PONKRUM, Ghana — The one public bathroom in Ponkrum collapsed a few years ago. An effort to build a new one yielded a large pit that is used for trash, not defecation. For the people living in the small village near the Ghanian coast, there is no other option than going out in the open.
They are a part of the 15 percent of people globally, a total of nearly 1 billion, who still defecate in the open. The practice is responsible for nearly 280,000 deaths caused by diarrhea each year. Governments and NGOs have sought to end the practice through various campaigns. New evidence suggests that subsidies are key to success.
Research published in Science Magazine last week shows that providing subsidies for the construction of latrines in northwest Bangladesh was more effective than information and motivation programs. Putting the two together produced even better results.
Use of hygienic latrines increased by 22 percent among people who received both subsidies and motivation programs, found Raymond Guiteras of University of Maryland and James Levinsohn and Mushfiq Mobarak of Yale University. The findings address some concerns that providing subsidies for products can erode motivation to use them.
“While there is general agreement among development professionals and institutions about the importance of improving access to hygienic latrines, there is still vigorous debate about the most cost-effective ways to achieve this,” said Mobarak, in a news release.
The research provides guidance. Mobarak and his co-researchers worked with 18,254 households in Bangladesh for the study. People were divided into four groups:
- community motivation program
- subsidies (in the form of vouchers) and motivation program
- information and technical support
Subsidies covered 75 percent of the cost to construct a latrine, reducing the cost to between $5 and $12 per household. The community motivation program was modeled after the Community-Led Total Sanitation, an open-sourced program used in more than 50 countries, including Bangladesh. Community organizations and groups including World Vision, UNICEF, care and WaterAid, implement the program.
Compared to groups receiving no support or information, the community motivation tactic did not do much to increase the use of hygienic latrines nor reduce open defecation. The success of the subsidies are alone impressive, but the fact that neighbors take up of latrines grew by 8.5 percent shows that the benefits may extend beyond the people directly reached.
“The study also teaches us about how to conduct ‘smart subsidy’ policy, allocating subsidies in a way that maximizes the chances of behavioral changes among neighbors. Given how widespread the community motivation model is, the results of this study can help the sector allocate funds more efficiently,” said Annie Duflo, executive director of Innovations for Poverty Action, the research NGO that helped implement the study.
Bangladesh previously implemented a subsidy plan to local governments. But research in 2011 revealed it was ineffective because it was used improperly. Knowing what programs will help encourage building and using latrines would help change the practice of open defecation seen in places like Bangladesh and Ghana.
Tom Murphy reported from Ghana on a fellowship with the International Reporting Project (IRP).