Sanitation drive: Bring it all in from the open
If you are a natural scientist, a publication the journal Science carries enormous prestige. In the last few years Science has started to publish a small number of articles in the social sciences on topics of special importance.columns Updated: Apr 28, 2015 02:07 IST
If you are a natural scientist, a publication the journal Science carries enormous prestige. In the last few years Science has started to publish a small number of articles in the social sciences on topics of special importance.
It is a measure of the global concern with open defecation in South Asia (and of course, the quality of the research) that a recent issue of Science carried a piece by Ray Guiteras from the University of Maryland and Jim Levinsohn and Mushfiq Mobarak from Yale University, on strategies for getting people to buy and use toilets in Bangladesh. The starting point of the study was that we still don’t know very much about why there is so much open defecation in South Asia. It is of course true that many people are poor and toilets cost money, but a whole lot of those who can easily afford them also opt to go outside. Either toilet use is not enough of a priority for these households or something else is stopping them — such as non-availability of toilets (or the proper servicing of toilets) at the village level. In economics parlance, they must be either constrained by demand (for toilets) or their supply.
The study, covering more than 18,000 households in 380 neighbourhoods in the Rajshahi division of Bangladesh, aimed to systematically investigate these alternative hypotheses. In order to make sure that the results were in no way contaminated by pre-existing differences among the neighbourhoods, a lottery was employed to assign different interventions to different neighbourhoods. Some neighbourhoods got a version of the highly touted Community Led Total Sanitation (CLTS) campaign, where, over two days, the community participated in graphic demonstrations of how diseases travel from the faeces left in the field to their bodies, along with extended harangues and appeals to their better nature. VERC, the NGO that has promoted CLTS all over the developing world, designed and led the campaign.
Another randomly chosen set of neighbourhoods got help with supply. Latrine supply agents were appointed to provide assistance with the installation and maintenance of toilets.
Both these interventions failed comprehensively: At the end of the study period people in these neighbourhoods showed no more interest in toilets than their counterparts in neighbourhoods where absolutely was nothing done.
On the other hand, there was a very substantial increase in toilet construction and a correspondingly large reduction in open defecation in those (randomly chosen) localities where the demand generation campaign was combined with a discount of 75% on the cost of installing a toilet (only the poor were eligible for the subsidy). The demand, it seemed, was there; just not enough to make people to want to pay the full price. A combination of demand generation and subsidies works.
This is somewhat ironic because the sponsors of CLTS have always been vocal opponents of subsidies. On the other hand it is entirely consistent with the standard economic logic that argues that since the benefits of reducing open defecation accrue to the entire community, it is not reasonable to expect individual households to bear the full cost of the toilet even after they are convinced of its value.
The results are also consistent with what came out of a piece of action research carried out by the Arghyam Foundation working with the state and district authorities in Karnataka. A combination of a demand generation campaign and an effort to ensure that those who built toilets actually got the subsidy they were promised under the Swachh Bharat Abhiyan seems to have had a very large effect on the construction of toilets.
None of this guarantees that the same package will work equally well everywhere in India. In particular these toilets relied on there being enough water available to keep them clean. In parts of both North and South India, this is not necessarily true throughout the year. Chemical toilets could solve that problem, but it might be harder to persuade people that they are ‘clean’.
It has also been suggested that for reasons that have to do with caste and ritual cleanliness, parts of Hindu North India may be especially hard to convert. There is probably some truth to this — interestingly, Muslims in North India, despite being poorer, are much less likely to practise open defecation. However it is not obvious that these preferences are immutable — it is also true that Hindus living with lots of Muslims are more likely to use toilets. The Bangladesh study confirms that there are strong neighbourhood influences — those who were surrounded by people who were eligible for a subsidy (and therefore built toilets) were much more likely to build unsubsidised toilets for themselves. Once some people are induced to change their behaviour, others might follow suit.
From the point of view of the Swachh Bharat Abhiyan, there is both good news and bad news here. The good news is that these ingredients are already there in the scheme. The Arghyam study argues that the budget allocation for demand generation is adequate. The promised subsidies are also large enough.
The challenge is to combine them in the right way. It is not hard to stimulate demand, but it is unlikely that the effect lasts forever. The view on the ground is that there is a relatively a small window (though I would have loved to have seen some research proving that) before people forget. The government schemes, on the other hand, tend to move slowly and creakily, especially when paying out money is concerned. The Arghyam study went into a lot of trouble to make sure that the subsidy got paid on time (within 20 days) and there was no harassment or bribery involved, but it is not clear that this is easily replicated. The alternative, unfortunately, is what we have seen so far: Toilets dumped on people who no longer wanted them if they ever did, sitting unused.
One possible alternative is to invite private companies to adopt blocks or districts where they will implement the programme. They would supply the man-power (as part of their CSR) to coordinate the demand campaigns with the disbursement of the subsidies, and make sure it all happens seamlessly. They will pay the subsidies, get the receipts (bio-metrically identified?) and send the bill to the government for reimbursement. If the government is late in repaying them, they get to deduct the interest cost as CSR expenses. Random audits will be conducted to keep everyone honest.
India is so vast and there is so much happening that I won’t be surprised if something like this is already being implemented somewhere. If so, it should be studied carefully. If not it’s worth a try.
Abhijit Banerjee is Ford Foundation International Professor of Economics and Director,
Abdul Latif Jameel Poverty Action Lab, MIT
The views expressed by the author are personal