In mid-May, Thrive Networks, known as East Meets West Foundation in Asia, sent one of the largest NGO delegations to the WASH Futures Conference 2016, a research and practitioner event hosted by the International Water Centre (IWC) and sponsored by the Australia Department of Foreign Affairs and Trade (DFAT). IWC is an institute founded by four Australian universities (University of Queensland, Monash University, Griffith University, and the University of Western Australia) dedicated to applied research in water resources and water, sanitation and hygiene (WASH).
This meeting, which is convened roughly every 18 months, represents a big effort by DFAT’s Civil Society (CS) WASH Fund. The CS WASH Fund (“the Fund”) is a grant instrument that supports Thrive Water’s AUD$10M WASHOBA program, dedicated to applying output-based aid (OBA) measures to the expansion of water supply and sanitation coverage in Vietnam, Cambodia, and Laos. Other civil society organizations supported by the Fund include such important international development players as Plan International, World Vision, Save the Children, WaterAid, and iDE.
In addition to meeting with the Fund staff and our fellow grantees, this event was an opportunity to present our applied research and to learn of other best practices in the sector. Our own contribution was a research presentation on the interactions between OBA and the sanitation marketing (SanMark) approach for delivering latrines to the poor. The goal of this research was to generate evidence that would inform the question of whether targeted pro-poor subsidies tend to dampen demand for latrines at current market prices among the non-poor (who are not eligible for subsidy). Specifically, the concern has been that that higher-income customer segments are likely to delay purchase of latrines from existing suppliers out of the expectation that they too could qualify for subsidies in the future.
Our research was conducted in collaboration with the World Bank’s Water & Sanitation Program to generate evidence in support of (or in opposition to) the hypothesis of demand dampening, also known as “negative spillover.” The results of the research were overwhelmingly inconsistent with the negative spillover hypothesis, pointing instead to “positive spillover,” in which pro-poor subsidies actually increase demand for latrines among those households ineligible for subsidy. Our findings reinforce evidence published last year in the journal Science that observed such positive spillover in a randomized experiment in Bangladesh.
The session included a rich discussion as well as a series of social media posts from influential organizations in attendance:
At any given point during the two days of the conference and three succeeding days of training events, there were six thematic sessions being convened simultaneously. These sessions included an array of topic areas, including (among others):
- innovative financing
- sustainable/professional system management
- WASH in schools
- fecal sludge management and the sanitation value chain
- private sector engagement
- hygiene interventions and behavior change
- the WASH/nutrition nexus
- WASH in health care facilities.
Hygiene behavior change without behavior change communication. A new innovation prize sponsored by DFAT was announced at the WASH2016 award dinner, with a very public and enthusiastic affirmation of a new approach to increasing handwashing behaviors among children.
The novel intervention, known colloquially as “nudge”, is a form of habituation intended to circumvent the knowledge-based behavior change communication that has long dominated hygiene improvement efforts (and that has also been largely discredited as a means of increasing handwashing). The winning approach was recently tested by researchers and a team from Save the Children in Bangladesh and was shown to be an effective and extremely low-cost way to increase handwashing in schools. Here is a photo of the intervention.
The beauty of this approach is that it relies on visual cues and requires none of the traditional, expensive, and often ineffective efforts intended to make children aware of the linkages between dirty hands and disease. This research is based on the idea that rather than seeking to increase knowledge and impart values via changing “thinking” in the brain’s neocortex, we ought to be focusing on the basal ganglia and the intuitive, automatic behavior that we do without thinking.
The results of the Bangladesh research are indeed impressive:
(CREDITS FOR THESE TWO FIGURES: Dreibelbis, Robert, Anne Kroeger, Kamal Hossain, Mohini Venkatesh and Pavani K. Ram. 2016. Behavior Change without Behavior Change Communication: Nudging Handwashing among Primary School Students in Bangladesh. Int. J. Environ. Res. Public Health 13, 129.)
We plan to replicate this experiment in Vietnam with funding from DFAT, and if we see similarly encouraging results we will be advising the Vietnamese government to adopt the nudge approach in schools throughout the country as part of our integrating hygiene and deworming program.
WASH2016 was a fantastic gathering, with high quality research and practice presentations as well as the opportunity to spend five days with an array of implementers, academics, and government officials. We were honored to participate.