Social shaming techniques work better in making people adopt proper sanitation habits in rural India, a new study has suggested.
The study was done by Subhrendu Pattanayak, an associate professor at Duke University's Sanford School of Public Policy and Nicholas School of the Environment, and colleagues.
It was carried out in an effort to reduce elevated childhood death and disease rates blamed on the microbial pathogens that cause diarrhea in rural India, which is all a result of improper sanitation practices like defecating in the open.
Neighbors caught in open defecation, for example, may be taunted.
Pattanayak's evaluation focused on efforts to combine both shaming and reward tactics in the state of Orissa, which has a child mortality rate higher than average for India.
Pattanayak worked with frustrated government officials and his collaborators at RTI International, where he then worked.
ollectively, they designed a study, funded by the World Bank, to measure the effectiveness of what his report called "a social mobilization strategy."
Twenty Orissa villages were selected at random in 2006 for locally led efforts that included village "walks of shame" and "defecation mapping" that identified sources of contamination and their distances from drinking water supplies.
As that study began, about 30 percent of the interviewed households reported a child younger than 5 years had experienced diarrhea within the previous two weeks.
Community based groups were empowered "to establish systems of fines, taunting or social sanctions to punish those who continued to defecate in the open," the report said.
As Total Sanitation Campaign workers organized these additional efforts, Pattanayak's study group remained behind the scenes gathering data through "before and after" health and sanitation surveys.
The results were striking when surveys from those 20 villages were compared with 20 other randomly selected communities where no social mobilization efforts were organized.
Although subsidies for latrine construction were available to residents below India's poverty line in all 40 villages, latrine ownership only rose in those undergoing shaming, according to the surveys.
Within those "shamed" communities, latrine ownership rose from 5 percent to 36 percent among families below the poverty line, and from 7 percent to 26 percent among households above it.
Subsequent surveys by Orissa's state government showed that all households had installed latrines by 2007 in 10 of the 20 villages subjected to the shaming.
Statistical analysis suggests that shaming was responsible for about two thirds of the improvements in those communities.