On-site sanitation: peer pressure builds more latrines than financial assistance in Orissa

Updated - Wednesday 18 November 2009

Government subsidies persuade some people to change habits, but social shame works even better, suggests a recent ground breaking, comparative study [1] of efforts to reduce elevated childhood death and disease rates blamed on the microbial pathogens that cause diarrhoea in rural India.

“All this started with public health workers there just beating their heads against the reality of how sticky human behaviour is and how hard it is to change it,” said Subhrendu Pattanayak, an associate professor at Duke University. Pattanayak evaluated efforts to combine both shaming and reward tactics in the state of Orissa, which has a child mortality rate higher than average for India.

Health workers participating in India’s Total Sanitation Campaign had previously knocked on doors throughout India, handing out pamphlets designed to persuade individual households to install pit latrines. The poorer households were even offered construction subsidies that would reduce their costs to US$ 7.50 (€ 5.00). But after those initial efforts, follow-up studies found less than a quarter of the nation’s population and less than 10 per cent of residents of Orissa had “access to safe water and good sanitation,” according to the report.

The results of Pattanayak’s new research were striking when surveys from 20 villages in Tihidi and Chandbali block in the coastal district of Bhadrak were compared with 20 other randomly selected communities where no social mobilization efforts were organized. Although subsidies for latrine construction were available to residents below India’s poverty line in all 40 villages, latrine ownership only rose in those undergoing shaming, according to the surveys. Within those “shamed” communities, latrine ownership rose from 5 per cent to 36 per cent among families below the poverty line, and from 7 per cent to 26 per cent among households above it.

Subsequent surveys by Orissa’s state government showed that all households had installed latrines by 2007 in 10 of the 20 villages subjected to the shaming. Statistical analysis suggests that subsidies were responsible for about one third of the improvements in those communities and shame for about two thirds, the report concluded.

[1] K Pattanayak, S.K. ...[et.al.] (2009). Shame or subsidy revisited: social mobilization for sanitation in Orissa, India, Bulletin of the World Health Organization ; vol. 87, no. 8 ; p. 580-587. doi: 10.2471/BLT.08.057422

Related news: Once on the sanitation ladder, families want to go higher, Source Bulletin, Aug 2008

Contact: Subhrendu K Pattanayak, Sanford Institute of Public Policy and Nicholas School of the Environment, Duke University, USA, e-mail: subhrendu.pattanayak@duke.edu

Keywords


Comment