Nudge, Dont Shove: A Case for Reflexive WASH Behavioural Change, Part I We ere taught in the s!

hool"ard that shoving is una!!e#ta$le $ehaviour, "et do%inant a##roa!hes to !hanging sanitation and h"giene #ra!ti!es in develo#ing !ountries do exa!tl" that & for!eful #ushing that ta'es a a" the ti%e and s#a!e for a #erson to de!ide hi!h dire!tion the" ant to go( )a'e for exa%#le Co%%unit"&*ed )otal Sanitation +C*)S,: its effe!tive in !o%#elling !o%#liant $ehaviour $e!ause it leaves #eo#le ith no !hoi!e to a!t other ise lest the" fa!e sha%ing and even stoning +Chatter-ee ./001 Ngo2o ./0/1 Devine .//3,( Ho ever, $ull"ing !o%es at a #ri!e( We 'no that $ullied !hildren suffer %ental health effe!ts for "ears after ards, "et there have $een no studies on the long&ter% %ental health effe!ts that C*)S leaves u#on those ho have $een 4saved5 fro% o#en defe!ation( So%eti%es WASH gets too !aught u# ith its %ost i%%ediate goals and loses sight of its overar!hing ai% of i%#roving ell&$eing & a ell&$eing hi!h in!ludes %ental health, as diffi!ult as it %a" $e to o$serve and %easure( I ant to #ro#ose another a" of !hanging ha$itual $ehaviours that !an $e -ust as effe!tive, $ut ithout the !ollateral da%age of $rute for!e( B" no %eans a% I suggesting that e #ara!hute soa# and toilets onto !o%%unities and then leave #eo#le to figure out ho to in!or#orate the% into their dail" lives, $ut I a% arguing that e treat our target audien!e as de!ision&%a'ers( *i'e all de!ision&%a'ers, the" have $ounded self&!ontrol hen it !o%es to follo ing through ith earlier de!isions, and their -udg%ents fli!'er ith their %ood, the eather, and a #lethora of other !ontextual noises( )his is here $ehavioural e!ono%i!ss do!u%entation of $ehavioural $iases !o%es in( As fi!'le as our $ehaviours %a" $e in relation to our !ons!ious intentions, the" res#ond s"ste%ati!all" to !ertain environ%ental !onditions, i(e( the" have #redi!ta$le $iases( )hrough different !o%$inations of $iases, $ehavioural e!ono%ists test out ho to %a'e !ertain $ehaviours easier to #erfor% $" su$tl" !hanging the !ontext( )hese !hanges influen!e hat neuros!ientists !all the reflexive !ognitive s"ste%: a 'nee&-er' rea!tion that outstri#s the slo er reflective s"ste% e !o%%onl" !all !ons!iousness or anal"ti!al thought +*ie$er%an .//.,( Instead of shoving #eo#le into sanitation and h"giene #ra!ti!es, e !an !reate an environ%ent that ena$les #eo#le to #erfor% $ehaviours that the" the%selves have !hosen( Peo#le have diffi!ult" !arr"ing out hat the" !ons!iousl" !hoose to do $e!ause their ha$its are engrained in %us!le %e%or", and are #erfor%ed s#ontaneousl" $" the reflexive s"ste%( Hand ashing and defe!ation are done auto%ati!all", and are alread" !o%#leted $" the ti%e a #erson even thin's to !he!' their $ehaviour( )his is h" solel" edu!ating !o%%unities on the $enefits of h"giene and sanitation has li%ited effe!tiveness +Curtis .//31 )orres .