Low rates of exclusive breastfeeding and exposure to water-borne contaminants due to inadequate sanitation, water treatment, and hygiene contribute to high levels of infant morbidity and mortality in low-income countries. This pilot leverages detailed micro-data from over 100,000 households in Punjab, Pakistan in combination with a quasi-experimental change in Community Health Worker (CHW) coverage to generate high-quality evidence on the impact of CHW-based community health work and its interaction with a key environmental health threat: poor water quality due to inadequate sanitation. Health behaviors encouraged by CHWs (hand washing, exclusive breastfeeding) can help to mitigate the health risks of exposure to contaminated water for infants. By studying the interaction of community health outreach through CHWs with the environmental threat of contaminated water, this pilot will make an important contribution to understanding the relationship between biological, environmental, and behavioral factors in affecting infant health outcomes.
Duke Principal Investigator(s)
Primary Funding Agency