3ie Funded Evaluation, TW14.1005 A link to the completed study will appear here when available.
This study tests the impact of a behaviourally informed intervention for increasing the intent and use of latrines amongst toilet-owning households in the Jamui, Khagaria, Madhepura, Naalanda, Nawada, Saharsa districts of rural Bihar, India.
Although large-scale sanitation subsidy programmes have been implemented in India in the last two decades, rates of open defecation remain high compared to other countries with similar socioeconomic characteristics. According to the Swacchta (Cleanliness) Status Report of 2015, 52.1 per cent of the rural population was still defecating in the open. Within India, the state of Bihar has one of the highest rates of open defecation, with a prevalence rate of 70 per cent. The SQUAT report finds that at least one household member will continue to openly defecate in 44 per cent of households with a latrine.
Developing scalable, cost-effective interventions to bridge the gap between availability and use of latrines in rural Bihar is key to the overall success of India’s drive to eliminate open defecation. The findings of this study can be important for developing solutions to increase the rate of toilet use in rural Bihar, which will consequently improve sanitation outcomes across the country.
The intervention that will be evaluated uses an inter-related and internally coherent set of activities and tools to create and activate intentions to use latrines through community meetings and follow-up household visits.
Does the intervention contribute to increasing the proportion of people regularly using their twin-pit latrines?
Does the intervention increase knowledge of pit-filling rates and attitude towards pit emptying?
The intervention aims to change behaviour at both the household and community levels by shifting norms related to the acceptability of open defecation. The community meetings are aimed at addressing behavioural barriers such as: overestimation of pit filling rates, ambiguity around benefits of latrine use, pit decomposition and emptying. These meetings are supplemented and reinforced by a set of behavioural nudges, commitments and pledges during ongoing household-level visits.
Theory of change
Key barriers to reduced toilet use in rural Bihar revolve around incorrect perceptions around pit filling and anxiety about pit cleaning that are tied primarily to caste prejudices. Through targeted community meetings and household visits the intervention will involve behavioural games that aim to: correct mental models about pit filling, address reasons for latrine aversion, and address anxiety about pit emptying as well as create a commitment to use latrines. The intervention does not tackle supply side barriers to toilet use such as toilet design and water tables. This theory of change assumes that these ‘behavioural nudges’ will be sufficient to overcome other barriers to toilet use.
The study will be carried out in six districts in Bihar where World Vision International has its operations. Through random assignment, half the villages will be designated as treatments areas receiving the behavioural intervention while the other half will be control areas where World Vision International’s regular programming along with the Swachh Bharat Mission will continue.
The eligible population for the study is households that have functional latrines (defined by having a twin-pit, pan, and pipe connecting the two). The intervention thus focusses on a target population that is likely to be affected by the intervention but who (as owners of twin-pit latrines) are broadly representative of the broader population, amongst whom this intervention would need to be scaled.
A potential source of impact heterogeneity is non-attendance of certain households at community-level meetings. To minimise the cost of attending such meetings, they will be conducted at the tola (hamlet) level instead of the village level. Implementation at the household level is expected to be relatively homogenous across all targeted households in treatment villages, a process evaluation will test the validity of the same.
This mixed-methods evaluation will also assess the impact of this behavioural interventions on latrine use through qualitative research. Focus group discussions will be carried out to understanding perceptions of latrine use, pit filling, and savings. A process evaluation using qualitative and quantitative techniques will provide insights on intervention uptake and use.