Social marketing of water and sanitation products A systematic re.docx

Social marketing of water and sanitation products: A systematic
review of peer-reviewed literature
· W.D. Evansa, , ,
· S.K. Pattanayakb, ,
· S. Younga, ,
· J. Buszinc, ,
· S. Raib, ,
· Jasmine Wallace Bihma,
Show more
doi:10.1016/j.socscimed.2014.03.011
Get rights and content
Highlights
•
Water and sanitation behaviors can be marketed like commercial
products.
•
There has been no systematic review of theory, research, and
practice in this area.
•
We identified 32 articles over a 22 year period that met search
criteria.
•
Evaluations show improvements in mediators but mixed results
in behavior change.
•
Social marketing can improve water and sanitation programs
worldwide.
Abstract
Like commercial marketing, social marketing uses the 4 “Ps”
and seeks exchange of value between the marketer and
consumer. Behaviors such as handwashing, and products such as
those for oral rehydration treatment (ORT), can be marketed

like commercial products in developing countries. Although
social marketing in these areas is growing, there has been no
systematic review of the current state of practice, research and
evaluation.
We searched the literature for published peer-reviewed studies
available through major online publication databases. We
identified manuscripts in the health, social science, and
business literature on social marketing that used at least one of
the 4 Ps of marketing and had a behavioral objective targeting
the behaviors or products related to improving water and
sanitation. We developed formalized decision rules and applied
them in identifying articles for review. We initially identified
117 articles and reviewed a final set of 32 that met our criteria.
Social marketing is a widespread strategy. Marketing efforts
have created high levels of awareness of health threats and
solutions, including behavior change and socially marketed
products. There is widespread use of the 4 Ps of marketing, with
price interventions being the least common. Evaluations show
consistent improvements in behavioral mediators but mixed
results in behavior change.
Interventions have successfully used social marketing following
widely recommended strategies. Future evaluations need to
focus on mediators that explain successful behavior change in
order to identify best practices and improve future programs.
More rigorous evaluations including quasi-experimental designs
and randomized trials are needed. More consistent reporting of
evaluation results that permits meta-analysis of effects is
needed.
Keywords
· Social marketing;
· Health promotion;
· Behavior change;
· Water;
· Sanitation;
· Diarrheal disease

1. Introduction
At its core, marketing is about an exchange of value between
the marketer and consumer. If the marketer can promote a
product or service to make the consumer perceive sufficient
value, the consumer is more likely to purchase it. The
marketer's objective is to create value for consumers and
thereby financial benefit for the marketer or her clients. Social
marketers use the same powerful idea in a different way – not to
sell products and services for the benefit of the marketer but to
promote socially beneficial causes and behaviors for the benefit
of the audience (Hastings, 2007). A growing body of evidence
shows that marketing is highly effective in this arena as well
(Evans et al., 2008).
Like commercial marketing, social marketing uses the basic
principles of the “marketing mix”, or 4 “Ps” of place, price,
product, and promotion (Borden, 1964 and Kotler and Lee,
2008). Just as a brand of toothpaste can be effectively marketed
by making it available to consumers in convenient locations,
pricing it right relative to competitors, endowing it with
attractive perceived benefits, and advertising it in persuasive
ways with sufficient frequency, behaviors such as handwashing
and treatment products such as those for oral rehydration salts
(ORS) can also be marketed. In the case of handwashing, we
may need to think differently about factors such as ‘price’ (time
and effort, or convenience) and ‘product’ (the social or
functional benefits gained from the behavior) but the basic
approach is the same (Evans and Hastings, 2008).
Recently, there has been growth in social marketing to promote
healthy drinking water and sanitation practices, as well as
treatments to prevent water-related illnesses such as diarrheal
disease (Devine, 2008 and Freeman et al., 2009). However, to
date there have been no known efforts to systematically review
and assess the extent, nature, and evidence of effectiveness for
social marketing in global water and sanitation programs. The
purpose of this paper is to systematically review the published
literature on this topic and evaluate the state of practice and

evidence in the field. Specifically, we sought to identify 1) the
presence or absence of specific social marketing activities in
each intervention, 2) the presence or absence of each of the 4 Ps
of marketing in the interventions, and 3) the outcome of the
evaluation conducted in these social marketing interventions.
Based on results of this review, we discuss the need for
interventions that incorporate more Ps, more outcomes research,
and more research on the effectiveness of specific intervention
strategies and combinations of the 4 Ps.
2. Methods
We conducted a systematic search of the published, peer-
reviewed literature using all relevant major online research
literature databases (specified below) and following widely
accepted methods for systematic review (Higgins and Green,
2011). We note that social marketing and interventions focused
on water and sanitation are also widely represented in
unpublished reports and other ‘gray’ literature. However, we
focused on peer-reviewed literature in order to ensure quality of
evidence and consistency with accepted systematic review
practices.
We identified as relevant any manuscripts in the published
health, social science, and business literature that used at least
one of the 4 Ps of marketing, had a behavioral objective
targeting water and sanitation related behaviors, and had a
health objective targeting diarrheal disease. We based the
review methodology in part on methodologies from a previous
review of branded social marketing campaigns conducted by the
lead author (Evans et al., 2008). Specifically, we searched the
following health, social science, and business databases:
•
PubMed, PsycINFO, Web of Science (includes Science Citation
Index Expanded, Social Sciences Citation Index, and Arts &
Humanities Citation Index), Communication & Mass Media
Complete, Academic Search Premier, Business Source Premier,
CINAHL, Health Source: Nursing/Academic Edition, and Health
Source: Consumer Edition.

Search terms included the following: Diarrhea/Diarrhoea,
Hygiene, Water, Sanitation, Social Marketing, Health
Promotion, Health Communication, Community Intervention,
Community Health, Behavior Change. We selected these terms
based on the authors' experiences in the field and conducting
previous reviews, and in consultation with a medical research
librarian.
For completeness, we also searched literature known to the
authors, including publications on water and sanitation
intervention studies in the developing world. In particular, the
bibliographies of two recent meta-analyses on social marketing
and mass media intervention were reviewed and potential
citations screened following the methods described (Snyder
et al., 2004 and Grilli et al., 2002).
We searched all sources listed above in the date range of 1991–
June 2013). Based on this process, we created a database of all
352 unduplicated articles on social marketing interventions
regarding diarrhea and water or sanitation. We immediately
excluded 235 articles regarding ‘breastfeeding and diarrhea’,
‘zinc supplementation and diarrhea’, and articles that did not
include an intervention of any kind. After this initial phase, we
identified 117 articles.
Next, we reviewed the articles based on our specific criteria for
inclusion in study. Namely, we screened them for reports on
interventions that: 1) were original research (not review papers,
meta-analyses, or commentaries); 2) utilized some form of
social marketing principles (i.e., reported on use of 1 or more of
the four Ps); 3) targeted behavior relating to water or sanitation;
and 4) targeted diarrhea prevalence and/or morbidity as a health
objective. We also screened to ensure the articles included
specific reports of evaluation or implementation of social
marketing activities, defined as coordinated efforts to promote,
distribute, or use pricing strategies to encourage adoption of
various products aimed primarily at diarrheal disease
prevention. Based on this in-depth screening process, we
excluded 85 articles and identified 32 articles for inclusion in

the study. Fig. 1 summarizes the review process.
Fig. 1.
PRISMA diagram of systematic review process.
Figure options
Note that due to the diverse nature of the literature on social
marketing interventions in this area, and the varying methods of
reporting outcomes, we chose not to attempt a meta-analysis of
effects of reviewed interventions on behavior. Rather the
purpose of this paper is to describe the nature of the
interventions and literature, hopefully promoting more uniform
reporting of outcomes in future.
Once the review sample of articles was identified, the first two
authors individually read each of the articles in-depth and coded
them for specific content reported in the results section. The
results of all reviews were compiled and discussed by the
reviewers. Potential sources of differences in assumptions and
approach in coding articles were identified and discussed. A
consensus was reached about coding, and common procedures
adopted where discrepancies had been identified.
3. Results
Table 1 provides a summary of basic information gleaned from
each water and sanitation article reviewed. The articles dealt
with interventions relating to household water treatment,
handwashing, safe disposal of feces and personal hygiene. The
studies covered 14 developing countries, mostly in South Asia
and Africa.
Table 1.
Overview of studies in this review.
Topic area
Citation
Public health campaign
Research design
Location
Safe water system
Dunston et al. (2001)

Safe Water System (Sûr’Eau)
Paired study; randomized
Madagascar
Safe water system
Makutsa et al. (2001)
Water, Sanitation, and Education for Health (WASEH) Project
Non-experimental
Kenya
Safe water system
Quick (2003).
Safe Water System (SWS)
Experimental; field trials
Zambia, Madagascar, Kenya
Point-of-use water treatment
Parker et al. (2006)
Safe Water System (SWS)
Non-experimental; Paired Study
Kenya
Handwashing; safe disposal of feces
Curtis et al. (2001)
Saniya
Observational study; randomized
Burkina Faso
Handwashing; dishwashing
Pinfold (1999)
Social marketing – (posters and curriculum within schools,
leaflets, stickers, handwashing containers, posters
Experimental; microbiological indicators (fingertip
contamination
Thailand
Faucet-fitted earthen vessels; point-of-use water treatment
Dongre et al. (2008)
Community-Led Initiatives for Child Survival (CLICS) program
Quasi-experimental
India
Safe Water System

Garrett et al. (2008)
Water, Sanitation, and Education for Health (WASEH) Project
Quasi-experimental
Kenya
Handwashing; point-of-use water treatment; use of local vessels
Luby et al., 2004a and Luby et al., 2004b
Home-based intervention
Quasi-experimental
Pakistan
Handwashing; point-of-use water treatment
Luby et al. (2006)
Children's books, notebooks, pens and pencils
Cluster randomized control
Pakistan
Handwashing
Luby et al., 2004a and Luby et al., 2004b
The Karachi Soap Health Study
Cluster randomized controlled trial
Pakistan
Handwashing
Luby et al. (2005)
The Karachi Soap Health Study
Cluster randomized controlled trial
Pakistan
Hygiene practices; infrastructure
Nanan et al. (2003)
Water and Sanitation Extension Programme (WASEP) project
Case Control
Pakistan
Hygiene practices
Onyango-Oumaa et al. (2005)
Participatory health education with students; peer training
among students
Quasi-experimental
Kenya
Handwashing; dishwashing

