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Behavioural barriers to toilet usage can be tackled by creating the right motivation to change habits
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Prime Minister Narendra Modi has given the sanitation problem the importance and seriousness it deserves. Many companies have responded swiftly with plans to build toilets. This is a welcome step, but it would be naive to assume that we will solve the sanitation problem by addressing just the supply side.
There are now studies that show the usage rate of toilets is not more than 50%. Usage rates are abysmal if we define usage as “entire household using the toilet on every ‘toilet’ occasion". For over a year now, FinalMile Consulting has been engaged in a project funded by Arghyam. Our objective was to understand why people are not using toilets and coming up with solutions to increase usage. We undertook field observations and conducted experiment-based research across many villages.
Women generally are the first to start using the toilets, though some women confessed to looking forward to “go out" once in a while with friends. Children continue to defecate in the open and so do men. Most toilets in the schools we visited were dysfunctional, built but hardly used or maintained.
This non-usage behaviour can be summarized into two primary issues—design issue and motivation issue.
We observed that the current design of most toilets is poor. Empathy, the most basic design principle, has been totally ignored. People find open defecation less disgusting because it happens out in the open, full of light and air. On the other hand, a large majority of people using toilets for the first time found their first experience to be pathetic. The toilets are dark and stinky with no air circulation. The constrained environment makes people think that the process is too long and onerous.
A good toilet design should include sufficient lighting, air circulation and water access. We also noticed that while all the houses in the village looked different and individualistic, the toilets looked the same. It all almost seemed like they were not “owned" by the people but just put there by someone else. To overcome this, we recommended some level of personalization, in the form of painting, installing name tags etc. The clear lesson here for companies building toilets in schools and villages is to not put their company logo on it but to instead put the name of the house owner. This will enhance the feeling of ownership and motivate people to use it more.
Why have the previous efforts to increase the usage of toilets failed? We believe this is because much of the messaging to drive usage is hinged on four factors i.e., health, shame, disgust and social norms. However, none of these factors seem to act as significant motivators.
1. The health implications of open defecation are not seen as detrimental. Diseases caused by open defecation are often not considered deadly. For example, diarrhoea is considered to be a part of growing up. This behaviour isn’t surprising and, in fact, is not just limited to the villagers. Most of us living a sedentary lifestyle don’t go the gym even though there is a clear health connection. Overconfidence combined with time discounting makes it hard for the health factor to impact behaviour. We as humans are bad at judging long-term risks. The poor especially are more prone to the present day bias, thinking just about surviving for the day.
2. The shame of open defecation is realized only in front of outsiders. However, this emotion is not realized among in-group members, who “go-out" together as a practice. Hence, when the external agent leaves, so does the emotion of shame.
3. Disgust. Repeated exposure or behaviour can completely suppress this emotion. For example, in an urban slum, an outsider feels deep disgust with all the muck, but people who live there get used to it. Ironically, in case of open defecation, since people are “used to it" , there is no disgust associated with it. However, this emotion comes in to play while using the toilet due to the smell and associated visual history as well as the perceived concern of the toilet being close to the house. Moreover, there, less disgust is associated with children defecating in the open.
4. Invoking social norms is often seen as a strong motivator for driving correct behaviour. However, neither can new norms be created nor can external norms be invoked. We can only highlight or reinforce social norms that already exist. Since social norms associated with toilets do not exist, this option is redundant.
When we applied these learnings to run a series of experiments in the villages, where people had to buy small but useful items for the toilet, the response was very encouraging. People bought mirrors, water tubs, air fresheners. And where people paid for it, usage was significantly improved.
Our experiments helped us unearth a number of behavioural barriers to the usage of toilets. We found that addressing these behavioural issues right at the design stage made a big difference.
Sanitation is a wicked problem. Addressing design issues and creating the right motivation will be crucial to changing habits. Else, we will end up spending a lot of money on building badly designed toilets and poorly conceived communication campaigns.
Ram Prasad is co-founder of FinalMile Consulting, a behaviour architecture firm.
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