An estimated 2.4 billion people lack access to improved sanitation which has devastating consequences for human health and the environment. Understanding what constitute sanitation demand is crucial for accelerating the spread of improved sanitation. This study aims to understand the adoption mechanisms for improved sanitation. An informal peri-urban settlement in Cochabamba, Bolivia was selected as a case study to understand adoption patterns. Various qualitative methods of data collection and analysis were employed. The findings showed that pour-flush toilets was the only preferred sanitation alternative at the study site. An adoption framework for waterborne toilets was developed based on diffusion of innovation theory. Factors that influence adoption were identified. Some functioned as triggers and initiated adoption, whereas some factors blocked adoption and constituted veto-barriers. Most factors were connected to the individual household situation and its members, but neighborhood development also affected pour-flush adoption. Based on adoption time the residents were divided into the following adoption groups: first adopters, early majority, late majority, laggards and non-adopters. Each adoption group followed its own adoption route with specific characteristics and respective triggers or veto-barriers. We argue that the strong demand for waterborne toilets in peri-urban areas need to be recognized and the developed framework could be used for customizing sanitation improvement programs for certain target groups.
Community management is often seen as part of the solution to increase access to drinking water and wastewater management where municipal services are lacking. This article intends to increase the knowledge regarding self-organized communitymanaged water and wastewater systems in urban and peri-urban areas. A theory-building case-study approach, including three different neighbourhoods in Bolivia and their respective communitybased organizations, was selected. Four prerequisitesleadership, agreed vision, collective action and managementand associated enabling factors connected to three distinct planning and management phases were found to be of major importance for community-managed water and wastewater systems.
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