Strengthening behaviour change communication in western Nepal: how can we do better?
The Government of Nepal aims to achieve full water and sanitation coverage by 2017. The bilateral Rural Water Supply and Sanitation Project in Western Nepal (RWSSP-WN) works with local governments in 14 districts, aiming to declare them open defecation free. This behaviour change communications evaluation explored how to improve RWSSP-WN’s present practices to reach the diverse target population in the Terai districts, where more than 1 million people still defecate in the open. The study reviewed RWSSP-WN’s present behaviour change triggering tools and related communications strategies. Our findings suggest that availability of subsidies seems to change how people think about sanitation and tends to eliminate willingness to pay for a latrine. We recommended strong advocacy for a no-subsidy policy, and more attention paid to alternative financing options with targeted support to the poorest of the poor. The present behaviour change triggering tools do work as intended, but there is a need to develop pre-triggering and post-triggering strategies to increase the overall impact. The pre-triggering strategy would ensure that potential barriers to change are identified and addressed before the actual triggering event, and that the key stakeholders are prepared for the actual triggering event. The post-triggering strategy is needed to continue motivating households to change via messages that tap into the drivers of change, addressing also the barriers which may keep each household from changing behaviour. This paper provides a number of recommendations applicable for those working with local governments and communities to increase the scope and scale of behaviour change triggering.Adhikari, K. (2015) Sanitation in Nepal: Past, Present and Future, 2nd edn, Kathmandu, Nepal: Kunti Bhoomi Memorial Trust.
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Devine, J. (2009) Introducing SaniFOAM: A Framework to Analyze Sanitation Behaviours to Design Effective Sanitation Programs [pdf], Global Scaling Up Sanitation Project, Washington, DC: Water and Sanitation Program <www.wsp.org/sites/wsp.org/files/publications/GSP_sanifoam.pdf> [accessed 30 August 2015].
Frost, M.D., Puri, M. and Hinde, P.R.A. (2013) ‘Falling sex ratios and emerging evidence of sex-selective abortion in Nepal: evidence from nationally representative survey data’, BMJ Open 2013 3(e002612) <http://dx.doi.org/10.1136/bmjopen-2013-002612>.
Gerwel-Jensen, L. and Poudel, B. (2014) Strengthening Behaviour Change Communication in RWSSP-WN Phase II – Assessment and Recommendations [online], Pokhara, Nepal: Rural Water Supply and Sanitation Project in Western Nepal Phase II <www.rwsspwn.org.np/#!studies/cu2o> [accessed 26 July 2015].
Government of Nepal (2011) Sanitation and Hygiene Master Plan [pdf], Kathmandu: Steering Committee for National Sanitation Action <www.washinschoolsmapping.com/projects/pdf/Nepal%20Government%20Sanitation%20and%20Hygiene%20Master%20Plan.pdf> [accessed 25 August 2015].
Guitaras, R., Levinsohn, J. and Mobarak, A.M. (2015) ‘Sanitation subsidies. Encouraging sanitation investment in the developing world: a cluster-randomized trial’, Science 348(6237): 903–6 <http://dx.doi.org/10.1126/science.aaa0491>.
Jenkins, M.W. and Scott, B. (2007) ‘Behavioral indicators of household decision-making and demand for sanitation and potential gains from social marketing in Ghana’, Social Science & Medicine 64(12): 2427–42 <http://dx.doi.org/10.1016/j.socscimed.2007.03.010>.
Shakya, H.B., Cristakis, N.A. and Fowler, J.H. (2015) ‘Social network predictors of latrine ownership’, Social Science & Medicine 125: 129–38 <http://dx.doi.org/10.1016/j.socscimed.2014.03.009>.
Stopnitzky, Y. (2012a) The Bargaining Power of Missing Women: Evidence from a Sanitation Campaign in India [online], Munich Personal RePEc Archive <https://mpra.ub.uni-muenchen.de/37841> [accessed 30 August 2015].
