In collaboration with the government of Karnataka, Arghyam is working on a behavior change communication (BCC) project around rural sanitation. The problem is that people don’t construct toilets or don’t use toilets if they have them. Our hypothesis is that a corporate-style communications approach will be effective in changing this situation, and we’re currently doing secondary research to determine if this hypothesis is supported by other people’s experiences.
Honestly, I’m a little out of my depth here, because while I’m good at research, I don’t have any experience with a corporate ad campaign, or really, a corporate approach to anything. I’ve worked in biomedical labs, and I’ve worked at non-profits. My work has always dealt with the concrete and the measurable. I’m starting to realize, though, that behavior change is fundamentally central to “making a difference” – that lofty goal to which we all aspire. It’s not enough to provide marginalized communities with empowering tools, just as it’s not enough to provide people with a gym, hoping they’ll use it. It’s true, some people are exceptionally motivated and will take advantage of the slightest opportunity to improve their lives, but they are just that – the exception. Most people need to be convinced. In economic terms, need doesn’t always lead to demand.
I know that BCC has a very specific meaning in the non-profit world, mostly having to do with inciting behaviors that are proven to enhance health outcomes. And I have criticisms regarding BCC’s core philosophy, which focuses on effecting change through an external mechanism, because I believe that critical self-reflection is a powerful and dignified way to achieve radical change. I’m deeply wary of behavior change campaigns like Community-Led Total Sanitation (CLTS), which promotes the use of shame, fear, and disgust as emotional triggers for inciting change, often at the expense of ethics and human rights.
Still, though, there is something undeniably compelling about understanding what drives people to change. It’s possible that I’m falling prey to that old adage – when all you have is a hammer, everything looks like a nail. But I think behavior change drives at something deeper than that. How do you convince people to do something that’s good for them and everyone else, whether it be building a toilet, installing solar panels, or participating in a women’s group? I haven’t even cracked this for myself, honestly – I have plenty of bad habits and a long list of good habits I’d like to develop.
The classic example of the need to convince people is the case of oral rehydration salts (ORS), which are a simple and effective treatment for the dehydration caused by acute diarrhea, mostly a concern for children. A mixture of salts and sugars comes in a packet to be mixed into water and drunk by the sick child; this therapy almost guarantees that the child will not die from dehydration. The packets cost next to nothing and are often fully subsidized. Yet in India alone, more than 220,000 children under five die from diarrhea yearly. Either their parents don’t know about ORS, or they’re not convinced the therapy will help. Dean Karlan and Jacob Appel have a passage about this phenomenon in their book More Than Good Intentions: Improving the Ways the World’s Poor Borrow, Save, Farm, Learn, and Stay Healthy:
“Often when I talk about these projects to noneconomists, to nonacademics, I am struck by how out of touch they think I am. And, frankly, how stupid I feel. News flash: we’ve got to sell this stuff!
“Maybe the reason we don’t think much about the marketing of aid and development is that we don’t want to feel like we are peddling something. It clashes with our idea of what aid should be. Most people who have a hand in development programs around the world – practitioners, policymakers, and donors great and small – are in it for the right reasons. They want to help people in need. And (at the risk of oversimplifying) many of the people in need really do want help. Since both parties’ basic intentions are aligned, why should we have to resort to the dark art of advertising to get people on board?
“Whether we should have to or not, the fact is that we can dramatically increase participation by presenting programs in the right way.” (53)
This is not a new concept. Social marketing, or the adaptation of commercial marketing concepts to promote social good, has been around for decades (PDF). It is an established industry, especially in Australia, North America, and Europe. In India, social marketing has been used, for example, in AIDS prevention and condom promotion campaigns. Several major advertising agencies have “rural marketing” or “experiential marketing” sections, although they focus on selling products like soap, biscuits, and liquefied petroleum gas (LPG) cooking cylinders to poor, rural communities.
But are marketing strategies really capable of dealing with the institutional, technological, and social factors that often go into complex decisions like whether to use a toilet? It’s one thing to switch from Budweiser to Stella Artois, or from Lifebuoy soap to Dettol; it’s another thing entirely to change something as sensitive and personal as where to defecate. I’m also not interested in replicating many of the traditional advertising techniques, which are often sexist and racist and classist and power-imbalanced, as well as crudely materialistic in a way development work should oppose.
I think the solution, as always, probably lies somewhere in the middle. While I believe behavior change is crucial to enacting social good, dogmatic social marketing may not be the panacea for which we’re all searching. Listening to, involving, and empowering communities in the planning, implementation, and evaluation stages of an intervention is key. We must keep in mind gender and socioeconomic concerns from the beginning, and we must think in terms of systems and communities, not isolated behaviors and individuals. It’s also important to realize that the middle-class aesthetics which dominate today’s advertising world may not resonate with other communities. In other words, we must blend the marketing and non-profit worlds, using techniques from the former, tempered by the knowledge and ethics of the latter. I don’t know what that looks like, but I’m excited to find out.