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How Small Interventions Can Solve Big Public Problems

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Research in behavioural science points towards the fact that although people are rational, they often act in a way that’s not in the best interest. However, they can be nudged into making better and healthy decisions if the choices are presented or framed differently. For this reason, many public and private organisations around the globe are investing in teams popularly called as nudge units to understand people’s behaviour and use this analysis to make policies and programmes more effective.

While India only recently started using this theory for the government programme like Swatch Bharat, it has been used around the world in various sectors ranging from health to education and from taxation to elections.

Here are 5 times nations used the nudge theory for good.

1. A personalised letter got more Britons to pay taxes on time

In Britain, it all worked through well-worded letters. Every time you forgot to pay your tax or delayed in paying fines – you’d receive a formal letter reminding the offenders to do their duty. But the response was pretty limited.

Enter: Nudge Units. These units also called as Behavioural Insights Team (BIT) were set up in 2010 by the David Cameron’s government soon after they came to power. The team mainly included economists and psychologists who analysed people’s behaviour to run the country better. Since then, they’ve conducted various successful experiments to make policies more effective. One of the most successful one was improving the tax collection. Ideally, when the Brits are late while paying their taxes, they are sent letters from the tax department – Her Majesty’s Revenue and Customs – which remind them to pay taxes. The nudge unit, based on people’s psychology suggested that people will respond better when the letters were made simple, personalised and included startling statistics. Accordingly, the letters were modified – each applying different insight from behavioural science. One letter replaced this sentence – “The great majority of people in [the taxpayer’s local area] pay their tax on time” with “Nine out of 10 people in the UK pay their tax on time”. Another one played on the neighbour effect and compared the taxpayers to their neighbours. It stated: “Nine out of ten people in your local area pay their tax on time.” A simple change in the wording of the letter led to a 15% rise in the tax payments. This experiment was extended to include visual messages for the collection of road tax. Those who did not pay road taxes more than once, were sent modified letters with words ‘Pay your taxes or lose your car’ with a photograph of the receipt’s car attached. Soon after the experiment was run, the number of payments tripled.

Similar was the case with late fine payment. Offenders of minor offence are usually slapped with small fines. However, they are never paid. In fact, fine worth $789 million was unpaid in Britain. While a person is likely to toss a reminder mail aside, he’s more likely to pay attention to a text message which had his/her name on it. An article states that an offender is more likely to respond to a personalised text – 33% – than an email – which is just 5%.

2. Qatar increased the Diabetes screening during a religious holiday

According to the International Diabetes Federation, globally there are 371 million people are affected by diabetes – but half of these do not even know they have this disease. Screening and early detection of this disease then become an important focus area, as sooner diabetes is diagnosed and treated, lower is the risk of complications. And this was a need of hour in Qatar where out of the 17% population suffering from diabetes, one-third either not aware of their diseases or have not been diagnosed.

That’s when Hamad Medical Corporation (main hospital provider in Qatar) and an NGO – Action on Diabetes – though of a unique way to increase the awareness for the disease and it’s screening. In 2014, they smartly used the religious holiday of Ramadan to increase the diabetes screening in Qatar. As people were anyway fasting so the hassle of having to not eat before the test was removed. The team set up 20 screening stations at the State Grand Mosque of Qatar, each with 2 nurses. The worshippers who attended the prayers at noon, who were also fasting since sunrise were invited for the screening. And Imams – the leaders of the religious community – were involved to encourage the worshippers to take the tests. In total, 2177 people were screened. At least one-third of the worshippers were unaware that they had diabetes. The behavioural pattern of fasting during the holy month of Ramadan provided timely moment for the patients to be diagnosed for diabetes.

3. A simple change in packaging reduced the suicide rates in the UK

During the late 90s, there was steady rise in a number of suicides from poisoning. While half the suicides were committed with firearms, at least 20% were by poisoning using drugs. In 1998, one of the common methods of committing suicide was through an overdose of Paracetamol (painkillers), a drug which is commonly available at people’s home. A research by the Oxford University pointed towards the fact that it was easier and rather motivating to consume many tablets (approximately 25 tablets) in one go when they are in a loose pack or a bottle. But, the same process get tougher when the tablets are in a blister pack (packaged ones). Back then, the UK made a very tiny, but effective way to deter suicide – by changing the packaging. The law banned selling these drugs in loose packs and required them to be sold in blister packs of 16 or 32 pills. Which meant anyone who wanted to swallow multiple pills would have to buy numerous blister packages and sit down and push out the pill one by one. This required a lot of commitment. And most of the people are not that committed. The government, by decreasing the ease to access a large amount of painkillers had helped reduce suicide to 43% over the next 11 years.

4. Visually clear signs encouraged Singaporeans to opt for a healthy diet

Singaporeans are foodies! For them, food is a part of their tradition, culture and a matter of pride. In this process, unhealthy consumption habits and junk food is hard to ignore – especially when 6 out of 10 Singaporeans were eating at food courts more than 4 times a week. Owing to their unhealthy eating habits, the nation is projected to hit obesity rates of 15% by 2024, according to the Health Promotion Board. In such a scenario, getting people to eat healthier was a priority. The Health Promotion Board soon came up with small ways through which the government could nudge the population to make better choices.

In Singapore, nudges come across as smaller, but visually clear hints – dropped here and there around the nation. In 2001, Singapore’s Health Promotion Board launched a Healthier Choice Symbol (HCS) which is a visual identifier clearly indicating which products are healthy. People are lazy. They do not want to spend time reading the endless list of ingredients on the food label. This one symbol was taken to eliminate the cognitive load required to read these labels. Soon, more and more consumers started choosing HCS products. In another programme called the Healthy Dining Programme, food and beverage providers would get grants and incentives for providing healthier options or dishes which are 500-calorie meals. To make it easier to spot these on a menu cluttered with many meal options, the healthy meals are too marked with the HCS. The programme also covers the food stalls on the streets. These are marked with a red sticker. These would include text like ‘Healthier option available here’ or ‘We use healthier oil’. So, if you want to eat something junk in Singapore, it’s likely you’ll have to pay more for it.

5. A bit of motivation increased the test scores of students in Peru

In Peru, there was a wide gap in the test scores between students from high and low-income households. The low-income household students had a pre-conceived notion about their own intelligence. They believed that they were not smart and there’s little they could do to improve this. A usual approach to deal with a situation like this would be to invest more in their training and learning material. But, the World Bank’s nudge unit (Mind, Behavior, and Development Unit), the University of Oxford and MineduLAB – Peru’s first nudge unit – decided to take a different approach. They developed a project called ‘Expand Your Mind’ which focused on using simple, cost-effective innovations to motivate these students to change their mindset. Under this programme, the students were given essays and handouts with titles which would change their mindset like “Did You Know You Can Grow Your Intelligence?”, “Everyone knows that when you lift weights your muscles grow stronger. Scientists have discovered the brain works in the same way; when you face big challenges your brain also grows.”

The students were also asked to write letters to their friend about how they could practice and grow their mind. The students who took part in the programme showed significant improvements on the National Assessment Test, a result that is expected to have far-reaching positive effects. It led to a 0.14 standard deviation increase in math test scores, equivalent to four extra months of schooling, at a cost of less than $0.20 per student. The largest results are equivalent of having a parent with three more years of education. The intervention demonstrates the power of a low-cost, high-impact intervention for improving student outcomes dramatically and over time.

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