Getting Zambians to upgrade their sanitation and reduce Cholera outbreaks

LSP engaged 17 Triggers to design and execute a marketing and sales strategy focused on creating ground up demand for a new suite of sanitation products and services: including new lined pit latrines, fecal sludge management services, and sewerage connections. At the same time, Lusaka was recovering from the most widespread cholera outbreak in recent decades, enabled by increasing population density and the use of home-dug toilets and wells within peri-urban areas.

In formative research, the key barriers to uptake were identified as a lack of ownership over the latrines, existing access to some form of latrine even if sub par, a lack of trust in the latrines, and cost. Added barriers were a lack of trust in capacity for maintenance and a belief that the technology would be provided free of charge, if they waited long enough. Once replaced or upgraded, households expected landlords, NGOs, or the city to manage their ongoing sanitation requirements (unblocking, desludging).

Community members point out their budget priorities as part of exploring their requirements for their ideal toilets.

Creating a sense of urgency to put sanitation first

The team targeted two main drivers of adoption – health and affordability. Together with local partners, 17 Triggers developed a campaign centred around protecting groundwater via a noxious ‘cholera monster’ character who taunted residents about their lax sanitation behaviors, providing opportunity for outbreaks.

This character generated demand for latrines by creating awareness of the linkage between latrines, groundwater, and disease and played on the desire to protect their families from cholera and prove the ‘cholera monster’ wrong. The character and key messages were delivered via a multi-media communications strategy comprising TV, radio, out-of-home and guerilla marketing, utilising community leaders and social groups to drive improvements to household sanitation facilities and behaviours.

By design, this program targeted lower income compounds and neighborhoods, where piped sewage systems were impossible based on the environment. Therefore, the cost barrier needed to be addressed. Customers were given the opportunity to pay their latrine off over time, therefore reducing the up front risks of adoption, they were told about the level of subsidisation of the latrines which enabled the low price, and sales tools modeled their savings over time using a lined vs. unlined latrine. Many customers were unaware of what came after adoption of a latrine, so the entire journey was laid out to the customers upon adoption – from upgrading to emptying the latrine – therefore clarifying any potential roadblocks down the line.

Mural at a treatment facility helps build trust in the service providers and illustrates the safe process to remove faecal sludge. 

Driving sales from the front-line

During the early stages of the marketing campaign it became clear that positive engagement with front-line sales and construction staff on the project had a significant impact on customer uptake. A comprehensive training, support and incentive program was developed and delivered to customer-facing staff across the project to drive increased frequency and quality of customer engagement. As the campaign progressed, front-line workers including customer service and sales staff, technical engineers, builders and painters were engaged in activities to build their understanding of positive sanitation practices and the causes of cholera, as well as their capacity to deliver this information throughout their local communities and existing clientele. Throughout the project, 930 frontline staff were trained.

To boost community engagement, the team developed a variety of community-based experiences such as a mobile and permanent showroom for latrines, community water point improvements, and a concert with local artist Slap Dee. Community ambassadors were also identified and invited to install latrines, as a proof of concept. This increased trust in the technologies and community members were ultimately willing to adopt the latrines and services.

The ‘Cholera Monster’ campaign ran nation-wide in Zambia from November 2019 through to July 2020. It achieved the sanitation product sales target of new and improved latrines, and reached more than 3.5 million Zambians with positive sanitation behaviour messages. The campaign was handed off to the local project implementing partner, Lusaka Water Supply & Sanitation Company, who has materials to develop the campaign further and plan future pivots to continue demand generation.

Local ambassadors pose with their sales gear.