Can disgust and shame lead to cleaner water and more handwashing? Impact evidence from Bangladesh

Aug. 27, 2015
Water and Sanitation
South Asia


Improvements in water quality, sanitation and hygiene are associated with a reduction in risk of diarrhoea. However, treating water and regular handwashing with soap are not common practices in several low- and middle-income countries, including Bangladesh. 

The idea of provoking shame and disgust about poor sanitation and hygiene has been used in community-led total sanitation programmes in a number of developing countries. But does it work?

To find out, 3ie supported a research team to conduct a randomised impact evaluation between 2011 and 2014. The team tested whether behaviour change messages provoking disgust and shame amongst people within each compound are more effective than public health-related messages promoting safe water and handwashing. This brief distills the main findings and the lessons learned.

Key messages 

  • The impact evaluation showed that the intervention did not change behaviours. 
  • The messages aimed at creating disgust and shame did not increase demand for water treatment or improve handwashing behaviour compared to the standard health messages. 
  • Use of the chlorine dispenser was low. 
  • This study pointed up a number of implementation factors that may have affected the impact of the messages and use of the dispensers.


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