Stopnitzky, Y. (2012b) Throwing Money Down the Toilet? India’s Toilet Subsidies and Household Sanitation Investment [pdf], presented at the Fifth World Congress of Environmental and Resource Economists, Istanbul, Turkey <www.webmeets.com/files/papers/wcere/2014/1763/stopnitzky-toilet-subsidies.pdf> [accessed 30 August 2015].
Tremolet, S., Kolsky, P. and Perez, E. (2010) Financing On-Site Sanitation for the Poor: A Six-Country Comparative Review and Analysis [pdf], Washington, DC: Water and Sanitation Program <www.wsp.org/sites/wsp.org/files/publications/financing_analysis.pdf> [accessed 30 August 2015].
Water and Sanitation Program (2012) Introductory Guide to Sanitation Marketing [pdf], Washington, DC: Water and Sanitation Program <www.wsp.org/sites/wsp.org/files/publications/WSP-Introductory-Guide-Sanitation-Marketing.pdf> [accessed 30 August 2015].
Waterkeyn, J. and Cairncross, S. (2005) ‘Creating demand for sanitation and hygiene through Community Health Clubs: a cost effective intervention in two districts of Zimbabwe’, Social Science & Medicine 61: 1958–70 <http://dx.doi.org/10.1016/j.socscimed.2005.04.012>.
Whaley, L. and Webster, J. (2011) ‘The effectiveness and sustainability of two demand driven sanitation and hygiene approaches in Zimbabwe’, Journal of Water, Sanitation, and Hygiene for Development 1(1): 20–36 <http://dx.doi.org/10.2166/washdev.2011.015>.
Rural Water Supply and Sanitation Project in Western Nepal (RWSS-WN) Phase II, Nepal-Finland Cooperation <www.rwsspwn.org.np> [accessed 30 August 2015].
Adhikari, K. (2015) Sanitation in Nepal: Past, Present and Future, 2nd edn, Kathmandu, Nepal: Kunti Bhoomi Memorial Trust.
Central Bureau of Statistics (2012) National Population and Housing Census 2011 (National Report) [pdf], November, 2012. Volume 02, NPHC 2011, Kathmandu: National Planning Commission Secretariat, Government of Nepal <http://countryoffice.unfpa.org/nepal/drive/Nepal-Census-2011-Vol1.pdf> [accessed 30 August 2015].
Devine, J. (2009) Introducing SaniFOAM: A Framework to Analyze Sanitation Behaviours to Design Effective Sanitation Programs [pdf], Global Scaling Up Sanitation Project, Washington, DC: Water and Sanitation Program <www.wsp.org/sites/wsp.org/files/publications/GSP_sanifoam.pdf> [accessed 30 August 2015].
Frost, M.D., Puri, M. and Hinde, P.R.A. (2013) ‘Falling sex ratios and emerging evidence of sex-selective abortion in Nepal: evidence from nationally representative survey data’, BMJ Open 2013 3(e002612) <http://dx.doi.org/10.1136/bmjopen-2013-002612>.
Gerwel-Jensen, L. and Poudel, B. (2014) Strengthening Behaviour Change Communication in RWSSP-WN Phase II – Assessment and Recommendations [online], Pokhara, Nepal: Rural Water Supply and Sanitation Project in Western Nepal Phase II <www.rwsspwn.org.np/#!studies/cu2o> [accessed 26 July 2015].
Government of Nepal (2011) Sanitation and Hygiene Master Plan [pdf], Kathmandu: Steering Committee for National Sanitation Action <www.washinschoolsmapping.com/projects/pdf/Nepal%20Government%20Sanitation%20and%20Hygiene%20Master%20Plan.pdf> [accessed 25 August 2015].
Guitaras, R., Levinsohn, J. and Mobarak, A.M. (2015) ‘Sanitation subsidies. Encouraging sanitation investment in the developing world: a cluster-randomized trial’, Science 348(6237): 903–6 <http://dx.doi.org/10.1126/science.aaa0491>.
