Tag Archives: behaviour change

Changing behaviours: there is no quick fix!

Experts come up with better ways to promote sanitation in India.

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School toilets, West Bengal, India, Photo: Stef Smits/India

India is home to the largest numbers of open defecators in the world. Over the last few decades the government has implemented national programmes, which attempted to address this complex challenge. The demand for sanitation, meaning a genuine demand for toilets and actual use, hasn’t been encouraging. In October 2014, the government launched the Swachh Bharat Mission (SBM), a national programme to eliminate open defecation by 2019. SBM has a rural (gramin) and an urban subcomponent.

Dialogue on behaviour change communication

On 23 September 2016, experts met in New Delhi to discuss how behaviour change communication (BCC) can best help to achieve India’s sanitation goals. They were invited by the India Sanitation Coalition, TARU and IRC to take part in “Insights: WASH Dialogues on Sanitation Promotion and Behavioural Science“.

When we set out to improve life for others without a fundamental understanding of their point of view and quality of experience, we do more harm than good (Lauren Reichelt, 2011)

Sector experts and experts involved in Corporate Social Responsibility (CSR) initiatives in sanitation, argued that it is crucial not just to look at how behaviour change interventions work, but also to understand what doesn’t work. There is general agreement that “soft interventions” are important at the community level to ensure that toilets are not just built but also used. Despite all the investments in sanitation over the years, little has been achieved in sanitation. There seems to be a gap between the planning of behaviour change communication interventions and how they are actually implemented.

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Nudge for good: How insights from behavioral economics can improve the world— and manipulate people

Nudge for good: How insights from behavioral economics can improve the world— and manipulate people | Source: World Bank Blog, Aug 16 2016 |

Richard H. Thaler is a world-renowned behavioral economist and professor of finance and psychology. Recently, he was interviewed by The Economist. The discussion covers some of the fundamental studies in the field, like “save more tomorrow” which encourages people to save more by signing up to increase their savings rate every year and auto-enrollment for pensions that have drastically increased employee participation in pension funds. thaler

Thaler also suggests, in the interview, that behavioral economics has the ability to influence human behavior for both good and bad.  He argues that much of what behavioral economics does is remove barriers.

The goal is not to change people but to make life easier, but that idea can be skewed by organizations or individuals looking to capitalize on the biases of people. Whenever he is asked to sign a copy of his book Nudge, he writes “nudge for good” which is a plea, he says, to improve the lives of people and avoid insidious behavior.

The list of ways companies nudge behavior is endless, and I would love to hear more examples from you all in the comments section. In the meantime here are a few- I’ll let you judge which ones “nudge for good”:

  • Waterborne diseases such as cholera cause widespread illness, especially among children, in developing countries without nation-wide water and sanitation networks. In Kenya, chlorine tablets are distributed by NGOs and other organizations, and people generally understand that the tablets disinfect their water, protecting them from disease. Nevertheless, usage rates are often low. Cost is not the barrier here, convenience is because routinely purifying water requires energy and attention. Michael Kremer of Harvard University and his colleagues found, through a series of randomized controlled trials conducted in Kenya, that providing chlorine as a concentrated liquid at prominently displayed dispensers at local water sources dramatically increase the rate of disinfection. The dispensers provided a visual reminder when and water was collected and made it easy to add the right does. Along with promotion by community members, this approach increased chlorine use by 53%. Thus, making it easier to disinfect water increased the rates at which tablets are used.

Read the complete article.

Nudging and Habit Change for Open Defecation: New Tactics from Behavioral Science

Nudging and Habit Change for Open Defecation: New Tactics from Behavioral Science, March 2016. 

Authors: David Neal, Ph.D. (Catalyst), Jelena Vujcic, M.P.H. (Catalyst), Rachel Burns Ph.D. (Catalyst), Wendy Wood, Ph.D. (University of Southern California) and Jacqueline Devine, MBA (World Bank, Water and Sanitation Program)

In this working paper, we draw on basic scientifc fndings from psychology, cognitive science, and behavioral economics to propose a framework of 8 System 1 Principles to support the initiation and maintenance of OD behavior change.

In doing so, we build from the general framework advanced in the World Bank Group’s (2015) World Development Report: Mind, Society, and Behavior, which emphasized three core insights from behavioral science, namely that people think (a) automatically, (b) socially and (c) using mental models that channel their decision-making.

 

Drivers of sustained hygiene behaviour change: A case study from mid-western Nepal

Drivers of sustained hygiene behaviour change: A case study from mid-western NepalSocial Science & Medicine, August 2016.

