In Ethiopia, three-fourths of all disease is related to sanitation. A significant number of the entire population (i.e. 28%) in the country still practice open defecation. Much of the remaining large population (57 million) use unimproved sanitation which often lack washable slabs, lids, doors and/or a roof.
To tackle this issue, PSI Ethiopia combined a commercially-driven, standard sales and marketing strategy with an SBCC campaign to better promote basic (improved) sanitation and sales of latrine products. Despite the strong commitment from the Ethiopian government and other key stakeholders to increase WASH coverage and access, the population-level behavior change made so far does not parallel that effort. Open defecation remains rampant as toilets are poorly maintained and privacy is compromised. Overall, the toilets are in a deteriorated and filthy state, poorly protecting family members and the community at large from contact with fecal matter.
Social Behavior Change Communication (SBCC) is a method of promoting positive change that employs a collection of tools and approaches that are informed by communication, behavior theory and marketing to improve adoption of and changes in behavior. It is an evidence-based process that allows the design of a comprehensive set of tailored interventions that promote a certain desired behavior.
PSI Ethiopia, through its two WASH projects – TRANSFORM WASH and Growth through Nutrition (GtN) – conducted door-to-door household engagement activations across four regions of the country (Amhara, SNNPR, Oromia and Tigray). This activity enabled the team (consisting of a mason, health extension worker, promoter and PSI Ethiopia WASH advisor) to conduct sales at the household level.
HOW IS IT DONE?
By employing sales techniques that are used in the fast-moving consumer goods industry, PSI Ethiopia designed an integrated door-to-door WASH SBCC promotion and sale strategy for basic (improved) latrine products. The team also managed to effectively track all sales at each household level through a GPS tracking system.
The team of promoters knocked on doors for sales opportunities and at each visit, they followed the basic sales process of introduce, understand, propose and close. Using this commercial approach, the conversion rate was promising (25% of the people who were approached purchased a product) compared to the sluggish annual increment of basic (improved) sanitation coverage at the national level which is only 0.2% (Mini DHS, 2019).
THE IMPACT
Looking into the project’s achievements, the two major upshots of the promotion were product awareness creation and sales order generation. In just a month, the team was able to exceed its plan by 10% with 10,200 households reached/educated on the importance of adopting safe hygienic practices including improving their latrine and a total of 2,500 product sales orders were collected. This showed the market potential and highlighted the ability to “increase awareness” and “improve sales”. In addition, PSI Ethiopia was able to establish a standardized sales reporting system that brought down discrepancies and made product installation follow-up easy.
LEARNINGS AND RECOMMENDATIONS
PSI Ethiopia faced a challenge in reaching out to scattered rural communities and reaching them at home during door-to-door visits. But blending a commercial approach with SBCC best practices rooted in dignity and pride, and door-to-door delivery can have a great impact on increasing adoption rates of basic (improved) latrines for households who do not prioritize latrine investment.
