Tackling India’s open defecation problem

Truly making India open defecation free requires a sustainable change in societal mindset and behaviour

While the ambition behind and success to date of the Swachh Bharat mission are laudable, it is at risk of unravelling unless it can ensure that India remains permanently open defecation free. To do so, the mission must bring about sustainable behavioural change through ‘System 2’ and ‘System 1’ drivers.

Much has been written about Swachh Bharat since its launch in 2014. Advocates of the scheme rightly point to the number of toilets constructed and the number of villages that are declared open defecation free— over 8 crore toilets and 5 lakh villages respectively—whereas critics point to the low usage of the toilets constructed and question the truth behind open defecation free claims.

The 2017 Swachh Survekshan survey conducted by the Quality Council of India reports that 62% of rural households now have a toilet. This is an increase of over 20 percentage points since 2014. More significantly, the survey concludes that more than 90% of the individuals who had access to toilets were using them. Yet, stories continue to pour in, suggesting that the ground reality isn’t so rosy. The lengthy queues, lack of water supply and the poor communication in remote and tribal populations have all resulted in low uptake in areas where it is needed the most. Reports suggesting that the Jaipur Municipal Corporation hired an event management company to ‘persuade’ citizens to give feedback that would make the programme seem a success, raise further questions of the mission’s reliability. Similar findings have also been reported in Maharashtra and Gujarat, both declared as open defecation free states.

As with most things, the true scale of Swachh Bharat’s success lies somewhere in the middle. Irrespective of the narrative weaved and the actual success achieved by the mission before its conclusion, a pertinent question still remains. What happens after it ends?
Until recently, the underlying philosophy of Swachh Bharat could be aptly described by quoting the Kevin Costner movie, Field of Dreams: “If you build it, he will come.” Policymakers hoped that once enough toilets were built to declare India open defecation free, it would continue to remain so. This failed to take into account that, unlike eradicating smallpox or polio, eliminating open defecation isn’t a one-off. To truly make India open defecation free requires a sustainable change in societal mindset and behaviour.
One way to bring about behavioural change is to adopt, what psychologists refer to as System 2 drivers of change. These focus on spreading rational knowledge (germ theory), having explicit action plans (such as personal and political commitments to change) and using human emotions of pride and shame to change behaviour. Community led Total Sanitation (CLTS) programmes is one such approach. It promotes the mobilisation of local communities to talk openly about, appraise and analyse their defecation practices. Triggers, both psychological and visual, are used to shock and disgust people in an effort to move away from such practices.
Maharashtra with its adoption of the ‘Good Morning Squads’, Indore with its ‘dibba gang’ and Delhi with its Gabbar posters, are all using System 2 drivers to trigger behavioural change. If policymakers believe that such methods can be effective, and evidence of CLTS programmes from Bangladesh and Malawi seems to suggest so, emphasis must be put on ensuring proper training, to prevent facilitators from using tactics of public shaming and coercion. Behavioural change must also be understood more widely to include System 1 drivers.
Poorly understood and inadequately adopted by policymakers, System 1 drivers play a critical role in facilitating desired behaviour. Research suggests that people tend to stick to their existing habits for tasks performed frequently and so, System 1 drivers, rather than focusing on changing habits, look to cultivate existing ones into a more positive outcome. They tap into the unconscious, cue-driven behaviours that all humans have.
To mitigate open defecation, a simple but ingenious System 1 driver would be the building of public toilets in fields which people already use to defecate openly. Leveraging India’s recent growth in mobile connectivity and growth in constructed household toilets, incentive programs for increased latrine use can also issue text message reminders, scheduled and framed to promote latrine usage at the same time and place each day.
Strategic timing of key interventions can also go a long way in disrupting behaviour. For example, promoting the use of toilets during the monsoon, when people find it difficult to defecate openly, or launching new interventions during the outbreak of a disease, when people are actively thinking about hygiene, are ways to ensure a new behaviour is developed. Lastly, initiatives creating an annual ritual, aligned with prevalent religious beliefs, when a village is declared open defecation free can ensure change is celebrated and thus, sustained in the long run.

For India to permanently eradicate open defecation, the Swachh Bharat Mission must adopt three pillars of support. The first must provide and maintain the infrastructure needed to aid toilet use. The second must motivate people to change behaviour towards toilet use and the third must harness cues and automatic habits to drive positive behaviour. It’s time policymakers start focusing on the third pillar, before the facade wobbles