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A unified approach is needed within
national policy that allows for flexibility at local level
as well as the development of workable solutions based on
improving health through incremental improvements in excreta
disposal practices. This should be backed up by useful, appropriate
and enforceable regulations designed to complement the education
and promotion processes. The three pronged “Carrots,
Sticks and Promises” approach (Rothschild 1999) outlined
in the box below needs to be adapted and adopted when designing
sanitation programmes.
Carrots, Sticks
and Promises - based on Rothschild (1999)
The Promise – Education
Comprising of messages that attempt
to inform and/or persuade a person to behave voluntarily
in a particular manner but does not provide on its own,
direct or immediate reward or punishment. Education
makes promises of future rewards for changes in behaviour
and these are often far into the future. They are often
based on promoting a negative e.g. If you use a latrine
you will not get diarrhoea.
The Carrot - Marketing
The exchange of goods or services for money. This works
by the mutual gratification of both parties involved
and the transaction and the rewards are usually immediate.
People get what they want and the key to successful
marketing is understanding what they want and then providing
it at a cost they can afford. Promotion techniques used
in marketing serve to inform people of the ‘carrot’
for changing a particular behaviour.
The Stick - the Law
Using force to change behaviour. This involves the use
of coercion to achieve behaviour change in a non-voluntary
manner, or to threaten punishment for non-compliance
or inappropriate behaviour. It is a particularly important
strategy when there are large public externality costs
associated with non-compliance and full voluntary compliance
is difficult to obtain through marketing and education.
Examples include seat belt and motorcycle helmet driving
laws, or no-smoking policies.
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Gaining full compliance with socially
beneficial behaviours related to excreta disposal will eventually
require some form of law, regulation and enforcement. It is
just a question of to what extent? It is unrealistic to believe
that education and marketing will induce the entire community
to change its behaviour and there will always be some with
ample opportunity, resources and ability to change voluntarily,
but who steadfastly refuse to do so. They see no self-interest
in the change (Rothschild 1999).
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