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Part 2: Five principles to behavior change: Lessons from social enterprises

Marta Milkowska's picture
So why do communities defecate in the open although sanitation infrastructure is provided? And how do successful social enterprises deliver services to the bottom of the pyramid to change behaviors? The World Bank Group’s Social Enterprise Innovation program, behavioral change experts from the World Bank Global INsights Initiative (GINI) and Ideas42, and Indian social enterprises identified useful behavioral principles to consider when designing solutions for poor customers.

1. Don’t try to “fix” a person. Fix the context.
Traditionally, development challenges focus on awareness, access, and affordability, but in reality, many contextual factors shape our decisions. We often think that in order to change behavior, we need to change something intrinsic to a person. But the context of decision making may be more important, said Saugato Datta, the managing director of Ideas42 at the workshop.

GVK EMRI, a Development Marketplace (DM) grantee, that provides free emergency services to rural women in labor, understands that the decision to call an ambulance might not primarily depend on a regular analysis of all available transportation options. Instead questions such as: Which transport options are readily available right now? Which taxi driver does the woman or her husband trust? Does she feel intimidated by the ambulance and hospital staff? Will her husband allow her to travel in an ambulance with mostly male paramedics? Analyzing answers to these questions is key to effective program design.

2. Decrease the hassle factor.
Hassle factors are roadblocks; these are things that may require time or effort and keep us from taking an action said Nina Mažar, GINI’s Senior Social Scientist. Maybe you have to wait in line to get your child vaccinated. Maybe you need to travel to a distant clinic to receive your free TB medications. There might be multiple forms to fill out. All of these hassles make it more likely that we’ll just say, “I’ll do it tomorrow” and less likely that we’ll actually convert our intention to action.

Some social entrepreneurs call this “human-centered design,” but regardless of the name, it is crucial to design a service, a product, or a program in a way that takes into account clients’ experiences and removes all possible roadblocks, even the small ones. Social enterprises have mastered this process by iterating on various axes of their business models: adjusting their opening hours, location or bundling offerings with other services. FIA, a 2014 DM grantee, offers access to banking services to millions of unbanked in remote areas in India. Its founders realized that getting to the bank on time was a major hassle for laborers, FIA adjusted its opening hours (currently 8:00 am to 8:00 pm) and clients can now deposit money after or before work. At Operation Asha, we had to decrease the hassle of travel to TB medicines’ distribution center for our patients, says Sandeep Ahuja, the CEO of another DM grantee. – After locating our health centers close to the patients, our treatment success rate increased and reached 87%. SMV Wheels, a DM 2013 grantee, provides innovative to rickshaw drivers in Varanasi. As the process of applying for an official license is too much of a hassle for rickshaw drivers, we just made it a default option included in our financing, - explains its founder, Naveem Krishna. Today each of the 3260 SMV rickshaw drivers has not only a license, but also accident insurance.

FIA customer service point which successfully enrolled more than 8,000 unbanked customers

3. Address inattention.
Reminders are a common way to address inattention both in low and high-income populations but what types of reminders are the most effective? Behavior science shows that reminders are more effective when they are goal-specific, relate to values, and have a physical representation.

People are more likely to save when they receive a message highlighting a particular savings goal than a general savings message. In a study by Dilip Soman and Amar Cheema aimed to increase savings in rural India, infrastructure labor workers’ intended savings were earmarked and put in envelopes with a printed photo of their children on them. In order to “withdraw” the money from the “savings” envelope, laborers had to open the envelope, tearing the photo of their children. Such a physical and goal-oriented reminder increased the savings by nearly 50%.  Although many social enterprises, such as Dimagi or Operation Asha, send reminders to their patients, they often need to go even a step further and use what behavior science calls “intrusiveness”. An Operation Asha counselor visits patients’ homes when they missed their TB treatment dose.

4. Create new social norms.
Leveraging peer groups as change agents to create and reinforce new social norms is a strong tool for behavior change.

Educate Girls, a DM grantee, brings unschooled rural girls to school, built a cadre of 4,500 village-based youth leaders to work as champions for girls' education and catalysts for school reform. The social enterprise works with the whole community – not only a girl, a father, a mother, a grandmother, and their respective peers, but also village elders, religious leaders and teachers’ associations to change the context and norms surrounding girls’ education. Even its slogan - My village. My problem. I’m the solution. – builds local ownership and a social norm.

Second, visibility matters. What matters most is not what the majority of people are actually doing, but instead, what we think most people are doing. That’s why many social enterprises establish a brand. SMV Wheels, for example, designs  rickshaws with a big, colorful SMV logo to create awareness among rickshaw drivers who have not signed up for its service yet, and GVK EMRI, organizes special village-level events during which mothers who have used GVK’s services during labor share their stories.
SMV decreases the hassle factor for its rickshaw drivers to obtain an accident insurance.

5. Address present bias.
Families may focus on the immediate gratification such as indulging their kids with soda pops instead of the long-term needs such saving money for future school fees. So how do you address the present bias? You either fight it or take advantage of it. An example of the former is a program in South Africa run by Janet Schwartz, which helped grocery shoppers make healthier food purchases in the long run, by convincing clients to pre-commit to healthy purchases and imposing costs on breaking the commitment.

Social entrepreneurs, often use this approach. A ‘pay-as-you-learn’ Omega School in Ghana allows low-income parents to pay for school on a daily basis. Thus, parents don’t need to save a large chunk of money until the end of the month; instead they can immediately “spend” small amounts every day to ensure their children’s education.

With international development facing increasingly complex challenges, deeply dependent on people’s behavior, getting behavior change right is essential for development. While designing for the bottom of the pyramid, look at the social enterprises - they will provide useful insights.

Check Part 1: Five principles to behavior change: Why don’t they use these toilets?