Vaparshun : a cluster randomised controlled trial in Gujarat, India

Publication Details

3ie Funded Evaluation, TW14.1002 A link to the completed study will appear here when available.


Author
Val Curtis, Robert Aunger, Wolf Peter Schmidt, Dileep Mavalankar, Kavita Chauhan, Deepak Saxena, Banalata Sen, Balaji Gopalan, Nipa Desai, Ketan Hingu
Country
India
Region
South Asia
Sector
Water and Sanitation
Subsector
None specified
Gender analysis
No
Equity Focus
None specified
Evaluation design
Randomised Control Trials (RCT), Mixed Methods
Status
Ongoing 3ie Funded Studies
3ie Funding Window
Promoting Latrine Use in Rural India

Synopsis

Vaparshun (Will use) is a scientifically designed programme based on the theory and process of the behaviour centred design framework. The study aims to assess how toilet use behaviours can be changed by addressing the key drivers of toilet use through this programme.

Context

Almost 3 million toilets have been constructed in Gujarat since 2014. Some of these have been built by households on their own, others used the government’s subsidy or as part of its toilet construction programmes. The quality of toilets built as part of these programmes ranges from satisfactory, to poorly constructed, to dysfunctional. Beneficiary involvement is often limited to signing up and providing labour, while toilet usage is often sub-optimal. 

Formative research has shown that households who built their own toilets (alone or with the subsidy), were more likely to be committed users. The reason behind the commitment include: aspirations for a better life, social status, pride in owning a toilet, convenience, time saving, scarcity of space for open defecation (OD), the physical difficulty of squatting in the open, OD being perceived as dirty, and privacy. Reasons for OD included: an incomplete or poorly-built toilet; lack of engagement with an alien ‘government toilet’; desire to limit use to prevent pit filling; preference for fresh air; poor initial use experience associated with a bad smell; and, a ‘packed’ feeling, preference for sticking to routine of going to the fields to defecate (particularly among men), limited water supply for flushing, and traditions concerning child faeces disposal.

Research questions

  1. How far can an innovative theory-based, scalable intervention improve toilet use behaviour of all the family members in households having contractor-built toilets in areas of high coverage in rural Gujarat?
  2. Does the intervention have a different effect on men’s toilet use behaviour?
  3. How comparable are the toilet use estimates using different methods used (survey, sticker diaries and structured observations)?
  4. How do factors (fidelity, dose reach and so on) associated with the intervention delivery influence toilet use behaviours of target populations?

Methodology

Intervention design

Vaparshun! addresses the complex determinants of low latrine use through different ways. It will aim to create motivation and increase engagement through toilet makeovers using low-cost materials and stencils.  The intervention will also include a pit emptying and a pit filling estimation demonstration to graphically convince families that toilets do not have a limited life. Community activities including films, games and testimonies will reinforce the idea that toilets increase convenience.  Transition nudges in the form of rewards will be given to those who become habitual toilet users.

Theory of change

Vaparshun! uses the behaviour centred design framework and theory of change to design its intervention. The framework is a logical and comprehensive approach for designing and evaluating behaviour change programmes. This model, derived from reinforcement learning theory, develops a fundamental taxonomy of needs based on evolutionary biology. It shows how the disruption of ‘behaviour settings’ is key, and sets out the steps involved in programming for behaviour change. In addition, it provides means of identifying the levers to change behaviour, provides guidance for the intervention and a tool to design process for creating, delivering and measuring behaviour change programmes.

Evaluation design

The evaluation uses the cluster randomised controlled trial design and will involve four administrative taluks (blocks) Bhavnagar, Gujarat. A total of 94 eligible Village gram panchayats (scheduled areas) will be selected by simple random sampling. A panchayat will be eligible if toilet coverage is 75 per cent or higher according to the most recent coverage data. Within each panchayat, the study team we will select one eligible village at random for outcome assessment. A village will be eligible if it has more than 75 per cent coverage of toilets, using the latest district figures.

The intervention will be sequentially rolled out to 47 villages, with 47 others serving as control villages. The control villages will receive an abridged version of the intervention after the trial is complete.

Data will be collected at baseline, and two months after the intervention is implemented. A detailed process evaluation will be done in four villages which will not be part of the end line quantitative survey.

The primary outcome measure will be the proportion of family members using toilets (i.e. never go for OD) living in target households who have a contractor-built toilet, as assessed through surveys. The secondary outcome measure will be toilet use amongst men living in target households.

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