The wisdom of the rear view mirror – Part III

By Balaji Gopalan, Centre of Gravity

Most health communication assumes that once people are informed and provided with the relevant knowledge, they will transform themselves to exhibit a healthier behaviour pattern. However, this is far from the truth. For instance, most anti-smoking ads speak about the possibility of cancer. To a 16-year old trying out his/her first cigarette, this communication can seem like coming from the establishment (parents/teachers) and they may in fact want to rebel against it by smoking – the cigarette being a sign of rebellion. The same person might stop smoking to attract his/her first love.

There is a lot of merit for behaviour change communication to look beyond information and knowledge, to emotional motivators for answers. We had a glimpse of the power of emotional motivators in a campaign for handwashing with soap. The campaign consciously didn’t use words like germs or diseases, but focussed on the emotional motivation of ‘nurturing’ – a mother’s instinct to instill good manners in her child so that he or she may succeed in life. Handwashing with soap, we realised could be one such good behaviour along with combing hair, cutting nails and talking respectfully to elders.
The significant results in this campaign encouraged us to look for emotional motivators even in the toilet campaign and we found a powerful one.

Myth 3: ‘Health is a strong motivator’
Naturally, we found that government campaigners speak the language of health, and therefore the need for toilets. Without doubt, this was the reason why the government wanted to build toilets. But, the motivations for people to construct toilets were quite different.

To explore these motivations deeply, we identified people who had already constructed toilets and spoke to them to understand their motivations. There were three broad motivations for constructing a toilet.

Urbanness/ Shame
When there is a lot of interaction in the household with the city – a person from the family studying or working in a city, a daughter-in-law who comes from the town or a marriage where relatives and friends are expected from the city, the need for toilets becomes an urgent, immediate one. Deeper within the motivation of ‘urbanness’ is the motivation of shame at not being ‘urban’, and therefore the urgency of building a toilet. However, this motivation works only for homes with frequent interactions with the city – which in the case of a GP we surveyed was less than 5%.

Convenience/ Comfort
The other occasion when toilets become an urgent need is when there is an ailing person at home who is immobile – an old person, or someone who is physically challenged or bed-ridden with an illness. Once again, this segment of households are in the minority, with less than 5% people having such a person at home.

Protection/ Providing/ Being Responsible
Part IIIThe most powerful catalyst for toilet construction was the expansion of villages and loss of forest cover, resulting in less privacy for open defecation. Now, women have to walk longer and search harder to find a place to defecate. This poses many difficulties, such as fear of the dark as one goes farther than the village boundaries, humiliation when chased from someone else’s field, waiting all day for the dark cover of the evenings and gathering people to go out in groups.

However, this was an issue felt only by the women. While the men also went out on a similar journey every day, they had a very different experience and had very little empathy for the difficulties of women. The communication challenge here was thus, how to create this empathy and find a motivation that can move them.

One way is to inspire men to love/care for their women more. A loving husband is a very aspirational personality in a city, but in a village, loving/caring for one’s wife is not seen to be very ‘manly’, and therefore men would shrink away from such a portrayal.

The second was this whole idea of protecting women. While this is a powerful motivation, it can easily fall into the area of ‘protecting honour’ which can reinforce patriarchal structures.

Part II-3Therefore, a higher order motivation was identified in ‘becoming responsible’ – a responsible man who understand the family’s needs and provides for them is respected more among men. He is a man’s man. This is the one single quality that women expect their men to have – to be more responsible and share the family’s burden.

Health as a motivation to construct toilets was non-existent. The only person who mentioned ‘health as a motivation’ was an ASHA worker! However, it didn’t mean that health can’t be a motivation; it just is not perceived to be a valid enough reason to build a toilet. But, the ‘responsible man’ is surely a powerful motivation for constructing toilet. It is a fairly universal motivation and should work anywhere else as well.

This understanding guided one half of the campaign, which was about creating demand for toilets. Through a skit and a song, empathy was created for what women suffer every day. Through films, songs and interactions, the message of The Responsible Man was brought alive.

In hindsight, looked through the rear view mirror, all myths like, ‘people don’t want toilets’ or ‘women and children should be the target’ or, ‘health should be the message’ – may seem ridiculous. But, that is probably an unfair place to judge a myth from. A myth is often rooted in a real experience and that may not be valid in another time or another place.

However, the safest bet is to keep one’s nose close to the ground. The project has once again reinforced our faith in knowing one’s audience better before creating a campaign for them. And to have the courage and openness to walk away from deep-rooted assumptions if they are proven to be untrue.



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