Increasing Demand for Hygienic Latrines in Bangladesh

Researchers suggest that inadequate sanitation contributes to high rates of diarrheal disease causing 20 percent of diarrhea deaths (approximately 280,000 deaths in 2012)i. Despite the billions of dollars that governments and multi-lateral donors are spending on sanitation programming around the developing world, there is still disagreement on the fundamental reasons for high rates of inadequate sanitation. The four impediments to sanitation investment that researchers and donors commonly cite are: (i) poverty, (ii) lack of knowledge about the importance of sanitation, (iii) lack of knowledge of and access to markets where sanitation supplies can be purchased, and (iv) collective action and free riding problems associated with a product that generates health benefits which are largely external to the household that incurs the cost of installing the toilet. If poverty is the main constraint, price subsidies should increase sanitation adoption. However, some practitioners express concerns that if poverty is not the constraint then subsidies may undermine motivation in the future by creating dependency. If instead information and knowledge are the key constraints, education campaigns could be a sufficient and cost-effective solution. Collective action problems favor interventions that target groups rather than individuals, and education campaigns that emphasize collective action and require communities to make simultaneous joint commitments to invest. Without an understanding of the key constraints that deter sanitation investments it is difficult to create a consensus on how to best improve sanitation outcomes in a cost-effective manner. Understanding why there is the low demand for sanitation is essential to finding an effective strategy to counter open-defecation (OD). To that end, researchers from the University of Maryland and Yale University partnered with Innovations for Poverty Action (IPA), VERC and WaterAid Bangladesh to design, implement and test a range of sanitation marketing strategies in the Tanore district in rural Bangladesh. The result was a large-scale randomized controlled trial covering over 18,000 households in about 380 communities designed to understand the importance of financial and information constraints, and collective action problems, and the effectiveness of different marketing strategies that counter these problems.