India’s toilet crisis is largely about its men. Women want the safety and privacy of a toilet at home. But how do you convince a man to give up his scenic open-air loo, with its cool breeze and its ringside view of a verdant paddy field for a cramped, smelly, dark room with a hole? How do you convince him (and his friends) that their children will be healthier if they sacrifice the macho camaraderie of “going" in a group and take their business indoors?
Some 626 million Indians don’t have access to a toilet and defecate in the open (neighbour Bangladesh has nearly eradicated open defecation or OD). But even having a toilet here doesn’t necessarily mean all family members go there. It’s what they call the “usage issue" in sanitation, and these days bureaucrats too speak this lingo.
Economist Dean Spears’ recent SQUAT (Sanitation Quality Use Access and Trends) survey interviewed people in 3,235 households in Rajasthan, Madhya Pradesh, Haryana, Uttar Pradesh and Bihar. More than half the households surveyed didn’t have access to a toilet. More importantly, 40% of households with a working loo had at least one person who regularly defecates in the open.
Arghyam, a non-profit domestic water and sanitation focused foundation set up in 2005 with an endowment by philanthropist Rohini Nilekani, is really at the forefront of thinking and research about toilet usage. The organization understood two years ago that to tackle the rural sanitation emergency, India needs behavioural experts more than bricks. Clearly the message has percolated. These days even official government notes on sanitation use the B-word.
Dog trainers, marriage counsellors, dietitians, hypnotists—currently, Arghyam is enlisting ideas from anyone who has successfully nudged someone to make a behaviour change. Attendees at a recent Arghyam workshop organized in Bangalore to brainstorm ways to change toilet usage behaviour (loo nudges) included Spears, Ram Prasad, co-founder at behaviour architect firm FinalMile, Balaji Gopalan, creative director of communications firm Centre of Gravity (COG), and assorted others, including a marriage counsellor and an anthropology student. The workshop was conducted by Nirat Bhatnagar, the founder and CEO of Wash For India, whose mission is to find creative ways to solve the sanitation crisis. All ideas are welcome. Are there any lessons in the tried and tested psychology of the Default Effect? Remember that classic experiment where organ donation numbers showed a direct correlation to the default option? They were higher when the default option said: check this box if you don’t want to donate.
Arghyam already has a head start from a year-long project in 119 villages of Davangere, a district at the geographic heart of Karnataka. Its partners for this intensive exercise included the state government; FinalMile, which seeks to explain and influence behaviour using cognitive neuroscience and behavioural economics; and COG. Over the course of the experiment, Gopalan says his team encountered scores of stories: like the one about Umesh, who migrated to Bangalore and got married. When he brought his wife home, she was shocked there were no toilets and vowed never to return until he built a toilet. Or the daughter of a family who went to study in the city. When she’s home for the holidays, she feels ashamed to go out to defecate. So much so that she eats less.
The first issue, of access, was tackled by an agreement with the state government which promised quick availability of funds allotted for toilet building. “Jaldi became our tag line," says Jayamala Subramaniam, CEO of Arghyam. Moreover, nearly 30% of people didn’t understand the complexities of the scheme. They didn’t know what funds were available, how to access them, or if they were even eligible. Just getting the information across and promising speedy release of funds drove toilet construction activity higher. “When you move the focus to subsidy and when you have a leaky pipe, you’re actually preventing people—who would otherwise have built a toilet—from getting one," says Rohini Nilekani, chairperson of Arghyam.
Teams went door-to-door inviting people to attend street events where they shared information, screened messages from key officials, staged a play where a woman tells a man, you be the woman for a day. So he wears a sari, goes out to do his business, encounters a snake, gets harassed by men, comes back and says, now I get the point. “We wanted to see if the interest generated could convert into applications for toilets and it did. Lots of people signed on," says Subramaniam.
Women, predictably, were open to the idea of toilets, they found. “In Davangere the green cover is vanishing, there are less places for people to defecate in the open with security and privacy, so they, especially the women, don’t need a lot of convincing," says Vijay Krishna, director of Arghyam’s sanitation programme.
Adds Subramaniam: “Yet the action of going and getting a toilet is a man’s job. Construction is a man’s job, dealing with the administration, visiting the gram panchayat office six-seven times is also the man’s job. Given that men didn’t think it was a priority, we realized that if the job needed to get done, we needed to attack and message the men."
Emotion worked better than reason when it came to convincing men they should build toilets. Improved health and hygiene were not motivation enough but one idea that worked well in Davangere was the idea of a responsible father. “Some 60% of households had an adolescent girl, the most vulnerable group, and most men felt responsible for their adolescent daughters. So we felt that that the message of the responsible father would be aspirational. Men wanted society to look up to them," says Subramaniam. The short film they made was a hit.
The lack of government personnel on the ground to monitor the process of toilet building was another big block, they found.
Overall, people were four times more likely to build toilets with this intervention, the experiment found, than a similarly sized control group that had not been exposed to this aggressive campaign. Incidentally, the exercise was part-funded by the state’s ‘behaviour change’ budget (called IEC or information, education and communication).