Shifting Beliefs Changing Behavior: Experimental Evidence on Sanitation from India

Abstract

Open defecation, which is linked to poor health outcomes and lower cognitive ability has been widespread in India. Improved sanitation practice generates local health externalities, which implies that the returns to private toilet usage depend on community wide compliance. Therefore, beliefs about others toilet usage behavior may influence both sanitation choices and the perceived value of residing in areas with lower prevalence of open defecation. This paper evaluates a randomized, intervention in peri-urban Tamil Nadu designed to shift social expectations regarding sanitation practice. The intervention combines descriptive norm messaging, community engagement, and information provision to increase perceived prevalence and approval of toilet usage. The findings indicate a significant increase in toilet access in the intervention areas by 8 percentage points and consistent toilet usage by 6 to 7 percentage points relative to control areas. The effects are robust to potential bias due to disruption due to local socio-political protest and the COVID 19 pandemic during the study period. We also find significant increase in empirical expectations (beliefs about the prevalence of toilet usage) and normative expectations (beliefs about its approval). Mediation analysis indicates that the improvement in toilet access and usage is substantially driven by changes in these social expectations. We further observe significant increase in the willingness to pay among respondents for residing in open defecation free surroundings, suggestive of an increased perceived valuation of cleaner sanitation environments because of the intervention. The findings underscore the need for norm-centric interventions to propel change in beliefs and achieve long-term and sustainable sanitation behavior.