Pinfold and Horan (1996)
Social marketing techniques to promote dishwashing and hand
washing
Quasi-experimental
Thailand
Point-of-use water treatment; safe storage
Quick et al. (1999)
Point-of-use water disinfection; safe storage; community
education; weekly visits by community health workers
Quasi-experimental
Bolivia
Safe water system
Migele et al. (2007)
Water treatment with bleach, safe storage, and behavior-change
communications
Observational
Kenya
Safe water system
Stockman et al. (2007)
Safe Water System, “Waterguard”
Observational
Malawi
Safe Water System
Thevos et al. (2003)
Safe Water System, “Clorin”
Experimental
Zambia
Safe Water System
Thevos (2000)
Experimental
Zambia
Safe Water System
Thevos (2000)
Experimental

Zambia
Feces disposal; appropriate places for defacating
Yeager et al. (2002)
Promotion through nurses at health clinics – use of IPC, video
presentations and leaflets
Quasi-experimental
Peru
Hygiene; sanitation
Kariuki et al. (2012)
Capacity building and empowerment
Repeat cross-sectional
Kenya
Hand washing; water treatment; latrines
Greene et al. (2012)
School-based water, sanitation, and hygiene (WASH)
intervention
Cluster randomized trial
Kenya
Hand hygiene; drinking water treatment and storage
Ryman et al. (2012)
“Waterguard”
Experimental
Kenya
Zinc-promotion
Wang et al. (2011)
Social Marketing Plus for Diarrhoeal Disease Control: Point of
Use Water Disinfection and Zinc Treatment (POUZN) project
Experimental
Nepal
Handwashing
McDonald et al. (2011)
“No Germs on Me”
Observational
Australia
Water treatment
Wood et al. (2012)

“Waterguard”
Observational
Malawi
Water treatment
Luby et al. (2008)
Marketing of flocculant-disinfectant
Experimental
Guatemala
Water treatment and storage
Lule et al. (2005)
Safe water system
Experimental
Uganda
Water treatment and storage
Quick et al. (2002)
Safe water system
Experimental
Zambia
Safe water system
John et al. (2007)
Safe water system
Retrospective ecological study
Kenya
Table options
The interventions used a wide range of health communication
and social marketing strategies, including mass media,
interpersonal communication (IPC), community outreach and
visits to households by health workers. New and social media,
while rapidly growing forms of communication, were not
identified as strategies in any of the reviewed papers. High
levels of awareness of the promoted health messages were
reported.
Table 2 provides a summary of the topic areas that were the
focus of social marketing interventions. Most interventions
focused on behaviors practiced inside the home, such as
handwashing, point-of-use water treatment, dishwashing and

various hygiene practices. Several interventions incorporated
more than one desired behavior, such as appropriate water
storage in combination with point-of-use water treatment.
Table 2.
Topic area (n = 32). a
Variables
Frequency
%
Safe water system
10
31.3
Point-of-use water treatment
12
37.5
Handwashing
9
28.1
Dishwashing
2
6.3
Improved water supply
1
3.1
Use of local vessels
2
6.3
Infrastructure
1
3.1
Appropriate places for defecating/Safe disposal of feces
3
9.4
Ground sanitation
1
3.1
Hygiene practices

3
9.5
Latrines
2
6.3
Safe storage
4
12.5
a
Several articles addressed multiple topics.
Table options
Table 3 provides a summary of the social marketing
development described in the water and sanitation articles
reviewed. In some cases, studies described specific scientific
theories used in the development of the social marketing effort
used. Psychology and communication theories were the most
commonly used theories, found in 26% and 23% of the studies
reviewed, respectively. Some of the articles described
intervention efforts based in formative research such as
interviews and focus groups. Examination of the studies in
terms of the use of the 4 Ps of marketing revealed a majority
using each of the four marketing techniques. Almost all articles
(96.8%) used “product” and “promotion” marketing techniques.
The product P was represented by 1) safe water treatment
products and 2) behavioral product approaches in which hand-
washing and sanitation behaviors were marketed as having
social and functional benefits. The price P was only explicitly
addressed in the safe water treatment product interventions,
with subsidies to reduce costs of the marketed systems used to
encourage purchase and use. The place P was represented by 1)
community-based sales approaches, 2) home visit approaches,
and 3) health clinics to simplify distribution. The promotion P
was represented by mass advertising, community outreach, use
of branded gear such as t-shirts, and promotion by health care
providers at clinics. Community outreach was a heavily utilized
marketing channel present in 96.8% of the intervention efforts.

Table 3.
Social marketing development (n = 32).
Variables
Frequency
%
Scientific theory
Communication
7
21.9
Marketing
2
6.3
Psychology
8
25.0
Other
1
3.1
Formative research
Focus groups
10
31.3
Interviews
9
28.1
Other
2
6.3
Marketing P's
Product
31
96.9
Price
20
62.5
Place

26
81.3
Promotion
31
96.9
Marketing channels
Paid mass media
13
40.6
Unpaid mass media
4
12.5
Earned media
0
0.0
Community outreach
31
96.9
Community mobilization
19
59.4
Mobile phones
0
0.0
Social media (not Mobile)
0
0.0
Other marketing techniques
Audience segmentation
16
50.0
Message tailoring
3
9.4
Other
0

0.0
Table options
Table 4 provides a summary of the study design and outcomes
in the water and sanitation articles reviewed. Most of the
articles reviewed described studies with an observational
design; the remaining studies were equally split between
experimental and quasi-experimental designs. Almost all
articles reported on the study sample size and sample
characteristics. Multivariate analysis was used to report
statistics in over half of the studies. Most of the studies (75%)
aimed to assess behavioral objectives and clearly stated these
objectives. Almost all of these studies reported
product/behavior awareness or reactions to the interventions.
Table 4.
Study design and outcomes (n = 32).
Variables
Frequency
%
Research design
Experiment
9
28.1
Quasi-experiment
9
28.1
Observational study
14
43.8
Sample size reported
30
93.8
Sample characteristics described
26
80.6
Response = follow-up rate reported
12

38.7
Statistics reported
Descriptive
10
31.3
Multivariate analysis (ANOVA = regression)
18
56.3
Path analysis
1
3.1
None Reported
2
6.3
Objectives clearly stated
Product/behavior awareness or reactions
18
56.3
Pre-behavioral outcomes
17
53.1
Behavioral outcomes
24
75.0
Effects reported
Product/behavior awareness or reactions
28
87.5
Pre-behavioral outcomes
12
37.5
Behavioral outcomes
27
84.4
Estimate of precision reported
24

75.0
Table options
4. Discussion
Table 1, Table 2, Table 3 and Table 4 outline various aspects of
the studies that used social marketing in water and sanitation
interventions. We analyzed activities that each of the
interventions used and examined the extent to which they
incorporated the four Ps of social marketing.
4.1. Product
Over a third of the studies reviewed used the Safe Water
System, which promotes point-of-use water treatment
(specifically a sodium hypochlorite solution), safe storage and
behavior change. The sodium hypochlorite solution is marketed
under different names - Sur’ Eau in Madagascar, Klorin in
Kenya, WaterGuard in Malawi – but is always locally produced
and sold. The use of a distinctive brand name and logo echoes
the marketing techniques used by the private sector to ensure
product differentiation. However not every intervention
employed such a strategy.
In Dongre et al. (2008), for example, unbranded faucet-fitted
earthen vessels were sold to consumers in India; in Nanan et al.
(2003) and Pattanayak et al. (2009), the programs provided
unmarked latrines to rural households in Pakistan and India.
Branding can also extend to the entire campaign. In Ahmed
et al. (1993), hygiene behaviors in Bangladesh were marketed
under a “Clean Life campaign”.
The product, in both the Safe Water System and other
interventions, is in some cases behavioral or attitudinal. Every
reviewed study also had as a product the health gains that arose
from a hygiene-related behavior like handwashing, water
treatment or safe disposal of feces.
4.2. Place
Place in social marketing refers to the distribution channels and
outlets through which tangible products are made available to
consumers. In the case of health-related behaviors, place could
also mean the location where the consumer performs the desired

behavior, or accesses information about the product. Where the
interventions surveyed involved the transactional exchange of a
tangible product, the programs tried to facilitate availability and
easy access by utilizing local resources.
In Madagascar, for example, community-based sales agents
were trained to provide the sodium hypocholorite solution
(Dunston et al., 2001). In Karachi, Pakistan, fieldworkers
visited households to distribute soaps for handwashing (Luby
et al., 2005), while lidded storage vessels were distributed along
with water treatment solutions to households in Nicaragua
(Macy and Quick, 1998).
Programs also used home visits to promote health related
behaviors. Volunteers in Burkina Faso trained volunteers to
conduct monthly house-to-house visits to educate households
about the benefits of handwashing and safe disposal of feces
(Curtis et al., 2001). Where the intervention involved
performances or the use of print or visual media, public spaces
in the community were also utilized. In northeastern Thailand,
for instance songs about hygiene messages were broadcast
through village loudspeakers (Pinfold and Horan, 1996).
Researchers used weekly prayer meetings at local mosques in
rural Bangladesh to talk about cleanliness as a common goal
(Ahmed et al., 1993). Targeted interventions also focused on
specific groups. In a study in western Kenya, for example,
health education was given to schoolchildren in grades three
and five using drawings, role-play, songs and poems (Onyango-
Ouma et al., 2005).
4.3. Price
Price in social marketing could refer to the provision of
monetary subsidies (about whose effectiveness there is
considerable disagreement) or the costs of time and effort that
individuals and households have to bear in adopting the
intervention. For the purposes of this paper, however, we focus
on monetary subsidies/incentives.
In interventions that used the Safe Water System, household
water treatment solutions were sold at subsidized rates,

