Association for Public Policy Analysis & Management

Despite concerted efforts by central governments, NGOs, and intergovernmental organizations to promote improved sanitation and hygiene practices, open defecation and the lack of access to improved sanitation facilities remain persistent challenges in rural India. Open defecation imposes a substantial mortality, morbidity, and financial burdens on households, often disproportionally affecting the most vulnerable populations. Such burdens have long term consequences for economic development more generally, as they limit economic productivity through direct--decreased human capital--and indirect--time re-allocation--pathways. National policies such as the Total Sanitation Campaign and, more recently, the Swachh Bharat Mission have increased access to latrines through technology subsidization; however, targets of universal access and use have not been met. Importantly, the mechanisms by which household adopt, use, and maintain latrines are not well identified; in particular, while social influences are often posited as important determining factors, the causal impact of social influences on environmental health technology adoption remains ambiguous. In this paper, I adapt and implement a minimum-effort coordination game to test the impact of social network structure on private household sanitation and hygiene decisions. I randomly assign households within 70 villages throughout rural Orissa and Bihar to one of two game groups: self-selected among friends within the village or groups pre-assigned among participants with dissimilar characteristics. Through a series of game-play rounds, participants choose how much to contribute to improved sanitation by making decisions in the game that are associated with actual sanitation and hygiene choices they face every day. Comparing the contributions made by participants in the socially-selected groups and the pre-selected groups provides evidence regarding the causal effect of social influence on stated sanitation and hygiene choices. In addition, I use household survey data on sanitation and hygiene choices and technologies as well as various measures of social connectedness--spatial, family and friends, and village centrality to measure households' revealed preferences for sanitation. By combining both stated evidence from the experimental games with household-level data about actual practices and social networks, I provide a more comprehensive examination of the role of social influence on sanitation technology adoption, which could be incorporated into designed policies to promote sustained sanitate behavioral change in rural India.