Touch for Health: Use of Pavlovian Processes with Physical Touch as a Means to Improve Menstrual Hygiene Management Initiatives, Measured by Willingness to Pay

BACKGROUND: To combat the lack of proper facilities and menstrual health knowledge in developing countries, many WASH (Water, Hygiene, and Sanitation) initiatives are including menstrual hygiene management (MHM) components. However, evidence shows that prior efforts have not been ultimately successful in inducing relevant behavior changes, due in part to cultural constraints and unidimensional interventions. As such, MHM research may need to include consideration of new theories/approaches. Evidence is growing of the role that physical presence/proximity and ability to touch objects has on incentives for consumers to purchase goods, captured through willingness to pay (WTP) figures. Such findings can be partially explained by Pavlovian processes. OBJECTIVE: This study sought to provide field-work validation of such findings of the role of Pavlovian processes and endowment effect on WTP figures for a female hygiene kit, reflecting motivation to adopt better hygiene behaviors. METHODS: This study used primary survey data collected from females in two upper-level schools in southwestern Nepal (n = 169). When presented in conjunction with a hygiene education session, one group of females was allowed physical interaction with a female hygiene kit, while another was not, before being surveyed on their WTP for the kit. Both non-parametric and parametric statistical analyses were performed to assess the impact of this ability to touch the kits on WTP figures. RESULTS: Results show a statistically significant difference between the WTP figures of those females allowed interaction with the kits prior to being surveyed and those who did not. This confirms the positive impact of physical presence/touch on motivations to use/acquire hygiene-related tools. CONCLUSIONS: Such findings reveal how, through application of the theory of Pavlovian processes, future (menstrual) health education efforts could harness the human instinct to consume, remember, and use those objects presented in physical form, and include personal contact and demonstrations of better health practices in future MHM and WASH education initiatives. Such an approach may allow protocols and interventions to have more success, and dissemination of healthier behaviors and knowledge to be more prominent. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s41669-019-0168-6) contains supplementary material, which is available to authorized users.