typically a small fraction of the market price. In Madagascar,
for instance, sodium hypocholorite solution was sold at 30 cents
for a 500 ml bottle (Dunston et al., 2001), while in western
Kenya, the price was 33 cents a bottle (Makutsa et al.,
2001 and Garrett et al., 2008). In Wardha, India, a 50 ml bottle
was sold for 30 cents, along with an earthen vessel fitted with a
plastic faucet (Dongre et al., 2008). Similarly, in Zambia, water
vessels were supplied at subsidized rates (Thevos et al., 2003).
Water treatment solutions were also sold at reduced prices to
wholesalers and retailers to stimulate sales (Makutsa et al.,
2001). In addition, health workers also sometimes received
small commissions as incentives (Garrett et al., 2008). Where
the intervention took the form of investments in sanitation
infrastructure, households were often asked to bear part of the
costs of construction. For instance, CARE Kenya paid for 40%
of the costs for providing new latrines in rural communities, but
households were expected to pay the remaining 60%, and also
provide labor for the latrine construction. Similarly, in a
community-led sanitation intervention in Orissa, India,
households below the poverty line had to pay 15% of the cost of
a new latrine, while other households paid the entire cost
(Pattanayak et al., 2009). Another solution, called WaterGuard,
was initially distributed at low cost and later provided freely at
antenatal women in order to overcome cost barriers (Wood
et al., 2011).
4.4. Promotion
Promotion is perhaps the most visible aspect of social
marketing. It aims to generate demand for the product by
imparting information and changing attitudes. Most of the water
and sanitation intervention surveyed used extensive promotion
techniques. One common strategy – used in interventions in
Burkina Faso, Pakistan, Uganda and Bolivia – was to train local
health workers/volunteers to impart hygiene education through
household visits. Another strategy was to organize
neighborhood meetings to promote awareness of hygiene
behaviors. For example, in Wardha, India, community-based

village co-ordination committees were formed to act as go-
betweens between households and program workers (Dongre
et al., 2008).
Some studies focused on particular spaces of interaction, like
clinics and schools. For instance, in Homa Bay, Kenya, nurses
at a maternal and child health clinic were trained to
communicate information about water chlorination to their
clients (Parker et al., 2006). Schoolchildren too can sometimes
act as health behavior change agents. In Bondo, western Kenya,
schoolchildren underwent participatory health communication
training, where they learnt about hygienic behaviors through
songs, poems and drawings (Onyango-Ouma et al., 2005).
Print and electronic media were used in several studies to
disseminate hygiene-related information. Advertisements on
radio, television and in newspapers, pamphlets and signs on
buses, walls and billboards were just some of the techniques
used. Some interventions used community-related activities to
get the message of hygiene out. In Nyanza, Kenya, program
workers organized soccer tournaments and Klorin quizzes to
spread awareness about their product (Makutsa et al., 2001). In
Thailand, comic books and T-shirts were developed to support
program activities (Pinfold, 1999).
4.5. Design and impacts of interventions that employ social
marketing: water treatment at the household level
In the 1990s, The Centers for Disease Control and Prevention
(CDC) and the Pan American Health Association (PAHO)
designed the “Safe Water System,” an intervention using point-
of-use treatment, proper storage, and behavior change to
improve water safety in developing countries. The behavior
change component of the intervention employs media
campaigns, community mobilization, and interpersonal
communication techniques to increase the connection made
between water quality and disease (Centers for Disease Control
and Prevention, 2013).
Organizations such as CARE International and Population
Services International (PSI) have used the Safe Water System

(SWS) framework to promote household-level water treatment
in nineteen countries across five continents. Participating
organizations have often grounded the intervention, tailoring
the social marketing component to fit the particular needs of
each target community. For example, in Madagascar, CARE and
PSI used branding and media campaigns in conjunction with
community mobilization in a randomized study to promote the
use of the point-of-use treatment system and increased sales
from 76,000 bottles in March 2000 to 250,000 bottles in
December of the same year (Dunston et al., 2001). CARE also
implemented the SWS intervention in Western Kenya and used
social marketing and motivational interviewing combined with
subsidized prices to promote home water treatment and safe
storage. A non-experimental study found that the project
resulted in adoption rates of 33.5% for chemical water treatment
and 18.5% for clay pots modified for safe water storage
(Makutsa et al., 2001). When CARE used the SWS intervention
in southern Kenya in another non-experimental study, they
grounded the intervention to the target community by
incorporating social marketing with a nurse training program
focused on the six steps of proper handwashing. One year later,
71% of clients of the clinic had chlorine residuals in their
drinking water and 34% were observed using proper hand
washing techniques (Parker et al., 2006).
Motivational interviewing has been found to be an effective
technique for promoting SWS adoption and promotion of
behavior changes, as described below, in several African
countries (Thevos et al., 2000). A randomized trial in Zambia,
Madagascar, and Kenya demonstrated the effectiveness of
household SWS promotion interventions (Quick, 2003).
4.6. Handwashing
Diarrheal diseases and acute respiratory infections are two of
the leading causes of mortality among children under five
worldwide. Handwashing promotion is the most cost-effective
public health intervention available and has the potential to
prevent 50 percent of both diarrheal diseases and ARIs (Luby

et al., 2005 and Cogswell and Jensen, 2008).
Programme Saniya, launched as part of a randomized
observational study in Burkina Faso, aimed to reduce the
prevalence of diarrheal disease by promoting correct
handwashing techniques and proper stool disposal. For three
years, researchers implemented a combination of mass media
campaigns, street theatre, house-to-house visits, and a hygiene-
focused school curriculum. Post-intervention surveys and
observations revealed a significant increase in the occurrence of
handwashing with soap (Curtis et al., 2001).
Another example of the effectiveness of social marketing in
handwashing promotion interventions is a study conducted in a
rural area of northeast Thailand, in which researchers used
various social marketing techniques (songs, print media,
theatre) along with workshops for health workers and students
to promote dishwashing and handwashing. Researchers also
eliminated literacy barriers by including illustrations in all print
media. The results of the randomized controlled study showed a
39 percent decrease in the incidence of diarrheal disease among
children under 5 years. When subjects were asked to detail
messages learned from various sources, they reported retaining
the most information from print media, namely stickers and
leaflets (Ahmed et al., 1993).
In several squatter settlements located in Karachi, Pakistan,
researchers conducted a randomized control trial on the effect
of community health promoters on the incidence of diarrhea,
impetigo, and pneumonia. One treatment group received
antibacterial soap and the other received plain soap. For one
year, community outreach workers made weekly visits to
households in both treatment groups to promote proper hand
washing techniques. There was no significant difference
between the two treatment groups, but treatment households had
53 percent lower incidence of diarrhea, 36 percent lower
incidence of impetigo, and 50 percent lower incidence of
pneumonia than households in the control group (Luby et al.,
2005).

4.7. Oral rehydration therapy
Oral rehydration therapy (ORT) is the most cost-effective
method for lowering childhood mortality during a severe
episode of diarrhea (UNICEF, 2008). Social marketing saves
lives by enabling organizations to reach and educate large
segments of the population simultaneously. In India, researchers
compared mothers who had seen television spots about ORT to
those exposed to ORT through other means. They found that the
mothers who learned about ORT through television spots were
significantly more likely to correctly apply the knowledge in
daily life.
Social marketing can also enhance the effectiveness of a private
sector approach to increase the use of ORT. In Kenya, public
clinics provided oral rehydration packets free-of-charge, while
private pharmacies sold flavored packets. This approach was
coupled with a mass media campaign educating the public on
the availability and proper use of ORT, which resulted in a
significant increase in ORT sales through both clinics and
pharmacies and an increase in the percentage of residents
correctly utilizing the packets (Kenya et al., 1990).
4.8. General hygiene education
The United States Agency for International Development,
Environmental Health Project, UNICEF, and Water Supply &
Sanitation Collaborative Council designed the Hygiene
Improvement Framework, outlining the necessary components
of a successful diarrhea prevention program (UNICEF, 2010).
One of the three pillars of a diarrhea prevention program is
hygiene promotion, which includes social mobilization,
marketing, community participation, and raising awareness, all
of which can be achieved through the “four P's” of an effective
social marketing campaign (Kleinau et al., 2004).
Organizations can use social marketing in a variety of ways to
promote proper hygiene and lower the prevalence of diarrhea. In
rural Bangladesh, village leaders implemented the “Clean Life”
campaign, a community-based hygiene intervention focusing on
ground sanitation, personal hygiene, and food hygiene. The

quasi-experimental study found improved growth and a
reduction in the number of undernourished infants (Ahmed
et al., 1993).
5. Conclusion
The goal of a published body of literature is to advance the field
by providing insight and direction to future research. As such,
we identified a number of characteristics that are important to
the field of social marketing relating to water and sanitation
behaviors and products, and should be included in future
published studies of such public health efforts. The current
literature represents a broad span of quality, with most studies
providing clear reports of the strategy and actions taken to
develop and evaluate the marketing effort, but others providing
only minimal information in a few of the identified domains.
We addressed the specific aims of this systematic review set
forth at the outset. First, we identified the types of activities
that water and sanitation social marketing interventions efforts
have used. There have been widespread efforts to change
sanitation practices ranging from personal hygiene to building
sanitation infrastructure in villages. Programs have used both
individual behavior change and infrastructure improvement
schemes to create an environment in which behavior change can
occur.
Second, we described the marketing mix used in social
marketing in this area. Overall, there is widespread use of each
of the 4 Ps of marketing, with some interventions not having an
explicitly reported ‘price’ strategy. This is a strength of the
programs reviewed, and it is noteworthy that many use an
explicit branding strategy to build long-term relationship with
product consumers, such as in ORT and SWS.
Third, we identified the research evaluation methods, design,
and reported impacts from the social marketing efforts.
Evaluations were generally well designed under challenging
local circumstances and there is consistent evidence of
improvements in behavioral mediators (ie, knowledge, attitudes,
beliefs targeted by the social marketing). Virtually all

