The difficulty of changing behaviour: no quick fix, say experts

It's one of the biggest challenges facing anyone working in water and sanitation. No matter how many toilets or hand washing stations you build, they will be a monumental waste of money if people don't use them. 

India is trying to grapple with this problem. It has more open defecators than any other country in the world. Over the last few decades the government has implemented national programmes to change this, including the Swachh Bharat Mission (SBM), a national programme launched in 2014 with the aim of eliminating open defecation by 2019.

However, the demand for sanitation – i.e. a genuine demand for toilets and actual use of those toilets – has not been encouraging.

​In September, a number of experts met in Delhi to discuss the reasons for this and what can be done to bring about lasting behaviour change. For a longer report of the meeting, visit the article on Sanitation Updates. However, here are a few key lessons.

• It is just as important to understand what doesn’t work, as well as to understand what behaviour change interventions do work.
• Actual change in behaviour and practice in communities takes time. Interventions have to be designed to be delivered over a longer time with relevant and progressive messaging.
• Put communities first. Every community is different. Make sure you understand their context.
• The lack of land tenure security, cramped and smelly toilets can affect the adoption of hygienic behaviour.
• Low aspirations and negative self-perception, reinforced by sanitation campaigns focusing on shame and disgust, may discourage the poor to construct toilets.  
• Actions that reinforce communities’ pride in their way of life and cultural habits make them more open towards behaviour change messages.
• Another positive trigger is exposure to properly designed, well-functioning and clean toilet facilities in health care facilities, schools, bus/train stations etc. Toilets are more likely to be used if there is good light, space and ventilation, easy access to water and simple pit cleaning technology. 
• Children have a key role to play in behaviour change. Dettol's Swachhata Ki Paathshala campaign incorporates sanitation messaging into the school curriculum in different regional languages. 
• Faith-based leaders have been instrumental in influencing a large section of the community to adopt hygienic behaviour and toilets, according to the Global Interfaith WASH Alliance; 99% of Indians belong to a faith. The Alliance plans to start a ‘Swachhata Kranti’ (Clean Revolution).
• Targeting only women will not solve India’s sanitation problems. The focus should be all household members, including men.

---