How Behavioural Economics can Improve Sanitation in India
“Sanitation is more important than independence,”. This was said by Mahatma Gandhi during his fight for a cleaner, independent India. But these words don’t mean the same to the rest of the country as clearly we have forgotten the importance of sanitation. One of the major issues concerning sanitation in India is open defecation, which we think is a part of our tradition, our culture. Nearly 950 million people still practice this in the world, and 569 million of them live in India. Open defecation causes diarrhoea, intestinal worm infections, typhoid, cholera which further leads to malnutrition. The WHO estimates that 50 percent of malnutrition is associated with repeated diarrhoea or intestinal worm infections from unsafe water or poor sanitation. One of the goals of the Swachh Bharat Mission is to eliminate open defecation in our country. Although this has led to progress ( however slow this progress maybe ), using behavioural economics could further amplify that progress.
Social norms can be used to influence others and get them to showcase the desired behaviour. Consider a study to see the power of social nudges and the effects of the same on energy consumption of households (Schultz et al. 2007). A total of 287 households were taken in a community in California and were divided into two groups. One-half of the households received descriptive normative feedback about their energy consumption. Descriptive normative information is providing information as it is, so households were simply informed about their energy consumption and the average energy consumption of the community. The other half received descriptive normative information along with an injunctive message. These households were told whether their energy consumption was approved of or not by a positive emoticon of a smiling face ( incase their energy consumption was below the average ) or a negative frowning face emoticon ( incase their energy consumption was above the average ). The households which had above-average energy consumption reduced their energy consumption irrespective of the kind of information they used ( descriptive or inductive ). But the houses which had below-average energy consumption only continued to consume the same amount of energy if they were provided with injunctive information. This shows the power of social norms and our tendency to always want to do better than others, especially when what we are doing has been approved or disproved off. In this case, people wanted to stick to the norm of consuming below the average community consumption of electricity.
The same concept can be applied to the classification of ODF ( Open Defecation Free ) states. According to the Ministry of Housing and Urban Affairs of India, a city/ward can be notified/declared as ODF city/ ODF ward if, at any point of the day, not a single person is found defecating in the open. If all necessary conditions are met, the city/ward has to sign the declaration provided in the ODF protocol. The declaration of all wards is given to the ULB ( urban local body ) it falls under after which a public statement can be made. There are 15 days for any public objections, if there are no objections the state government must verify the claim with a third party and then the city/ward can be formally declared an ODF. To add to this, the central government can send a yearly report of each states’ status on their ODF title along with descriptive normative information and an injunctive message similar to the field experiment mentioned above. This report can include a list of states along with their title, neighbouring states which have acquired the ODF status as well as an emoticon expressing approval or disapproval. A simple smiling face or frowning face can encourage state governments to improve their sanitation levels. As we Indians are known for our competitiveness, a little healthy competition between states based on their ODF status can be very beneficial. Only when the state itself is concerned about improving its hygienic condition can measures be implemented to improve the same within the state.
Let’s assume state X is an ODF state and many of the 10,28,67,271 ( a figure taken from the official Swachh Bharat Mission- Gramin website ) toilets build in our country are situated in this state. Unintended consequences are outcomes of an act that were not foreseen, so building a toilet but not using it would be an unintended consequence. A RICE (Research Institute for Compassionate Economics) survey found that 23% of people who own a toilet continue to defecate out in the open, which means that even though state X is declared ODF there would still be people who prefer to pollute their surroundings rather than use a toilet. The 23% of people who choose not to use their toilets are the group of people that we should be looking at. These are the people who do not use toilets as they feel that they are following tradition by doing so. Generations before them did the same thing, and they are just continuing the cycle, following the norm of their society.
The Behaviour Change Wheel as proposed by Susan Michie, Lou Atkins & Robert West provides a new way of bringing about behavioural change interventions. According to this wheel, the problem can lie in the area of lack of opportunity, capability or motivation. If we look at the problem of open defecation in accordance with this wheel, we can see that the source of this behaviour lies in the lack of motivation. Here, there is an opportunity to build a toilet ( subsidies are given to build toilets under the SBM ) and people are capable, both physically and psychologically, of doing so. The Behavioural Change Wheel gives many options for interventions that can be followed to overcome this problem. One of them is education. Education can be used to change the norm and make people aware of the dangers of open defecation. A RICE survey found that 84% of its respondents had never heard of any village level meeting on sanitation and less than a third had never seen a poster or any other form of message about toilets. MLAs, panchayats and other village officials can hold meetings to educate the village residents. But what should be the main focus of this education?
Many associate open defecation with rising early, wholesome rural life and good health. The education provided to villagers should be aimed at deconstructing these beliefs. They should be made aware of the health risks, the threat of sexual assault and the invasion of privacy that come with open defecation. Another belief that must be tackled is the belief that toilets are impure, pollute its surroundings and disrespectful to the shrine inside the house. This taboo around toilets can only be removed by talking more them. The Sulabh International Museum of Toilets in New Delhi aims to do the same. It wants to create healthy conversations around toilets and sanitation. Initiatives like these can help educate the masses of the advantages of toilets.
A way to make the impact of education more effective is when the messenger of that information is someone who influences people. Authors Paul Dolan, Michael Hallsworth, David Halpern, Dominic King and Ivo Vlaev gave the acronym of MINDSPACE, which gives nine ways our behaviour can be affected, the first one being the messenger. The messenger of the information influences the impact on the listener. When actors like Amitabh Bachchan do advertisements discouraging defecating in the open it is more likely to encourage people to follow what they are saying. Increasing the number of familiar faces we see in such advertisements can lead to a greater impact.
Now let's assume that in our state X, the Amitabh Bachchan ad did wonders and every single family has a toilet and more importantly uses it.
The problem that arises now is the kinds of toilets that are built in our villages. Most of the toilets built are pit or twin pit latrines. These toilets are made by creating a deep pit into the ground, covering it with a seat and building four walls around it. After a few years when the pit is full, the faeces must be removed. An unintended consequence of building pit latrines is augmenting the discrimination of those belonging to lower casts. Certain people are made to empty these pits filled with human excreta solely because of the cast they belong to. The source of such behaviour, according to the Behaviour Change Wheel, would be the lack of psychological capability. We are not capable of believing the fact that those belonging to a lower caste are just as human as we are. The solution to this problem too is education. The use of a powerful messenger can help people realize that they are capable of cleaning up after themselves. In the district of Kanchipuran in Tamil Nadu, actor Akshay Kumar was seen emptying a twin pit latrine. By doing so, he encouraged many people to follow in his footsteps and not give this work to those belonging to lower castes. Another unintended consequence of building pit latrines is polluting the environment due to the incorrect disposal of excreta and badly kept toilets. This too can be solved by education. Those who own toilets can be taught to convert waste matter into compost which can be further used in fields to enrich the soil.
Behavioural Economics gives us insights into how people make decisions, and how those decisions can be nudged for the better. India should follow in the footsteps of countries like the UK and make use of behavioural economics to enhance its policies. In a highly populated, diverse country like ours it is difficult to ensure that one policy caters to all sections of the public. So, it is imperative that we target a particular audience, and look at changes that can be made in the behaviour of that particular group – using tailor made nudges and behavioural interventions.
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