For hundreds of millions of people in rural India, living life without a toilet used to be quite common. However, thanks to the Indian government’s toilet building program, millions of people now have regular access to toilets for the first time. Although this sounds like a tremendous success, there’s still one more thing to be done: convince people to use them.

There are several reasons why people have resisted using the new toilets. A common complaint is the need to clean out the pit where waste is stored. This also carries with it a social stigma since handling human waste was historically done only by the lowest castes. Some individuals believe the outdoors is healthier than using the toilet, and others believe using the toilet is only for women. Overall, the response to these new toilets has been less than favorable.

Convincing people to use toilets is a major health priority for India. According to the World Health Organization, poor sanitation is linked to the transmission of many diseases including dysentery, cholera, typhoid and polio. Over half a billion people in India don’t use toilets, and until toilet use and other basic sanitation habits become consistent, India’s rural poor will continue to suffer from many preventable diseases.

In addition to higher rates of infection, open defecation has other hazards, particularly for women. Recently, two women were raped and killed as they went to the fields at night to relieve themselves. In the dark, both men and women face the danger of being bitten by venomous snakes. Many of these dangers would be reduced if people had access to and used toilets in or near their homes. Despite these more obvious dangers, toilets have remained unpopular.

So what can be done? To date, various advertising campaigns have been employed to convince individuals to use the toilet, but not all have been successful. Many of the advertisements have focused on convincing the public that the toilet is a right for women as it provides women with safety and dignity. These campaigns have been partially successful: many people now believe that toilets are important — for women. Unfortunately these advertising campaigns have led many men to believe that they are exempt from using the toilet.

In order to convince more people (particularly men) to use the toilet, the toilet needs to become more than a convenience — it needs to become “cool.” This will require more than providing facts and figures to the public. A possible avenue that is yet to be explored is to use endorsements from Indian celebrities to make the toilet more popular. A study conducted by Bowling Green State University showed that young adults are more likely to support political stances that have been endorsed by a celebrity. Perhaps using similar tactics in India will help drive the necessary cultural change.

Improving sanitation in India will do more than reduce disease and danger. Experience has shown that installing toilets in Indian schools dramatically increases school enrollment, especially for girls. Improved health conditions also imply that fewer students will need to miss classes due to illness, improving individual learning outcomes. In short, improving sanitation will help to improve education.

Improving India’s sanitation practices is a major health priority since India accounts for half of the world’s population who don’t use toilets. This problem cannot be solved by infrastructure changes alone and will require a dramatic change in attitude towards the toilet. In order for India to succeed with this challenge, making the toilet “cool” is a necessity.

See Meet Mr Toilet video:  Act Now

John Hoffmire is director of the Impact Bond Fund at Saïd Business School at Oxford University and directs the Center on Business and Poverty at the Wisconsin School of Business at UW-Madison. He runs Progress Through Business, a nonprofit group promoting economic development.

Richard Payne, Hoffmire’s colleague at Progress Through Business, did the research for this article.