Abstract
Behavioral constraints may explain part of the low demand for preventive health products. We test the effects of two light-touch psychological interventions on water chlorination and related health and economic outcomes using a randomized controlled trial among 3,750 women in rural Kenya. One intervention encourages participants to visualize alternative realizations of the future, and the other builds participants' ability to make concrete plans. After 12 weeks, visualization increases objectively measured chlorination, reduces diarrhea episodes among children, and increases savings. Effects on chlorination and savings persist after almost 3 years. Effects of the planning intervention are weaker and largely insignificant. Analysis of mechanisms suggests both interventions increase self-efficacy-beliefs about one's ability to achieve desired outcomes. Visualization also increases participants' skill in forecasting their future utility. The interventions do not differentially affect beliefs and knowledge about chlorination. Results suggest simple psychological interventions can increase future-oriented behaviors, including use of preventive health technologies.
Highlights
Individuals often fail to invest in preventive healthcare, even when such investments cost little and individuals are aware of their benefits.1 An estimated two thirds of deaths of children under 5 could be averted with cheap preventive technologies (Dupas 2014a)
We present evidence from a field experiment in rural Kenya which studies the role of behavioral constraints in limiting the use of chlorine to treat drinking water, by targeting these constraints directly with simple psychological and informational interventions
We report results from comparing the three active (V+INF, P+INF, and Active Control exercise + Information Module (AC+INF)) to a pure control group (PC)
Summary
Individuals often fail to invest in preventive healthcare, even when such investments cost little and individuals are aware of their benefits. An estimated two thirds of deaths of children under 5 could be averted with cheap preventive technologies (Dupas 2014a). Diarrhea is the second leading cause of death worldwide among children aged 1–5, contributing to nearly half a million deaths in 2015 (Wang et al 2016). In our study areas in Kenya, only 3 percent of households used chlorine before any intervention (Null et al 2018), a month’s supply costs only KES 25 (USD 0.25). In the original WASH study control group, diarrhea prevalence in the past 7 days was 27 percent among children aged 1 and 2 (Null et al 2018); in our pure control group at endline, there have been 0.2 incidences of diarrhea per child under 15 in the last 3 months. Water can be contaminated as it is removed from storage pots
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