Using Behaviour Change Messaging to Improve Communal Toilets in Dhaka, Bangladesh

Hypothesis to be tested: A behavior change communication intervention can improve the quality and cleanliness of sanitation services available to low-income residents of Dhaka.

Specific Objectives:

1. To deliver communication messages (selected as the most promising for changing target behaviors influencing the quality and cleanliness of shared sanitation facilities) to randomly selected low-income communities in Dhaka.
2. To evaluate the effectiveness of a behavior change communication intervention designed to change targeted behaviors related to the quality and cleanliness of shared sanitation facilities.

Background The investigators contend that important barriers to improved sanitation in low-income communities in Dhaka include: 1) Low-income community residents lack the financial resources to purchase a better option. 2) The cost of land in Dhaka, which has increased 600 fold since the 1970s (Hossain, 2011), makes space for toilets expensive 3) A public sector characterized by weak institutions that lack funding and management capacity to implement and maintain effective sanitary infrastructure (Hossain, 2011) and 4) a pervasive informal local political system that maximizes the financial interests of politically connected elites over the communal interests of low-income community residents (Hackenbroch and Hossain, 2012, Hossain, 2011). More than one third of Dhaka residents live in informal settlements where government authorities do not accept responsibility for providing urban utilities including water and sanitation services (World Bank, 2007). A central motivation for politicians to avoid formalizing settlements is that informality keeps residents in a constant state of dependency on local party associates, a state which these local elites can use to extract a continuous stream of resources (Anjaria, 2006, Hossain, 2011).

Behavior change communication messages cannot directly resolve these major barriers to improving community sanitation in low-income communities in Dhaka. Simple general messages, such as encouraging people to clean keep their sanitary facility clean to reduce the risk of disease transmission, are unlikely to be effective because they do not address the determinants of the poor availability, cleanliness and maintenance of shared sanitary facilities. By contrast, by developing behavior change messages that are informed by the experience and perspective of the target population this study can identify some opportunities where new information or a new social norm could alter some key behaviors.