Promoting latrine use in rural Karnataka using the risks, attitudes, norms, abilities and self-regulation (RANAS) approach

Abstract

About 3ieThe International Initiative for Impact Evaluation (3ie) promotes evidence-informed, equitable, inclusive and sustainable development. We support the generation and effective use of high-quality evidence to inform decision-making and improve the lives of people living in poverty in low-and middle-income countries. We provide guidance and support to produce, synthesise and quality-assure evidence of what works, for whom, how, why and at what cost.3ie impact evaluations 3ie-supported impact evaluations assess the difference a development intervention has made to social and economic outcomes. 3ie is committed to funding rigorous evaluations that include a theory-based design and that use the most appropriate mix of methods to capture outcomes and are useful in complex development contexts. About this report3ie accepted the final version of the report, Impacts of community-led video education to increase vaccination coverage in Uttar Pradesh, India, as partial fulfilment of requirements under grant TW10.1039 awarded through Innovations in Increasing Immunisation Evidence Programme. The content has been copy-edited and formatted for publication by 3ie.The 3ie technical quality assurance team for this report comprises Monica Jain, Avantika Bagai, Ananta Seth, Kirthi Rao, Sayak Khatua, an anonymous external impact evaluation design expert reviewer and an anonymous external sector expert reviewer, with overall technical supervision by Marie Gaarder. The 3ie editorial production team for this report comprises Anushruti Ganguly and Akarsh Gupta.

The use of behavioural-science informed interventions to promote latrine use in rural India: a synthesis of findings

“…The Swachh Bharat Mission is likely responsible for the increase in self-reported latrine use in control areas, but the increase in the intervention arms that was beyond that observed in the control arms can be attributed to the evaluated interventions. This finding is consistent with the results the individual studies reported in their independent analyses, which indicated positive effects on latrine use in Karnataka, Odisha, and Gujarat, with null effects in Bihar (Caruso et al, 2019b;Chuahan et al, 2019;Friedrich et al, 2019;International Initiative for Impact Evaluation, 2020;Schmidt, Wolf-peter, Chauhan et al, 2020;Viswanathan et al, 2019). However, the calculation of the average effect across all four studies has the added benefit of being both statistically more powerful and applicable to a broader set of contexts.…”

“…This study builds on the work of the four independent impact (Caruso et al, 2019b;Chuahan et al, 2019;Friedrich et al, 2019;International Initiative for Impact Evaluation, 2020;Schmidt, Wolf-peter, Chauhan et al, 2020;Viswanathan et al, 2019). By using a common analytical approach to synthesize findings across studies, we are able to identify similarities in predictors of latrine use, such as sex and caste, and differences in predictors of latrine use, such as age, across these four states.…”

“…All studies randomized delivery of the interventions at the Gram Panchayat or village level and included between 66 and 120 clusters. Control sites were similar in basic sociodemographic characteristics (Table 2; Caruso et al, 2019bCaruso et al, , 2019aChuahan et al, 2019;Friedrich et al, 2019;International Initiative for Impact Evaluation, 2020;Viswanathan et al, 2019). Both control and intervention sites received SBM activities.…”

“…Each team chose their own target populations based on local context, including the availability of different types of latrines and open defecation rates. Additional detail regarding project activities, sampling design, and data collection is provided elsewhere (Supplemental materials 1; Caruso et al, 2019bCaruso et al, , 2019aChuahan et al, 2019;Friedrich et al, 2019;International Initiative for Impact Evaluation, 2020;Viswanathan et al, 2019).…”

Effect of a low-cost, behaviour-change intervention on latrine use and safe disposal of child faeces in rural Odisha, India: a cluster-randomised controlled trial

“…Only the intervention in Karnataka aimed to increase safe disposal of child faeces, and found no effect. 33 Collectively, these studies show the challenge of achieving the changes in sanitation practices that are necessary to prevent faecal exposures and improve health.…”