interventions reported on such mediators. Examples included
intentions to use water and sanitation products, self-efficacy to
use them following interventions such as motivational
interviewing and training, and social norms that use of such
products was widespread and a preferred practice in the
community post-intervention. Evidence for behavior change is
mixed, with successes clustered in SWS programs.
This review has some limitations. First, this study shared the
well known limitations in reviews of social marketing, which
stem mainly from variable use of keywords and descriptors for
interventions (McDermott et al., 2005). Not all relevant
published studies may have described themselves using social
marketing terms, and thus may have been missed by this review.
However, we used a variety of search terms and employed
expert inputs and knowledge of the field to address this
concern. Second, we identified relatively few sanitation related
social marketing interventions. This may be related to the first
limitation, and the possibility that social marketing aimed at
sanitation appears mainly in the gray literature. However, there
is a need to promote these studies and publication of sanitation
social marketing interventions.
Future research should focus on the mechanisms of behavior
change. While many programs were successful, it is unclear
from this review what behavioral mediators were responsible.
For example, many programs attempted to change social norms.
Are strategies aimed at changing personal hygiene practices by
promoting the norm that such behaviors are widespread among
peers and socially approved most effective? Future studies need
to focus squarely on these questions in order to identify best
practices in water and sanitation social marketing and diffuse
the most effective behavior change strategies.
Financial competing interests
The authors certify that they have received no financial support
of any kind related to preparation of this manuscript. The
authors certify that they hold no stocks or shares in any such
organization. The authors certify that they have not applied for

any patents or received any reimbursement from organizations
holding patents related to this manuscript. The authors certify
that they have no other competing financial interests.
Non-financial competing interests
The authors certify that they have no competing non-financial
interests related to this manuscript.
Author's contributions
WDE co-conceived the study, directed the literature search,
reviewed articles, and wrote sections of the manuscript. SKP
co-conceived the study, reviewed articles, and edited sections of
the manuscript. SY searched the literature, created the tables,
edited sections of the manuscript and compiled references. JB
assisted in literature searching and edited sections of the
manuscript. SR assisted in literature searching and edited
sections of the manuscript. JWB assisted with literature
searching and edited sections of the manuscript. All authors
read and approved the final manuscript.
Acknowledgment
The authors gratefully acknowledge their institutions, The
George Washington University and Duke University, for their
support of this publication effort. While no financial support
was provided and the institutions played no role in the
manuscript preparation, both institutions encouraged the authors
to pursue this project and allowed the use of institutional
facilities to support the work.
References
1.
· Ahmed et al., 1993
· N.U. Ahmed, M.F. Zeitlin, A.S. Beiser, C.M. Super, S.N.
Gershoff
· A longitudinal study of the impact of behavioural change
intervention on cleanliness, diarrhoeal morbidity and growth of
children in rural Bangladesh
· Social Science & Medicine, 37 (2) (1993), pp. 159–171
· Article
|

PDF (1177 K)
|
View Record in Scopus
|
Citing articles (27)
2.
· Borden, 1964
· N. Borden
· The concept of the marketing mix
· Journal of Advertising Research, 4 (6) (1964), pp. 2–7
· View Record in Scopus
|
3.
· Cogswell and Jensen, 2008
· L. Cogswell, L. Jensen
· Guidelines for Assessing the Enabling Environment
Conditions for Large Scale, Effective and Sustainable
Handwashing with Soap Projects
· World Bank (2008) Retrieved on 23 August 2013 from
https://www.wsp.org/wsp/sites/wsp.org/files/publications/EEA_
Guidance_HW.pdf
·
4.
· Curtis et al., 2001
· V. Curtis, B. Kanki, S. Cousens, I. Biallo, A. Kpozehouen, M.
Sangaré, M. Nikiema
· Evidence of behaviour change following a hygiene promotion
programme in Burkina Faso
· Bulletin of the World Health Organization, 79 (6) (2001), pp.
518–527
|
5.
· Developing World, 2013

· Developing World: 2013. A Handbook for Implementing
Household-based Water Treatment and Safe Storage Projects.
Atlanta, GA: Author. Retrieved on 23 August 2013 from.
http://www.cdc.gov/safewater/manual/sws_manual.pdf
·
6.
· Devine, 2008
· J. Devine
· Sanitation Marketing
· (2008) Retrieved on 23 August 2013 from:
http://www.wsp.org/wsp/sites/wsp.org/files/Brighton_Jacquelin
e_Devine_PPT.pdf
·
7.
· Dongre et al., 2008
· A.R. Dongre, P.R. Deshmukh, B.S. Garg
· Effect of use of socially marketed faucet fitted earthen
vessel/sodium hypochlorite solution on diarrhea prevention at
household level in rural India
· Online Journal of Health and Allied Sciences, 7 (2) (2008)
Retrieved on 23 August 2013 from
http://openmed.nic.in/3040/01/2008-2-1.pdf
·
8.
· Dunston et al., 2001
· C. Dunston, D. McAfee, R. Kaiser, D. Rakotoarison, L.
Rambeloson, A.T. Hoang, R.E. Quick
· Collaboration, cholera, and cyclones: a project to improve
point-of-use water quality in Madagascar
· American Journal of Public Health, 91 (10) (2001), pp. 1574–
1576
|
Full Text via CrossRef
|

9.
· Evans and Hastings, 2008
· W.D. Evans, G. Hastings
· Public Health Branding: Applying Marketing for Social
Change
· Oxford University Press, USA (2008)
·
10.
· Evans et al., 2008
· W.D. Evans, J. Blitstein, J. Hersey, J. Renaud, A. Yaroch
· Systematic review of public health branding
· Journal of Health Communication, 13 (8) (2008), pp. 721–741
|
|
11.
· Freeman et al., 2009
· M.C. Freeman, R.E. Quick, D.P. Abbott, P. Ogutu, R.
Rheingans
· Increasing equity of access to point-of-use water treatment
products through social marketing and entrepreneurship: a case
study in western Kenya
· Journal of Water and Health., 7 (3) (2009), pp. 527–534
|
|
12.
· Garrett et al., 2008
· V. Garrett, P. Ogutu, P. Mabonga, S. Ombeki, A. Mwaki, G.
Aluoch, R.E. Quick
· Diarrhoea prevention in a high-risk rural Kenyan population
through point-of-use chlorination, safe water storage,

sanitation, and rainwater harvesting
· Epidemiology of Infection, 136 (2008), pp. 1463–1471
|
|
13.
· Grilli et al., 2002
· R. Grilli, C.R. Ramsay, S. Minozzi
· Mass media interventions: effects on health services
utilization
· Cochrane Database of Systematic Reviews (2002), pp. 1–26
10.1002.14651858.CD000389
·
14.
· Hastings, 2007
· G. Hastings
· Social Marketing: or, Why Should the Devil Have All the Best
Tunes
· Butterworth-Heineman, London (2007)
·
15.
· Higgins and Green, 2011
· J.P.T. Higgins, S. Green (Eds.), Cochrane Handbook for
Systematic Reviews of Interventions Version 5.1.0 (2011)
[updated March 2011]. The Cochrane Collaboration, 2011.
Retrieved from: www.cochrane-handbook.org
·
16.
· Kenya et al., 1990
· P.R. Kenya, S. Gatiti, L.N. Muthami, R. Agwanda, H.A.
Mwenesi, M.N. Katsivo, et al.
· Oral rehydration therapy and social marketing in rural Kenya
· Article

|
PDF (985 K)
|
|
17.
· Kleinau et al., 2004
· E. Kleinau, M. Post, F. Rosensweig
· Advancing Hygiene Improvement for Diarrhea Prevention:
Lessons Learned
· Environmental Health Project, Washington, DC (2004)
Retrieved on 22 August 2013 from
http://www.ehproject.org/PDF/Strategic_papers/SR-
10%20HI%20LL%20Format.pdf
·
18.
· Kotler and Lee, 2008
· P. Kotler, N. Lee
· Social Marketing: Influencing Behaviors for Good
· (third ed.)Sage, Thousand Oaks, CA (2008)
·
19.
· Luby et al., 2005
· S.P. Luby, M. Agboatwalla, D.R. Feikin, J. Painter, W.
Billhimer, A. Altaf, R.M. Hoekstra
· Effects of handwashing on child health: a randomized
controlled trial
· Lancet, 366 (9481) (2005), pp. 225–233
· Article
|
PDF (125 K)
|
|

20.
· Luby et al., 2004a
· S.P. Luby, M. Agboatwalla, R.M. Hoekstra, M.H. Rahbar, W.
Billhimer, B.H. Keswick
· Delayed effectiveness of home-based interventions in reducing
childhood diarrhea, Karachi, Pakistan
· American Journal of Tropical Medicine & Hygiene, 71 (4)
(2004), pp. 420–427
|
1.
· Luby et al., 2004b
· S.P. Luby, M. Agboatwalla, J. Painter, A. Altaf, W.L.
Billhimer, R. Hoekstra
· Effect of intensive handwashing promotion on childhood
diarrhea in high-risk communities in Pakistan: a randomized
controlled trial
· JAMA, 291 (21) (2004), pp. 2547–2554
|
|
2.
· Luby et al., 2006
· S.P. Luby, M. Agboatwalla, J. Painter, A. Altaf, W. Billhimer,
B. Keswick, R.M. Hoekstra
· Combining drinking water treatment and hand washing for
diarrhoea prevention, a cluster randomised controlled trial
· Tropical Medicine & International Health, 11 (4) (2006), pp.
479–489
|
|

3.
· Macy and Quick, 1998
· J.T. Macy, R.E. Quick
· Evaluation of a novel drinking water treatment and storage
intervention in Nicaragua
· Revista Panamericana de Salud Pública, 3 (2) (1998), pp. 135–
136
|
Citing articles (9)
4.
· Makutsa et al., 2001
· P. Makutsa, K. Nzaku, P. Ogutu, P. Barasa, S. Ombeki, A.
Mwaki, R.E. Quick
· Challenges in implementing a point-of-use water quality
intervention in rural Kenya
· American Journal of Public Health, 91 (10) (2001), pp. 1571–
1573
|
|
5.
· McDermott et al., 2005
· L. McDermott, M. Stead, G. Hastings
· What is and what is not social marketing
· Journal of Marketing and Management, 21 (2005), pp. 545–
553
|
|
6.

