Learning, Hygiene and Traditional Medicine

Abstract

Information provision is only an effective behaviour-change strategy if the information is credible. A novel programme augments conventional hygiene instruction by showing participants everyday microbes under a microscope. Through a randomised evaluation in Pakistan, we show that this programme leads to meaningful hygiene and health improvements, while instruction alone does not. Traditional medicine, which offers an alternative disease model, may undermine learning by strengthening prior beliefs about hygiene. We show that believers in traditional medicine have smaller impacts, suggesting that traditional and modern medical beliefs are substitutes and that traditional medicine may exacerbate the infectious disease burden in this context. medical beliefs may attenuate the impact of information by increasing the prior precision. Alternatively, traditional beliefs could strengthen the impact of information by reducing the prior mean. The negative interaction between ML and traditional medical beliefs suggests that traditional beliefs influence the prior precision.This study makes two primary contributions. Using a rigorous, randomised design, we show that an intervention designed to educate participants about microbes has a strong, lasting impact while instruction alone does not. Notwithstanding several caveats, this finding suggests that the provision of corroborating evidence (which is not the default approach in this area) may strengthen the impact of health recommendations. It may also help to explain heterogeneity across studies in the impact of hygiene promotion (Curtis and Cairncross, 2003;Fewtrell et al., 2005;Aiello et al., 2008;Waddington and Snilstveit, 2009). Our findings also contribute to a broader literature on learning and technology adoption (Conley and Udry, 2010;Argent et al., 2014).Secondly, this article is one of the first well-identified analyses of the role of traditional medical beliefs. We uncover substantial heterogeneity in the impact of information according to beliefs in traditional medicine. Despite the ubiquity of traditional medicine (WHO 2003), very little social science research considers its implications (Leonard, 2003;Leonard and Graff Ziven, 2005;Wang et al., 2010;Kooreman and Baars, 2012; Sato, 2012a,b). Traditional medical beliefs may help to explain the low demand for ostensibly valuable health products like deworming treatment, antimalarial bed nets, and low-emission cook stoves (Kremer and Miguel, 2007;Cohen and Dupas, 2010;Mobarak et al., 2012). Although it is difficult to generalise, results suggest that traditional beliefs exacerbate the burden of infectious disease in this setting by discouraging healthy behaviour. F547 1 A literature in economics examines the role of learning in agricultural technology diffusion (Foster and Rosenzweig, 1995; Conley and Udry, 2010; Argent et al., 2014). Genius et al. (2014) and Krishnan and Patnam (2014) examine the impact of agricultural extension services on technology adoption. The credibility of extension agents has parallels to the...

Health shocks and their long-lasting impact on health behaviors: Evidence from the 2009 H1N1 pandemic in Mexico

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Habit Formation and Rational Addiction: A Field Experiment in Handwashing

“…Surveyors observed the cleanliness of respondent hands and nails at the time of survey and graded each on a three point Likert scale: 0 indicating no visible dirt, 1 indicating some visible dirt, and 2 indicating extensive visible dirt. This direct observational measure is a popular primary outcome in the handwashing literature (Bennett et al 2015, Ruel and Arimond 2002, Luby et al 2011, Halder et al 2010. However, given the subjective nature of the rating and the fact that surveyors are not blinded to treatment assignment in this (and most) hygiene experiments, this measure is vulnerable to surveyor bias.…”

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