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Assessing the impact of monetary incentives on open defecation: Experimental evidence from a CLTS program in rural Laos
Last registered on July 18, 2019

Pre-Trial

Trial Information
General Information
Title
Assessing the impact of monetary incentives on open defecation: Experimental evidence from a CLTS program in rural Laos
RCT ID
AEARCTR-0003408
Initial registration date
October 17, 2018
Last updated
July 18, 2019 12:20 AM EDT
Location(s)

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Primary Investigator
Affiliation
University of Melbourne
Other Primary Investigator(s)
PI Affiliation
Monash University
PI Affiliation
East Meets West
PI Affiliation
Georgetown University
Additional Trial Information
Status
On going
Start date
2015-01-01
End date
2019-12-31
Secondary IDs
N/A
Abstract
Evidence on the effectiveness of Community-Led Total Sanitation programs (CLTS) and latrine subsidies in promoting hygiene practices has been documented in a number of studies, reviewed in Garn et al. (2016). Less is known about how collective and individual financial incentives can interact to improve sanitation for the poorest households. We investigate this question in two provinces of South Laos, where over half of our sample of 2,400 households practiced open defecation at the beginning of our study. We conduct a randomized controlled trial encompassing 160 villages. All households were exposed to CLTS. In treatment groups, we augmented CLTS with packages of financial incentives to test their impacts on hygiene. We are interested in how the incentives promote hygienic behavior across the wealth distribution. This study will provide evidence on the complementarity of small financial incentives to demand-triggering campaigns and their role in promoting equity in areas where sanitation coverage remains low.
External Link(s)
Registration Citation
Citation
Cameron, Lisa et al. 2019. "Assessing the impact of monetary incentives on open defecation: Experimental evidence from a CLTS program in rural Laos." AEA RCT Registry. July 18. https://doi.org/10.1257/rct.3408-2.0
Former Citation
Cameron, Lisa et al. 2019. "Assessing the impact of monetary incentives on open defecation: Experimental evidence from a CLTS program in rural Laos." AEA RCT Registry. July 18. https://www.socialscienceregistry.org/trials/3408/history/50221
Sponsors & Partners

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Experimental Details
Interventions
Intervention(s)
Between June 2014 and June 2015, a community-led total sanitation (CLTS) program was rolled out in 160 villages across 10 districts of rural Southern Laos by the health ministry (with technical support from the World Bank Water and Sanitation Program). Between February 2015 and June 2017, we complemented the CLTS program by providing packages of financial incentives designed to increase take-up of improved sanitation, especially in poor households.

The incentives offered were:

Village incentive: targeted at village administration, and delivered after verification of open defecation elimination by district health officials. The reward value was around USD 300-500, depending on village size, and could be used at the village head's discretion for any development project.

Promoter+household incentive: targeted at poor households, and delivered after verification of installation and use of pour-flush toilets. The reward value was around USD 20 (roughly equal to a 40% rebate on the cheapest poor flush toilet model without a superstructure). An accompanying reward was targeted at village sanitation promoters (part of village sanitation committee), and delivered upon verified installation of pour-flush toilets by poor households. The promoter reward value was around USD 3 per toilet.

To investigate how individual and community monetary incentives interact with the CLTS program to improve rural sanitation, we randomly assigned the interventions at the village level (see Experimental Design).
Intervention Start Date
2015-01-01
Intervention End Date
2018-06-01
Primary Outcomes
Primary Outcomes (end points)
Latrine construction, open defecation, caretaker reported diarrhea prevalence and diarrhea symptoms, children’s height- and weight-for-age.
Primary Outcomes (explanation)
Secondary Outcomes
Secondary Outcomes (end points)
Social cohesion.
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
160 villages were randomly assigned to one of four equally-sized treatment groups. All groups received Community-Led Total Sanitation (CLTS). In Treatment Group 1, we also implemented smart subsidies targeted to the poorest 30% of households and provided promoter commissions. In Group 2, open defecation elimination rewards were offered to villages. Group 3 included all incentives in Groups 1 and 2. Group 4 is the control group, which received CLTS with no individual or community incentives.
Experimental Design Details
Not available
Randomization Method
Randomization by computer.
Randomization Unit
Village level randomization.
Was the treatment clustered?
Yes
Experiment Characteristics
Sample size: planned number of clusters
160 villages.
Sample size: planned number of observations
2400 households.
Sample size (or number of clusters) by treatment arms
40 villages per treatment arm.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB
INSTITUTIONAL REVIEW BOARDS (IRBs)
IRB Name
National Ethics Committee For Health Research (Laos)
IRB Approval Date
2014-09-15
IRB Approval Number
039
Analysis Plan

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