· Migele et al., 2007
· J. Migele, S. Ombeki, M. Ayalo, M. Biggerstaff, R. Quick
· Diarrhea prevention in a Kenyan school through the use of a
simple safe water and hygiene intervention
· American Journal of Tropical Medicine and Hygiene, 76 (2)
(2007), pp. 351–353
|
7.
· Nanan et al., 2003
· D. Nanan, F. White, I. Azam, H. Afsar, S. Hozhabri
· Evaluation of a water, sanitation, and hygiene education
intervention on diarrhoea in northern Pakistan
160–165
|
8.
· Onyango-Ouma et al., 2005
· W. Onyango-Ouma, H.J. Aagaard, B.B. Jensen
· The potential of schoolchildren as health change agents in
rural western Kenya
· Article
|
PDF (244 K)
|
|
9.
· Parker et al., 2006
· A.A. Parker, R. Stephenson, P.L. Riley, W. Ombeki, C.
Komolleh, L. Sibley, R.E. Quick

· Sustained high levels of stored drinking water treatment and
retention of hand-washing knowledge in rural Kenyan
households following a clinic-based intervention
· Epidemiology of Infection, 134 (5) (2006), pp. 1029–1036
|
|
10.
· Pattanayak et al., 2009
· S.K. Pattanayak, J.C. Yang, K.L. Dickinson, C. Poulos, S.R.
Patil, R.K. Mallick, P. Praharaj
· Shame or subsidy revisited: social mobilization for sanitation
in Orissa, India
580–587
|
|
11.
· Pinfold, 1999
· J.V. Pinfold
· Analysis of different communication channels for promoting
hygiene behavior
· Health Education Research, 14 (5) (1999), pp. 629–639
|
|
12.
· Pinfold and Horan, 1996
· J.V. Pinfold, N.J. Horan

· Measuring the effect of a hygiene behavior intervention by
indicators of behaviour and diarrhoeal disease
· Transactions of the Royal Society of Tropical Medicine and
Hygiene, 90 (4) (1996), pp. 366–371
· Article
|
PDF (838 K)
|
|
13.
· Quick, 2003
· R. Quick
· Changing community behavior: experience from three African
countries
· International Journal of Environmental Health Research, 13
(S1) (2003), pp. S115–S121
|
|
14.
· Quick et al., 2002
· R.E. Quick, A. Kimura, A. Thevos, M. Tembo, I. Shamputa, L.
Hutwagner, et al.
· Diarrhea prevention through household-level water
disinfection and safe storage in Zambia
· American Journal of Tropical Medicine and Hygiene, 66 (5)
(2002), pp. 584–589
|
15.
· Quick et al., 1999

· R.E. Quick, L.V. Venczel, E.D. Mintz, L. Soleto, J. Aparicio,
M. Gironaz, R.V. Tauxe
· Diarrhoea prevention in Bolivia through point-of-use water
treatment and safe storage: a promising new strategy
· Epidemiology and Infection, 122 (1) (1999), pp. 83–90
|
|
16.
· Snyder et al., 2004
· L.B. Snyder, M.A. Hamilton, E.W. Mitchell, J. Kiwanuka-
Tondo, F. Fleming-Milici, D. Proctor
· A meta-analysis of the effect of mediated health
communication campaigns on behavior change in the United
States
· Journal of Health Communication, 9 (Suppl. 1) (2004), pp. 71–
96
|
|
17.
· Stockman et al., 2007
· L.J. Stockman, T.K. Fischer, M. Deming, B. Ngwira, C.
Bowie, N. Cunliffe, R.E. Quick
· Point-of-use water treatment and use among mothers in
Malawi
· Emerging Infectious Disease, 13 (7) (2007), pp. 1077–1080
|
|

18.
· Thevos et al., 2000
· A.K. Thevos, F.A. Kaona, M.T. Siajunza, R.E. Quick
· Adoption of safe water behaviors in Zambia: comparing
educational and motivational approaches
· Education for Health, 13 (3) (2000), pp. 366–376
|
19.
· Thevos et al., 2003
· A.K. Thevos, S.J. Olsen, J.M. Rangel, F.A.D. Kaona, M.
Tembo, R.E. Quick
· Social marketing and motivational interviewing as community
interventions for safe water behaviors: follow-up surveys in
Zambia
· International Quarterly of Community Health Education, 21
(1) (2003), pp. 51–65
|
20.
· UNICEF, 2008
· UNICEF
· The State of the World's Children 2008
· (2008) Retrieved on 23 August 2013 from:
http://www.unicef.org/publications/files/The_State_of_the_Wor
lds_Children_2008.pdf pp. 1–9
·
1.
· UNICEF., 2010
· UNICEF
· Social Marketing Approaches to Child Survival
· (2010) Retrieved from:
http://www.unicef.org/supply/files/11_Angus_Spiers_-_PSI_-
_Social_Marketing_Approaches_to_Child_Survival.pdf

·
2.
· Wood et al., 2011
· S. Wood, J. Foster, A. Kols
· Understanding why women adopt and sustain home water
treatment: Insights from the Malawi antenatal care program
· Social Science & Medicine (2011), pp. 634–642
http://dx.doi.org.contentproxy.phoenix.edu/10.1016/j.socscimed
.2011.09.018
·
3.
· Yeager et al., 2002
· B.A. Yeager, S.R. Huttly, R. Bartolini, M. Marin, C.F. Lanata
· An intervention for the promotion of hygienic feces disposal
behaviors in a shanty town of Lima, Peru
· Health Education Research, 17 (6) (2002), pp. 761–773
|
|
Citing articles (4)
Corresponding author.
Copyright © 2014 Elsevier Ltd. Published by Elsevier Ltd. All
rights reserved.
Open by default: a proposed copyright license and waiver
agreement for open access research and data in peer-reviewed
journals

Iain Hrynaszkiewicz* and Matthew J Cockerill
· * Corresponding author: Iain Hrynaszkiewicz
[email protected]
Author Affiliations
BioMed Central Ltd, 236 Gray’s Inn Road, London, WC1X
8HB, UK
For all author emails, please log on.
BMC Research Notes 2012, 5:494 doi:10.1186/1756-0500-5-
494
The electronic version of this article is the complete one and
can be found online at: http://www.biomedcentral.com/1756-
0500/5/494
Received:
11 June 2012
Accepted:
4 September 2012
Published:
7 September 2012
© 2012 Hrynaszkiewicz and Cockerill; licensee BioMed Central
Ltd.
This is an Open Access article distributed under the terms of the
Creative Commons Attribution License
(http://creativecommons.org/licenses/by/2.0), which permits
unrestricted use, distribution, and reproduction in any medium,
provided the original work is properly cited.
Abstract
Copyright and licensing of scientific data, internationally, are
complex and present legal barriers to data sharing, integration
and reuse, and therefore restrict the most efficient transfer and
discovery of scientific knowledge. Much data are included
within scientific journal articles, their published tables,
additional files (supplementary material) and reference lists.
However, these data are usually published under licenses which
are not appropriate for data. Creative Commons CC0 is an

appropriate and increasingly accepted method for dedicating
data to the public domain, to enable data reuse with the
minimum of restrictions. BioMed Central is committed to
working towards implementation of open data-compliant
licensing in its publications. Here we detail a protocol for
implementing a combined Creative Commons Attribution
license (for copyrightable material) and Creative Commons CC0
waiver (for data) agreement for content published in peer-
reviewed open access journals. We explain the differences
between legal requirements for attribution in copyright, and
cultural requirements in scholarship for giving individuals
credit for their work through citation. We argue that publishing
data in scientific journals under CC0 will have numerous
benefits for individuals and society, and yet will have minimal
implications for authors and minimal impact on current
publishing and research workflows. We provide practical
examples and definitions of data types, such as XML and
tabular data, and specific secondary use cases for published
data, including text mining, reproducible research, and open
bibliography. We believe this proposed change to the current
copyright and licensing structure in science publishing will help
clarify what users – people and machines – of the published
literature can do, legally, with journal articles and make
research using the published literature more efficient. We
further believe this model could be adopted across multiple
publishers, and invite comment on this article from all
stakeholders in scientific research.
Introduction
Much has been written about, and support stated for, sharing
and publishing scientific data, in recognition of the benefits for
the economy [1], scientific discovery [2] and public health [3].
Maximizing the potential of scientific data sharing for the
discovery of new knowledge involves reducing barriers to data
dissemination, reuse, reproducibility and integration. Licensing,
ownership, copyright and intellectual property present legal

obstacles to data integration and reuse, which has led to the
development of, and calls for, licensing standards for open data;
where data are explicitly placed in the public domain with legal
rights of the owners waived [4].
BioMed Central has previously stated that the concept of open
data, analogous to its policy on open access to journals, goes
beyond making data freely accessible. Data should also be free
to distribute, copy, re-format, and integrate into new research,
without legal impediments [5]. This position is consistent with
the Panton Principles, which hold that for society to reap the
full benefits of scientific research the published body of
knowledge must be open – readily available such that it can be
evaluated, reused, criticized and integrated with other
knowledge without restrictions [6]. For the remainder of this
article the term ‘open data’ is reserved exclusively for data
available according to these principles.
Unfortunately much data – and other content – freely available
on the web are available under restrictive or ambiguous terms,
which risks impeding or potentially criminalizing secondary
users of scientific data. According to evidence submitted to the
UK Government’s intellectual property review by the Wellcome
Trust, 87 per cent of the material housed in the full-text
scholarly archive UK PubMed Central is unavailable for legal
text and data mining [7]. A key finding of a more recent report,
commissioned by JISC, was a need to overcome legal
restrictions and uncertainties surrounding text mining of
scientific literature [8].
Indeed, as recognition of the value of shared life science data
has increased, so has recognition of intellectual property and
copyright as barriers to progress. Writing in Nature in 2009,
Schofield et al., urged that “any restrictions on use should be
strongly resisted and we endorse explicit encouragement of
open sharing” [9]; and Conway and VanLare in JAMA, in 2010,
called for US health care data to be available without
intellectual property constraints [10]. Waiver of all intellectual
property rights in research data is central to the achievement of

