The challenge
Many households in the Lao People's Democratic Republic (PDR) struggle to afford a toilet. Having access to sanitary toilet facilities is important for good health outcomes. However, getting households and communities to invest in sanitation is difficult. Community-led total sanitation (CLTS) is an approach that has been widely-used around the developing world. It seeks to harness community support for building sanitation through leveraging the emotional reaction of disgust towards poor sanitary conditions. A key challenge is that in its standard form, CLTS does not provide any financial support for the construction of these facilities.
The research
In this project, we evaluated the impact of different types of financial incentives on the construction of toilets in Lao PDR, including:
- The provision of subsidies for poorer households
- Community rewards
- Household subsidies with community rewards
The impact
Household incentives were successful at increasing sanitation take-up by poorer households, whereas community rewards increased take-up among the non-poor. These findings are important for future evidence-based policy-making and have the potential to contribute to the United Nations Sustainable Development Goal 3 - ensuring healthy lives and promoting well-being for all at all ages.
This project found that improved sanitation in the communities led to significant decreases in childhood stunting (increases in child height). Stunting is an indicator of nutritional deficiencies and is associated with decreased cognitive ability.
In a companion paper we show that improved sanitation in a village frees up women and girls’ time that would otherwise have been spent boiling water for drinking. This decrease in the boiling of water is a rational response to a cleaner environment. Girls can now spend this time on educational opportunities.
Our researchers
Lisa Cameron - Melbourne Institute
An Huang and Paulo Santos - Monash University
Milan Thomas - Asian Development Bank
Jeff Albert - USAID
Publications
- Sanitation, financial incentives and health spillovers: cluster randomised trial
- Behavioral Adaptation to Improved Environmental Quality: Evidence from a Sanitation Intervention