Bathroom Habits Die Hard

A handful of popular authors in the new discipline of Behavioral Economics — Nudge by Thaler & Sunstein, Thinking Fast and Slow by Kahneman, and Predictably Irrational by Ariely — reveal important clues about how people make choices. In the moment of decision, we let our emotions rule the day. It’s only later that we justify our choices through the process of rationalization. In fact, in order to change a habit, the new science says
we must change our sense of identity. In other words, to be vegetarian,
we need to become “the kind of person who doesn’t eat meat.”

Maybe this isn’t earthshaking news, but what is surprising is that
we came to the same conclusions in our work selling toilets to
rural families in Cambodia.

iDE’s behavior change campaign relies on a number of striking visuals. This picture of flies and feces tells the story of disease transmission to a couple who are deciding whether or not to buy a toilet for their family.

Millions of people in the developing world don’t have a place to go to the bathroom. This massive public health crisis is hard to get people to pay attention to, and even harder to solve. iDE is dedicated to solving this problem, but not by giving toilets away. Instead, we fill a gap in the market with affordable, desirable toilets designed specifically for rural families at the base of the economic pyramid. With a thriving customer base, toilets are likely to be available for a long time, not just while charity dollars hold out.

Selling Behavior Change

As a market-based organization, we admire a good sales pitch. It’s counterintuitive in our society, however, to believe you can help people
by refining the art of the sales pitch. But try selling a toilet to someone who has open defecated their whole life and has big time demands with modest economic resources to meet them. Making a purchase decision with a delayed benefit requires some persuasion.

“It’s just a hole. Why do you need more?”
— An Unconvinced Husband

A good sales person knows why it’s easier to deal in a product like cell phones rather than toilets. Toilets, despite their ability to prevent disease and death, are not sexy, income generating, or representative of a flashy lifestyle. A “pull” product, like a cell phone, motorbike, or goat, for example, is easier to sell and requires less customer education. These products may be a symbol of status or generate income — they are purchases that are
often driven by desire, rather than rational need.

“Why invest in a toilet when I can invest in land or animals?”
— Rationalization at work.

Conversely, there are “push” products that people know they should buy, but don’t immediately desire, like a toilet. iDE’s Global WASH Initiative shines here. We have found that “push” products require a more sophisticated form of selling — one that involves selling to the problem,
not the product. Our sales agents are trained in this approach to sales by Whitten & Roy Partnership, a sales and management change consultancy that works extensively in the development world.

I used to walk, now I have a bike. Next, I want a motorcycle.
That’s what modern is. — Research Participant

During the research phase, which we call a Deep Dive, we discovered
the customer’s motivations to desiring a toilet. We collected insights
that helped our product designers keep the customer at the center of the solution. But a good product design is only the starting point. It won’t get into the customer’s hands unless we understand the behavior change required for long term adoption. Once we understand the messages that
will trigger behavior change, we must next design a method to deliver
them to people in the right way.

Can the Government Sell Toilets?

We felt there was an appropriate role for the government of Cambodia
to be the messenger of a “push” campaign. We wanted to explore how government employees could play an active role in behavior change by delivering (pushing) the message via in-village social marketing events.
To test this theory, we conducted a one-year pilot in partnership with
the Water and Sanitation Program of the World Bank, and 17 Triggers,
a Cambodian firm with expertise in social marketing.

QUESTION:
How do we get people to shift from open defecation, which requires no upfront investment, to investing their money in a latrine? And how do we break down this process of change so that government employees can deliver the message if training is provided?

ANSWER:
Design games to deliver trigger messages in a supportive, social environment.

One of the puzzle games we designed is depicted at right. The other games are described in detail in the download at the end of this post.

A few conclusions from our pilot

Perception of Money. We had to take on people’s perception of money itself. We designed a game that changed their perception of money, price, and what they believed they could afford. We knew there was room to influence how people prioritized purchases, we only had to introduce the right sales technique through a game that’s enjoyable to play.

Emotional Drivers. In many cultures, it’s not acceptable for women to be seen open defecating, so they often wait for nightfall. Once we got women talking candidly about the problems they encountered during their nightly ritual, feelings of shame and fear became strong drivers to action. We created puzzles that, once assembled, visually portrayed this emotional narrative and provided a spark for the much-needed conversation to
take place.

We used to eat less so that we did not have to go out in the day time.
Now we can have a full meal without worry. — Female Latrine Customer

Many rural people in developing countries have a strong desire to feel modern, so one of our puzzles revealed the shame that comes with asking visitors to use the bush.

We learned to avoid rational health messages until after the purchase. Just as Behavioral Economists have been reporting for years, practical arguments are weak motivators to purchase.

Make it Social. We hosted events in a social environment. The games
we developed were designed to use social interaction as a positive driver
of behavior change. Community influences play a large role in shaping individuals’ beliefs. We made the experience fun and interactive to
create an open and safe space where people could loosen up and
share their experiences.

Make it Actionable. Provide an easy way to act. A key part of leading people down the path to behavior change is to offer an actionable step in the right direction. We made it easy for people to place an order on a latrine immediately after the village meeting.

From Behavior Change to Impact

iDE’s sanitation marketing program in Cambodia is selling 6,000 toilets per month on average, an unprecedented achievement in WASH development globally. At this rate, we are on course to reach 100% coverage in our program areas by 2025.

We place a high value on monitoring toilet sales and the overall
business performance of the local entrepreneurs who manufacture them. Our local Monitoring & Evaluation staff collects business data every two weeks in the field, which is uploaded to our global team for analysis. This data is an essential input for management decisions. But — despite our
data-loving culture — it’s hard to deny that the most telling indication
of impact is best captured in an image.

Photos by David Graham

Download to learn more. “Putting the Puzzle Together: Grounding Behavior Change in User Insights.”

Learn more about how iDE’s Global WASH Initiative is outsmarting diarrheal disease on twitter: @ideorg.