//6,( Peo#le do not #erfor% $ehaviours si%#l" out of ignoran!e, $ut out of $ounded self&!ontrol( )his is not to sa" that e !an dis#ense ith WASH edu!ation altogether( 7no ledge is i%#ortant for #eo#le to $e a$le to %a'e !hoi!es a$out their $ehaviours, even though 'no ledge %a" not translate into a!tuall" !arr"ing out those $ehaviours( Ho ever, e need to !ontextuali2e the i%#a!t of WASH edu!ation a%ong the finan!ial and so!ial stresses that alread" ta'e a heav" !ognitive toll u#on the #oor( 8ani et al(s re!ent stud" !on!ludes that #overt" i%#edes !ognitive !a#a!it" +8ani ./09,( )he 'ind of !ognitive !a#a!it" that the stud" assessed $elongs to hat neuros!ientists identif" as the inherentl" slo er reflective s"ste% that our auto%ated rea!tions alread" easil" $eat out, %a'ing it even less li'el" for interventions targeting this slo er reflective s"ste% to su!!eed( Sin!e #ro!essing ne infor%ation is done through the sa%e reflective s"ste%, WASH edu!ations effe!t is extre%el" ea'( 8oreover, to !ontinuall" $ela$our the reflective s"ste% ith WASH infor%ation !onsu%es #re!ious !ognitive resour!es and leaves #eo#le ith even less !a#a!it" to #ro!ess other as#e!ts of survival su!h as getting out of de$t or %a'ing arrange%ents for their !hildrens s!hooling :see ;igure 0<( B" instead targeting the larger

!ognitive resour!es of a #ersons auto%ated reflexive s"ste% +=vans .//>,, e !an avoid a!hieving WASH goals at the ex#ense of other !on!erns that are e?uall" i%#ortant in ensuring a #ersons ell&$eing( A!!ounting for environ%ental effe!ts is not a ne !on!e#t in WASH #ro-e!ts, $ut $ehavioural e!ono%i!s or's at the level of auto%ati! rea!tions rather than !ausal reasoning( ;or exa%#le, the Water Sanitation Progra%s Sani;@A8 fra%e or' $rea's do n $ehavioural deter%inants to o##ortunit", a$ilit" and %otivation +Devine .//3,( While its anal"sis of o##ortunit" and %otivation en!o%#asses availa$ilit", so!ial nor%s, #rodu!t attri$utes, e%otional drivers and illingness to #a" & all of hi!h are !on!erns for $ehavioural e!ono%ists &, it see's out intentional reasons for o$served $ehaviours( Behavioural e!ono%ists, on the other hand, argue that intentionalit" has little to do ith ho e a!tuall" a!t( )a'e for instan!e this Sani;@A8 finding: 4In )an2ania, surve"s have found that #eo#le #refer a ater !loset $e!ause it is eas" to !lean, %odern, and dura$le( )hose ho #referred AIP latrines re#orted Bno s%ell as the %ain reason5 +Devine C,( )he ver" %ethod of surve"& ta'ing assu%es that #referen!es are rooted in !ons!ious thought, even though studies sho that all sorts of su$!ons!ious fa!tors strongl" influen!e de!isions +7ahne%an ./00,( Although #eo#le give ell&reasoned ans ers -ustif"ing their toilet #referen!es, e have to as' ho the surve" ?uestion as fra%ed and hat #eo#le felt ere at sta'e hen the" ans ered( Indeed, Curtis et al( argue that h"giene and sanitation surve"s generate distorted infor%ation $e!ause #eo#le tend to $e e%$arrassed a$out re#orting 4irrational5 %otivations, and tr" to give hat the" thin' is the 4right5 ans er to intervie ers +0D&0E,( A #ro-e!t using Sani;@A8 ould assu%e that as long as #eo#le are given eas" to !lean, dura$le, and ventilated toilets, the" ill $e %ore li'el" to use the%( Behavioural e!ono%ists, on the other hand, ould loo' at i%#ra!ti!al attri$utes irrelevant to the fun!tion of a toilet and !o%e u# ith a different list of attri$utes that attra!t toilet use( )he" !ould in!lude things li'e #eo#les %ood hen the" first en!ounter the toilet, the !olour and si2e of the toilet, or the feel of the toilet( )hese are not influen!es that register !ons!iousl", nor !an the" $e as!ertained si%#l" through o$servation( @$servers !ould $e una are of nu%erous fa!tors that are at #la" in an o$served #heno%enon, resulting in fla ed for%ative resear!h( Whats needed instead is e%#iri!al testing ith, sa", different !oloured toilets so that e !an deter%ine hat !olour ill #redis#ose a !ertain !o%%unit" to use toilets( )his 'ind of testing ta'es u# a lot %ore ti%e, %one", and energ" than surve"s do, $ut front&loading invest%ents this a" does #a" off( =%#iri!al testing gives interventions %ore #redi!ta$ilit" $e!ause the" have alread" $een 4realit" tested5, and $ehavioural e!ono%i!s interventions often !onsist of ver" s%all, eas" to i%#le%ent %oves that "ield dra%ati! results( Nudging ta'es a lot of ti%e to !raft and #erfe!t, $ut I $elieve that an alternative to $rute shoving is ell orth the ti%e and energ"( B" extra#olating fro% existing $ehavioural e!ono%i!s studies, WASH !an $egin to for%ulate its o n $ehavioural tools( In Part II, I ill revie %ore s#e!ifi! $ehavioural e!ono%i!s #rin!i#les that lend the%selves to WASH #ro-e!ts( Wor's Cited: Chatter-ee, *i2( 4)i%e to a!'no ledge the dirt" truth $ehind !o%%unit"&led sanitation(5 The Guardian( 3 Fune ./00( Ghtt#:HH (theguardian(!o%Hglo$al&develo#%entH#overt"& %attersH./00H-unH/3Hdirt"&truth&$ehind&!o%%unit"&sanitationI!o%%ent#ageJ0K Curtis, Aalerie, *isa @( Dan?uah and Ro$ert A( Aunger( 4Planned, %otivated and ha$itual h"giene $ehaviour: an eleven !ountr" revie (5 Health Education Research .6(6 +.//3,:

CDD&CE9( Devine, Fa!?ueline( 4Introdu!ing Sani;@A8: A ;ra%e or' to Anal"2e Sanitation Behaviors to Design =ffe!tive Sanitation Progra%s(5 Water and Sanitation Progra% Wor'ing Pa#er( @!to$er .//3( Ghtt#:HH ( s#(orgHsitesH s#(orgHfilesH#u$li!ationsHLSPMsanifoa%(#dfK =vans, Fonathan St( B( )( 4Dual&Pro!essing A!!ounts of Reasoning, Fudg%ent, and So!ial Cognition(5 Annual Review of Psychology +.//>, D3: .DD&.E>( G htt#:HH (ual$erta(!aHNfran!is#HPhil6>>H=vansDualPro!essing.//>(#dfK 7ahne%an, Daniel( Thinking, Fast and Slow( Canada: Dou$leda", ./00( *ie$er%an, 8atthe D( et al( 4Refle!tion and Reflexion: A So!ial Cognitive Neuros!ien!e A##roa!h to Attri$utional Inferen!e(5 Advances in Ex eri!ental Social Psychology 96 +.//.,: 033&.63( Ghtt#:HH (s!n(u!la(eduH#dfH*ie$er%anO./etO./al O./+Advan!es,(PD;K Ngo2o, Claire( 4Cata#ults against !holera(5 The "aily Ti!es( .D ;e$ruar" ./0/( *ifest"le #( D( G htt#:HH (!o%%unit"ledtotalsanitation(orgHsitesH!o%%unit"ledtotalsanitation(orgHfilesH%e diaHCata#ultsMagainstM!holera(#dfK )orres, 8ar!o Polo et al( 4Co%$ining H"giene Behaviour Change ith Water and Sanitation: A Pilot Pro-e!t in Hato 8a"or, Do%ini!an Re#u$li!5( ;e$ruar" .//6( Ghtt#:HH (eh#ro-e!t(orgHPD;HA!tivit"MRe#ortsHAR&0.DO./DRO./H"giene O./Behavior(#dfK BI@ Ste#hanie )a% s#e!iali2es in $ehavioural a##roa!hes to sanitation and h"giene in international develo#%ent, ith a fo!us on ho !ultural #ra!ti!es %ediate the i%#a!t of te!hnolog" in o#erations and %aintenan!e( A graduate of the Harvard Lraduate S!hool of Design, she has $een or'ing on hu%an $ehaviour through the lenses of #erfor%an!e studies and $ehavioural e!ono%i!s, and than's Dili# So%an at the Rot%an S!hool of 8anage%ent at the Pniversit" of )oronto for su##ort on this !urrent #ro-e!t( She is dee#l" invested in %onitoring the so!ioe!ono%i! i%#a!t of WASH #ro-e!ts, and has or'ed ith various NL@s, hu%an rights advo!ates, anthro#ologists, environ%ental engineers, and ur$an #lanners to develo# te!hnologies, infrastru!ture and $ehavioural #ra!ti!es that e%#o er the underserved in a %easura$le and a!!ounta$le a"( We$site: *in'edIn: (ste#htta%(!a (lin'edin(!o%H#u$Hste#hanie&ta%H0$Ha/CH30H

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