UNC School of Social Work faculty are collaborating with partners in India to examine whether community programs that promote hygienic behavior and financial savings, gender equality, and enhanced mental health are having a positive impact on some of the country’s poorest residents.
Over the next year, Associate Professor Gina Chowa and Assistant Professors Latoya Small and Rainier Masa will turn their research toward the work of Samagra, a nonprofit that encourages improved sanitation through accessible and affordable public toilets; and the Comprehensive Rural Health Project, which promotes community-based healthcare, mental health, and the empowerment of girls and young women.
“With these projects, we hope to generate rigorous evidence and inform practitioners and policymakers on what works to improve the well-being of the poor in India,” Masa explained.
The faculty members, along with Dean Jack M. Richman, traveled to India in November to discuss the work and to meet with research partners, including Suresh Pathare, a professor and director of the Centre for Studies in Rural Development, Institute of Social Work and Research in Ahmednagar, India. The School has a five-year memorandum of understanding (MOU) with the Centre, which is affiliated with the University of Pune. Pathare, a former visiting scholar at UNC, has been helping the School of Social Work explore ideas that foster collaboration.
Although Chowa has focused most of her interest in Africa, she’s excited about the opportunity to expand her research to India.
“The continent of Asia is very similar to Africa in that we have similar contexts, and there are certain themes that you can see across the developing world,” she said. “That makes me optimistic that our work will have impact.”
In fact, the faculty members’ partnership with Samagra will focus on an issue that Chowa has explored extensively in Ghana—the impact of financial savings on an individual’s well-being. Specifically, the researchers intend to examine how the program’s offering of financial services, including savings accounts and other financial products, have increased the use of public toilets.
Samagra, which was started by Swapnil Chaturvedi and has gained support from the Bill and Melinda Gates Foundation, is working to improve sanitation in India, where well over 50 percent of the population, mainly in urban slums, defecate in the open. Such a practice not only increases sanitation-related diseases and death, but Samagra estimates that the urban poor lose at least 10 percent of their income due to health-related costs.
Although community restrooms have existed for years, many avoid them because they are unclean, unsafe—especially for women at night—and not easily accessible to the elderly and disabled, Chowa said.
Chaturvedi’s organization partners with municipal agencies and local businesses to renovate and improve the conditions of these restrooms. But he has been especially innovative, Chowa noted, by offering individuals incentives to use the public toilets, including on-site access to financial services, such as savings accounts, and rewards, such as discounts on washing and sanitation products. The discounts and rewards target users who can afford a small membership fee to use the restrooms, although the community toilets are still open to all, she said.
“What Chaturvedi is pursuing is behavioral economics,” Chowa said of how Samagra’s founder is attempting to change sanitation habits. “He has said that if people feel they own the place and if they are nudged and incentivized, they will use (the restrooms).”
The fees also help to maintain the facilities and keep them clean. But Samagra is also helping to “bank the unbanked,” Chowa said.
“This program has made life easier for the blue collar workers,” she said. “Most of them leave very early in the morning for work and get home really late. So if they need to go to the bank, it just doesn’t happen during the day because if they leave their workplace, they lose their job. But with the community toilets, they usually visit them early in the morning and late at night. So to find somebody who can do all of this for them and help them have access to all of these services is really convenient.”
The program truly embraces the triple bottom line, Richman added. “It’s health related, environmentally related, and economically beneficial for the community.”
Chowa and her colleagues hope to roll out an impact study with Samagra at the end of 2016 or by early 2017.
With the Comprehensive Rural Health Project (CRHP), School faculty will focus on some of India’s poorest villages and on the impact of the organization’s gender equality program, which discourages discrimination and violence against women and teaches all adolescents to value girls and education early in life.
“Although there are adolescent programs for girls and boys, CRHP’s approach really focuses on changing the minds of boys and teaching them the importance of treating women as human beings,” Chowa explained.
Faculty will also work with CRHP to examine the effectiveness of its mental health program, which trains community volunteers to become mental health workers. These workers—mainly uneducated women who live within the villages that CRHP serves—help to diagnose the symptoms and the behaviors of mental illness, including schizophrenia, bipolar and anxiety disorders, and refer individuals for services where needed.
“The training is very comprehensive and intense,” Chowa said. “They are also trying to change behaviors toward people with mental illness, so it’s quite holistic and really an amazing program. But they don’t have any evidence of impact. Our goal will be to look at the outcomes. Currently, all they have is anecdotal, but that has been very, very positive.”
Chowa hopes to get the study off the ground by early 2017.
Ultimately, the projects should not only benefit the agencies and the communities they serve but also give research partners an opportunity to work alongside School faculty to strengthen their intervention research skills, Richman said.
“It will also help us to continue to build our research presence internationally, so it’s really a win-win-win all around,” he said.
Photos courtesy Dr. Gina Chowa