Promoting Latrine Use : Midline Findings from a Randomized Evaluation of a Community Mobilization Campaign in Bhadrak , Orissa

A subset of the Millennium Development Goals reflect the world’s collective hope and resolve to reverse a particularly pernicious, pervasive, and persistent set of problems in much of the developing world: high rates of diarrhea (the number one killer of small children), insufficient water and sanitation services, and seemingly unsafe, inadequate, and myopic behaviors. How can we change this? In a previous paper, we described a randomized, community-level sanitation intervention in rural Orissa, India to gain insight into household-level decisions to build and use individual household latrines and to examine health impacts of sanitation improvements. This paper reports on the results of the campaign. Our data show that the sanitation campaign had a substantial impact on latrine adoption and use. Using a difference-in-differences estimator, we find that the intervention increased latrine uptake by about 30%. This increase in latrine ownership, in turn, may have reduced child diarrhea, although these results are less robust to different model specifications. Taken together, these results highlight the importance of understanding the motivators of household decisions in designing and implementing health and development interventions.