Jenkins, M.W. and Scott, B. (2007) ‘Behavioral indicators of household decision-making and demand for sanitation and potential gains from social marketing in Ghana’, Social Science & Medicine 64(12): 2427–42 <http://dx.doi.org/10.1016/j.socscimed.2007.03.010>.
Shakya, H.B., Cristakis, N.A. and Fowler, J.H. (2015) ‘Social network predictors of latrine ownership’, Social Science & Medicine 125: 129–38 <http://dx.doi.org/10.1016/j.socscimed.2014.03.009>.
Stopnitzky, Y. (2012a) The Bargaining Power of Missing Women: Evidence from a Sanitation Campaign in India [online], Munich Personal RePEc Archive <https://mpra.ub.uni-muenchen.de/37841> [accessed 30 August 2015].
Stopnitzky, Y. (2012b) Throwing Money Down the Toilet? India’s Toilet Subsidies and Household Sanitation Investment [pdf], presented at the Fifth World Congress of Environmental and Resource Economists, Istanbul, Turkey <www.webmeets.com/files/papers/wcere/2014/1763/stopnitzky-toilet-subsidies.pdf> [accessed 30 August 2015].
Tremolet, S., Kolsky, P. and Perez, E. (2010) Financing On-Site Sanitation for the Poor: A Six-Country Comparative Review and Analysis [pdf], Washington, DC: Water and Sanitation Program <www.wsp.org/sites/wsp.org/files/publications/financing_analysis.pdf> [accessed 30 August 2015].
Water and Sanitation Program (2012) Introductory Guide to Sanitation Marketing [pdf], Washington, DC: Water and Sanitation Program <www.wsp.org/sites/wsp.org/files/publications/WSP-Introductory-Guide-Sanitation-Marketing.pdf> [accessed 30 August 2015].
Waterkeyn, J. and Cairncross, S. (2005) ‘Creating demand for sanitation and hygiene through Community Health Clubs: a cost effective intervention in two districts of Zimbabwe’, Social Science & Medicine 61: 1958–70 <http://dx.doi.org/10.1016/j.socscimed.2005.04.012>.
Whaley, L. and Webster, J. (2011) ‘The effectiveness and sustainability of two demand driven sanitation and hygiene approaches in Zimbabwe’, Journal of Water, Sanitation, and Hygiene for Development 1(1): 20–36 <http://dx.doi.org/10.2166/washdev.2011.015>.
Rural Water Supply and Sanitation Project in Western Nepal (RWSS-WN) Phase II, Nepal-Finland Cooperation <www.rwsspwn.org.np> [accessed 30 August 2015].
Adhikari, K. (2015) Sanitation in Nepal: Past, Present and Future, 2nd edn, Kathmandu, Nepal: Kunti Bhoomi Memorial Trust.
Central Bureau of Statistics (2012) National Population and Housing Census 2011 (National Report) [pdf], November, 2012. Volume 02, NPHC 2011, Kathmandu: National Planning Commission Secretariat, Government of Nepal <http://countryoffice.unfpa.org/nepal/drive/Nepal-Census-2011-Vol1.pdf> [accessed 30 August 2015].
Devine, J. (2009) Introducing SaniFOAM: A Framework to Analyze Sanitation Behaviours to Design Effective Sanitation Programs [pdf], Global Scaling Up Sanitation Project, Washington, DC: Water and Sanitation Program <www.wsp.org/sites/wsp.org/files/publications/GSP_sanifoam.pdf> [accessed 30 August 2015].
Frost, M.D., Puri, M. and Hinde, P.R.A. (2013) ‘Falling sex ratios and emerging evidence of sex-selective abortion in Nepal: evidence from nationally representative survey data’, BMJ Open 2013 3(e002612) <http://dx.doi.org/10.1136/bmjopen-2013-002612>.
Gerwel-Jensen, L. and Poudel, B. (2014) Strengthening Behaviour Change Communication in RWSSP-WN Phase II – Assessment and Recommendations [online], Pokhara, Nepal: Rural Water Supply and Sanitation Project in Western Nepal Phase II <www.rwsspwn.org.np/#!studies/cu2o> [accessed 26 July 2015].
