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T.45 Social Norms and the Use of Shame and Disgust

Social Norms are the informal, mostly unwritten, rules that define acceptable, appropriate and obligatory actions in a given group or society.

Social Norms B.6 can be described as a person’s beliefs about what others in their group do (descriptive norms) and what they approve and disapprove of (injunctive norms). Many norms are context specific, differ between groups and change over time but some norms seem to be universal. There are various ways to create ‘new’ Social Norms, such as identifying hygiene or sanitation Champions T.22, Exchange Visits T.12, Public Commitment T.37 or by simply conveying the idea that ‘the majority of people are doing this’ e.g. handwashing with soap or having their vaccination. Care must be taken not to encourage unwanted Social Norms. For example, media coverage about people not staying at home during COVID-19 lockdowns could inadvertently encourage the same behaviour by others.

Social Norms or their infringement can produce strong emotional responses such as Shame and Disgust; this is widely used in Community-Led Total Sanitation’s (CLTS, F.2) ‘triggering’ activities. Shame is an emotion that involves self-reflection and evaluation. Disgust is often described as a cross-cultural human emotion that has evolved as a protective mechanism against contamination and infectious disease. The use of Shame and Disgust (and concurrent positive emotions such as pride, self-respect and dignity) can lead to self-realisation and growth. However, the use of Shame and Disgust during CLTS triggering sessions continues to be debated in the sector. Some see it as unethical as it may degrade and embarrass the community and generate stigma. Others believe that the element of shame is positive and helps to collectively awaken the community to the realities of Open Defecation (OD).


Social Norms can be applied in any context or phase of the response. The use of Shame and Disgust in CLTS is most widely used in rural communities and where the majority practise OD. It works best in contexts with sufficient social cohesion and strong local leadership.


  • Assess different Social Norms relating to hygiene and consider how they can be used

  • Allow people to work things out for themselves when using Shame and Disgust


  • Do not tell people what is good and bad

  • Do not inadvertently create harmful Social Norms in hygiene communications

  • Do not use Shame and Disgust if only a small percentage of a community practises OD

Practical Example

An urban CLTS F.2 intervention conducted by Malteser International in Juba, South Sudan used elements of Shame and Disgust as part of the initial processes of Community Mapping T.7, Transect Walks T.52 and ‘Water and Shit’ Demonstrations T.10. The Transect Walk - also known as a ‘Walk of Shame’ – was used to visit different OD areas in the community where people were given time to inhale the unpleasant smell and take in the unpleasant sight of large-scale OD while asking questions (e.g. which families use which areas for defecation? Where do women go? What happens during emergency defecation at night?).

Key Decision Critria

Response Phase
Acute Response
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Protracted Crisis
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HP Component
Preconditions and Enabling Environment
Community Engagement and Participation
Assessment, Analysis and Planning
Social and Behaviour Change
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Monitoring, Evaluation, Accountability and Learning (MEAL)
Target Group
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Older People
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Persons with Disabilities
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Local Leaders
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Society as a whole
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Application Level
Individual / Household
Community / Municipality
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Overview of practice of using Social Norms and common pitfalls

Cislaghi, B., Heise, L. (2018): Theory and Practice of Social Norms Interventions: Eight Common Pitfalls, Globalization and Health, Vol. 14 (83)

Petit, V., Zalk, T. (2019): Everybody Wants to Belong: A Practical Guide to Tackling and Leveraging Social Norms in Behavior Change Programming, UNICEF, PENN SoNG

General information and research on shame and disgust

Otieno, P. (2012): The 'Shame Question' in CLTS, CLTS Knowledge Hub

Brewis, A., Wutich, A. (2019): Why We Should Never Do It: Stigma as a Behavior Change Tool, BMJ Global Health 4(5)

Harvey, P. (2011): Community-Led Total Sanitation, Zambia: Stick Carrot or Ballon?, Waterline, Vol. 30(2)

Lawrence, J., Yeboah-Antwi, K. et al. (2016): Beliefs, Behaviors, and Perceptions of CLTS and Their Relation to Improved Sanitation in Rural Zambia, American Journal of Tropical Medicine and Hygiene, Vol. 94(3). Pages 553-562

Bolton, L., Kanguru, L. (2013): Helpdesk Report: Community-Led Total Sanitation in Africa, HEART

Gonzales, L., Güllemann, H. et al. (2010): Community-Led Total Sanitation in the Red Cross / Red Crescent Movement. Discussion Paper, IFRC, Swiss Red Cross, French Red Cross

Detailed description of the CLTS approach incl. shame and disgust and experiences in post-emergency and fragile contexts

Kar, K., Chambers, R. (2008): Handbook on Community-Led Total Sanitation, IDS, Plan International

Greaves, F. (2016): CLTS in Post-Emergency and Fragile States Settings. Frontiers of CLTS Issue 3, IDS