marketed

-

Handwashing stations and 1 month's supplies 4

420 1,680 1,

680

Water treatment stations and 1 month's supplies 24

420 10,080 10,

080

Data Collection -

Chlorine Residual Tests

0.8 3,780

3,024

1,984

1,040

H2S Tests

0.75 3,780

2,835

1,860

975

Survey Materials

0.25 2,520

630

630

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Subtotal 19,859

3,844

16,015

Interdepartmental and Others Rate No.

Data Entry Services 5,000

3,500

1,500

Communication (Fax, Phone bill, Courier, postage, skype, SMS etc.) 1,

500 1,

800 (3

00)

Rent, Utilities, repairs and maintenance Monthly Months -

Moyeen Centre 89 27 1 2,

400 6,

240 (3,8

40)

Field Offices 115 6 2 1,380

1,380

Internet Connection 30 27 5 4,

050 7,

200 (3,1

50)

Research review committee 2,400

2,400

-

Ethical review committee 2,

400 2,

400 -

Printing 1,

000 1,

000 -

Subtotal 20,130

24,540

(4,410)

Equipment (Capital Items) $ Rate Qty. ICDDR, B Office Supplies Computers with software, UPS 0 0 0 10500 -10500 Subtotal 0 10500 -10500

Total direct cost

230,686

152,070

78,616

Total indirect (15%)

34,603

15,207.0

Total cost

265,289

167,277.0

98,011.90

Gates Provides:

115,000

Our Surplus: 16,988

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Timeline:Disgust Study Timeline Jan 2011 Jan 2012 Jan 2013 Month: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29Draft Protocol Site Selection RRC and ERC Staff rec., hiring Procure supplies Pilot instruments Pilot Interven. Procure Material Baseline Midline Endline Data Entry Intervention Fee Collection Qual assess. Quant. Assess Qual. Analysis Quant. Analysis Prelim. Report Final Report

Budget Justifications

Please provide one page statement justifying the budgeted amount for each major item. Justify use of human resources, major equipment, and laboratory services.

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20 April_kanizThe personnel cost required to implement the intervention, collect, process and evaluate the data is divided between grants from 3IE and the Gates foundation. The research investigator will oversee local implementation of the protocol, and will write a manuscript based on the data with the help of internal and external co-investigators. The qualitatitive research investigator will assist in developing instruments for data collection, with ongoing qualitative data collection and qualitative data analysis. The field research assistants (FRAs and FISs) and the field assistants, supervised by the field research officers will conduct the intervention and collect the data.

Travel costs cover local field staff transport, office staff visits to the field and a trip for the Principal Investigator to Washington D.C. to present findings.

We estimate a cost of roughly $50 for one set of intervention materials, not including video presentation equipment which we estimate to cost $200 per unit. Subject to piloting we might not use video at all. Though we will be selling the hardware, we have budgeted to pay the full cost which comes to ~$12,000. We have chosen Chlorine residuals and H2S tests, much cheaper alternatives to E. Coli lab tests for testing water quality. That is our materials cost ~$6,000 whereas using E. Coli Lab tests could costs with the same frequency would cost ~$89,000.

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