SciELO - Scientific Electronic Library Online

vol.87 issue8Knowledge about pandemic influenza and compliance with containment measures among Australians author indexsubject indexarticles search
Home Page  

Services on Demand




Related links

  • Have no similar articlesSimilars in SciELO


Bulletin of the World Health Organization

Print version ISSN 0042-9686


PATTANAYAK, Subhrendu K et al. Shame or subsidy revisited: social mobilization for sanitation in Orissa, India. Bull World Health Organ [online]. 2009, vol.87, n.8, pp.580-587. ISSN 0042-9686.

OBJECTIVE: To determine the effectiveness of a sanitation campaign that combines "shaming" (i.e. emotional motivators) with subsidies for poor households in rural Orissa, an Indian state with a disproportionately high share of India's child mortality. METHODS: Using a cluster-randomized design, we selected 20 treatment and 20 control villages in the coastal district of Bhadrak, rural Orissa, for a total sample of 1050 households. We collected sanitation and health data before and after a community-led sanitation project, and we used a difference-in-difference estimator to determine the extent to which the campaign influenced the number of households building and using a latrine. FINDINGS: Latrine ownership did not increase in control villages, but in treatment villages it rose from 6% to 32% in the overall sample, from 5% to 36% in households below the poverty line (eligible for a government subsidy) and from 7% to 26% in households above the poverty line (not eligible for a government subsidy). CONCLUSION: Subsidies can overcome serious budget constraints but are not necessary to spur action, for shaming can be very effective by harnessing the power of social pressure and peer monitoring. Through a combination of shaming and subsidies, social marketing can improve sanitation worldwide.

        · abstract in French | Spanish     · text in English     · English ( pdf )