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We implement a mixed method approach that combines a randomized controlled trial and qualitative data collection to assess whether, and if so how, behavioural change can be sustained. We do so in the context of Pakistan’s national sanitation strategy to combat open defecation, Community-Led Total Sanitation. Our findings demonstrate that continued follow-up activities, that build on the original intervention, reduced reversal to unsafe sanitation, but only where initial conditions are unfavourable —i.e. poor public infrastructure and low-quality sanitation facilities. Promotion efforts are hence best targeted towards those that face larger difficulties in constructing and maintaining high quality sanitation.
Authors

Associate Director
Britta is an IFS Associate Director, Associate Staff at the Department of Economics at the UC and Researcher at NIHR Obesity Policy Research Unit.

Senior Research Economist
Antonella Bancalari is a Senior Research Economist at the Institute for Fiscal Studies.

Zara Durrani

Madhav Vaidyanathan

Zach White
Working Paper details
- DOI
- 10.1920/wp.ifs.2021.4621
- Publisher
- Institute for Fiscal Studies
Suggested citation
Augsburg, B et al. (2021). When nature calls back: sustaining behavioural change in rural Pakistan. London: Institute for Fiscal Studies. Available at: https://ifs.org.uk/publications/when-nature-calls-back-sustaining-behavioural-change-rural-pakistan (accessed: 25 April 2025).
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