The evaluation of a sanitation intervention on sanitation-related emotional and psychological well-being among women and girls in Bihar

ABSTRACT

Public health externalities from unhygienic sanitation remain a significant development challenge, even in areas where hygienic latrines are accessible or affordable. Our partner, Sanergy has created a network of hygienic latrines in Nairobi. However, as with many other technical solutions to a range of development problems, widespread adoption of this "clean toilet" option has been a challenge. Barriers such as distance, cost, long queues, or lack of understanding of health risks may preclude individuals from choosing the sanitation option that may be better from a public health point of view. We also hypothesize that behaviors like open defecation may persist because they represent ingrained habits that are difficult to change. Inspired by findings from psychology and neuroscience, we propose field experiments that are designed to instill a revised habit of community toilet use among the slum population of Nairobi. Habit loops have been successfully created by private sector firms to increase demand for many household products and behaviors such as brushing regularly with Pepsodent toothpaste, or spraying Febreze air freshener. We propose to create such a loop for Sanergy toilets using a combination of economic incentives and a marketing campaign that is attentive to psychological cues and rewards. The experiments are designed to separate habit formation from other closely related models of risk aversion and learning.