Government of Nepal (2011) Sanitation and Hygiene Master Plan [pdf], Kathmandu: Steering Committee for National Sanitation Action <www.washinschoolsmapping.com/projects/pdf/Nepal%20Government%20Sanitation%20and%20Hygiene%20Master%20Plan.pdf> [accessed 25 August 2015].
Guitaras, R., Levinsohn, J. and Mobarak, A.M. (2015) ‘Sanitation subsidies. Encouraging sanitation investment in the developing world: a cluster-randomized trial’, Science 348(6237): 903–6 <http://dx.doi.org/10.1126/science.aaa0491>.
Jenkins, M.W. and Scott, B. (2007) ‘Behavioral indicators of household decision-making and demand for sanitation and potential gains from social marketing in Ghana’, Social Science & Medicine 64(12): 2427–42 <http://dx.doi.org/10.1016/j.socscimed.2007.03.010>.
Shakya, H.B., Cristakis, N.A. and Fowler, J.H. (2015) ‘Social network predictors of latrine ownership’, Social Science & Medicine 125: 129–38 <http://dx.doi.org/10.1016/j.socscimed.2014.03.009>.
Stopnitzky, Y. (2012a) The Bargaining Power of Missing Women: Evidence from a Sanitation Campaign in India [online], Munich Personal RePEc Archive <https://mpra.ub.uni-muenchen.de/37841> [accessed 30 August 2015].
Stopnitzky, Y. (2012b) Throwing Money Down the Toilet? India’s Toilet Subsidies and Household Sanitation Investment [pdf], presented at the Fifth World Congress of Environmental and Resource Economists, Istanbul, Turkey <www.webmeets.com/files/papers/wcere/2014/1763/stopnitzky-toilet-subsidies.pdf> [accessed 30 August 2015].
Tremolet, S., Kolsky, P. and Perez, E. (2010) Financing On-Site Sanitation for the Poor: A Six-Country Comparative Review and Analysis [pdf], Washington, DC: Water and Sanitation Program <www.wsp.org/sites/wsp.org/files/publications/financing_analysis.pdf> [accessed 30 August 2015].
Water and Sanitation Program (2012) Introductory Guide to Sanitation Marketing [pdf], Washington, DC: Water and Sanitation Program <www.wsp.org/sites/wsp.org/files/publications/WSP-Introductory-Guide-Sanitation-Marketing.pdf> [accessed 30 August 2015].
Waterkeyn, J. and Cairncross, S. (2005) ‘Creating demand for sanitation and hygiene through Community Health Clubs: a cost effective intervention in two districts of Zimbabwe’, Social Science & Medicine 61: 1958–70 <http://dx.doi.org/10.1016/j.socscimed.2005.04.012>.
Whaley, L. and Webster, J. (2011) ‘The effectiveness and sustainability of two demand driven sanitation and hygiene approaches in Zimbabwe’, Journal of Water, Sanitation, and Hygiene for Development 1(1): 20–36 <http://dx.doi.org/10.2166/washdev.2011.015>.
Rural Water Supply and Sanitation Project in Western Nepal (RWSS-WN) Phase II, Nepal-Finland Cooperation <www.rwsspwn.org.np> [accessed 30 August 2015].
Adhikari, K. (2015) Sanitation in Nepal: Past, Present and Future, 2nd edn, Kathmandu, Nepal: Kunti Bhoomi Memorial Trust.
Central Bureau of Statistics (2012) National Population and Housing Census 2011 (National Report) [pdf], November, 2012. Volume 02, NPHC 2011, Kathmandu: National Planning Commission Secretariat, Government of Nepal <http://countryoffice.unfpa.org/nepal/drive/Nepal-Census-2011-Vol1.pdf> [accessed 30 August 2015].
Devine, J. (2009) Introducing SaniFOAM: A Framework to Analyze Sanitation Behaviours to Design Effective Sanitation Programs [pdf], Global Scaling Up Sanitation Project, Washington, DC: Water and Sanitation Program <www.wsp.org/sites/wsp.org/files/publications/GSP_sanifoam.pdf> [accessed 30 August 2015].