an “information commons”, advocated by organisations such as
Sage Bionetworks, to enhance the (slowing) pace of drug
discovery.
The genomics community has shown leadership in establishing a
framework for an “information commons”, engrained in the
Bermuda Principles, and have established built-in temporal
latencies to data for knowledge (when data are released), and
rights (when rights restricting use are removed) [11].
Researchers in this community typically must release their
genetic sequence data immediately, and within 6–12 months
release their exclusive rights in that data. During this relatively
short embargo researchers have their opportunity to exploit the
data for their discoveries, after which the community at large
can benefit, if they wish, from the new data. A similar model
for data release has since been proposed for clinical trials,
although is probably far from implementation [12]. A number of
factors seem to have led to a successful culture of sharing in the
genomics community: a need to collaborate and share to achieve
a major goal (the sequencing of the human genome); effective
mechanisms and infrastructure for sharing large amounts of data
(well-funded genetic sequence databases); scientific community
and funding agency mandates to share data; and importantly, in
the context of this article, successful collaborations with the
publishing community. Journals, their editors and publishers,
supported implementation of the Bermuda Principles by, for
example, requiring accession number for data deposits as a
condition of manuscript submission or publication.
BioMed Central in its August 2010 open data statement [5] and
subsequent cross-publisher Publishing Open Data Working
Group meeting identified that open data in journal publications
could be implemented by specifying that, from a specific date,
any author submitting to a journal or publisher agrees to
dedicate the data elements of their article and supplementary
material (in particular, additional data files; also known as
“supplementary” data files) to the public domain [13]. Much of
the contents of academic journals could be considered as data

but licensing terms cannot be applied retroactively by
publishers without authors’ consent, and any changes to
authors’ agreements should ideally be made in consultation
between authors and publishers.
This article aims to describe practically what is needed from
publishers to explicitly dedicate data within open access
journals to the public domain, and discusses the implications of
this development for authors, editors, publishers and funders of
research. Illustrative examples and use cases are provided
throughout the article. In this article “open access” is defined
according to the Budapest Open Access Initiative definition
[14].
Applying the right license to published research and data
The internet has revolutionized the way we access and distribute
information, enabling virtually anyone to post content online.
There is much potential in rapidly sharing content on the web,
but releasing content without information, or with ambiguous
information, about if and how it can be shared and reused can
also cause problems – especially for data.
Open access publishing of peer-reviewed journal articles
commonly utilizes the legal tools – licenses – prepared by
Creative Commons. BioMed Central, Public Library of Science,
Nature Publishing Group, BMJ and many others publish open
access articles where the authors retain the copyright to their
work. Authors typically apply a Creative Commons attribution
license (CC-BY), or variation of it, which means anyone is free
to copy, reuse, distribute and make derivatives from their article
provided that there is attribution of the original author(s).
However, many “open access” publishers place restrictions on
commercial reuse of published articles (papers) and on creation
of derivative works, which can include text mining in some
jurisdictions. Additionally, some commercial publishers’ terms
and conditions, by contract, can prevent text mining in any
jurisdiction. Commercial use restrictions have been strongly
discouraged – their use described as amounting to “pseudo open

access” – as authors will not reap the full benefits of paying for
open access publication (for example figures could not be
uploaded to Wikipedia with commercial use restrictions)
[15,16]. BioMed Central supports unrestricted use of open
access content including commercial use and as such requires
authors to apply a CC-BY license by default. BioMed Central’s
full text corpus of open access research articles published under
CC-BY is available for free distribution, reuse and creation of
derivatives with no commercial use restrictions – with data
mining research strongly encouraged [17]. For data published
by scholarly publishers, the Association of Learned and
Professional Society Publishers and International Association of
Scientific, Technical, & Medical Publishers (STM) issued a
joint statement in 2006 supporting sharing of raw datasets
among scholars and recommending that publishers do not
require transfer of copyright in data submitted for publication
[18]. Copyright and data
The policies and guidelines of many academic institutions
advise researchers to establish intellectual property and
copyrights at the start of any project (although whether the
issue of data ownership is consistently addressed by researchers
is unclear [19]). Copyright cannot generally be asserted in facts,
only the ways in which they are presented. At a basic level raw
data are merely simple, mathematical, descriptions of facts and
to claim copyright a scientist would need to exert individual
judgment, expression or skill in their representation. For
example, Einstein could not claim copyright in the formula
E = mc2, but could in text explaining the theory behind it [20].
You could conclude from this that copyright and associated
licenses and attribution requirements cannot legally be applied
to data. However, there are many levels at which data –
particularly digital data derived and integrated from different
sources – and collections of data and metadata can operate and
be represented, and many ways in which copyright law is
applied in different jurisdictions.
In the US the law focuses on creativity (“Copyright does not

protect facts, ideas, systems, or methods of operation, although
it may protect the way these things are expressed”) but in
Australia originality is more important – and copyright may
well apply to research data “in the same way that it applies to
written works like books, journal articles and reports” [21]. In
the European Union “sui generis” rights exist to protect data
within digital databases – effectively, copyright – which can,
furthermore, be implemented differently by member states.
Because of these substantial international legal differences
regarding how copyright can be applied to data, there are
inherent difficulties in ascertaining the extent of copyright in a
dataset. A more comprehensive summary of the different
approaches to copyright in data and databases can be found in
[22]. All of these issues compound the uncertainty about what
an individual or machine (such as a computer crawling the web)
can do, legally, with information they download from the
internet, including from journals. Licenses and waivers for data
A license is a legal instrument for a copyright holder or content
producer to enable a second party to use their content, and
apply certain conditions and restrictions to those uses. A waiver
is also a legal instrument but is designed for a rights holder to
give up their rights, rather than assert them. For a
comprehensive guide to the different approaches to the
licensing of research data see [23].
Placing restrictions on the reuse of scientific information,
particularly data, slows down the pace of research. Furthermore,
legal requirements for attribution ingrained in licenses such as
CC-BY can prohibit future research across large collections of
content – as commonly happens in data mining research.
Consider the Human Genome Project: a watershed moment for
scientific data sharing and collaboration. Without the collective
effort of many different research institutions, commercial
organizations and individual scientists the sequencing of the
human genome would not have been possible. But if a
researcher wishing to query the human genome database as part
of a new research project was legally required to attribute all

the – probably thousands – of data contributors, by providing a
link back to or citation, this would be unmanageable, and
probably un-publishable in the context of a traditional research
paper’s reference list.
International legal differences, described earlier, are another
important reason to apply specific, appropriate legal tools to
data. Also, it can be unclear what license to attach to copyright
in a dataset or structure (for example a textual description of
building the dataset could fall under CC-BY, but if source code
were used rather than text it might not). This is an area of
confusion where no licensing standard exists. Therefore, to
eliminate legal impediments to integration and re-use of data,
such as this stacking of attribution requirements in large
collections of data, and to help enable long-term
interoperability an appropriate license or waiver specific to data
should be applied. There are a number of conformant licenses
and waivers for open data [24], of which Creative Commons
CC0
(http://creativecommons.org/publicdomain/zero/1.0/webcite) is
widely recognized. Under CC0, authors waive all of their rights
to the work worldwide under copyright law and all related or
neighboring legal rights they have in the work, to the extent
allowable by law. Legal experts have recommended the use of
standard, globally accepted licenses for data instead of
developing ad hoc models [25]. The case for CC0 for scientific
data
The Creative Commons’ website catalogues a number of
different organizations – publicly and privately funded – which
use CC0 for data [26]. These include:
• Genomes Unzipped, which “aims to inform the public about
genetics via the independent analysis of open genetic data,
volunteered by a core group of genetics researchers and
specialists”
• GlaxoSmithKline (GSK), a leading pharmaceutical company,
has dedicated data on more than 13,500 compounds known to be
active against malaria to the public domain [27].

• The British Library and Cologne-based Libraries, which have
released large amounts of bibliographic data under CC0 [28]
• FigShare (http://figshare.com/webcite), a freely-accessible
repository for scientific content including images, video and
data, uses CC0 for datasets
Data repositories are particularly relevant users of waivers and
licenses for research data. Although there are many data
repositories in life sciences (for a list see
http://www.datacite.org/repolistwebcite), which are growing in
size and number, not all scientific domains have a common
repository and journals often function as repositories when data
are included as additional files (supplementary material). Dryad
(http://datadryad.org/webcite) is an international repository for
the datasets supporting published, peer-reviewed journal articles
across the biosciences which requires authors to explicitly place
deposited data in the public domain using the CC0 waiver. An
entry on the Dryad weblog sets out cogently why CC0 is the
most effective solution for achieving its goals:
“By removing unenforceable legal barriers, CC0 facilitates the
discovery, re-use, and citation of [that] data…
“Furthermore, Dryad’s use of CC0 to make the terms of reuse
explicit has some important advantages:
• interoperability: Since CC0 is both human and machine-
readable, other people and indexing services will automatically
be able to determine the terms of use.
• universality: CC0 is a single mechanism that is both global
and universal, covering all data and all countries. It is also
widely recognized.
• simplicity: there is no need for humans to make, and respond
to, individual data requests, and no need for click-through
agreements. This allows more scientists to spend their time
doing science.” [29]
Dryad’s policy ultimately follows the Science Commons’
recommendations, set out in their Protocol for Implementing
Open Access Data [30].
The online laboratory notebook software LabArchives

(http://www.labarchives.com/webcite), which includes the
ability to share data privately and to publish datasets publicly
and permanently online, also uses CC0 for public datasets [31].
Concerns about public domain dedication of dataCredit where
credit’s due – attribution and citation
A common concern about moving from an attribution license,
such as CC-BY, to CC0 for data and waiving attribution rights
is that academic credit (citations) will be lost if there is no
longer a legal requirement to attribute the original rights holder
(author). While attribution can sometimes be achieved in the
same way as citation the two practices serve different purposes.
Attribution is a legal tool designed to permit copying,
distribution, and creation of derivative works such as
translations. As copyright does not protect ideas (in the US), to
give scientists credit for their ideas the established norm in
scholarly communication is citation [32].
Consider a scientist paraphrasing a concept put forward in a
peer’s research article. He or she does not legally have to cite
their peer’s published paper, but it is beneficial or possibly
essential for the validity and reliability of the subsequent work
to specify the source(s) of assertions made. Community norms
are enforced by the community, and in science unacceptable
citation practices are typically identified and resolved through
peer review, and the publication ethics and editorial policies of
peer-reviewed journals. See Table 1 for common citation and
attribution events in scholarly communication. These examples
are for illustrative purposes and do not constitute legal advice.
Table 1. Attribution vs. citation in (re)uses of open access
scientific content published under a Creative Commons
Attribution license (CC-BY)
The examples in Table 1 demonstrate that, although they can
sometimes be achieved in the same way, attribution and citation
are not the same. Citations are much more important and
relevant than attribution when tracking scholarly outputs and
giving appropriate credit for individuals’ contributions.

