Learning, Hygiene, and Traditional Medicine

Information provision, which is a common behavior-change strategy, is only effective if the information is credible. Infectious disease prevention messages that rely on the germ theory may fail to persuade people who are unfamiliar with microbes. A novel program in rural Pakistan augments conventional hygiene instruction by demonstrating with microscopes that microbes exist. Through a randomized evaluation, we show that this program leads to strong and lasting hygiene and health improvements for participants and their children, while instruction alone does not. Adherence to traditional medicine, which offers another, non-pathogenic disease model, may undermine learning by strengthening prior beliefs about hygiene. We show that hygiene and health improve less for believers in traditional medicine, while the intervention modestly weakens traditional beliefs. These results suggest that traditional and modern medical beliefs are substitutes in this situation and that traditional medicine may exacerbate the burden of infectious disease.