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Bull World Health Organ. 2009 Aug;87(8):580-7.

Shame or subsidy revisited: social mobilization for sanitation in Orissa, India.

Author information

  • 1Sanford Institute of Public Policy and Nicholas School of the Environment, Duke University, Durham, NC, United States of America. subhrendu.pattanayak@duke.edu

Abstract

OBJECTIVE:

To determine the effectiveness of a sanitation campaign that combines 'shaming' (i.e. emotional motivators) with subsidies for poor households in rural Orissa, an Indian state with a disproportionately high share of India's child mortality.

METHODS:

Using a cluster-randomized design, we selected 20 treatment and 20 control villages in the coastal district of Bhadrak, rural Orissa, for a total sample of 1050 households. We collected sanitation and health data before and after a community-led sanitation project, and we used a difference-in-difference estimator to determine the extent to which the campaign influenced the number of households building and using a latrine.

FINDINGS:

Latrine ownership did not increase in control villages, but in treatment villages it rose from 6% to 32% in the overall sample, from 5% to 36% in households below the poverty line (eligible for a government subsidy) and from 7% to 26% in households above the poverty line (not eligible for a government subsidy).

CONCLUSION:

Subsidies can overcome serious budget constraints but are not necessary to spur action, for shaming can be very effective by harnessing the power of social pressure and peer monitoring. Through a combination of shaming and subsidies, social marketing can improve sanitation worldwide.

PMID:
19705007
[PubMed - indexed for MEDLINE]
PMCID:
PMC2733281
Free PMC Article
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