Compared to legal requirements, cultural norms benefit from
flexibility, and can evolve with the community which
established them. In other words, using norms retains control
and decision making within the research community, instead of
taking it out of our control and handing it to lawyers and
judges. Many scientific ideas, after a number of years, become
undisputed and the community may deem it unnecessary for
credit to be rigorously applied. For example, it would today be
very unusual for an article describing a DNA sequencing
experiment to cite the original work by Watson and Crick that
elicited DNA’s structural properties. This is a cultural norm at
work, where an idea is now so widely accepted, and the initial
authors clearly recognized for their discoveries (in citations and
prizes) a citation is not needed.
Jonathan Rees, formerly of the Creative Commons, said of
community norms for influencing behavior over legal
requirements: “For widest latitude of use and best scalability,
and therefore greatest return to the research community, the
entirety of the data set, including any incidental copyrightable
elements, should be dedicated to the public domain. Note that
public domain is not incompatible with a request for attribution
or other terms of use following community norms. Such a
request may be as effective – or more effective – at getting
users to follow desired practices as any attempted legal
restrictions [33].”
To our knowledge there have been no empirical studies of the
citation of scholarly datasets assigned public domain dedication
licenses compared to a comparable group available under
attribution licenses. However, given public domain dedication –
and specifically CC0 – is intended to maximize the potential for
data discovery, reuse and therefore citation, it would be
reasonable to hypothesize that citation potential of public
domain data would be unaffected or might even increase. With
CC0 there is no need for transfer agreements and preconditions,
which inherently impede further (re)uses of data. Sharing of
microarray experimental research data underlying journal

articles has been associated with increased citation share [34],
and increased reproducibility and repeatability of results [35].
In social science data collections funded by the National
Institutes of Health and National Science Foundation in the US,
data sharing has been associated with “many more times the
publications” than collections where data were not shared [36].
Linking of publications to supporting datasets has also been
associated with more citations to the linked paper in the marine
science journal Paleoceanography, according to a conference
abstract, and in the field of astronomy according to a pre-print
paper [37]. Competition
Researchers who apply CC0 to their data, or any other product
of their scholarship, waive all rights in that data allowable by
law. Such a waiver has been described as an “unattractive
option for data whose creators have yet to fully exploit them,
academically or commercially” [23]. This is true, but a waiver
or license required by a journal or publisher generally applies
only in the context of data submitted for publication. If a
portion of a large database was analyzed and an additional data
file included for publication the larger, unpublished, body of
work would retain whichever license the researchers, their
employers or institutions require. In other words, researchers
remain in control of what they chose to publish – what they
submit to a journal – and a change in the publishers’ license
does not affect this. Moreover, waivers and licenses for journal
articles do not replace existing, established community norms
for sharing of some data types (e.g. depositing microarray and
genetic sequence data in appropriate databases) – nor do they
affect requirements of many journals for sharing readily
reproducible materials including raw data on request [38].
There is a trade-off between the additional opportunities which
may result from transparency (such as new collaborations,
secondary use) and the threat, improbable or otherwise, that
opening up data may be valuable to competitors. Certain types
of research, such as genetic sequencing to elucidate
susceptibility to disease, generates far more data than one

research team could conceivably analyze – which logically lead
to sharing and collaboration. A number of companies have
opened up some of their data and seen benefits [39]. A lot of
data may have commercial value but much raw data, such as
protein sequences of potential drug targets, are just the
beginning of a knowledge-discovery process. More can be
gained by “pre-competitive” sharing with the waiver of
intellectual property. Such an approach is being championed by
Sage Bionetworks in the US [40]. Plagiarism
Plagiarism is research misconduct and an unfortunate but
ineliminable occurrence in scholarship. Plagiarism and the
potential for plagiarism have increased with the proliferation of
digital access to information [41]. Plagiarism is often not
illegal, but it is certainly unethical, and undoubtedly damaging
for the career of someone guilty of perpetrating plagiarism.
Effective online tools for detecting plagiarism exist, such as
CrossCheck
(http://www.crossref.org/crosscheck/index.htmlwebcite), as
does human detection via the peer-review process. Removal of a
legal requirement for attribution for data elements of articles
would be unlikely to impact on the potential for plagiarism. In
addition, CC0 would not apply to the main, copyrightable text
of articles. Other safeguards
Public domain dedication of data does not mean that those who
generated the data cannot express certain wishes about how the
data are used. The Panton Principles frequently asked questions
(FAQs) state: “You should always aim to follow any reasonable
requests made by the data owners/publishers. These may be
explicit or may be implicitly understood by the community. You
should make an effort to understand any relevant ‘community
norms’ for the data you are using [42].”
A code of conduct has been proposed for those wishing to reuse
clinical trial data obtained from other researchers [43] and a
clinical trial dataset published in the journal Trials, by
Sandercock et al., has requested that “any publications arising
from the use of this dataset acknowledges the source of the

dataset, its funding and the collaborative group that collected
the data.” [44].
Electronic publishing platforms provide further safeguards to
ownership and authorship of published content, in the form of
date stamping manuscript submissions and version control in
some repositories, such as Edinburgh DataShare
(http://datashare.is.ed.ac.uk/webcite).
Citation of articles and datasets is facilitated through standard
citation formats – such as those advocated by DataCite where
persistent dataset identifiers, such as digital object identifier
(DOI) names, are displayed as linkable, permanent URLs – and
are increasingly supported by some publishers [37].
What do we mean by data?
There are numerous definitions of data. According to Wikipedia
data “are qualitative or quantitative attributes of a variable or
set of variables. Data are typically the results of measurements
and can be the basis of graphs, images, or observations of a set
of variables,” [45]. Data can exist electronically or non-
electronically, so a definition that includes electronic access is
important, in the context of integration, reuse and data mining
of online scholarly content. The Copyright, Designs and Patents
Act, part of UK statute, uses a broad definition of databases
incorporating electronic access:
“Databases(1)In this Part “database” means a collection of
independent works, data or other materials which—
(a)are arranged in a systematic or methodical way, and
(b)are individually accessible by electronic or other means.
(2)For the purposes of this Part a literary work consisting of a
database is original if, and only if, by reason of the selection or
arrangement of the contents of the database the database
constitutes the author’s own intellectual creation.”
Other definitions, such as at the United States National Science
Foundation ‘DataNet’ program, have been broader and implied
anything capable of existing digitally, including publications
and software, could be considered data [46]. The former

definition is more broadly applicable to data which can be
harvested, mined or downloaded from open access journals –
and to which CC0 rather than CC-BY should apply. This
inevitably means information which can be processed by
machines as well as being transferred electronically by them
(e.g. papers attached to emails) [47]. It is not possible to
comprehensively define and account for all data and data file
types, particularly given the rapidly evolving nature of data and
text mining applications, but a number of general examples and
definitions follow below. We strongly encourage readers to
comment on these data definitions and provide additions and
amendments. These examples intentionally do not include
domain-specific data standards (agreed upon formats for
disseminating and presenting particular types of scientific
experiments), which are comprehensively catalogued by
BioSharing (http://biosharing.org/?q=standardswebcite).
Tabular data
Data elements organized in columns and rows – a table – are
extremely common in scientific publications. While attribution
would be required for reproduction in whole or in part of a table
as presented in a journal publication, the individual values and
collection of values should be considered as data and therefore
open. Data, in the course of a scientific experiment, are usually
collected at a greater level of detail than are reported in a paper,
with tables reporting summary or mean values. Although these
data are aggregated from the raw data they remain numerical
representations of a fact, and therefore data. Tables are
furthermore often included as additional files in a variety of
formats including PDF, HTML/XML, DOC and Excel/CSV.
Ideally all tables included in the main body of a journal article
should also be included as additional CSV files – an open,
machine-readable format – but when they are not present as
tables in journal articles CSV would represent good practice for
tabular data. Proprietary file types, such as Microsoft Office,
and formats which are not readily editable, such as PDF, are not
recommended for tabular data provided as additional data files.

Graphs and graphical points
Graphs, graphical representations of relationships between
variables, are ostensibly images and therefore not, when
considered as a collective entity, data. However, the individual
data points underlying a graph, similar to tables, certainly are.
An example of best practice when submitting a manuscript with
a graph to a peer-reviewed journal would be for authors to also
submit accompanying CSV tables with the corresponding data
points, so that graphs could be re-plotted. Although this
practice is required by some specific journals it is not
widespread. However, software tools exist that are capable of
“scraping” underlying data points from graphs and images (for
example http://www.chardta.com/webcite) and can be useful,
for example, for enhancing the discoverability of scientific
information by exposing underlying data points to internet
search engines. XML
According to the World Wide Web Consortium (W3C),
“Extensible Markup Language, abbreviated XML, describes a
class of data objects called XML documents and partially
describes the behavior of computer programs which process
them” [48]. XML is widely used as a standard for data transfer
and for creating versions of works intended for machine
reading, and therefore to be used as data. Therefore for our
purposes we can assume XML files are data. XML has many
applications in science and is frequently published with journal
articles as additional files in BioMed Central journals as well as
underlying the online articles themselves. XML forms the basis
of many domain-specific data standards such as Gating-ML in
flow cytometry, FuGE-ML in functional genomics, GelML in
gel electrophoresis and so on (see:
http://biosharing.org/standards_viewwebcite). Bibliographic
data
Bibliographic data have been historically described as
information not included in the full text and images included
with an article, which includes reference lists. “Core
bibliographic data” have been further described as “data which

is necessary to identify and / or discover a publication” and
defined under the Open Bibliography Principles:
• names and identifiers of author(s) and editor(s)
• titles
• publisher information
• publication date and place
• identification of parent work (e.g. a journal)
• page information
• Uniform resource identifiers (URIs) [49]
Therefore, these core bibliographic data should be considered
open data.RDF
Resource Description Framework (RDF) is a standard language
for encoding data and metadata on the web. It is designed to
indicate the relationship between online objects in a human and
machine-readable way, and facilitate merging of data between
different sources even if the underlying schemas of the sources
are different. RDF forms the basis of the semantic web, and is a
core component of achieving Tim Berners-Lee’s vision of
Linked Data on the web [50]. RDF provides new opportunities
for data and knowledge management in life sciences, chemistry,
and publishing. All BioMed Central journal articles, for
example, contain embedded RDF, which conveys harvestable
information about content, such as authors, licensing
information and the unique identifier for the article [51]. What
aren’t data?
Although source code may be represented as data and is
certainly machine readable there are a wide range of existing
licensing systems and community norms that exist around
software. Therefore we choose to regard software, compiled
code, and source code as a separate category and not as data.
Specific licenses and repositories have been developed for
source code for software and Open Source Initiative compliant
licenses [52] are recommended. Files pertaining to programming
languages can be included as additional files with journal
publications, either directly in formats such as SQL or
indirectly in compressed or packaged file formats such as ZIP.

