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Studying the impact of a behaviour change communication intervention on faecal sludge management in urban India

While faecal sludge management is considered to be an infrastructure issue, our study highlights the demand side concerns that need to be included in the larger discussion to address urban sanitation challenges.

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Rishika Das Roy

While India has made huge leaps forward in tackling sanitation since 2014, only a third of urban Indian homes are connected to sewer systems and almost 38% rely on on-site sanitation structures such as septic tanks. There is an urgent need to start tackling the safe containment, disposal and treatment of faecal waste which constitute the Faecal Sludge Management (FSM) value chain.  The maintenance of on-site sanitation systems such as pits and septic tanks is critical and so is ending indiscriminate dumping of untreated faecal sludge in empty plots, water bodies and drains.

Navrangi Re! (Nine to a Shade), a 26-episode television drama series was created to take the discussion on FSM to mainstream audiences, beyond the domain of infrastructure and technology. It was the result of a unique partnership between a commercial media network (Viacom18), a donor (the Bill & Melinda Gates Foundation), a Research and Evaluation partner (Oxford Policy Management), and a global media brand with proven social and behaviour change communication expertise (BBC Media Action).

The challenge

FSM has traditionally been seen as an infrastructure issue with its demand-side concerns unexplored. Inadequate FSM disproportionately impacts low income, high density urban settlements in India but has received relatively little policy focus.

Educational entertainment TV shows are challenging to evaluate as everyone with a TV set can watch them. A rigorous evaluation requires a baseline of treatment and control groups to enable difference-in-differences estimation, but baseline surveys have to be undertaken before it is known who will actually watch the show. This creates practical challenges and risks (whilst also introducing the risk of self-selection bias).

Our approach

Our evaluation determined impact on intent creation towards:

a) building/maintaining septic tanks;
b) regular desludging; and
c) safe disposal of faecal sludge.

A mixed method, panel study, that included a quantitative quasi-experimental approach, using difference-in-difference and production function specifications was employed to compare outcomes between those exposed and unexposed. A large listing exercise of 75,790 households was undertaken to find households who were likely to be exposed to the show or form a comparable control group. 2,959 individuals meeting the study criteria (watched the channel in question, had a septic tank/insanitary toilet, five years of education, aged 25-40 years) were recruited from nine cities in India.

Behavioural intent was significantly impacted with high exposure to the programme, with intent to hold neighbours to account, ask desludgers about disposal and willingness to pay for desludging. Interpersonal communications were most positively affected, with conversations about construction, collection and transportation rising among family, friends and neighbours. Awareness about having a septic tank, beliefs about desludging frequency and the risks associated with untreated sludge also moved positively. However, sticky attitudes such as the preference for building the biggest septic tank was not significantly reduced which can be targeted in future seasons of the programme.

Outcomes

This project aimed to influence FSM behaviours through changing knowledge, attitudes, increasing risk perception, stimulating conversations, building collective-efficacy, and creating social disapproval against poor faecal sludge management practices. The quasi-experimental evaluation compares changes in outcomes of those exposed to the TV show with the unexposed and confirms that an edutainment intervention can be a successful social and behavioural change communication strategy for FSM.

While FSM is considered to be an infrastructure issue, this study highlights the demand side concerns that need to become a part of the discourse. Overall, the show was effective in shifting select knowledge, attitudes and intent indicators amongst those exposed.

Evaluation results have been published in a peer-reviewed journal: 
http://jdc.journals.unisel.edu.my/ojs/index.php/jdc/article/view/208

This shows that such an edutainment intervention can be successful in bringing about social and behavioural change on an invisible and a hard-to-address topic like FSM. These insights also highlight the important role other actors such as media, research partners and content creators and SBC actors can play in Faecal Sludge Management. BBC Media Action is now developing Season 2 of the Navrangi series as a web-drama Life Navrangi! to be disseminated through YouTube. The web series and the planned randomised control trial will breathe a new life into these results to understand how far the needle has shifted on mainstreaming conversations on sanitation behaviours.

We would like to thank Tom-Newton Lewis, Ishleen Sethi, Rituparna Sanyal, and Udit Ranjan for their efforts on this project.