In India and Africa we’ve investigated the complex personal and social factors that influence people’s behavior around health, safety, and financial inclusion. Working with partners, we’ve co-designed strategies and tools to guide positive choices.
HIV Prevention with Adolescent Girls
and Young Women
In sub-Saharan Africa, rates of HIV are much higher among girls and young women aged 15-24 than among boys and men of the same age. Often, the need for financial and emotional security leads young women into relationships with men who may pass HIV on to them. But current programs such as cash transfers – which aim to help young women stay safe by becoming financially self-sufficient – don’t always succeed. Our investigation of the aspirations and beliefs behind young women’s choices revealed that programs must provide holistic platforms that support development of healthy relationship habits.
Maternal and Neonatal Child Health
The causes of poor reproductive health in low-income countries are not just structural problems like access to healthcare: often, it’s societal norms that deter women from practicing birth control or giving birth safely at medical facilities. We uncovered the factors that make a difference by examining in depth the beliefs and behaviors not just of women, but also their family members, community health workers, and healthcare providers. Understanding this ecosystem of influences makes it possible to design programs to help women take care of themselves and their infants during pregnancy and following childbirth.
Male Circumcision for HIV Prevention
Voluntary medical male circumcision is a proven, one-time intervention that more than halves a man’s risk of getting HIV through sexual intercourse. In some African countries with high rates of HIV, most men know that circumcision can help protect them – but they still resist getting the procedure done. Uncovering the full range of emotions and behavioral barriers that a man must confront on his journey to circumcision is key to creating interventions that will help him take the step to protect his life and that of his partner.
Improving Toilet Usage and Handwashing Behaviors
More than a quarter of India’s population don’t use indoor toilets, despite large-scale government campaigns to encourage it. Open defecation is a source of disease, but it remains culturally ingrained for many. We investigated why people resist using indoor toilets, and found that alongside habit, misconceptions about sanitation and visceral reactions of disgust at smells and dirt all play a role. These insights allowed us to propose campaigns in schools, villages, and urban slums to address emotional responses, change the norms, and make it easier for people to feel comfortable about going indoors.
An Indian government program to promote financial inclusion led 177 million people to open a no-frills bank account – yet after a year, half of these new accounts were dormant, with almost no funds in them. Paradoxically, many people living in a financially precarious state preferred to take high-interest loans from local moneylenders. We looked at how chronic financial scarcity conditions people’s emotions and actions about coping with present needs and planning for the future. What we learned had implications for the design and marketing of banking products to successfully appeal to the financially excluded.
In Mumbai, more people die from being struck by suburban trains than from any other unnatural cause. Efforts to reduce the average daily toll of 10 deaths on the tracks frustrated railway authorities for years. We took a fresh look at the data to understand why people decided to cross the lines in front of oncoming trains. Were they young thrill-seekers, or just people trying to get to work or school? And why did so many fatally miscalculate the risk? Applying insights from behavioral science, we came up with some simple but remarkably effective solutions.