Efforts to eradicate open defecation and unhygienic toilets in countries like India can succeed with a well-designed private-sector led approach, Scott Roy and W Roy Whitten argue
The statistics are staggering: roughly two million deaths occur annually from poor quality or non-existent sanitation, more than HIV, malaria, and tuberculosis deaths combined. According to UN statistics, in 2015, 4.9 billion people globally used an improved sanitation facility; 2.4 billion did not. Among those lacking adequate sanitation were 946 million people without any facilities at all, who continued to practise open defecation, exposing themselves and others to life-threatening pathogens. Open defecation and unhygienic toilets expose unsuspecting inhabitants to diseases that creep into their food and water supply.
Mass toilet giveaways and subsidies have resulted in the installation of toilets. But this comes with problems: giveaways and subsidies rarely engage people in the behaviour change that underpins permanent change. Subsidies often fail to reach their intended target audience and, above all, free toilets tend to be poorly constructed and unhygienic in design.
This was the case in India, where Narendra Modi's Swachh Bharat mission tried with no success to transform people’s behaviour by installing toilets. These were deserted by the population mainly for two reasons:
1. People weren’t enrolled in the projects because nobody helped them to see the problems linked to open defecation. Without a deep understanding of the problems there is no need for a permanent change.
2. The toilet’s design didn’t take into account the population’s need; rural people felt suffocated inside an enclosed toilet and preferred to stick to the habit of defecating in open field.
One method that shows great promise is sanitation marketing. The act of buying a latrine is a personal commitment to change. People only part with their hard-earned money when they truly need or want something. However, the product must be both desired and affordable.
Many organisations are working to deliver rural sanitation marketing. Some engage directly as players in the supply chain, whereas others are market facilitators, working with market actors to improve capability. Many are using human-centred design approaches to assure local appeal of their products, while some firms manufacture hygienic sanitation components, such as American Standard Brands’ SaTo Pan.
Intense focus is put on getting the supply chain right, but often these helping organisations are left stumped by lackluster sales. One major component of sanitation marketing that is misunderstood or missed entirely is customer engagement. To sell well, sanitation businesses must deliver an experience that makes hygienic sanitation appealing, so much so that people realise the need, want a solution and are willing to pay for it. There are some key considerations to plan for:
Employ a problem-led selling approach
Key to people realising the dangers of open defecation and unhygienic toilets is engaging them with the problem at a deeper experiential level. This approach awakens people to what they have been putting up with for a long time, indeed their lifetime. When people deeply understand the problem and its impact they become awakened and concerned.
Then, involve them in performing an explicit calculation of what it is costing them financially, both directly (eg doctor visits and medicines) and indirectly (eg loss of work and income), and they become dissatisfied and want change urgently.
This approach is contrasted with what we normally see - a product pitch that assumes people already understand the problem and its impact, which they don’t. People think that good selling is pitching and convincing people to buy. Instead, organisations need to train sellers to lead with the problem and engage people in dialogue about it rather than starting with a pitch.
Use 'below the line' marketing
Changing behaviour is most effective with personal engagement. Although traditional above the line methods (mass media) can be used to advertise and promote sanitation, it is best to use in conjunction with a direct, “boots on the ground” campaign. To change behaviour you must engage people at a personal level to deal with their fears, cultural norms, and deeply held beliefs. Therefore below the line approaches that create a direct connection with the target consumer are more effective.
Seek endorsement from local opinion leaders
Local leaders from governmental, non-governmental, religious, and other groups can influence target groups. Reach out to key opinion leaders and educate them in the same problem-led way – don’t assume they understand the depth of problems created by open defecation and unhygienic toilets.
Mix group events and door-to-door selling
Each method has pros and cons. Group sales events are a way to engage with a lot of people at once, creating mass interest and momentum. However, the engagement is generalised and often misses a personalised connection, therefore it tends to have a lower percentage of buyers.
Door-to-door is effective at reaching everyone in a target area and is the best opportunity to create unique customer experiences, thus achieving a higher penetration rate. On the downside, it is a tedious process, one that requires dedication because it takes planning, time, and effort to see everyone.
Work territory systematically, over smaller, focused footprints to benefit from word of mouth, referrals and community momentum. Applying both group and door-to-door methods in a complementary way will generate the greatest penetration and the highest number of adopters.
Reduce reliance on microfinance
Many organisations steer toward microfinance as a vehicle to pay for upgraded sanitation because of the $200-500 price tag when a shelter is included.
Instead, sell the solution in two parts, starting with the underground working components of the latrine, then save up to build a shelter made of permanent materials at a later point. In the meantime, families can afford to pay cash for lower priced items to set up a temporary shelter of local materials. This approach is pragmatic, speeds up the adoption process, and avoids some of the pitfalls of borrowing at high interest rates. It also brings the latrine into the range of affordability for lower income families.
Solving the sanitation situation for the ultra poor can still include a market approach, but should be addressed by targeted subsidies that are thoughtfully distributed so as not to undermine the market.
In 2015, 68% of the global population was using improved sanitation facilities compared to 59% in 2000. Steady improvement is being made, but unsafe management of faecal waste and wastewater continues to present a major risk to public health and the environment. Still, much will need to be done if open defecation is to be eliminated by 2030.
Private sector approach applied to other products
Sanitation is not the only sector to apply a market-based approach. In fact, the developing world is now filled with organisations that have designed thoughtful, innovative, and life-changing products. Solar lighting replaces dangerous kerosene lamps; high-reliability water filters remove pathogens from drinking water; clean burning cook stoves are saving forests and improving women and children’s health; bio-digesters are providing inexpensive and safe alternative fuel sources; drip irrigation is transforming farming and farm incomes.
A private sector approach is not the only solution, but it is a good one, because a decision to buy is a decision to change. It is one of the most effective ways for people to change and to take full responsibility for their family’s health and well-being.
Scott Roy and W Roy Whitten are co-founders of Whitten & Roy Partnership, (www.wrpartnership.com) a sales consultancy that has worked in over 20 developing countries, applying private-sector approaches to solving poverty issues
India sanitation hygeine