Authors: Celia McMichael, Priscilla Robinson

Behaviour change is central to the prevention of many population health problems, yet it is typically difficult to initiate and sustain. This paper reports on an evaluation of a water, sanitation and hygiene (WASH) intervention in mid-western Nepal, with particular focus on the drivers and barriers for handwashing with soap/ash and elimination of open defecation.

The research was conducted during October–November 2014, two and half years following the intervention’s end-point. Qualitative data were collected from the target community (n = 112) via group discussions, interviews and drawings/stories of ‘most significant change’. Households’ handwashing/water facilities and toilets were observed.

Analysis was informed by a model that highlights environmental, psychosocial and technological factors that shape hygiene behaviours across multiple levels, from the habitual to the structural (Dreibelbis et al. 2013). Findings indicate the intervention has supported development of new norms around hygiene behaviours.

Key drivers of sustained hygiene behaviour were habit formation, emotional drivers (e.g. disgust, affiliation), and collective action and civic pride; key constraints included water scarcity and socio-economic disadvantage. Identifying and responding to the drivers and constraints of hygiene behaviour change in specific contexts is critical to sustained behaviour change and population health impact.

Beyond hardware: how a portable sink can inspire behaviour change

Beyond hardware: how a portable sink can inspire behaviour change by Geoff Revell at WaterSHED | Source: WaterAid Blog, June 29, 2016 |

Despite having a cheap and simple fix that could prevent millions of deaths, how to encourage handwashing has puzzled WASH sector experts for years. The rate of handwashing with soap after using the toilet is still estimated to be only 16%. So how do we get people to wash their hands? Geoff Revell, Program Director at WaterAid partner NGO WaterSHED, explains how development of the HappyTap sheds light on new ways to target behaviour. 

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Children using a Happy Tap at school in Ben Tre province, Vietnam.

Awareness campaigns have long been the mainstay of public health efforts to improve handwashing, but on their own they are typically unsuccessful. A multi-year, large-scale behaviour-change campaign in Vietnam, led by World Bank and funded by the Bill & Melinda Gates Foundation, put the challenge in focus. The evaluation of the campaign concluded: ‘the intervention led to an increase in knowledge’, but ‘handwashing with soap behavior in the target population has not changed substantially as a result of the intervention, and thus no health or productivity impacts are found’.

Unfortunately, there is a persistent gap between knowledge and action; after years of education and promotion, many families understand when and why to wash their hands, but still aren’t doing it. Various studies, including one from Kyrgyzstan, have shown a link between the presence of handwashing facilities and rates of handwashing, suggesting a possible causal relationship. But is having more sanitary hardware enough to get people to routinely wash their hands?

Bridging the adoption gap

It’s unlikely that any single intervention would be a silver bullet. However, although sanitary hardware might help improve rates of washing, we can go beyond the physical hardware and use facilities to reinforce and build on awareness. The HappyTap is the first such hardware designed with behaviour change front and centre. It’s a portable sink that not only delivers functionality, but also inspires change.

How can a handwashing station be more than the sum of its parts? Three crucial elements in the design and marketing help boost its success.

Read the complete article.

WASHplus: Behavior-Centered Approaches to Improve Health Outcomes, A Learning Brief

Behavior-Centered Approaches to Improve Health Outcomes, A Learning Brief, 2016. WASHplus.

This technical brief presents the WASHplus approach to behavior change applied in various country settings to imrove WASH practices and serve as the foundation of the project’s global guidance.

 

Can collective action strategies motivate behavior change to reduce open defecation in rural India?

Can collective action strategies motivate behavior change to reduce open defecation in rural India? Waterlines, April 2016.

Authors: Payal Hathi, Dean Spears, Diane Coffey. RICE Institute.

The world’s remaining open defecation is increasingly concentrated in rural India. The Indian government’s efforts to reduce open defecation by providing subsidies for latrine construction have been largely unsuccessful in addressing the problem. It is now clear that behavior change must be the priority if progress on ending open defecation is to be made.

While community-led strategies have proven effective in various developing country contexts, there are serious reasons to question whether similar methods can work in rural India.  Through both quantitative and qualitative analyses, we find that strict social hierarchies that continue to govern daily interactions in rural life today obstruct the spirit of cooperation upon which such methods rely.

Additionally, caste-based notions of purity and pollution make the simple latrines used all over the developing world unattractive to rural Indians.  In a context where people identify most closely with their caste and religious groups rather than their geographical villages, our findings suggest that a more nuanced understanding of the idea of “community” is required.  More experimentation, both with community-led and other strategies, is needed in order to effectively move from open defecation to latrine use in rural India.