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.