In October 2014, Prime Minister Narendra Modi of India declared a new national campaign to eliminate open defecation within five years. An estimated half of all Indians—mainly those living in rural areas—still defecated in the open, as humankind had done for centuries. Because India’s past programs had focused on building toilets, achieving little success, this time the emphasis was on motivating behavioral change. But exactly how to approach the challenge was left to each state. Ajoy Sharma, a veteran Indian Administrative Service officer, took on the task of implementing Modi’s plan in northern Punjab state in January 2015. To change long-held public acceptance of open defecation, Sharma developed an innovative pilot program that integrated sensitization and social mobilization at the individual, family, and community levels with financial subsidies to support toilet construction. The success of the program and its acceptance in five districts gave Sharma the evidence he needed to apply a similar template across all districts in his state. By September 2017, the project had successfully certified 11 districts—half of the state—as Open Defecation Free, a total of nearly 6,000 villages. This case study offers lessons for governments interested in altering social norms and expectations on a large scale to bring about long-term societal change.

Tini Tran drafted this case study with the help of Asha Brooks and Arpita Tripathi based on interviews conducted from April to October 2017. Case published November 2017.