Frost, M.D., Puri, M. and Hinde, P.R.A. (2013) ‘Falling sex ratios and emerging evidence of sex-selective abortion in Nepal: evidence from nationally representative survey data’, BMJ Open 2013 3(e002612) <http://dx.doi.org/10.1136/bmjopen-2013-002612>.
Gerwel-Jensen, L. and Poudel, B. (2014) Strengthening Behaviour Change Communication in RWSSP-WN Phase II – Assessment and Recommendations [online], Pokhara, Nepal: Rural Water Supply and Sanitation Project in Western Nepal Phase II <www.rwsspwn.org.np/#!studies/cu2o> [accessed 26 July 2015].
Government of Nepal (2011) Sanitation and Hygiene Master Plan [pdf], Kathmandu: Steering Committee for National Sanitation Action <www.washinschoolsmapping.com/projects/pdf/Nepal%20Government%20Sanitation%20and%20Hygiene%20Master%20Plan.pdf> [accessed 25 August 2015].
Guitaras, R., Levinsohn, J. and Mobarak, A.M. (2015) ‘Sanitation subsidies. Encouraging sanitation investment in the developing world: a cluster-randomized trial’, Science 348(6237): 903–6 <http://dx.doi.org/10.1126/science.aaa0491>.
Jenkins, M.W. and Scott, B. (2007) ‘Behavioral indicators of household decision-making and demand for sanitation and potential gains from social marketing in Ghana’, Social Science & Medicine 64(12): 2427–42 <http://dx.doi.org/10.1016/j.socscimed.2007.03.010>.
Shakya, H.B., Cristakis, N.A. and Fowler, J.H. (2015) ‘Social network predictors of latrine ownership’, Social Science & Medicine 125: 129–38 <http://dx.doi.org/10.1016/j.socscimed.2014.03.009>.
Stopnitzky, Y. (2012a) The Bargaining Power of Missing Women: Evidence from a Sanitation Campaign in India [online], Munich Personal RePEc Archive <https://mpra.ub.uni-muenchen.de/37841> [accessed 30 August 2015].
Stopnitzky, Y. (2012b) Throwing Money Down the Toilet? India’s Toilet Subsidies and Household Sanitation Investment [pdf], presented at the Fifth World Congress of Environmental and Resource Economists, Istanbul, Turkey <www.webmeets.com/files/papers/wcere/2014/1763/stopnitzky-toilet-subsidies.pdf> [accessed 30 August 2015].
Tremolet, S., Kolsky, P. and Perez, E. (2010) Financing On-Site Sanitation for the Poor: A Six-Country Comparative Review and Analysis [pdf], Washington, DC: Water and Sanitation Program <www.wsp.org/sites/wsp.org/files/publications/financing_analysis.pdf> [accessed 30 August 2015].
Water and Sanitation Program (2012) Introductory Guide to Sanitation Marketing [pdf], Washington, DC: Water and Sanitation Program <www.wsp.org/sites/wsp.org/files/publications/WSP-Introductory-Guide-Sanitation-Marketing.pdf> [accessed 30 August 2015].
Waterkeyn, J. and Cairncross, S. (2005) ‘Creating demand for sanitation and hygiene through Community Health Clubs: a cost effective intervention in two districts of Zimbabwe’, Social Science & Medicine 61: 1958–70 <http://dx.doi.org/10.1016/j.socscimed.2005.04.012>.
Whaley, L. and Webster, J. (2011) ‘The effectiveness and sustainability of two demand driven sanitation and hygiene approaches in Zimbabwe’, Journal of Water, Sanitation, and Hygiene for Development 1(1): 20–36 <http://dx.doi.org/10.2166/washdev.2011.015>.
Rural Water Supply and Sanitation Project in Western Nepal (RWSS-WN) Phase II, Nepal-Finland Cooperation <www.rwsspwn.org.np> [accessed 30 August 2015].
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