There are myriad file types which can be published as
additional files but amongst the most common, in BioMed
Central journals, are those usually pertaining to text and written
works – PDF and DOC/DOCX and HTML (a full list of
published additional data files is available on request from
BioMed Central [53]). Caution is recommended in the
interpretation of these objects as open data.
Implementing a variable license for open access research and
dataSetting date (CC) Zero
Creative Commons licenses (CC-BY, specifically) have
provided an effective and penetrative solution for digital
copyright in open access scientific works (papers). But as the
nature of the published scientific paper (article) has evolved
then so too should the copyright and licensing structure which
authors apply to their content. Published articles are
increasingly collections of different digital objects, perhaps
including a few thousand words of text, half a dozen images and
a similar number of CSV or XML (data) files.
The fact that CC-BY is a suboptimal license for data does not
mean that the many thousands of published authors have done
something wrong, as CC-BY was (and often still is) the best
instrument available when copyright license agreements for
open access journals were prepared (although, CC-BY version
4.0, currently in draft form, aims to tackle the issue of sui
generis database rights [54], described earlier). A number of
data repositories, including Dryad and FigShare, initially asked
authors to make their deposited data available under a Creative
Commons attribution license but have since changed their
policy
(https://twitter.com/#!/figshare/statuses/50241486796754944we
bcite). However, licenses and waivers cannot be applied
retroactively by a publisher without explicit consent of the
copyright holder(s) – in the vast majority of cases at BioMed
Central, the authors. A small number of datasets remain in
Dryad which are not available under CC0, as explicit agreement

from data depositors (rights holders) could not be obtained to
change the terms of data release [29].
A change to BioMed Central’s standard license agreement to
include a CC0 waiver for published data would remove
ambiguities about the copyright and attribution requirement
status of parts of published articles and associated data files,
and enable instead the application of scientific, cultural norms
that meet the needs of scientists better than an inflexible legal
instrument [33,55]. To implement open data in journal
publications the new license agreement would need apply to all
authors from a specific date, such that any author submitting to
a journal/publisher agrees to dedicate the data elements of their
article and additional files to the public domain. A proposal for
how this could be reflected in published articles’ copyright
license statement follows:
"© 2012 <Author> et al. This is an Open Access article
distributed under the terms of the Creative Commons
Attribution License
(http://creativecommons.org/licenses/by/2.0webcite), which
permits unrestricted use, distribution, and reproduction in any
medium, provided the original work is properly cited. Data
included in this article, its reference list(s) and its additional
files, are distributed under the terms of the Creative Commons
Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/webcite;
http://www.biomedcentral.com/about/accesswebcite).”
This would be further indicated in article metadata, RDF and on
the journal and publisher’s policy pages and author submission
pages online. This addition to the statement aims to succinctly
summarize that data in published articles generally originates
from three sources – tabular data or text-minable factual data
(e.g. numerical instances of a particular word or phrase, such as
gene/protein names) in the main body of an article; additional
(supplementary) files such as XML and CSV file extensions that
include data; and the reference list (bibliographic data). From a
legal perspective, we might need to be more comprehensive

about our definitions of data (see ‘What do we mean by data?’,
above) in the full legal code of a new license and in guidelines
accompanying this proposed change. And practically, authors
would need to agree to apply two different legal tools to content
they submit for publication as part of the submission process –
with links to both CC-BY and CC0, for example, in journal
submission checklists.
The need for change in author behavior, as a result of this
proposed modification, is minimal. CC0 would not apply to nor
affect the availability of data not submitted for publication; we
would instead be asking authors to apply different terms of use
to a proportion of the content they already publish. By
submitting a manuscript and all associated files to a BioMed
Central journal authors already confirm that they agree to all
terms of the BioMed Central Copyright and License Agreement
[56], including that they are able to apply a CC-BY license.
This proposed change to the license agreement should provide
clarity to the licensing of specific components of published
articles and does not represent a substantial change to the
overall license agreement for authors’ published work. Open
data by default – opt out
Public domain dedication of data, while universally desirable, is
not always universally possible. Authors, for the most part,
prepare research articles in the context of employment by a
third party and can be subject to licensing terms which
supersede the standard terms of a publisher. This already
happens for a small proportion of the content published by
BioMed Central and undoubtedly by other publishers, such as
some articles funded by the World Health Organization and US
government. Therefore, any submitting author who is not able to
agree to all terms of the BioMed Central Copyright and License
Agreement should contact the journal editorial office at the
earliest opportunity – ideally before, during or immediately
after manuscript submission. The onus is on the authors and, if
applicable, their employers to decide on the applicability of the
publisher’s standard license agreement to their work and

whether an exception is needed. Alternatives to the standard
license agreement can be discussed. This process of checking
suitability of the standard license agreement, and requesting
alternatives where necessary, therefore already happens for all
manuscripts submissions. The owners of the rights (if any) in
the data must decide if their data can be made open. According
to the Panton Principles FAQs “[i]n most cases, the people who
make a decision to publish, and were intimately involved in the
generation of the data, should be making this decision.” [42]
Publishing platform developments
Implementing a new license agreement will have technical as
well as policy and procedural implications. While it is not
possible to specify these changes in detail here, and is beyond
the scope of this document, the following would be essential for
implementation:
• Tagging of articles and data files published under a non-
standard license agreement (where authors have opted out of the
new default open access-open data license)
• Editing standard embedded license information in article XML
metadata and RDF and a tool to automate insertion of non-
standard licensing terms
• Insertion of license information to additional files and
associated metadata
Furthermore, the following would be desirable to enhance the
discoverability and usefulness of open data in journal articles:
• Tagging and classification of published data files, for example
by file type
• A tool to automatically discover and aggregate additional files
• A tool to (retrospectively) associate data objects with papers
on the web
• Approaches to associating published datasets with journal
articles which go beyond hyper-linking, such as through linked
data methods
• Searching within and filtering of additional files
Open data in science use cases in published and unpublished

contexts
There are many uses for open data but probably many more as
yet unknown. As stated by Tim Berners-Lee and Nigel Shadbolt
in The Times on New Year’s Eve 2011, “One reason that the
worldwide web worked was because people reused each other’s
content in ways never imagined or achieved by those who
created it. The same will be true of open data.”
The examples that follow focus on licensing and reuse of data
included with and/or harvestable from journal publications, in
the context of the proposed change to BioMed Central’s
standard license agreement, above, for open access and open
data journal articles. Example #1 – analysis of a large clinical
trial dataset
In April 2011 Sandercock et al., published in Trials ‘The
International Stroke Trial Database’ [44], which “aimed to make
individual patient data from the International Stroke Trial (IST),
one of the largest randomised trials ever conducted in acute
stroke, available for public use, to facilitate the planning of
future trials and to permit additional secondary analyses.”
The “database”, including 19,000 anonymized individual patient
data, is available with the journal article as a 4.3 Mb CSV file
(http://www.trialsjournal.com/content/supplementary/1745-
6215-12-101-s1.csvwebcite) under a CC-BY license. With the
new license agreement as proposed in this article the CSV file
would be available for reuse without a legal requirement for
attribution engrained in CC-BY. Secondary uses for this dataset
might include a novel secondary analysis by a different group of
researchers, and analysis and integration of the dataset in the
context of a systematic review and meta-analysis of randomized
trials of heparin and/or aspirin in acute ischemic stroke. Both of
these activities might conceivably result in further publications.
Although there would be no legal requirement for attribution,
for any secondary article about this dataset – or indeed any
systematic review – to be scientifically valid it would need to
cite its source(s) of data. Example #2 – Application of magnetic
resonance techniques to cross-species comparative studies

Magnetic Resonance Imaging (MRI) techniques are used to
better understand the evolution of specific traits in animals and
cross-species comparisons (for example in primates) are
particularly important. But due to ethical, practical and funding
limitations single studies typically are only able to consider one
or two species. There is only one publicly available dataset that
has brains from multiple primate species scanned according to a
common protocol and these scans (of 11 species) were recorded
(in vivo) well over a decade ago, and so do not meet the quality
criteria that underpin more recent brain morphometric
algorithms of the kind required for cross-species studies of
brain structure. However, a review of this area of research
found that “the major barrier to cross-species MR-based brain
morphometry is not the lack of data nor analytical tools but
barriers preventing to combine them” [57]. Open data in this
field would undoubtedly drive new discoveries. Example #3 –
Research utilizing text and data from journal publications
The copyright status of data obtained though text-mining is
debatable. The numerical instances of a particular gene or
protein name in a full-text corpus of articles could be valuable
for secondary research and, in the US at least, are likely to be
considered (non-copyrightable) facts. Some scholars take the
position that mining does not violate copyright law because it
does not meet the statutory definition of copying which requires
“fixing” the work in a permanent form [15]. Yet text mining is
often restricted by commercial publishers. In the study of small
angle scattering (a “technique based on the deflection of a beam
of particles, or an electromagnetic or acoustic wave, away from
the straight trajectory after it interacts with structures that are
much larger than the wavelength of the radiation” according to
Wikipedia [58]), a researcher might be interested to harvest the
data used in other publications to test their analysis tools and
provide better teaching aids. Generally, in this area of research,
the data are only presented as a graph, the data analysis is not
spelt out and there is no specific license attached if the data are
available (Cameron Neylon, personal communication). Example

Social marketing of water and sanitation products A systematic re.docx

Social marketing of water and sanitation products A systematic re.docx

Recommended

Recommended

More Related Content

Similar to Social marketing of water and sanitation products A systematic re.docx

Similar to Social marketing of water and sanitation products A systematic re.docx (20)

More from jensgosney

More from jensgosney (20)

Recently uploaded

Recently uploaded (20)

Social marketing of water and sanitation products A systematic re.docx