Shame or subsidy revisited: social mobilization for sanitation in Orissa, India

Abstract

Objective To determine the effectiveness of a sanitation campaign that combines "shaming" (i.e. emotional motivators) with subsidies for poor households in rural Orissa, an Indian state with a disproportionately high share of India's child mortality. Methods Using a cluster-randomized design, we selected 20 treatment and 20 control villages in the coastal district of Bhadrak, rural Orissa, for a total sample of 1050 households. We collected sanitation and health data before and after a community-led sanitation project, and we used a difference-in-difference estimator to determine the extent to which the campaign influenced the number of households building and using a latrine. Findings Latrine ownership did not increase in control villages, but in treatment villages it rose from 6% to 32% in the overall sample, from 5% to 36% in households below the poverty line (eligible for a government subsidy) and from 7% to 26% in households above the poverty line (not eligible for a government subsidy). Conclusion Subsidies can overcome serious budget constraints but are not necessary to spur action, for shaming can be very effective by harnessing the power of social pressure and peer monitoring. Through a combination of shaming and subsidies, social marketing can improve sanitation worldwide.Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se facilita una traducción al español. ‫املقالة.‬ ‫لهذه‬ ‫الكامل‬ ‫النص‬ ‫نهاية‬ ‫يف‬ ‫الخالصة‬ ‫لهذه‬ ‫العربية‬ ‫الرتجمة‬

Effectiveness of Large Scale Water and Sanitation Interventions: The One Million Initiative in Mozambique

“…We find that the CLTS intervention does have a favourable effect on health, confirming the findings in the literature on the effectiveness of sanitation programs. The impact is driven by the outcomes for adults: for young children (under-5) we do not find a significant health impact of CLTS, confirming Pattanayak et al (2009). Regarding the water intervention, we find a significant impact of the water intervention on the health of very young children.…”

“…Like Pattanayak et al (2009) we find that the CLTS intervention succeeded in inducing people to build and use latrines. We also find that the creation of new improved water points induced many households to switch to the new water sources.…”

“…While many developing countries have adopted this approach in recent years, 2 its effectiveness has rarely been assessed rigorously. An exception is Pattanayak et al (2009) who finds that in India the CLTS shaming techniques in combination with a subsidy resulted in a 30 percent increase in improved latrine ownership. However, Pattanayak et al (2007) do not find an impact on diarrhoea prevalence among under-5 children.…”

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“…Research on latrine adoption in South Asia has primarily focused on economic constraints, infrastructure, and social influence (Duflo, Greenstone, Guiteras, & Clasen, 2015; Guiteras, Levinsohn, & Mobarak, 2015; O’Reilly & Louis, 2014; Pattanayak et al, 2009). While Banda et al (2007) identify the importance of socio-cultural factors for latrine adoption in rural India, only very recently have researchers begun to investigate religion in particular.…”

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