IEb18

Can disgust and shame lead to cleaner water and more handwashing? Impact evidence from Bangladesh

Improvements in water quality, sanitation and hygiene are associated with a reduction in risk of diarrhoea. However, treating water and regular handwashing with soap are not common practices in several low- and middle-income countries, including Bangladesh. 

The idea of provoking shame and disgust about poor sanitation and hygiene has been used in community-led total sanitation programmes in a number of developing countries. But does it work?

To find out, 3ie supported a research team to conduct a randomised impact evaluation between 2011 and 2014. The team tested whether behaviour change messages provoking disgust and shame amongst people within each compound are more effective than public health-related messages promoting safe water and handwashing. This brief distills the main findings and the lessons learned.

Key messages 

  • The impact evaluation showed that the intervention did not change behaviours. 
  • The messages aimed at creating disgust and shame did not increase demand for water treatment or improve handwashing behaviour compared to the standard health messages. 
  • Use of the chlorine dispenser was low. 
  • This study pointed up a number of implementation factors that may have affected the impact of the messages and use of the dispensers.

IEb39, kenya-smallholder-farmer-tw4.2.01-brief.JPG

Capacity building of smallholder dairy farmers in Kenya through extension services and market linkages

Impact evaluation 3ie 2019
This brief is based on the findings of an impact evaluation that examined the effects of the Smallholder Dairy Commercialization Programme in Kenya on farmers’ production, income and food security and on the empowerment of female dairy farmers.

IE female sex workers,IEb38

What works to increase HIV testing for female sex workers in Kenya, Uganda and Zambia

Impact evaluation 3ie 2018

This brief is based on the findings of three impact evaluations that examined the effectiveness of oral HIV self-tests.

IE Self test Zambia, IEb37

Investigating the feasibility of HIV self-testing in Zambia

Impact evaluation 3ie 2018

This brief is based on the findings of an impact evaluation that examines whether HIV self-tests increase HIV testing among female sex workers in

IE TW7, IEb36

Impacts of community delivery of antiretroviral drugs in Dar es Salaam, Tanzania

Impact evaluation 3ie 2018

This evaluation showed that community delivery of drugs by community health workers to clinically stable patients is not inferior to standard care, where patients visit a clinic-based doctor t

Tanzania-IE59, IEb35

A low-cost patient appointment and tracking system for ART at reproductive and child health clinics in Tanzania

Impact evaluation 3ie 2018

This brief is based on the findings of an impact evaluation that looks at whether orienting staff at reproductive and child health clinics improves patient appointment attendance rates.