Social Norm Analysis to eradicate open defecation

in Madagascar

© UNICEF/NYHQ2013-0166/Holt

Problem statement• MADAGACAR is 4th largest island in the world, ‘off radar’ • Total population 20.7 million• 22 Regions• Linguistically (& ethnically) diverse• Since 2009 increase in poverty • More than 92 percent of the population living under $2 a day,

82 per cent of children living in poverty)• South of the country considered as a ‘cemetery’ of

development projects (no change in indicators over the time)• South of the country is the poorest and most vulnerable• South of the country considered to have strong cultural beliefs

that conditions life style and behavior

• Sanitation (CLTS) programms are not picking up in the South of Madagascar

Why it matters?• More than 70% of consultations are

due to illnesses related to poor hygiene and sanitation and lack of safe water

• The main causes for child mortality are pneumonia, diarrhea and malaria (reduction in 88% of diarrhea mortality, 23% pneumonia, 44% neonatal mortality)

• Diarrhea alone:• 3th cause of consultation in CSB (around

71% are <5 children)• 2nd cause of child mortality in hospitals• 3.5 millions of school days lost per year• 5 millions of working day lost per year

• Over 53 per cent of children in Madagascar are stunted

For sanitation, only 15 per cent of the population use an improved sanitation facility, making Madagascar the 8th worst country worldwide. More than 37 per cent of the population practises open defecation, a total of 7.7 million people.

Source: Analysis done with JMMP 2012 report data and MIS 2011 for wealth quintiles

Total Urban Rural

0

10

20

30

40

50

60

70

80

9

15

7

15

21

12

Trends in access to sanitation Madagascar 1990 - 2010

1990 2010

Pe

rce

nta

ge

(%

)

72 per cent of people without access to improved sanitation live in rural areas

Poorest 2nd 3rd 4th Richest0

20

40

60

80

100

Open defecation

Unimproved

Shared

Improved

All of the poor practice open defecation compared to almost none among the richest part of the population.

Analysis of WASH indicators

Mapping of actors and practices in two out of four regions in the south, 12 districts

Methodology based on causal analysis, underlying and structural causes and an analysis of those traditions

Interviews with local authorities, focus group discussions in communities and individual interviews

Main outputs:1. Cultural and traditional beliefs track2. Mapping of influencing actors

Anthropological study in its way Formative research in its way

What has been done so far

Architecture of beliefs and Expectations

Factual beliefs Normative Personal Beliefs

Empirical Expectations

Normative Expectations

Excrements dispersed in the nature are harmless Ancestors are the most important thing in the

society Ancestors are buried in the land, therefore the

land is sacred Only graves are made from cement, the rest of

the buildings like houses are not

It’s taboo to stock excrements near the house or in the land, it’s better to disperse them away in the nature

Digging a pit and putting excrements in it is profaning the ancestors’ land

The most valuable material to build graves is cement

Boys and girls can’t defecate in the same place

Everyone –even traditional leaders- defecate in the open Cement is used only to build funerary graves

Stock excrements is not appropriate, therefore no one should be building latrines at home No one should be digging a pit for constructing a latrine since this is profaning the ancestors’ land

where they were buried. A good person would never profane the land because it belongs to the ancestors Boys and girls can’t use the same latrine because they can’t defecate in the same place; therefore to use

latrines in schools is taboo Structures built with cement are sacred and can’t be used to put excreta inside.

We have a strongly endorsed social norm in the south of Madagascar based on solid beliefs about what is sacred and what are the most important values in life

Overriding the norm will be perceived as a moral violation of the most important and sacred beliefs and therefore they won’t have the possibility to burry their deaths in the future and will be named and shamed by the community. This is a very heavy sanction

This makes the challenge bigger

Unlike other situations where CLTS creates a social norms, in this context we will need to change the norm by using some of the tools CLTS provides and additional ones based on the change of social norms theory

A change is required

How do we cook it?

Scripts & schemaso Related with privacy and dignity.

Women need to go to the bush at night in order to prevent being seen by others

o Boys and girls need to use different places for defecation

Relevant networkInhabitants of the same community and the people belonging to the same ethnics. With the exception of the ethnic leaders, all are in the neighbouring communities and shared by a group of villages (fukutany)

Applying social norms theory to change

Core groupo the traditional leaderso religious leaderso the natural leaderso the heads of big families (or heads of clans)o nobleso community agents o chief of fukutanyeo delegate of populationo teacherso influential leaders at national level that may

come from this particular area or belong to the same ethnic group

Higher order of values

1. Value of life of children

2. Value of a REAL clean land for ancestors

3. Religious value

Applying social norms theory to change

Value deliberations (pre and partial triggering)

1. Links between lack of sanitation and diarrhea, CLTS tool

2. Show case diffusion of excreta on the land through rain water

3. CLTS tool on shit calculation4. Bible quotation

deuteronomy 23:13-14: dig a hole and cover your faeces. for the lord your god moves about in your camp to protect you and to deliver your enemies to you. your camp must be holy, so that he will not see among you anything indecent and turn away from you

“enough people see that enough people is changing”

Multiple Core Groups participate in value deliberations with the purpose of:

- More critical, genuine and challenging discussions- More endorsement when realizing contradictions, incoherence or higher values- Amplify engagement to change- More empowerment to go back and promote change if others are also doing it (fear

to work on isolation in the same ethnic group will deter from action)- Maximize numbers of people that believe in need of change will legitimate their

localized actions in the context of a global action- Amplify and diffuse better the positive results of change

Maximizing and enlarging the change

Publicity / public declarations Diffusion from Core group to the community triggering Public declarations and action plans in each village Signaling in multiple villages the desire to change (diffusion from community to community) Signaling the change achieved (ODF) Public declaration ODF - common celebrations in a fukutany

Incentives • CLTS discourages the use of subsidy o rewards for individual households, because the sense of

proud is very high and may be contra producive• Things like panels, radio programs diffusions or collective celebrations with local authorities

once a geographical area is collectively ODF may be a powerful positive incentive that works well with this sense of proud.

Moral, social and legal norms coherence in a later stage

Applying social norms theory to change

Thank you!