An Evaluation of the Educational Impact of the Sisimpur Community Outreach Project Prepared for Sesame Workshop Prepared by June 2007 The Sisimpur project and this research were made possible by the generous support of the United States Agency for International Development. The contents are the responsibility of the authors and do not necessarily reflect the views of USAID or the United States Government. Table of Contents EXECUTIVE SUMMARY..............................................................................................................................4 Chapter 1: Introduction ....................................................................................................................................7 1.2 Rationale for the Study ...................................................................................................................7 1.3 Objectives of the Study...................................................................................................................8 Chapter 2: Methodology ...................................................................................................................................9 2.1 Study Design.....................................................................................................................................9 2.2 Research Approach .......................................................................................................................10 2.3 Selection of Target Groups..........................................................................................................10 2.4 Information Gathered from Target Groups..............................................................................11 2.5 Research Tools...............................................................................................................................11 2.6 Coverage Area Rationale ..............................................................................................................12 2.7 Sample Size by Location...............................................................................................................13 2.8 Sample Selection Procedure and Survey ....................................................................................15 2.9 Recruitment of Research Field Staff...........................................................................................17 2.10 Training of research field staff ....................................................................................................17 2.11 Pre Testing......................................................................................................................................17 2.12 Quality Control and Monitoring..................................................................................................18 2.13 Data Processing and Analysis ......................................................................................................18 Chapter 3: Profile of Respondents................................................................................................................19 3.1 Analysis............................................................................................................................................19 3.2 Demographic Profile.....................................................................................................................20 3.3 Education and Occupational Background.................................................................................23 3.4 Access to Education for Children...............................................................................................26 3.5 Household Size & Structure of Dwelling...................................................................................27 3.6 Monthly Income and Expenditure..............................................................................................29 3.7 Access to Services ..........................................................................................................................30 3.8 Access to Media and Media Habits .............................................................................................30 Chapter 4: Health & Hygiene Practices........................................................................................................34 4.1 Teeth Cleaning Habits...................................................................................................................34 4.2 Hand-Washing Practices...............................................................................................................44 4.3 Bathing Habits................................................................................................................................50 4.4 Grooming practices .......................................................................................................................53 4.5 Qualitative Insights: Health and Hygiene Knowledge & Behavior........................................58 Chapter 5: Nutritional Habits ........................................................................................................................61 5.1 24-Hour Diet Cycle .......................................................................................................................61 5.2 Regularity of Vitamin and Protein Intake among children......................................................69 5.3 Qualitative Insights: Knowledge and Habits about Nutrition ................................................72 Chapter 6: Regression Modeling: Assessing the Relation between Outreach Participation and Outcomes..........................................................................................................................................................74 6.1 Multivariate Logistic Regression Modeling...............................................................................74 6.2 Summary models based on caregiver interviews......................................................................78 6.3 Summary models based on child interviews .............................................................................88 Chapter 7: Application of Outreach Kit.......................................................................................................91 7.1 Possession of Outreach Kit ........................................................................................................91 7.2 Use of Outreach Kit Materials by Caregivers...........................................................................92 2 7.3 Application of Outreach Kit Materials.......................................................................................96 7.4 Opinions of Beneficiaries about the Outreach Kit................................................................ 110 Chapter 8: Perceptions about Workshop .................................................................................................. 115 8.1 Reasons for Attending and Attendance Rates........................................................................ 115 8.2 Learning from Workshops......................................................................................................... 116 8.3 Assessment of Workshop.......................................................................................................... 116 8.4 Qualitative Insights- Perceptions about Workshop............................................................... 119 Chapter 9: Process Review—Workshop Observation and Trainer Interviews................................... 122 9.1 Trainer In-Depth Interviews ..................................................................................................... 122 9.2 Workshop Observation ............................................................................................................. 125 Chapter 10: Conclusions.............................................................................................................................. 131 3 EXECUTIVE SUMMARY Background and Objectives Sisimpur is the Bangladeshi co-production of the educational children’s program, Sesame Street. In addition to the television program, the project also includes an extensive community outreach component. In its first season, the Sisimpur outreach team in Bangladesh developed a kit containing materials designed to promote health, hygiene, and nutrition among caregivers and their children. Caregivers received training on how to use the materials with their children in a series of workshops. These caregivers were from disadvantaged communities served by non-governmental organizations (NGOs). This document reports on an evaluation of the impact of the Sisimpur outreach program on participants’ health, hygiene, and nutrition knowledge and behavior. Method The study utilized a design in which participants in the outreach program were compared with non- participants (or the “control” group) who lived in geographically, socially, and economically similar circumstances. Participants attended workshops and received outreach materials, while the control group was not exposed to the materials. In addition to quantitative data on knowledge and behavior, researchers also interviewed caregivers and trainers to uncover in-depth information about outcomes and training. Researchers also conducted observations of households and one training workshop to augment the survey. The study assessed outcomes across a range of domains, including hygiene behaviors like teeth cleaning,