Subsidy proponents believe that the poor need economic incentives while shaming proponents contend that to bring out lasting behavioural change, intrinsic motivation is required; people are more likely to use and value things they have had to pay for.

What explains the Total Sanitation Campaign: The first impact evaluation study carried out in Orissa, by a multi disciplinary team, comes up with a few answers on how to answer this key policy question !

Sumeet Patil contributes to this ongoing debate, providing insight on a study carried out to examine the effects in Orissa of a “community-led total sanitation” model implemented there. For the study, a random sample selection of villages was done and survey carried out. Data was collected through questionnaires, interviews and field visits and subsequently analyzed.

Community Participation - Total Sanitation Campaign ( Image: India Water Portal)

Some important findings from the study reveal:

• Not just health awareness but importance of privacy and dignity play a key role in influencing household demand for latrines
• Households priority for toilets is low; 80% want health dispensary’s , 59 % roads and only 7-8% give priority to water and sanitation
• Constructing individual household latrines placed conveniently next to the house for the family’s exclusive use rather than community toilets
  brought in a larger change
• Social pressure and peer monitoring are stronger tools than targeting individuals for success of sanitation program
• Poor need to spend 85% of their monthly income on a full-price latrine, hence subsidies clearly helped 
• Equally important is how and when the subsidies are given
• Among households above the poverty line, subsidies are not necessary to spur action and shame alone can be very effective

Cartoons explaining importance of hygienic toilet habits: TSC (Image: India Water Portal)

Conclusion

Success of the campaign lies in a unique combination of shame and subsidies. The inference drawn is that the “shame and subsidy” strategy together  have a larger effect than “shame” or “subsidy” alone. It is this Community Led Total Sanitation  (CLTS) based behavior change, coupled with subsidy based intervention that impacts the sanitation campaign.